title: The burden of rotator cuff surgery in Italy: a nationwide registry study.
abstract: OBJECTIVE
  This study aimed to estimate the yearly number of RC surgeries in Italy, a country with universal access to healthcare for its population, from 2001 to 2014, based on official information source as hospitalization records. A secondary aim was to explore geographical variation in equity in access to RC surgery between three macroregions of Italy (North, Center and South). A tertiary aim was to perform statistical projections of the number of RC procedure volumes and rates on the basis of data from 2001 to 2014. Finally, we aimed to perform a prediction of charges by 2025 to examine the economic impact of RC surgery.
  
  
  METHODS
  The analysis of the National Hospital Discharge records (SDO) maintained at the Italian Ministry of Health, concerning the 14 years of our survey (2001 through 2014) was performed. These data are anonymous and include the patient's age (in aggregate for class of age), sex, domicile, region of hospitalization, length of the hospitalization, and type of reimbursement (public or private).
  
  
  RESULTS
  During the 14-year study period, 390,001 RC repairs were performed in Italy, which represented an incidence of 62.1 RC procedures for every 100,000 Italian inhabitants over 25 years old. Approximately 65% of RC repair were performed annually in patients ages <65 years, thus affecting the working population. 246,810 patients (63.3%) from the North underwent RC repairs from 2001 through 2014, 78,540 patients (20.2%) from the Center, and 64,407 patients (16.5%) from the South. The projection model predicted substantial increases in the numbers of RC repairs.
  
  
  CONCLUSIONS
  This study confirms that the socioeconomic burden of RC surgery is growing and heavily affecting the working population. According to the prediction model, hospital costs sustained by the national health care system for RC procedures are expected to be over 1 billion euros by 2025.
  
  
  METHODS
  II.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University Campus Bio-Medico of Rome, Via Álvaro Del Portillo, 200, 00128, Rome, Italy. ug.longo@gmail.com.
authors.forename: Umile Giuseppe
authors.initials: UG
authors.lastname: Longo
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University Campus Bio-Medico of Rome, Via Álvaro Del Portillo, 200, 00128, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Salvatore
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University Campus Bio-Medico of Rome, Via Álvaro Del Portillo, 200, 00128, Rome, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Rizzello
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University Campus Bio-Medico of Rome, Via Álvaro Del Portillo, 200, 00128, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Berton
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University Campus Bio-Medico of Rome, Via Álvaro Del Portillo, 200, 00128, Rome, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Ciuffreda
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University Campus Bio-Medico of Rome, Via Álvaro Del Portillo, 200, 00128, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Candela
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University Campus Bio-Medico of Rome, Via Álvaro Del Portillo, 200, 00128, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries / Q000191:economics / Q000453:epidemiology / Q000601:surgery*
keywords: Burden; Cuff; Nationwide; Registry; Rotator; Surgery