Disease staging analysis of the timeliness and appropriateness of hospital admissions: no relevant improvements in the Abruzzo Region of Italy from 2001 to 2005 [Analisi tramite Disease Staging della tempestività dei ricoveri quale indice di appropriatezza di utilizzo dell’assistenza ospedaliera: assenza di miglioramento nella Regione Abruzzo nel quinquennio 2001-2005]

The study was aimed at evaluating whether the degree of hospital admission inappropriateness and timeliness was improved in the Abruzzo Region of Italy between the year 2001 and 2005. All hospital admissions for the year 2001 (n = 286,924) and 2005 (n = 280,761) in the Region were analysed (SDO discharge data), and three diseases were in-depth reviewed: diabetes mellitus; cholecystitis/cholelithiasis; and bacterial pneumonia. Using Disease Staging methodology, the timeliness of hospitalisation was assessed by grouping admissions in three categories: premature or medically unnecessary, timely, and late. Overall, the rate of medically unnecessary admissions for diabetes mellitus was 72.3% in 2001 and 73.4% in 2005. The percentage of late hospitalizations for the same disease was still 20.2% in 2005, when the rate of late admissions for cholelithiasis/cholecystitis was 53.3% (+10.5% compared to 2001);for bacterial pneumonia 14.5%. The rate of early admissions did not improve for any disease, and any of the six local health units in Abruzzo showed an improvement in all the measures evaluated. In the period 2001 and 2005, in the Abruzzo Region there is no evidence of an improvement in the rates of inappropriate hospital admission, both early and late, which are still excessively high for all diseases examined excepted bacterial pneumonia. Interventions to address this issue are strongly needed.