[Gastroenterologists in ambulatory care. The experience in Turin in the year 2000].
BACKGROUND
Digestive diseases (GI) have a major impact on public health in Italy. Hospital stay for digestive pathologies parallels that due to cardiovascular causes. Total mortality for GI causes is also very high. The management of GI pathologies is therefore a major task for the National Health System. To the experienced gastroenterologist it is clear that a large number of hospitalisation is linked to a lack of careful outpatient follow-up of diseases such as cirrhosis, ulcerative colitis and peptic ulcer.


METHODS
One year of activity of our Gastro-entero-Hepatology outpatient service is examined. The management of the majority of GI diseases is organized in  working teams  of physicians and surgeons following cohorts of patients suffering of a specific disease.


RESULTS
During the year 2000 not only a statistically significant higher number of patients has been examined (p<0.05), in comparison with 1994, but also the hospitalisation rate was lowered resulting in a very significative cost-containment.


CONCLUSIONS
The specialization of outpatient activities into  working teams  offers advantages in terms of more appropriate medical care and cost reduction, partly due to a less frequent hospitalisation. The obvious counterpart was an increase of request of such form of follow-up from patients, resulting in longer delay to the access.
Pellicano
R
R
Ambulatori di Gastro-Epatologia, Azienda Ospedaliera San Giovanni Battista, Molinette, Turin, Italy. rinaldo_pellican@hotmail.com
Ponzetto
A
A
Astegiano
M
M
Smedile
A
A
Saracco
G
G
Durazzo
M
M
Balzola
F
F
Berrutti
M
M
Lavezzo
B
B
Ponti
V
V
Morgando
A
A
Ciancio
A
A
Rizzetto
M
M
Palmas
F
F
D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data*; D003363:Cost Control; D004066:Digestive System Diseases / Q000191:economics / Q000628:therapy*; D005762:Gastroenterology / Q000191:economics / Q000639:trends*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D010348:Patient Care Team