Leader: Giovanni Fattore (BOCCONI); Other collaborator(s): Simone Ghislandi (BOCCONI), Irene Torrini (BOCCONI)
Task 3 will perform an elaboration of a comprehensive framework of different models of community care services in Italy (social and healthcare) and develop a data platform integrating individual level data on the use of hospital and other health service (hospital discharge records SDO, administrative dataset from Lombardy Region) with other data collecting information on the interventions provided to elderly patients by social and primary care providers in the community. .
In particular, the activities carried out for this task involve the construction of two datasets. The first, which is at an advanced stage, brings together national data at the Local Health Authority (LHA) level from Hospital Discharge Records (SDOs) and Municipalities’ balance sheets in order to analyze the relationship between local public spending on territorial social services and the number, length of stay and cost of avoidable hospitalizations (AHs), used as a proxy for the quality of primary care. AHs in fact are hospitalizations required for all those conditions (Ambulatory Care Sensitive Conditions, ACSC) for which it is found that timely and effective care at the territorial level can prevent the use of inpatient hospital services. This dataset is then enriched by other context variables derived from national public sources, such as ISTAT, Internal Revenue Service, National Strategy for Inner Areas.
The second dataset comes from the Region of Lombardy registers and was received on June, 2024. These collect individual-level information on all over-65 residents with chronic conditions related to inpatient and outpatient care, pharmaceuticals, and residential, home-based, and preventive care services. For each patient, various information related to the General Practitioner (GP) such as age, gender, years of experience, and health district of membership is also available. When information at the municipality level will be added to the dataset, it will make it possible to analyze the relationship between health service utilization and GP characteristics and how such a relationship depends on territorial characteristics.
The Task aims at providing a unique example on how to supplement the databases typically used by policy makers with more specific details on the relevant supply-side aspects affecting the provision of health and community care services to the elderly. Moreover, a single data platform that collects information on the use of health services by the elderly and the current delivery of community services is crucial for analyzing whether, and how, the needs of the elderly population are being met.
The working group of Task 3 has begun construction of the first dataset. In particular, individual-level information from hospital discharge records is being merged with municipality-level information such as: socio-demographic and economic characteristics of the municipality, characteristics of territorial and hospital health service supply, geographic characteristics, social spending.
The working group of Task 3 completed the construction of the first dataset and has started work on the second.
The construction of the second dataset is ongoing.
The construction of the second dataset is ongoing.
The construction of the first dataset is completed.