title: White paper of Italian Gastroenterology: delivery of services for digestive diseases in Italy: weaknesses and strengths.
abstract: In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999-2009, with more than 1,500,000 admissions/year; however only 5-9% of these admissions was in specialized Gastroenterology units. Reported data show a better outcome in Gastroenterology Units than in non-specialized units: shorter average length of stay, in particular for admissions with ICD-9-CM codes proxying for emergency conditions (6.7 days versus 8.4 days); better case mix (higher average diagnosis-related groups weight in Gastroenterology Units: 1 vs 0.97 in Internal Medicine units and 0.76 in Surgery units); lower inappropriateness of admissions (16-25% versus 29-87%); lower in-hospital mortality in urgent admissions (2.2% versus 5.1%); for patients with urgent admissions due to gastrointestinnal haemorrhage, in-hospital mortality was 2.3% in Gastroenterology units versus 4.0% in others. The present document summarizes the scientific societies' official report, which constitutes the "White paper of Italian Gastroenterology".
authors.affiliation: Gastroenterology Department, Maggiore Hospital, Crema, Italy. Electronic address: ebuscarini@rim.it.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Buscarini
authors.affiliation: Gastroenterology Department 2, IRCCS Cà Granda Foundation, Maggiore Hospital and Policlinic - University of Milan, Milan, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Conte
authors.affiliation: Gastroenterology Department, Oncology Referral Center - IRCCS, Aviano, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Cannizzaro
authors.affiliation: Gastroenterology Department - S. Orsola Hospital - University of Bologna, Bologna, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Bazzoli
authors.affiliation: Gastroenterology Department, ULSS2 Hospital - Feltre, Feltre, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: De Boni
authors.affiliation: Gastroenterology Department, S. Andrea Hospital - University of Rome, Rome, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Delle Fave
authors.affiliation: Gastroenterology and Surgical Sciences Department, University of Padua, Padua, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Farinati
authors.affiliation: Gastroenterology Department, Riuniti Hospital, Bergamo, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Ravelli
authors.affiliation: Gastroenterology Department - San Raffaele Hospital, University Vita e Salute, Milan, Italy.
authors.forename: Pier Alberto
authors.initials: PA
authors.lastname: Testoni
authors.affiliation: Regional Epidemiology Service (SER) - Veneto Region, Castelfranco Veneto, Italy.
authors.forename: Manola
authors.initials: M
authors.lastname: Lisiero
authors.affiliation: Regional Epidemiology Service (SER) - Veneto Region, Castelfranco Veneto, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Spolaore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D005260:Female; D005762:Gastroenterology / Q000458:organization & administration / Q000706:statistics & numerical data*; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000628:therapy; D006285:Health Planning; D006296:Health Services / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012955:Societies, Medical; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cancer; Digestive diseases; Emergency; Gastroenterology; Gastrointestinal bleeding; Hospital discharge record; Hospital stay; Mortality