Aprile 2013 - Volume XXXII - numero 4
Ricerca
1Pediatri di famiglia, Zona Territoriale 5 - Jesi Area Vasta 2 - Ancona
2Responsabile Budget Medici delle Cure Primarie Zona Territoriale 5 - Jesi Area Vasta 2 - Ancona
Indirizzo per corrispondenza: mircogrugnetti@libero.it
Key words: Chronic disease, Severe disabilities, Developmental age, Family paediatricians, Epidemiology, Budget, Training
Background - The chronic disease and severe disability are realities that increasingly involve
also the developmental age and they are going to test culture and health organization.
In early 2009, a group of eleven family paediatricians began to “observe”, to
explore the Disability World starting from their own territorial reality.
Aims - The aim was to acquire a deep knowledge of the phenomenon, even from a financial
point of view, and simultaneously to start to understand the pathways and needs
and try to improve the quality of care.
Materials and methods - The prevalence study was based on an area-based and multi-source
investigation. After the record linkage, the patient cataloguing was designed according
to the severity of the disease and the complexity of care. The cost analysis was carried out
using the criteria of job order costing that is based on the cost inputs that directly affect Family
Paediatrics health care budget.
Results and conclusions - A prevalence rate of 4.6‰ of children with severe disabilities was
found on a general paediatric population of 10,195 individuals. The patients with neurological
or cognitive-neurological problem represent the two more frequent categories.
3.67% of the paediatric population with chronic diseases and/or severe disability affect
the variable cost of paediatrics public health care budget for 36% of its total. Direct and
continuous contact with their families and patients offers family paediatricians a vantage
point and allows them to process data on large population samples both quantitatively and
qualitatively. In addition to the epidemiology, the Narrative Medicine instrument has helped
the group to better understand the disability world and, probably, to rediscover the essence
of being medical doctors.
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