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Introduction: Uncompleted visits in the emergency department (UEDC) are a patient safety concern. The purpose of this study was to further investigate risk factors for UEDC, describing socio-demographic characteristics but also access and hospital characteristics both of those left AMA and those who LWBS. Methods: this was a retrospective case–control study on administrative anonymous data using a population-based emergency department database. Results: overall, 9,147,415 patients attended the EDs of Veneto Region from 2011 to 2015. Rate of UEDC was 28,7‰, composed by slightly higher rate of AMA compared to LWBS (15,3‰ Vs 13,4‰). Age, sex, citizenship, residence are sociodemographic factors associated with UEDC and also the characteristics of access as admission mode, the type of referring, the emergency level, waiting time of visit and the type of complaint, finally also the characteristics of the structure as type and volume of hospital could be associate with UEDC. Conclusion: Patients with Uncompleted Emergency Department Care both those who leave AMA and LWBS greatly differs from other not UEDC. These results are important for planning and staffing health services. Decision makers should identify and target factors to minimise walkouts from public hospital emergency departments., Journal of Preventive Medicine and Hygiene, Vol 60, No 1 (2019): 2019601

Introduction: Geographic Information Systems (GIS) have become an innovative and even more crucial tool for analyzing relationships between public health data and environment. This study, though focusing on a Local Health Unit of northeastern Italy, could be taken as a benchmark for developing a standardized national data acquiring format. Methods: Geocoding analysis was carried out on a health database comprising 268,517 records of the Local Health Unit of Rovigo in the Veneto region, covering a period of 10 years, starting from 2001 up to 2010. The Map Service provided by the Environmental Research System Institute (ESRI, Redlands, CA), and ArcMap 10.0 by ESRI® were, respectively, the reference data and the GIS software, employed in the geocoding process. Results: The first attempt of geocoding produced a poor quality result, having about 40% of the addresses matched. A procedure of manual standardization was performed in order to enhance the quality of the results, consequently a set of guiding principle were expounded which should be pursued for geocoding health data. High-level geocoding detail will provide a more precise geographic representation of health related events. Conclusions: The main achievement of this study was to outline some of the difficulties encountered during the geocoding of health data and to put forward a set of guidelines, which could be useful to facilitate the process and enhance the quality of the results. Public health informatics represents an emerging specialty that highlights on the application of information science and technology to public health practice and research. Therefore, this study could draw the attention of the National Health Service to the underestimated problem of geocoding accuracy in health related data for environmental risk assessment., Journal of Preventive Medicine and Hygiene, Vol 56, No 2 (2015)

Obiettivi: l’epidemiologia delle malattie infiammatorie croniche intestinali fino ad adesso in Italia è stata poco studiata. Da alcuni studi emerge una minor incidenza di questi fenomeni nel Sud Europa rispetto al Nord Europa e agli Stati Uniti. Lo scopo di questa indagine è quello di valutare l’incidenza della Rettocolite Ulcerosa (RU) e del Morbo di Crohn (MC) nella popolazione dell’Azienda ULSS 17, situata nella provincia di Padova.Metodi: per la realizzazione di questa indagine ci si è avvalsi della collaborazione di 23 Medici di Medicina Generale (MMG) operanti in 14 comuni dell’ULSS 17. I dati sono stati prelevati dal sistema informatizzato comune ai 23 MMG (Millenium), in base ai codici 555 e 556 dell’ICD9. È stato considerato il periodo di tempo 1995 - 2001. La popolazione media di riferimento è di 29.740 abitanti. Risultati: nel periodo considerato sono stati registrati in totale 45 nuovi casi, 35 casi di RU e 10 di MC. L’incidenza media della RU è stata di 16,76/100.000, quella del MC di 4,7/100.000. La RU ha avuto un’incidenza maggiore nel sesso maschile (rapporto 2:1), mentre per il MC si rileva l’opposto (rapporto 2:3). L’età media alla diagnosi per la RU è stata di 44 anni, quella del MC di 51,9. Dall’analisi temporale si evidenzia un progressivo aumento dell’incidenza del MC, mentre la RCU è più costante.Conclusioni: paragonando i risultati ottenuti con quelli di altre indagini condotte in Italia, l’incidenza delle malattie infiammatorie croniche intestinali è apparentemente più elevata nel territorio dell’ULSS 17. Dalla revisione della letteratura nazionale e internazionale emerge che variazioni dell’incidenza di questi fenomeni possono essere ricondotte ad un diverso accesso ai servizi sanitari, a diverse pratiche diagnostiche o alla presenza di fattori di rischio di tipo genetico o ambientale

Road accidents are a major public health problem that affect all age groups but their impact is most striking among the young. The aim of this study is to quantify the burden of road traffic injuries, their mortality and direct in-patient economic costs and to identify the age classes at highest risk for severe road traffic injuries, through analysis of data collected by information systems of an Italian Local Health Authority.The study was conducted in a Local Health Authority of Veneto Region. Injured people were selected from Emergency Department (2006-2010). Data were linked to the Hospital Information System for hospital admissions and to the Mortality Registry to check 30-day mortality. The direct costs associated to hospitalizations were estimated through Diagnosis Related Group reimbursement rates. Multivariate analysis was performed using hospitalization and mortality as the dependent variables and gender, age, day of week when accident occurred as the independent variables. Traffic injury, hospitalization and mortality incidence rates were calculated by gender and age per 100,000 residents per year.The road traffic injuries were 9,192, decreasing from 2,112 in 2006 to 1,980 in 2010. Among injured persons 55.3% were male (68.1% among 15-19 age class); 41.7% young people aged 15-34 years (43.9% among male, 39.0% among female). Total hospitalisation rate was 5.9%. Overall mortality rate was 0.3% (0.9% among aged 65 or older). The cost of hospital admission was euro 2,742,505 (hospitalization mean cost euro 5,097). Risk of hospitalization and death was higher in male, in elderly and during week end. Young people aged 15-19 had the highest incidence of visits (2,258.4 per 100,000) and high hospitalisation weekend and mortality rates (respectively 101.5 and 8.5).Analysis at local level, using current data sources, permits to estimate the burden of injuries caused by road-traffic, to describe the characteristics of injured persons and finally to estimate costs of care. All this information could be used to make the population aware of its own risk for road accidents. Linkage of these data with police and transport data is required to focus prevention on higher risk groups and to adopt effective local road safety strategies.

Objective. The study aimed to assess the impact of HPV immunization campaigns organizational aspects, the characteristics of immunization program (vaccination targets and type of offer), and communicative strategies adopted by four Italian administrative regions on vaccination coverage observed. Methods. From November 2017 to March 2018, regional and Local Health Units (LHUs) representatives were invited to complete an online survey including 54 questions evaluating vaccination invite systems, access systems to vaccination centres, reminder and recall systems, and adverse events surveillance. An overall descriptive analysis was conducted. Since observed vaccine coverage (VC) obtained in females (2002-2004 birth cohorts) was lower than objectives fixed by the Italian Ministry of Health, variables were assessed using the national VC mean obtained in the 2003 girls birth cohort as outcome. Results. Twenty-six LHUs belonging to 4 Northern and Southern Italian regions participated in the study. Organizational aspects significantly related to VC lower than the national mean were access to vaccine centres without appointment and parents’ reservation as appointment planning system. Recall systems for both the first and the second dose, including the appointment in the invitation letter, the availability of regional immunization registry, and education of healthcare workers on universal HPV immunization strategies, instead, were related to higher VC. As regards preadolescent immunization strategies, both VC obtained in girls and boys were far from the Ministerial goals. Only 20% of LHUs introduced multicohort female strategies while all LHUs adopted copayment targeting both men and women. Immunizations strategies targeting subjects at risk were implemented only in half of participating LHUs. Conclusions. VC observed in participating LHUs are largely lower than the national objectives in all anti-HPV vaccine targets. Both organizational and educational strategies have to be implemented to improve the VC goals.