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2. Health care for older people in Italy: The U.L.I.S.S.E. Project (Un link informatico sui servizi sanitari esistenti per l'anziano - a computerized network on health care services for older people)

Author

Lattanzio F, Mussi C, Scafato E, Ruggiero C, Dell'Aquila G, Pedone C, Mammarella F, Galluzzo L, Salvioli G, Senin U, Carbonin PU, Bernabei R, Cherubini A, Laguzzi E, Cucinotta D, Arnone G, Rozzini R, Cassinadri A, Putzu P, Porceddu C, Zaru C, Abate G, Di Iorio A, Abate M, Guglielmi M, Foschini N, Battaglini C, Fellin R, Volpato S, Cavalieri M, Fotini S, Guerra G, Rossi L, Masotti G, Fumagalli S, Odetti P, Cataldi A, Monacelli F, Nicita Mauro V, Basile G, Maltese G, Nicita Mauro C, Pellicciotti F, Scotto R, Vaccina A, Minnucci A, Forte L, Lo Storoto MR, Licata G, Tuttolomondo A, Barbagallo M, Dominguez LJ, De Leo M, Belvedere M, Putignano E, Longo A, Mancioli G, Patacchini F, Palmari N, Ierardi BA, Marino P, Soldato M, Pilotto A, Paris F, Forconi S, Guerrini M, De Paduanis GA, De Palma A, Boschi S, Molaschi M, Poli L, De Colle P, Bonoldi G, Puricelli S, Pellegrini R, Consolaro E, Bosello O, Zivelonghi A, Gravic G, Guariento S, Di Francesco V, Tua E, Pisaturo A, Lacava R, Gareri P, Borgia R, Cristiano VN, Palummeri, Pescetelli, Galdi M, Bochicchio GB, Solimano A, Brugaletta S, Carnazza L, Gallitto E, Albano G, Schipani G, Conte, Pagella A, Perrero L, Sabato V, Marella L, Schiavina, Zacco B, Scaglia L, Virgilio A, Iera M, Doria, Pansini L, Boni N, Inzitari M, Aramini I, Musante S, Cavagnaro P, Riello F, De Alfieri W, Pescetelli P, Trecca R, Di Iusto, Zamboni V, Cuppone R, Foschi, Marino S, Simone M, Scarlata A, Battegazzore C, Morucci R, Luchetti M, Menculini G, Cichetti G, Orlando I, Fantoni B, Ognibene G, Gobbi C, Cascone A, Avanzi GL, Casu A, Zeni S, Santin S, Scotti G, Cappella C, Penzo P., TOIGO, GABRIELE, Lattanzio, F, Mussi, C, Scafato, E, Ruggiero, C, Dell'Aquila, G, Pedone, C, Mammarella, F, Galluzzo, L, Salvioli, G, Senin, U, Carbonin, Pu, Bernabei, R, Cherubini, A, Laguzzi, E, Cucinotta, D, Arnone, G, Rozzini, R, Cassinadri, A, Putzu, P, Porceddu, C, Zaru, C, Abate, G, Di Iorio, A, Abate, M, Guglielmi, M, Foschini, N, Battaglini, C, Fellin, R, Volpato, S, Cavalieri, M, Fotini, S, Guerra, G, Rossi, L, Masotti, G, Fumagalli, S, Odetti, P, Cataldi, A, Monacelli, F, Nicita Mauro, V, Basile, G, Maltese, G, Nicita Mauro, C, Pellicciotti, F, Scotto, R, Vaccina, A, Minnucci, A, Forte, L, Lo Storoto, Mr, Licata, G, Tuttolomondo, A, Barbagallo, M, Dominguez, Lj, De Leo, M, Belvedere, M, Putignano, E, Longo, A, Mancioli, G, Patacchini, F, Palmari, N, Ierardi, Ba, Marino, P, Soldato, M, Pilotto, A, Paris, F, Forconi, S, Guerrini, M, De Paduanis, Ga, De Palma, A, Boschi, S, Molaschi, M, Poli, L, Toigo, Gabriele, De Colle, P, Bonoldi, G, Puricelli, S, Pellegrini, R, Consolaro, E, Bosello, O, Zivelonghi, A, Gravic, G, Guariento, S, Di Francesco, V, Tua, E, Pisaturo, A, Lacava, R, Gareri, P, Borgia, R, Cristiano, Vn, Palummeri, Pescetelli, Galdi, M, Bochicchio, Gb, Solimano, A, Brugaletta, S, Carnazza, L, Gallitto, E, Albano, G, Schipani, G, Conte, Pagella, A, Perrero, L, Sabato, V, Marella, L, Schiavina, Zacco, B, Scaglia, L, Virgilio, A, Iera, M, Doria, Pansini, L, Boni, N, Inzitari, M, Aramini, I, Musante, S, Cavagnaro, P, Riello, F, De Alfieri, W, Pescetelli, P, Trecca, R, Di, Iusto, Zamboni, V, Cuppone, R, Foschi, Marino, S, Simone, M, Scarlata, A, Battegazzore, C, Morucci, R, Luchetti, M, Menculini, G, Cichetti, G, Orlando, I, Fantoni, B, Ognibene, G, Gobbi, C, Cascone, A, Avanzi, Gl, Casu, A, Zeni, S, Santin, S, Scotti, G, Cappella, C, and Penzo, P.

Subjects
computerized network, Health care, service, elderly
Abstract

Objectives: The U.L.I.S.S.E. study is aimed at describing older patients who are cared for in hospitals, home care or nursing homes in Italy. Design: The U.L.I.S.S.E. study is an observational multicenter prospective 1-year study. Setting: Overall, 23 acute geriatric or internal medicine hospital units, 11 home care services and 31 nursing homes participated in the study. Measurements: The patient’s evaluation was performed using comprehensive geriatric assessment instruments, i.e. the interRAI Minimum Data Set, while data on service characteristics were recorded using ad-hoc designed questionnaires. Results: The older subjects who are in need of acute and long term care in Italy have similar characteristics: their mean age is higher than 80 years, they have a high level of disability in ADL, an important multimorbidity, and are treated with several drugs. The prevalence of cognitive impairment is particularly high in nursing homes, where almost 70% of residents suffer from it and 40% have severe cognitive impairment. On the other hand, there is a shortage of health care services, which are heterogeneous and fragmented. Conclusions: Health care services for older people in Italy are currently inadequate to manage the complexity of the older patients. An important effort should be undertaken to create a more integrated health care system.

Published
2010

4. Health care for older people in Italy: The U.L.I.S.S.E. Project (Un link informatico sui servizi sanitari esistenti per l'anziano - a computerized network on health care services for older people)

Author

Lattanzio, F, Mussi, C, Scafato, E, Ruggiero, C, Dell'Aquila, G, Pedone, C, Mammarella, F, Galluzzo, L, Salvioli, G, Senin, U, Carbonin, Pu, Bernabei, R, Cherubini, A, STUDY GROUP LAGUZZI E, U. L. I. S. S. E., Cucinotta, D, Arnone, G, Rozzini, R, Cassinadri, A, Putzu, P, Porceddu, C, Zaru, C, Abate, G, DI IORIO, A, Abate, M, Guglielmi, M, Foschini, N, Battaglini, C, Fellin, R, Volpato, S, Cavalieri, M, Fotini, S, Guerra, G, Rossi, L, Masotti, G, Fumagalli, S, Odetti, Patrizio, Cataldi, A, Monacelli, Fiammetta, NICITA MAURO, V, Basile, G, Maltese, G, NICITA MAURO, C, Pellicciotti, F, Scotto, R, Vaccina, A, Minnucci, A, Forte, L, LO STOROTO MR, Licata, G, Tuttolomondo, A, Barbagallo, M, Dominguez, Lj, DE LEO, M, Belvedere, M, Putignano, E, Longo, A, Mancioli, G, Patacchini, F, Palmari, N, Ierardi, Ba, Marino, P, Soldato, M, Pilotto, A, Paris, F, Forconi, S, Guerrini, M, DE PADUANIS GA, DE PALMA, A, Boschi, S, Molaschi, M, Poli, L, Toigo, G, DE COLLE, P, Bonoldi, G, Puricelli, S, Pellegrini, R, Consolaro, E, Bosello, O, Zivelonghi, A, Gravic, G, Guariento, S, DI FRANCESCO, V, Tua, E, Pisaturo, A, Lacava, R, Gareri, P, Borgia, R, Cristiano, Vn, Palummeri, Pescetelli, Galdi, M, Bochicchio, Gb, Solimano, A, Brugaletta, S, Carnazza, L, Gallitto, E, Albano, G, Schipani, G, Conte, Pagella, A, Perrero, L, Sabato, V, Marella, L, Schiavina, Zacco, B, Scaglia, L, Virgilio, A, Iera, M, Doria, Pansini, L, Boni, N, Inzitari, M, Aramini, I, Musante, S, Cavagnaro, P, Riello, F, DE ALFIERI, W, Pescetelli, P, Trecca, R, Iusto, Di, Zamboni, V, Cuppone, R, Foschi, Marino, S, Simone, M, Scarlata, A, Battegazzore, C, Morucci, R, Luchetti, M, Menculini, G, Cichetti, G, Orlando, I, Fantoni, B, Ognibene, G, Gobbi, C, Cascone, A, Avanzi, Gl, Casu, A, Zeni, S, Santin, S, Scotti, G, Cappella, C, and Penzo, P.

Subjects
residenzialità, non autosufficienza, cura anziani, servizio sanitario
Published
2010

6. For debate: The August sun and the December snow.

Author

Monacelli F, Aramini I, and Odetti P

Subjects
Aged, Data Collection, Europe epidemiology, Humans, Nursing Homes, Climate, Cold Temperature adverse effects, Hot Temperature adverse effects, Mortality trends
Abstract

A growing body of evidence claims there is a pivotal role of heat temperatures and summer hot spells in the pathogenesis of exceeding morbidity and mortality among older people. The European well-known "2003 killer hot summer" has boosted many epidemiological and clinical investigations to clarify the pathogenetic correlation between hot spells and elderly mortality with new acquirements in terms of pathophysiology, preventive measures, and therapeutic approaches. However, a quite controversial issue arises: overall elderly mortality is higher in the cold winter compared with summer. The progressive development of preventive, therapeutic, and environmental measures, if targeted with promptness, has generally proven effective in coping with heat temperature, restraining elderly mortality. However, few investigations have been performed dealing with cold, with pioneeristic as well as simplistic approaches, without any conclusiveness or effectiveness in terms of prevention or therapy. Data from recent literature enlist various clinical and environmental approaches in counteracting cold-related mortality in elderly, but lack evidence-based results; a recent European collaborative study reported cold-related elderly mortality as non-negligible, deserving the growing attention of public authorities. We conducted a 4-year survey among 6 different nursing homes located in a seaside city of northern Italy so as to collect epidemiological data on stressful weather spells and elderly mortality. Our results showed that overall elderly mortality in the cold season displayed as significantly high rates as in summer, and the monthly deaths per year of observation showed higher rates in the cold season, addressing it as the most prevalent time period related to mortality in older people. Thus, research in the field is mandatory so as to draw a broader conceptual framework for the stratification of specific population risk profiling and the assessment of adequate preventive and therapeutic measures. To the present knowledge, the lack of pathophysiological understanding, the missing evidence-based data in coping with cold weather-related elderly mortality, together with policy makers' misconceptions is mounting the controversy on this emerging clinical issue., (2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.)

Published
2010
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