Publications (19) View all
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Article: The effect of healthcare delivery privatisation on avoidable mortality: longitudinal cross-regional results from Italy, 1993-2003.
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ABSTRACT: BACKGROUND: During the 1990s, Italy privatised a significant portion of its healthcare delivery. The authors compared the effectiveness of private and public sector healthcare delivery in reducing avoidable mortality (deaths that should not occur in the presence of effective medical care). METHODS: The authors calculated the average rate of change in age-standardised avoidable mortality rates in 19 of Italy's regions from 1993 to 2003. Multivariate regression models were used to analyse the relationship between rates of change in avoidable mortality and levels of spending on public versus private healthcare delivery, controlling for potential demographic and economic confounders. RESULTS: Greater spending on public delivery of health services corresponded to faster reductions in avoidable mortality rates. Each €100 additional public spending per capita on NHS delivery was independently associated with a 1.47% reduction in the rate of avoidable mortality (p=0.003). In contrast, spending on private sector services had no statistically significant effect on avoidable mortality rates (p=0.557). A higher percentage of spending on private sector delivery was associated with higher rates of avoidable mortality (p=0.002). The authors found that neither public nor private sector delivery spending was significantly associated with non-avoidable mortality rates, plausibly because non-avoidable mortality is insensitive to healthcare services. CONCLUSION: Public spending was significantly associated with reductions in avoidable mortality rates over time, while greater private sector spending was not at the regional level in Italy.Journal of epidemiology and community health 09/2012; · 3.04 Impact Factor -
Article: Patients' evaluation of hospital foodservice quality in Italy: what do patients really value?
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ABSTRACT: OBJECTIVE: Patients often do not eat/drink enough during hospitalization. To enable patients to meet their energy and nutritional requirements, food and catering service quality and staff support are therefore important. We assessed patients' satisfaction with hospital food and investigated aspects influencing it. DESIGN: We conducted a cross-sectional study collecting patients' preferences using a slightly modified version of the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ). Factor analysis was carried out to reduce the number of food-quality and staff-issue variables. Univariate and multivariate ordinal categorical regression models were used to assess the association between food quality, staff issues, patients' characteristics, hospital recovery aspects and overall foodservice satisfaction (OS). SETTING: A university hospital in Florence, Italy, in the period November-December 2009. SUBJECTS: Hospital patients aged 18+ years (n 927). RESULTS: Of the 1288 questionnaires distributed, 927 were returned completely or partially filled in by patients and 603 were considered eligible for analysis. Four factors (explained variance 64·3 %, Cronbach's alpha α C = 0.856), i.e. food quality (FQ; α C = 0·74), meal service quality (MSQ; α C = 0·73), hunger and quantity (HQ; α C = 0·74) and staff/service issues (SI; α C = 0·65), were extracted from seventeen items. Items investigating staff/service issues were the most positively rated while certain items investigating food quality were the least positively rated. After ordinal multiple regression analysis, OS was only significantly associated with the four factors: FQ, MSQ, HQ and SI (OR = 17·2, 6·16, 3·09 and 1·75, respectively, P < 0·001), and gender (OR = 1·53, P = 0·024). CONCLUSIONS: The most positively scored aspects of foodservice concerned staff/service, whereas food quality was considered less positive. The aspects that most influenced patients' satisfaction were those related to food quality.Public Health Nutrition 08/2012; · 2.17 Impact Factor -
Article: Data display format and hospital ward reports: effects of different presentations on data interpretation.
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ABSTRACT: BACKGROUND: Graphs are often used in medical communication, both in clinical practice and health management. They can help the processing of quantitative information but may also contribute to drawing wrong conclusions. The aim of the survey is to study the graphical perception of the data at the management level and its possible effects, showing how some criteria of appraisal of a phenomenon are influenced by the graphical format. METHODS: One hundred and five medical doctors and health direction professionals of hospitals in Naples, Rome, Siena and Turin were interviewed. Four different graphs or table related to the same hypothetical data on average hospital stay in the period January 2000 to September 2003 were shown to participants, and their impressions were recorded. RESULTS: Less than one-fourth of the participants understood that the data set was the same for the different diagrams. The process of understanding is mostly correlated with being a director, having a degree in medicine and working in central-northern cities. The table seems easier for interpretation (98.1%), more suitable (84.8%), more used (92.4%) and more pleasant than other data presentation. On the other hand radar format had worse results in all questions. CONCLUSIONS: The choice of a graphical format may influence the understanding of data. Further research is needed in order to sustain the improvement of medical and health professionals' knowledge in the display data format.The European Journal of Public Health 03/2012; · 2.73 Impact Factor -
Article: How many bacteria live on the keyboard of your computer?
American journal of infection control 09/2011; 39(7):616-8. · 3.01 Impact Factor -
Article: Is it possible to evaluate addiction from clinical records? Testing a retrospective addiction severity evaluation measure.
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ABSTRACT: To compare an addiction severity score estimated from clinical records to addiction severity index (ASI) scores. During April-May 2004, 31 patients treated in a therapeutic community in the Piedmont region (Italy) were interviewed using the ASI questionnaire and their clinical records were used to obtain severity scores in seven areas: physical health, occupational functioning, alcohol use, drug use, legal problems, family/social relationships, psychological health. Correlation, agreement, and discriminatory capacity of the clinical records score in correctly classifying persons with low or high severity were investigated using Spearman, Kappa coefficient, and receiver operating characteristics curves. Clinical records score showed good correlation, agreement, and discriminatory accuracy with respect to ASI scores, especially in the drug use and legal problems areas. Further research is suggested to study the use of the score in other settings.Substance Use & Misuse 04/2010; 45(12):2045-58. · 1.10 Impact Factor
