F Moirano

Sex differences in use of interventional cardiology persist after risk adjustment

Background: Studies from several countries have documented gender disparities in the management of coronary artery disease. Whether such gender disparities are seen in Italy and, if so, whether they can be explained by factors such as age and severity of illness were investigated. Methods: 77 974 Piedmontese patients, admitted between 1999 and 2002, with a primary diagnosis of myocardial infarction (ICD 410), angina (ICD 413), chronic ischaemia (ICD 414) and chest pain (ICD 786.5) were studied. The number of men and women undergoing surgical treatment was extracted and the male–female odds ratios calculated. Several risk factors and a risk adjustment technique (APR-DRG) were used to control for possible confounders. Backward stepwise multiple logistic regression was used to adjust for significant covariates. Results: Crude analysis demonstrated that gender is a discriminating factor in the probability of surgery (OR 2.11, 95% CI 2.04 to 2.19), with similar findings among those with each main diagnosis. The odds ratios decreased after adjustment for age, co-morbidity and disease severity but remained significant. Conclusions: Men and women admitted to hospitals in a region of northern Italy with a diagnosis of cardiovascular disease are treated differently and this cannot be explained by age or severity of disease.

The post-graduate public health school of Siena (Italy): ten years of experience

Introduction : Public universities and private schools in all countries have substantially expanded the postgraduate courses as a sign that degree is often not sufficient to ensure access to employment. Aim : To present the experience of an Italian Post-Graduate Public Health School (SPGPHS) from 1996-2005. Activity : We made a review of the Italian legislation governing the postgraduate training and we studied the structure of Post Graduate School in Public Health in several Italian and foreign prestigious universities. Results : The SPGPHS was attended by about 1,000 students from all the Italian Regions. 100 scientific papers were published and/or presented at national/international conferences; SPGPHS has also proven to be able to completely finance itself. Conclusions : Postgraduate university courses are becoming very important and attenders range widely in age. Many students undertake Postgraduate courses to improve their work position, to attain Continuing Medical Education credits, but at the same time, to gather multidisciplinary scientific knowledge and to acquire professional skills. SPGPHS has proven to be able in financing itself responding to the market logic which is guided by performance and efficiency aspects.