title: [The study "Social health need of elderly people in Tuscany (Italy)": an example of epidemiology inside a regional programming cycle].
abstract: OBJECTIVE
  in 2008,Tuscany Region (Italy) allocated the "Regional Fund for Disabled Elderly People" to support a dedicated local welfare system mainly characterised by universal access and resource allocation proportional to assessed individuals' personal care needs. To assure sustainability, reliable estimates of disabled elderly people living in the Region, stratified by level of personal care needs, were needed. For such a purpose, in 2009, the Regional Health Agency of Tuscany conducted a survey called Bi.S.S.
  
  
  METHODS
  cross-sectional survey inside the resident population over 65 years. A structured questionnaire was used for detection: it contains the same multidimensional evaluation instruments used by Multidisciplinary Evaluation Units of the region.
  
  
  METHODS
  sample of Tuscany population over 65 years; stratified sampling by gender, age and residence zone (No. 2.551). Cases were extracted from the inhabitants registry of Tuscany. Evaluation data were collected only for the elderly who lived at home.
  
  
  METHODS
  prevalence estimation and current and forecasted expected cases (by gender and age) of home resident disabled elderly people (according to inability to perform basic activities of daily living), by level of personal care needs (according to a pre-defined scale ranging 1-5, based on the level of dependence in performing basic activities of daily living, cognitive impairments and behaviour disorders). Expected cases were calculated on demographic data supplied by the Italian National Institute of Statistic (ISTAT).
  
  
  RESULTS
  about 67,000 home resident disabled elderly people (49,000 women and 18,000 men) are currently expected to live in Tuscany, equal to 7.8% of the population aged 65 years and over. Of these, about 13,000 are classified at level of personal care needs 1; 7,500 at level 2; 15,500 at level 3; 24,000 at level 4; and 7,000 at level 5. By 2015, disabled elderly people living in Tuscany are expected to increase up to 80,500.
  
  
  CONCLUSIONS
  on the basis of the available resources and of these results, amount of resources to be allocated for the personal care of the individual disabled people according to his/her level of care needs have been decided. Therefore, Bi.S.S. has been a good example of an epidemiological survey fully integrated in a regional programming plan. The expected increase in the next future of elderly disabled people calls for urgent prevention programmes and organization of cost-effective personal care services.
authors.affiliation: Agenzia regionale di sanità della Toscana, Firenze. paolo.francesconi@ars.toscana.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Francesconi
authors.forename: Francesco
authors.initials: F
authors.lastname: Profili
authors.forename: Matilde
authors.initials: M
authors.lastname: Razzanelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Cipriani
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D006801:Humans; D007558:Italy / Q000453:epidemiology; D011795:Surveys and Questionnaires