Human cost of disease in Italy
- Presenter:
Chair: Melayne McInnes; Discussant: TBA Tue June 6, 2006 13:45-15:15 Room 121
Introduction: Mortality data represents essential elements for the quantification of health problems and, from an economic perspective, the most important element among human costs. They are recorded all over the country and coded following current and internationally approved criteria.
Death counts and related rates are among the simplest indicators to analyze mortality. They are a short and clear measure of a population’s mortality pattern, that may be used to establish and monitor health priorities or objectives. In particular, within the actual federal framework of the Italian health system, a mortality analysis at a regional level provides specific information which allows for detection of health priorities and objectives for each region.
Methodology: Official mortality data recorded and coded by ISTAT (Italian National Statistics Institute) in accordance with the IX Revision of the International Classification of Disease (ICD IX) were analyzed. The data refers to deaths occurred in Italy among the resident population during the year 2001 (most recent available year).
Taking mortality data, as a starting point, it is possible to calculate a series of indicators, such as: life expectancy, standardized mortality rates, Years of Potential Life Lost (YPLL) and rates of YPLL, which allow us to compare mortality through time and space.
Median ages at death were also calculated (in demography: “median life”) for both men and women and each cause of death. The median age is an indicator of longevity in a population and technically it is the age at which the reference population (i.e. regional population) halves. The causes of death taken into account are the most relevant in Italy: they contributed about 90% to the absolute number of deaths in our country in 2001.
Moreover, other causes of death were analyzed, according to their impact on general mortality and their relative weight within the above mentioned groups of causes. In particular, Acute Myocardial Infarction, Malignant Neoplasms such as Lung cancer, Breast cancer and Colon-rectum cancer, among Violent causes of death, Road accidents and Suicide.
Taking into account the federal debate and related problems, it is useful to underline that the spatial distribution of these indicators allows a comparison among regions in terms of years of potential life lost and age at death for each specific cause of death.
Results: From a federal perspective, YPLL and median ages at death result to be effective indicators of possible lack of the Regional Health Services. It is worth noticing the variability among Regions of the median age at death for Breast cancer; it is well known nowadays that mortality from this cause can be reduced thanks to early diagnosis and treatment, consequently regional values of the median ages lower than those at national level could suggest, apart from any possible epidemiological and clinical difference regarding women affected by this pathology, also the lack of effective screening programmes as well as treatments the Regional Health Services are in charge of. This analysis supports the financial and organizational considerations on different impacts of the Regional Health Services in Italy.
