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A Muzzi

Publications and source records attributed to A Muzzi.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

[The health services epidemiology in health agency: the initiatives, the activities, the structures. Introduction to the subject].

The subject which has been developed within the Workshop "the health services Epidemiology in health Agency: the initiatives, the activities, the structures. Direct and indirect evidences", held in Rome, in November 15th, 2001, is introduced and updated. After a historical excursus, the topical interest in the health services epidemiology, which has now assumed the aspect of a real, independent discipline, and the reasons for its development, are analysed. As an independent discipline, its typical methodology and function have to be recognised. The methodology is characterised by the wide use of qualitative methods, by the importance assigned to the secondary epidemiologic research (i.e. systematic reviews and meta-analysis) and by the particular interest devoted to evaluation rather than investigative surveys. The function is aimed at improving people's health by means of health care services and, as a practical consequence, useful to the former one, at improving the quality of health care services themselves.

Delivery of Health Care↗
PubMedDate not supplied

[Model for the regional allocation of the National Health Care Fund].

In 1978 a National Health Service (Servizio Sanitario Nazionale = SSN) was constituted in Italy which exercises jurisdiction in the sector of health care and is duty bound to assist all citizens. Basically speaking, the NHS is organized on three levels (national, regional and local) with the management of direct operations assigned to the (about 700) Local Health Boards (Unità Sanitaria Locale = USL) each of which covers a well determined territorial area. The Authors indicate that rarely discussed or evaluated are the procedures for the regional allocation of health care funding which is determined by Parliament within the ambit of the National Budget (The National Health Care Fund). The current allocation model distributes the available capital resources for each expense item (e.g. hospitalization, pharmaceutical assistance, etc.) on a per capita basis with respect to the regional populations modified in order to allow for differing degrees of health care requirements. The regional populations are subdivided into broad age groups (e.g. children, intermediary, the elderly) with specific weighting factors expressing the different level of health care requirements. The application of these weighting factors alters the regional populations (with no change in the total population of the country) in order to express them in equivalent units with respect to the health care need. Moreover, standardized death rates are introduced into the model as indicators of the different health risk, and their application leads to a further modification in the level of the regional populations so as to express them in equivalent units with respect to the health risk as well. Once the available financial resources have been subdivided in this "theoretical" way, the following corrective factors are applied: a) hospital mobility correction factor: the regions with a credit admissions balance are assigned an additional cost which is borne by the regions with a debit admissions balance; b) historical expenditures correction factor: a comparison is made between the theoretical allocation and the allocation according to expenditures ascertained in 1985, and the final allocation falls into an intermediary position; s) Local Health Board income correction factor: the assignment of funds is reduced in direct proportion to the estimated income specific to the Local Health Boards of each region. The authors point out that even though this model represents a positive evolution when compared to the superficial criteria of past expenditure levels, it does manifest application potential limits.(ABSTRACT TRUNCATED AT 400 WORDS)

Financing, Government↗
PubMedDate not supplied

[Possibilities and limitations of the predictive risk estimates and epidemiological studies following the Chernobyl incident].

The disastrous accident at the nuclear power station at the Chernobyl on 1986 (April 26) has brought attention to the estimation of radiation health effects and many "experts" were attending to the evaluation on oncogenic mortality increase among the Italian population in the next future. On the contrary at that time too few peoples were worried about the possibility of detecting such an increase. Discussion of this topic is notoriously fraught with difficulties arising from differences of opinion how to estimate low-dose risk in humans without data from direct observation. One opinion is to extrapolate from the data points obtained at relatively high doses toward zero dose (zero extrapolation theory). This permit estimates of risk to be made but, in the final analysis, no data from humans exist that show that low-level radiation exposures produce measurable biologic effects. For that this theory is more useful in radio-protection and medico-legal subjects. It is easy on a statistical basis to prove the impossibility to establish an increase in human cancer after low doses of ionizing radiation such as those received environmentally after the Chernobyl's accident. In this condition to observe the numbers of radiation-induced cancer deaths that far exceed the "natural" incidence would require a follow-up a sample more and more greater than the italian population herself. Indeed the statistical power of a hypothetical follow-up study at a suitable confidence level would require a sample size higher than a milliard of persons for the detection of an increase of a generic cancer mortality and higher then seven hundred of millions for the detection of an increase of the specific thyroid cancer mortality. In more detail the following figures for the parameters needed to curring out the evaluation have been used: medium dose equivalent to the thyroid, 2.03 mSv; medium effective dose equivalent up to december '87, 0.6 mSv; thyroid cancer mortality in the italian population, 0.94 10(-5) y-1; total cancer mortality in the italian population, 22.2 10(-2) y-1; risk factor per unit dose equivalent in thyroid, 0.5 10(-6) mSv-1; risk factor per unit effective dose equivalent, 2.0 10(-5) mSv-1. Applying the foregoing values in statistical inference methods it could be achieved that 7.5 18(8) and 1.25 10(9) persons must be followed-up in the next 30 years to detect a significant increase over the "natural" cancer mortality for thyroid and "total body" radioinduced cancers respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

Accidents↗