Tiziana Sabetta

Health status of the Italian people: gender inequalities. Commentary.

Differences between male and female affect diseases onset, evolution and prognosis. In terms of survival, women have a higher life expectancy at birth than men, with strong differences at regional level (the highest values in Trento AP and the lowest in Campania). Smoking, alcohol consumption, overweight and obesity and physical activities indicators are analyzed among men and woman. A reduction in smokers and number of smoked cigarettes is observed, especially among men. Men also show a higher number of ex-smokers than woman. Also for alcohol consumption, the prevalence of consumers at risk is higher among men than women. Overweight and obesity are more prevalent among men than women, the same as physical activity played continuously and occasionally. Gender differences are also shown in hospitalization rate and mortality rate for ischemic heart disease, affecting men twice more than women. The analysis shows a good health status condition of Italian people, but it is important to be aware that gender is one of essential characteristics in health care field, independently of people age.

The Osservasalute Health Report 2010: the contribution of a wide and independent Italian research network to decision making in healthcare

Background : The Italian Observatory Healthcare Report (IOHR - 8th edition) [1] aims to help policy makers in the process of decision making through a set of validated indicators resulting from the multidisciplinary activity of several public health experts. Its main task is to gather comparable data on the health status and the quality of health care services throughout the Italian regions. Methods : The report adopts a European approach in order to build a benchmarking activity and the selection criteria of indicators include: meaning, feasibility and quality, comparability and reliability. Each indicator is analyzed by experts in terms of meaning, pattern, validity and limits, graphic representation; recommendations are included for decision makers. A peer reviewing is performed for quality assessment. Results : The IOHR 2010 included 96 indicators, analysed by 203 authors. Through comparable regional data coming from different sources, an overview of the Italian Health System, and a gauging of the impact that different regional organizational and institutional arrangements have on the quality of health services, have been provided. Though data analysis showed a North-South gradient in the quality and the organization of health care services, nevertheless, the overall health status of Italian population is good. Risk factors, lifestyles and prevention together with geographical and social differences in health status and service access are the main priorities. Conclusions : The IOHR helps monitoring the health status in the Italian regions through specific indicators characterized by scientific strictness. It contributes to identifying the situations of excellence and disseminating public health care control tools in order to facilitate the decision making process.

Effetti della crisi sulla salute e sull’accesso ai servizi nelle regioni italiane

The Italian Observatory Healthcare Report (IOHR - 9th edition) collects comparable data on health status and quality of healthcare services throughout Italy and supply policy makers with a set of indicators validated at international level in order to help them in the decision making process. The present IOHR aims to describe quality of healthcare and the effects of the economic crisis on health. The report realizes a benchmarking activity and indicators selected are analyzed according to: meaning, feasibility and quality, comparability and reliability. Each indicator is validated by a panel of public health experts in terms of meaning, pattern, validity and limits; graphic representations and recommendations for decision makers are included and a peer reviewing is performed for quality assessment. Indicators on population dynamics, survival, cardiovascular diseases, cancer, infectious diseases show that the overall health status of Italians is good, nevertheless, changes in lifestyles, diet and healthcare supply are evident and out of pocket expenses are growing as well as anti-depressant drugs consumption and suicides. Regional differences are constant and economic crisis might increase inequalities. The IOHR describes the overall health status in Italy as good, nevertheless, the effects of economic crisis on health are already visible: it is necessary to stimulate the provision of preventive services and ad hoc social and health policies in order to prevent citizens to become ill and reduce differences between geographical macro-areas, regions and gender that are widening

Scelte di spesa e trend epidemiologici: un modello di simulazione

The Report Salute Italia 2028 aims at estimating the health needs of the Italian population by 2028 as a planning tool that can be used in the decision making process. The development of forecasts, trends and scenarios is helpful in identifying the actions to be taken with an evidence-based approach, in order to try to align the health services supply with the emerging health needs. The analysis is based on a set of indicators recognized at the national and international level. Most data derive from the Italian Observatory Healthcare Report and statistical models have been used to estimate future trends. An effort was made to develop a methodology able to link the trends emerged to the economic-financial and supply perspective. The report highlights which will be the peculiar needs of the Italian population and the main critical situations in the span time considered. Core indicators have been selected and analyzed regarding the following areas: demographic scenario, burden of disease (tumors, cardiovascular and infectious diseases, diabetes), institutional framework and health care expenditure. The financial crisis in Italy can affect substantially the crucial sector of the health care. The spending review process should avoid horizontal policies that can reduce the health expenditure in the short term, but resulting in the long term in a reduction of the health services covered and, thus, of the health status of the population.

Prevenire le malattie croniche: sfida del futuro

Prevention of Cronic Diseases: The Challenge of the Future - This article analyzes the trend of mortality and morbidity from chronic disease in the world and in Italy. We used WHO data and Istat (National Institute of statistics) data and survey. The high incidence and prevalence of all chronic diseases, risk factors and long term care were shown through some recent prevision. In last years, these diseases are spread even in the poor countries. The WHO will expect a very high number of deaths by chronic disease: 35 million in 2005. 18 million of death for cardiovascular disease, 8 million for tumour, 4 million for respiratory disease and 1,1 million for diabetes: the majority of deaths will be in low and middle income county. It is very important to invest in prevention of chronic disease: a long term investment and a higher consideration on prevention and chronic care services are the imperatives for the future.