Igiene e sanità pubblica
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Igiene e sanità pubblica · Sep 2006
[Positive predictive value of ICD-9-CM codes in hospital inpatient discharge abstract records, for identifying adverse events].
A retrospective study was conducted in the ambit of Risk Management research, in order to assess adverse events in patients hospitalised in hospitals in one Local Health Authority of the Piemonte region. Specifically, the aims of the study were to: evaluate the relative frequency of ICD-9-CM codes used to define adverse events, with respect to the total number of hospital discharge records submitted in 2003; identify true and false positives, by hospital chart review; estimate the positive predictive value (VPP) of the ICD-9-CM codes used, and determine, in each case, whether the adverse event had led to hospitalisation or if it had occurred during hospitalisation. ⋯ In fact, the probability that an ICD-9-CM code will accurately identify an adverse event is 100% for codes in the "Misadventures of surgical and medical care" category of adverse events, 62.8% for codes indicating "Complications of medications (adverse drug events)" and 56.8% for the "Complications of surgical or medical procedures" category. In most cases the adverse event had occurred prior to hospital admission.
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Igiene e sanità pubblica · Mar 2006
Comparative Study[Reasons for turning to healthcare services outside of own area of residence: a study among patients of the AV1 Local Health Unit in Italy].
In this study, 552 patients from the AV-1 Local Health Unit, who accessed healthcare services outside of their own area or region of residence ("intra- and extra-regional mobility") were interviewed by their general practitioner. The aim was to describe the healthcare "mobility" phenomenon and the reasons patient resort to it. ⋯ On the other hand cases that involved "extraregional mobility", that is involved patients who accessed healthcare services outside their own region of residence , occurred in Basilicata, Puglia, Emilia Romagna and Lombardia. Reasons given by patients for this choice are, in order of importance: prestige of a specific hospital or hospital department, trusted physician working in a given hospital, disease severity, specialist advice, reduced waiting times, friends' or relatives' suggestions, better hospital services, lack of trust in healthcare services provided locally, advice given by general practitioner.
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Igiene e sanità pubblica · Mar 2006
Comparative Study[Use of the Mini-Cog test as a screening method for dementia in the Italian population: the Argento Study results].
This article describes the use of the Mini Cog test in a sample of elderly subjects participating in a multicentre Italian study on the healthcare needs of older adults. The Mini Cog is a simple screening test for cognitive impairment. It combines a brief memory test and a simply scored clock-drawing test and allows rapid screening for short term memory defects, learning and different cognitive abilities that are impaired in dementia patients. Various studies have shown that the Mini-Cog, which can be administered in as little as 3 minutes, is as effective in detecting dementia as longer screening tests. In addition, it can be easily administered by personnel that is unfamiliar with cognitive testing. ⋯ The Mini-Cog test was found to be easy to administer by Italian Local Health Unit personnel in the context of evaluating healthcare needs of older persons. Study results were consistent with other population studies that evaluated cognitive impairment in elderly subjects in developed countries. In view of its high acceptability and reliability the Mini-Cog can be a valid screening tool for use in outpatient services and by general practitioners and in the planning and management of healthcare services.