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In order to correctly perform record linkage among databases and accurately determine outcome indicators using hospital discharge data and death records, the quality of data is fundamental. A deterministic record linkage method was use to link hospital discharge data with records from the Death Registry in the Puglia region (Italy) for the years 2001-2006. Thirty-five percent of hospital discharge records in which the recorded discharge modality was "death" were not in agreement with the corresponding death records. Furthermore, 40% of hospital discharge records where the date of death was the same as the date of discharge from hospital did not record "death" as the discharge modality.

Objective: To compare record linkage (RL) procedures adopted in several Italian settings and a standard probabilistic RL procedure for matching data from electronic health care databases., Design: Two health care archives are matched: the hospital discharges (HD) archive and the population registry of four Italian areas. Exact deterministic, stepwise deterministic techniques and a standard probabilistic RL procedure are applied to match HD for acute myocardial infarction (AMI) and diabetes mellitus. Sensitivity and specificity for RL procedures are estimated after manual review. Age and gender standardized annual hospitalization rates for AMI and diabetes are computed using different RL procedures and compared., Setting: Municipalities of Pisa and Roma, and Regions of Puglia and Piemonte., Participants: Residents in the considered areas on 31 December 2003 and corresponding episodes of hospitalization in the same areas during 2004., Main Outcome Measures: Measures of accuracy of RL procedures to match health care administrative databases., Results: Data quality varies among archives and affects the decision rule of the probabilistic procedure. A unique decision rule was therefore adopted by means of choosing a positive predictive value of at least 98% for all the considered areas. The number of matched pairs identified with the probabilistic procedure is on average more then 11% greater than the number identified with the deterministic procedure. Sensitivity of probabilistic RL is similar or greater than that of other procedures. Differences between annual standardized hospitalization rates computed with stepwise deterministic RL and the standard probabilistic RL procedure vary among areas., Conclusion: Exact deterministic RL works well when unique identifiers and high quality data are available. The probabilistic procedure here proposed works as well as semi-deterministic RL when the latter implements a quality control of data or a manual review of final results. Otherwise, deterministic or semi-deterministic procedures imply classification errors of unknown size and direction.

Management of healthcare organizations relies on the availability of decision-making tools. The Portfolio Activities Matrices is a method that can be applied to healthcare management. It allows simultaneous evaluation of indicators of efficiency, case-mix, cost and demand, so that the strengths and weaknesses of the organization may be identified. The method is complex and may have some degree of subjectivity. Nevertheless, it is a useful tool for performing the evaluations necessary for strategic planning management decisions, which must consider available resources as well as the social role of the organization.

This study is aimed at assessing the health care demand of the Albanian groups arrived in Italy (Apulia) in 1997 and accommodated in the Cassano and Palese refugee camps. The analysis is based on the forms filled in on their arrival and first aid registers. Albanian health and demographic official data were also analyzed. The most common health problems observed amongst refugee groups were slight illnesses (23.3%), respiratory tract infections (11.3%), gastroenteritis (9.9%). In the light of these data, the refugees' status does not appear to be critical, although there remains the need to carry out constant monitoring to prevent infectious diseases and improve the quality of social facilities.