[Testing an algorithm to identify disabilities using current health and social healthcare database: the experience of the Agency for Health Protection of the Metropolitan Area of Milan].

IF 1.2 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Maria Teresa Greco, Andrea Salvatori, Eliana Gabellini, Pietro Magnoni, Raffaella Mariani, Giuseppe Belleli, Guido Cavaletti, Giuseppe Citerio, Claudia Moneta, Clara Sabatini, Maria Antonella Costantino, Silvano Casazza, Walter Bergamaschi, Antonio Giampiero Russo
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引用次数: 0

Abstract

Objectives: to describe prevalence of disability in the population of the Agency for Health Protection of Milan (ATS Milan), integrating current administrative healthcare, socio-healthcare, and social data; to classify disability with a diagnosis into a predominant structural and functional category according to the International Classification of Functioning, Disability and Health (ICF), supplementing it with additional levels of detail.

Design: retrospective observational study.

Setting and participants: subjects residing in the territory of ATS Milan in the years from 2018 to 2022.  Main outcomes measures: prevalence of disability in the population of ATS Milan from 2018 to 2022; average annual costs since disability diagnosis of the entire population and stratified by the most common ICF classifications.

Results: the prevalence of disability ranges from 5.8% in 2018 to 8.4% in 2022. In general, women have a higher prevalence than men. However, there are significant differences in the gender distribution depending on the considered age group. The main disabilities (32.2%) affect the structures of the nervous system and mental functions, followed by disabilities identified solely by major prosthetic devices (9.4%) and sensory disabilities with alterations in sensory functions with the presence of a major device (5.2%). Analysis of average total annual per capita costs shows an upward trend with increasing years since the diagnosis.

Conclusions: the definition of standardized tools, such as the selection from several available healthcare data provided by service suppliers, can be helpful in obtaining reliable data on the prevalence of disability in the population. This evidence can be useful in planning public health interventions to address the needs of this population. The work developed by ATS Milan has been carried out in alignment with the activities outlined in Mission 5 of the National Recovery and Resilience Plan (PNRR), in particular for the reform of disability legislation, which foresees the definition of standardized tools for the in-depth study of the epidemiological aspects of the phenomenon.

[利用当前的健康和社会医疗保健数据库测试识别残疾的算法:米兰大都会区健康保护机构的经验]。
目标:综合当前的行政医疗保健、社会医疗保健和社会数据,描述米兰健康保护局(ATS Milan)人口中的残疾患病率;根据《国际功能、残疾和健康分类》(ICF)将确诊的残疾划分为主要的结构和功能类别,并补充更多的细节级别。 主要结果测量指标:2018 年至 2022 年米兰 ATS 人口的残疾患病率;整个人口自残疾诊断以来的年均费用,并按最常见的 ICF 分类进行分层。结果:残疾患病率从 2018 年的 5.8%到 2022 年的 8.4%不等。一般来说,女性的患病率高于男性。然而,不同年龄段的性别分布差异显著。主要残疾(32.2%)影响神经系统结构和精神功能,其次是仅由主要假肢装置确定的残疾(9.4%)和存在主要装置的感官功能改变的感官残疾(5.2%)。对年人均总成本的分析表明,随着诊断年数的增加,年人均总成本呈上升趋势。结论:标准化工具的定义,如从服务供应商提供的多个可用医疗保健数据中进行选择,有助于获得有关人口中残疾发生率的可靠数据。这一证据有助于规划公共卫生干预措施,以满足这一人群的需求。米兰 ATS 开展的工作与《国家恢复和复原计划》(PNRR)第 5 项任务中概述的活动相一致,特别是在残疾立法改革方面,该计划设想为深入研究这一现象的流行病学方面确定标准化工具。
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来源期刊
Epidemiologia & Prevenzione
Epidemiologia & Prevenzione 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.60
自引率
14.30%
发文量
0
审稿时长
>12 weeks
期刊介绍: Epidemiologia & Prevenzione, oggi organo della Associazione italiana di epidemiologia, raccoglie buona parte delle migliori e originali esperienze italiane di ricerca epidemiologica e di studio degli interventi per la prevenzione e la sanità pubblica. La rivista – indicizzata su Medline e dotata di Impact Factor – è un canale importante anche per la segnalazione al pubblico internazionale di contributi che altrimenti circolerebbero soltanto in Italia. E&P in questi decenni ha svolto una funzione di riferimento per la sanità pubblica ma anche per i cittadini e le loro diverse forme di aggregazione. Il principio che l’ha ispirata era, e rimane, che l’epidemiologia ha senso se è funzionale alla prevenzione e alla sanità pubblica e che la prevenzione ha ben poche possibilità di realizzarsi se non si fonda su valide basi scientifiche e se non c’è la partecipazione di tutti i soggetti interessati. Modalità di comunicazione aggiornate, metodologia statistica ed epidemiologica rigorosa, validità degli studi e solidità delle interpretazioni dei risultati sono la solida matrice su cui E&P è costruita. A questa si accompagna una forte responsabilità etica verso la salute pubblica, che oggi ha ampliato in forma irreversibile il suo orizzonte, e include in forma sempre più consapevole non solo gli esseri umani, ma l’intero pianeta e le modificazioni che l’uomo apporta all’universo in cui vive. L’ambizione è che l’offerta di nuovi strumenti di comunicazione, informazione e formazione, soprattutto attraverso l''uso di internet, renda la rivista non solo un tradizionale veicolo di contenuti e analisi scientifiche, ma anche un potente strumento a disposizione di una comunità di interessi e di valori che ha a cuore la salute pubblica.
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