Risultati per: Gestione della multimorbilità e polifarmacoterapia 2021

Life expectancy in the US may now vary by more than 2 decades based on demographic differences, according to a new systematic analysis. The largest gap between highest and lowest life expectancies was 12.6 years in 2000. It reached 13.9 years in 2010 and 15.8 years by 2019 before climbing to 20.4 years after the first 2 years of the COVID-19 pandemic—with the largest life expectancy difference being between Asian individuals and American Indian or Alaska Native people in the West.

The global mortality of patients with asthma is a significant concern. The analysis of the burden of asthma can help formulate public health policies, allocate resources, and prevent asthma.

Objectives
To determine the prevalence of hospital discharge communication problems with older adults, compare them across countries and determine factors associated with those problems.

Design
Secondary analysis of cross-sectional survey data.

Setting
2021 Commonwealth Fund International Health Policy (IHP) Survey of Older Adults conducted across 11 high-income countries, including Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK and the USA.

Participants
4501 respondents aged 60 and older in the USA and 65 and older in all other included countries who were hospitalised at least once in the past 2 years before the survey and answered discharge communication-related questions.

Primary outcome measure
Our primary outcome measure is poor discharge communication (PDC), a composite variable of three IHP questions related to written information, doctor follow-up and medicines discussed.

Results
Overall PDC rate was 19.2% (864/4501), although rates varied by nation. PDC was highest in Norway (31.5%) and lowest in the USA (7.5%). Gender, education, income and the presence of at least one chronic disease were not statistically associated with PDC.

Conclusions
Given the high rate of PDC observed, hospital discharge teams and leadership should carefully examine communication during the hospital discharge process to ensure minimisation of care gaps, particularly regarding medication, since this was the most reported problem.

Objective
This study examined economic inequality in coverage of selected maternal and child healthcare (MCH) indicators in India and its states over the last 15 years.

Design
The study analysed last three rounds of the National Family Health Survey data, conducted during 2005–2006, 2015–2016 and 2019–2021. Bivariate analyses, ratio of richest to poorest, slope index of inequality (SII) and multivariate binary logistic regression analyses were used to examine the coverage as well as inequalities in the outcome indicators for India and its states and at district level.

Primary outcomes
The outcome variables analysed in the study were full antenatal care, institutional delivery, postnatal care of mothers within 48 hours of delivery, and full immunisation among children.

Participants
Women aged 15–49 who had given a birth in the last 5 years before the surveys were unit of analysis for the maternal healthcare indicators, and children aged 12–23 months were unit of the analysis for childhood immunisation.

Results
Over the last 15 years, coverage of the MCH indicators has increased in India and across socioeconomic segment of the population, and the absolute increase was higher among the worse-off segments than the better-off. This led to decline in the inequality in coverage of all the MCH indicators. For instance, the value of SII for institutional births decreased from 0.76 in 2005–2006 to 0.45 in 2015–2016 and further to 0.37 in 2019–2021. Although inequality has decreased, geographic disparities persist across states and districts.

Conclusion
Though substantial improvement was observed, coverage of MCH indicators increased and the economic inequality declined; certain geographies are still characterised with the low coverage and persistent high inequality. This suggests that adding a spatial perspective to the inequality research and targeted strategies is essential for achieving universal access to reproductive healthcare services by 2030 in India.

La disfunzionalità dell’adipe si riflette sui tessuti arteriosi, cardiaci e renali e queste interconnessioni rappresentano una sfida importante per il Ssn, ma anche un’opportunità per migliorare la presa in cura dei pazienti con patologie complesse

The global burden of MBC significantly increased from 1990 to 2021, with notable geographic disparities. Efforts aimed at MBC prevention and control strategies should take into account the inequities in its global distribution.

Objectives
We aim to delineate the digestive congenital abnormalities burden in children under 14 years old between 1990 and 2021.

Design
We implemented data from the Global Burden of Disease (GBD) 2021 database to evaluate digestive congenital abnormalities burden with different measures in 204 countries and territories from 1990 to 2021. We present precise estimations with 95% uncertainty intervals. In addition, we computed the estimated annual percentage change (EAPC) to examine the temporal patterns of these indicators.

Setting
It uses prevalence, deaths and disability-adjusted life years (DALYs) data from the GBD study to analyse this issue.

Participants
Patients with digestive congenital abnormalities diagnosis.

Outcomes
Total numbers, age-standardised rates (ASRs) of prevalence, mortality and DALYs and their EAPCs were the main outcomes among children aged 0–14 years.

Results
In 2021, 2206.79 thousand prevalent cases were reported worldwide, with digestive congenital anomalies accounting for 47.16 thousand deaths and 4324.56 thousand DALYs among children aged 0–14 years. Digestive congenital anomalies prevalence was mitigated by 8.15% between 1990 and 2021, with the global ASR of prevalence declining to 40.09 per 100 000. Digestive congenital anomalies mortality was mitigated by 35.35% between 1990 and 2021, with an ASR of deaths declining to 0.77 per 100 000. The worldwide burden of digestive congenital anomalies decreased by 34.96% in terms of DALYs from 1990 to 2021, with an ASR of 70.44 DALYs per 100 000 population. There was a significant hindrance in the prevalence, particularly among older children. The likelihood of digestive congenital abnormalities peaked during infancy (2–4 years) in all regions.

Conclusion
We highlight promising global declines in the digestive congenital anomalies burden among children over the past 32 years. Prevalence, deaths and DALYs associated with these anomalies have shown consistent decreases, although regional variations persist. These findings offer crucial insights for shaping effective prevention and management strategies for paediatric digestive congenital anomalies.

Rinviato a metà gennaio voto su piano revisione Rete oncologica

Domani ad Ancona congresso scientifico alla Politecnica Marche

The QCI serves as an effective metric for evaluating the quality of leukemia care. Our findings reveal a strong association between leukemia QCI and regional economic and educational development. Age is a critical factor, with an aging population contributing to a potential decline in QCI. These results underscore the urgent need for targeted interventions to enhance health services for older adults and to improve care quality in economically disadvantaged regions.

An increasing trend in global DUD mortality was observed from 1990 to 2021, especially in HICs. Future DUD deaths were also predicted to increase until 2040 at the global level. Therefore, these findings suggest urgent and proactive strategies for DUD to reduce the mortality rates related to DUD are needed. However, further prospective research that accounts for potential confounding factors, such as socioeconomic variables and the quality of reporting data from individual countries, is imperative for more accurate estimation.