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Abstract Background Immigration is increasing in Italy. In 2003, 2.6 million foreign citizens lived in the country; 52% were men and the majority were young adults who migrated for work. The purpose of this study was to investigate differences in hospitalisation between immigrants and the resident population during the year 2000 in the Lazio region. Methods Hospital admissions of immigrants from Less Developed Countries were compared to those of residents. We measured differences in hospitalisation rates and proportions admitted. Results Adult immigrants have lower hospitalisation rates than residents (134.6 vs. 160.5 per thousand population for acute care; 26.4 vs. 38.3 for day care). However, hospitalisation rates for some specific causes (injuries, particularly for men, infectious diseases, deliveries and induced abortions, ill-defined conditions) were higher for immigrants than for residents. Immigrants under 18 years seem to be generally healthy; causes of admission in this group are similar to those of residents of the same age (respiratory diseases, injuries and poisoning). The only important differences are for infectious and parasitic diseases, with a higher proportion among immigrant youths. Conclusion The low hospitalisation rates for foreigners may suggest that they are a population with good health status. However, critical areas, related to poor living and working conditions and to social vulnerability, have been identified. Under-utilisation of services and low day care rates may be partially due to administrative, linguistic, and cultural barriers. As the presence of foreigners becomes an established phenomenon, it is important to evaluate their epidemiological profile, develop instruments to monitor and fulfil their specific health needs and plan health services for a multi-ethnic population.

Previous studies have shown that the quality of medical records is not uniform across Italian hospitals. Between March 2002 and January 2003, we assessed the quality of 6,215 medical charts regarding admissions to 11 different Rome hospitals in the year 2001. The hospitals were located within the territory of the ROMA "A" and ROMA "C" Local Health Units. The following were evaluated: 1) organization, format and lay-out of medical records; 2) medical chart and discharge abstract compilation; 3) ICD-9-CM coding accuracy. The quality of medical records and of discharge abstracts, as judged especially by their format and by the completeness, accuracy, congruency and clearness of the reported information, varied extensively among the different wards and hospitals. The main problems were identified and possible solutions are discussed. We suggest that improved quality of medical records and discharge abstracts may be promoted through: 1) use of a standardized format for medical records in all wards of the same hospital; a supplement may eventually account for the characteristic requirements of specialist wards; 2) adoption of guidelines for medical record-keeping and of a code of conduct for discharge abstract coders; 3) use of a new discharge abstract form that favours more accurate ICD-9-CM coding and that allows more effective gathering of clinical data for epidemiological purposes.