Francisci Silvia, Gigli Anna, Gesano Giuseppe, Folino-Gallo Pietro
Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy.
Health Care Manag Sci. 2008 Jun;11(2):111-20. doi: 10.1007/s10729-007-9051-6.
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.
本文通过研究急性心肌梗死患者从梗死到住院以及可能的死亡或康复的疾病发生过程，开发了一种评估急性心肌梗死患者结局地理差异的通用方法。该方法应用于意大利的区域数据，该国经济、社会和文化领域长期存在的地理差异在医疗保健中有所体现。急性心肌梗死的特殊特征，如高死亡率和疾病进展迅速，使其成为研究住院急性期区域卫生系统差异的合适追踪病症。本文结合了各地区的行政和官方统计数据，并提供了一种工具，为政策制定者提供建议，指出在护理路径方面需要进一步进行最终调查的地方，以及可能采取哪些行动来改善结局。
