Page 70 - S. Ličen, I. Karnjuš, & M. Prosen (Eds.). (2019). Women, migrations and health: Ensuring transcultural healthcare. Koper, University of Primorska Press.
P. 70
vanni Delli Zotti
imputable to the attribution of a general code together with a more specific
code to the same diagnostic situation. In the case of childbirths, a frequent
situation is that of the diagnosis ‘650 – Normal birth’ coupled to the ‘V270 –
Simple birth: born alive’ diagnosis.
The problem could be solved by using the ‘DRG – Diagnosis Related Group’
code, which assigns the reasons for admission to a single category by identi-
fying, using an algorithm, the ‘prevalent diagnosis.’ However, this may result
in the loss of essential information, because a diagnosis, relevant to the con-
struction of the Health Index, may not be ‘intercepted’ due to the attribution
of that hospitalization to a DRG that does not appear to be significant.
Other anomalies found in the data may depend on errors in the registra-
tion of information or on an uneven application of the criteria for registration
by the plurality of operators who contribute to the compilation of HDR cards.
In any case, as we learn from the most recent Annual Report on Hospitaliza-
tion in the section ‘Completeness and Quality of the HDR Survey’ (Ministero
della Salute, 2017), compilation errors significantly affect the quality of the
recorded information. The consequences of this situation are not trivial, as
claimed by Roberto Vattovani (2009) in his doctoral thesis ‘Italian–Slovenian
Hospital Health Mobility after Slovenia’s Accession to the European Union:’
‘Even if HDRs do not have a strictly epidemiological purpose, being part of an
administrative-accounting processes, the analysis of admissions by diagnosis
provides a broad and articulated picture of hospitalization, a phenomenon of
great importance for Public Health, both for the importance of the patholo-
gies for which patients access this service, and for the considerable finan-
cial commitment that the various local health authorities dedicate to hospi-
tals’ (p. 25).
The author adds that the Ministry of Health, differently from the FVG Re-
gion, usually does not provide the individual HDR records, but only data
aggregated according to some relevant attributes, thus limiting the execu-
tion of possible analyzes. For example, not knowing the place of residence of
Slovenian citizens, the actual extent of the phenomenon of international
health mobility cannot be estimated, even if this information is partially
derivable through the table on hospitalization charges (Vattovani, 2009, p.
116). Even if this is a rather specific example, it is useful to underline the need
to be able to count on detailed information at the ‘micro’ level, in order to
carry out analyzes aimed at tasks such as the construction of a health in-
dex. In fact, while performing some aggregation towards the ‘macro’ level
is possible, it is difficult to go down from the macro level to minute group
segmentations, and impossible to reach the individual level.
68
imputable to the attribution of a general code together with a more specific
code to the same diagnostic situation. In the case of childbirths, a frequent
situation is that of the diagnosis ‘650 – Normal birth’ coupled to the ‘V270 –
Simple birth: born alive’ diagnosis.
The problem could be solved by using the ‘DRG – Diagnosis Related Group’
code, which assigns the reasons for admission to a single category by identi-
fying, using an algorithm, the ‘prevalent diagnosis.’ However, this may result
in the loss of essential information, because a diagnosis, relevant to the con-
struction of the Health Index, may not be ‘intercepted’ due to the attribution
of that hospitalization to a DRG that does not appear to be significant.
Other anomalies found in the data may depend on errors in the registra-
tion of information or on an uneven application of the criteria for registration
by the plurality of operators who contribute to the compilation of HDR cards.
In any case, as we learn from the most recent Annual Report on Hospitaliza-
tion in the section ‘Completeness and Quality of the HDR Survey’ (Ministero
della Salute, 2017), compilation errors significantly affect the quality of the
recorded information. The consequences of this situation are not trivial, as
claimed by Roberto Vattovani (2009) in his doctoral thesis ‘Italian–Slovenian
Hospital Health Mobility after Slovenia’s Accession to the European Union:’
‘Even if HDRs do not have a strictly epidemiological purpose, being part of an
administrative-accounting processes, the analysis of admissions by diagnosis
provides a broad and articulated picture of hospitalization, a phenomenon of
great importance for Public Health, both for the importance of the patholo-
gies for which patients access this service, and for the considerable finan-
cial commitment that the various local health authorities dedicate to hospi-
tals’ (p. 25).
The author adds that the Ministry of Health, differently from the FVG Re-
gion, usually does not provide the individual HDR records, but only data
aggregated according to some relevant attributes, thus limiting the execu-
tion of possible analyzes. For example, not knowing the place of residence of
Slovenian citizens, the actual extent of the phenomenon of international
health mobility cannot be estimated, even if this information is partially
derivable through the table on hospitalization charges (Vattovani, 2009, p.
116). Even if this is a rather specific example, it is useful to underline the need
to be able to count on detailed information at the ‘micro’ level, in order to
carry out analyzes aimed at tasks such as the construction of a health in-
dex. In fact, while performing some aggregation towards the ‘macro’ level
is possible, it is difficult to go down from the macro level to minute group
segmentations, and impossible to reach the individual level.
68
