Chapter 2

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1.5.3 Structure of hospital “costs” by age We start our analysis of hospital “costs” 2 by age for acute cases in ordinary hospitalization and in day hospital. For acute cases hospitalised in the ordinary regime, the percentage of “costs” at various ages follows a qualitatively homogeneous trend in the various Regions: following the peak at birth (with pathologies), they rise little to the 15-24 age class and then increase exponentially for subsequent age classes. Quantitative analysis shows significant differences between Regions. At age zero, as in the intermediate age classes, the weight of hospital “costs” in greater in the Southern Regions and specifically in Campania (3,5%) in Puglia (3,3%) and in Sicilia (3,1%). The fact can be explained, but only partially, by Regional demographic structure and the higher birth rate in the South (Figure 1): it should be remembered that the costs of childbirth for babies born healthy are excluded. As age increases the relationship is obviously inverted and variation between Regions also increases. The 75+ age group is that in which the proportion of “costs” varies most from Region to Region. The highest values are recorded for Friuli Venezia Giulia (34,6%), Toscana (34,3%) and Marche (34,1%), while Campania has the lowest (20,1%) (Figure 2) Figure 1 - Share of hospital “costs” Ordinary hospitalization in acute cases - age zero – Year 2003 Hospitalization “costs” (acute cases RO, age=0) 4,0% 3,5% 3,0% 2,5% 2,0% 1,5% 1,0% 0,5% 0,0% Abruzzo Calabria Lazio Sardegna Val d’Aosta Veneto Piemonte Lombardia Bolzano Trento 2 As pointed out in the preceding paragraph “costs” should properly be understood as the amount of financing theoretically provided under the current Regional DRG tariffs. They therefore do not constitute expenditure in the strict sense but are an indicator of resource absorption by age class, in the text, the term “costs” appears in brackets. F.V.G. Regions Liguria Emilia [85] Toscana Umbria Marche Molise Campania Puglia Basilicata CEIS Health Report 2006 Sicilia
CEIS Health Report 2006 Figure 2 - Share of hospital “costs” Hospitalization of acute cases – age 75 + – Year 2003 Hospitalization “costs” (acute cases RO, age=75+) For day hospital cases, “costs” are concentrated on the 45-64 age class, decreasing thereafter. In general, variation between Regions is greatest for ordinary hospitalization (Figure 3). The 45-64 age group is that with the greatest variation between Regions, its share in the Val d’Aosta is 36,0%, in Campania and Molise 33,7%, but only 27,3 % in the Marche (Figure 3). Figure 3 - Share of hospital “costs” Day hospitalization in acute cases – age 45-64 – Year 2003 Hospitalization “costs” (acute cases DH, age=45-64) 35,0% 30,0% 25,0% 20,0% 15,0% 10,0% 5,0% 0,0% 40,0% 35,0% 30,0% 25,0% 20,0% 15,0% 10,0% 5,0% 0,0% Abruzzo Abruzzo Calabria Piemonte Lazio Val d’Aosta Sardegna Lombardia Val d’Aosta Bolzano Veneto Trento Piemonte Veneto [86] Lombardia F.V.G. Bolzano Liguria Trento Emilia F.V.G. Regions Toscana Regions Liguria Umbria Emilia Marche Toscana Lazio Umbria Molise Marche Campania Molise Puglia Campania Basilicata Puglia Calabria Basilicata Sicilia Sicilia Sardegna
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CEIS Health Report 2006 Management
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CEIS Health Report 2006 Management
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Index Report Presentation by Pagane
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1.6 - The Regional Primary Care Agr
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Chapter 3 - Efficiency 3.1 - The Ef
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3.8 - Private Health Insurance and
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Ceis - Sanità Report presentation
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Warning The figures in the volume f
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CEIS Health Report 2006 stantial, i
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CEIS Health Report 2006 If, therefo
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CEIS Health Report 2006 Cross-check
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CEIS Health Report 2006 over € 6.
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CEIS Health Report 2006 made; final
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CEIS Health Report 2006 Although th
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CEIS Health Report 2006 Aside from
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CEIS Health Report 2006 year (AIHW
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CEIS Health Report 2006 cost of the
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CEIS Health Report 2006 The Second
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CEIS Health Report 2006 2.5 - Imple
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CEIS Health Report 2006 2.5.3 Shift
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CEIS Health Report 2006 Table 1 - P
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CEIS Health Report 2006 and, conseq
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CEIS Health Report 2006 Grant whose
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CEIS Health Report 2006 Generally s
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CEIS Health Report 2006 Scheme for
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3.1 - The efficiency of Regional He
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Table 2 - LEA Financing REGIONS HOS
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• Campania, with strong financial
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[163] CEIS Health Report 2006
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hospital stays has reduced the aver
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treated varies greatly. The highest
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CMS = f(COST, CMP, PL, RC, DM , PME
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formance, implying an increase in a
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3.3 - The National Health System Ev
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3.3.3 Cooperation with the Regional
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the contract conditions are previou
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Consequentially, in order to avoid
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order through the MEPA) numbered 14
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3.4 - Strengthening the capacity fo
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for designing and governing organiz
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the hierarchical and management rol
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tions may appear and disappear, the
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lop, rather than a variable to be c
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units along business lines were unq
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cooperation to achieve the developm
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However, to manage a multi-site hos
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Figure 2 - AVS Strategy map • con
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cialties, but what sets them apart,
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nistically or quantitatively. Hence
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portant for healthcare industry, as
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tor is that General Managers usuall
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cation of the ABC and, in general,
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● Kaplan R, Norton D (1992), “T
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3.7 - The management of healthcare
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Table 1 - Pathway for st elevated a
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[217] CEIS Health Report 2006 Table
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Vaginal childbirth Some synthesis i
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Politiche sanitarie, marzo-aprile.
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dental work, the purchase or rental
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2. We might suppose that the state
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● OECD (2004), “Towards High -
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4.1 - Equity in the italian healthc
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Table 2 - Association indexes betwe
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4.1.5 Structure of health expenditu
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Table 9 - Regional distribution of
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strophic payments; moreover, the se
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● Doglia M, Spandonaro F, “Il p
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CEIS Health Report 2006 (i represen
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CEIS Health Report 2006 sence of di
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CEIS Health Report 2006 -0,0030, wh
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CEIS Health Report 2006 Although co
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5.1 - The median age at death for m
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causes and the median age at genera
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in the South and Islands, not only
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5.2 - Analysis of avoidable deaths
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population of Italian citizens acco
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We wish to underline the mortality
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Diagram 4 - % composition of years
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5.2.4 Comments The results of the a
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among whites and blacks,1979-1989
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Figure 1 - Division % of the quota
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Figure 3 - Pharmaceutics expenditur
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Table 3 - Gross fixed investments i
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Table 4 - Share of medical device w
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age dimension of enterprises (90 em
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BOX 2: National Medical Device Clas
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maceutiche in Italia (1997-2001)”
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5.4 - Mobility of italian patients
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Authority (ASL) will be charged for
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43.950.716,00. At this stage, if yo
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esting data are certainly provided
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have carried out economic and stati
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[295] CEIS Health Report 2006
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✔ DE POUVOURVILLE GÉRARD Researc
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✔ MENNINI FRANCESCO SAVERIO Degre
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✔ SCHWEIGER ARTURO Health Economi
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Chapter 2

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