Decomposing differences in acute myocardial infarction fatality in Italian regions

The paper develops a general method for evaluating geographical differences in the outcome of acute myocardial infarction patients, by looking at the process of disease occurrence from infarction to hospitalization and possible death or recovery. The method is applied to regional data in Italy, where the long history of geographical diversities in economical, social and cultural fields is reflected in health care. Specific features of AMI, such as high fatality and fast course of the disease, make it a suitable tracer condition to investigate into the differences of regional health systems during the acute phase of hospitalization. The paper combines administrative and official statistics by region and offers a tool providing suggestions to policy-makers where further eventual investigations are needed around the care pathway and also what possible actions might be undertaken to improve the outcomes.