ABSTRACT
SUMMARY: One of the main aims of Healthcare Information Technology is the safe and efficient management of significant amounts of clinical data. Now more than ever, such goal requires the creation of common semantics to ontologically organize knowledge enclosed in databases. By means of the application of the WHO ICD-ICF frameworks, the ensemble of rehabilitative activities lead in all the Maugeri institutes in Italy, has been formally standardized to create a Nomenclator, with the aim to: a) support clinicians in the definition of the individualized Care Pathway; b) program, optimize and maximize patient's rehabilitation activities, according to clinical and organizational requirements; c) qualitatively and quantitatively report the daily health-care professionals' workflows; d) provide a structured and detailed medical record meeting appropriateness requirements. In this regard, the application of the ICD-ICF framework as a baseline ontology, paves the path to an ongoing tracking of the rehabilitation processes, leading to a more accurate description of patient's functioning profile. The upcoming challenge for rehabilitation is the ultimate overcoming of a solely epidemiological perspective, in order to embrace a holistic approach, fostered by ontologically-based information technologies.
Subject(s)
Critical Pathways/organization & administration , Information Technology , Rehabilitation/organization & administration , Disability Evaluation , Health Personnel/organization & administration , Humans , International Classification of Diseases , International Classification of Functioning, Disability and Health , Italy , WorkflowABSTRACT
BACKGROUND AND AIM: Liver cirrhosis is characterized by high morbidity and mortality rates. This study was addressed to evaluate the epidemiological and economic impact of cirrhosis on hospitalizations in a large population in Italy. METHODS: Epidemiological analysis was performed using hospital discharge sheets of 57,720 hospitalizations due to liver disease from 2006 to 2008, selected from the Veneto regional archive. In a sample of 100 randomly selected hospitalizations, a detailed cost analysis was performed and a comparison was made with sets of patients admitted for heart failure (HF) and chronic obstructive pulmonary disease (COPD). RESULTS: Among patients with cirrhosis, ascites emerged as the most frequent cause of admission, followed by hepatic encephalopathy, hepatocellular carcinoma, and upper gastrointestinal bleeding. Encephalopathy and ascites were the complications with the highest rates of readmission. The detailed cost analysis of hospitalizations revealed that economic expenses in the set of patients admitted for cirrhosis were about 30% higher than those for patients admitted for HF or COPD, mainly due to the longer duration of hospitalization. CONCLUSIONS: Cirrhosis has a relevant epidemiological and economic impact on hospitalizations and preventive strategies for its clinical management are warranted.
