Abstract
The purpose of the study was to map and describe the healthcare utilization databases (HUDs) available in Italy’s 19 regions and two autonomous provinces and develop a tool to navigate through them. A census of the HUDs covering the population of a single region/province and recording local-level data was conducted between January 2014 and October 2016. The characteristics of each HUD regarding the start year, data type and completeness, data management system (DMS), data protection procedures, and data quality control adopted were collected through interviews with the database managers using a standard questionnaire or directly from the website of the regional body managing them. Overall, 352 HUDs met the study criteria. The DMSs, anonymization procedures of personal identification data, and frequency of data quality control were fairly homogeneous within regions, whereas the number of HUDs, data availability, type of identification code, and anonymization procedures were considerably heterogeneous across regions. The study provides an updated inventory of the available regional HUDs in Italy and highlights the need for greater homogeneity across regions to improve comparability of health data from secondary sources. It could represent a reference model for other countries to provide information on the available HUDs and their features, enhancing epidemiological studies across countries.
Highlights
In the past few decades, large amounts of information underwent digitalization in healthcare, where a number of administrative data related to the utilization of healthcare services and financial and clinical information are routinely and continuously collected in large databases
The aims of this study were to make an inventory of the Italian regional healthcare utilization databases (HUDs), to describe them in terms of start year, data type and completeness, data management system (DMS), quality control strategy, and data protection procedures in place, and to develop a tool to navigate through them
Data were transmitted from the healthcare providers to the administration at the time of recording in 11% of HUDs (Table 8), within 3–12 months in about 25%, and within one month of being recorded in most cases
Summary
In the past few decades, large amounts of information underwent digitalization in healthcare, where a number of administrative data related to the utilization of healthcare services and financial and clinical information are routinely and continuously collected in large databases (healthcare utilization databases, HUDs). In Italy, the National Health Service (NHS) provides healthcare to all residents (about 60 million), irrespective of income, gender, or other factors. Healthcare is publicly financed, and services are either free at the point of delivery or involve co-payment of a small flat rate [1]. The Italian NHS is decentralized and organized at three levels: national, regional (19 regions and two autonomous provinces), and local. The general NHS objectives and principles are set at the national. Res. Public Health 2020, 17, 8; doi:10.3390/ijerph17010008 www.mdpi.com/journal/ijerph
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