Gini Rosa, Capon Alessandra, Roti Lorenzo, Mastromattei Antonio, Buiatti Eva
Azienda regionale di sanità della Toscana, Firenze.
Epidemiol Prev. 2007 Jul-Aug;31(4):197-203.
to compare the assistance delivered to elderly persons (age 65 +) hospitalized in 1999-2003 after femur fracture between two Italian regions (Lazio and Tuscany). Indicators derived from current databases have been used.
incident cases and patients undergoing surgery were retrieved from abstract discharge records, while deaths were traced through record linkage with mortality registers.
in the period covered by the study, 32019 incident cases occurred in Lazio region and 30406 in Tuscany. The analysis shows better results for Tuscany for each indicator. In 2003, the age-standardized proportions of patients treated surgically were 83.0% in Lazio and 86.2% in Tuscany. The age-standardized proportion of patients undergoing surgery within 2 days from admission were respectively 14.7%, and 29.8%. The age-standardized proportions of deaths occurring within 30 days from admission were 5.0% and 2.8%. Lazio shows higher proportions of deaths both for patients with and without surgery.
the use of the same procedure based on purely administrative data (available at national level) provides confidence on the reliability of the comparison between the two regions. Similar low-budget studies may easily be extended to other geographical areas.
比较1999年至2003年期间意大利两个地区(拉齐奥和托斯卡纳)因股骨骨折住院的老年人(65岁及以上)所接受的护理情况。采用了从现有数据库得出的指标。
1)接受手术治疗患者的年龄标准化比例;2)在所有接受手术的患者中,入院后2天内接受手术患者的年龄标准化比例;3)入院后30天内死亡的年龄标准化比例。
从出院摘要记录中检索出事件病例和接受手术的患者,而死亡病例则通过与死亡率登记册的记录链接进行追踪。
在研究涵盖的时间段内,拉齐奥地区发生了32019例事件病例,托斯卡纳地区为30406例。分析表明,托斯卡纳地区在各项指标上的结果更好。2003年,拉齐奥地区接受手术治疗患者的年龄标准化比例为83.0%,托斯卡纳地区为86.2%。入院后2天内接受手术患者的年龄标准化比例分别为14.7%和29.8%。入院后30天内死亡的年龄标准化比例分别为5.0%和2.8%。拉齐奥地区接受手术和未接受手术的患者死亡率均较高。
基于纯粹行政数据(国家层面可用)采用相同程序,为两地区之间比较的可靠性提供了信心。类似的低成本研究可轻松扩展至其他地理区域。