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Pecoraro F.,CNR Institute for Research on Population and Social Policies | Pecoraro F.,National Research Council Italy | Luzi D.,National Research Council Italy | Ricci F.L.,National Research Council Italy
Studies in Health Technology and Informatics | Year: 2015

Aim of this paper is to propose a methodology to design Extract, Transform and Load (ETL) tools in a clinical data warehouse architecture based on the Electronic Healthcare Record (EHR). This approach takes advantages on the use of this infrastructure as one of the main source of information to feed the data warehouse, taking also into account that clinical documents produced by heterogeneous legacy systems are structured using the HL7 CDA standard. This paper describes the main activities to be performed to map the information collected in the different types of document with the dimensional model primitives. © 2015 European Federation for Medical Informatics (EFMI).

Mysiak J.,Fondazione Eni Enrico Mattei | Mysiak J.,Euro Mediterranean Center for Climate Change | Testella F.,Euro Mediterranean Center for Climate Change | Bonaiuto M.,University of Rome La Sapienza | And 5 more authors.
Natural Hazards and Earth System Sciences | Year: 2013

Italy's recent history is punctuated with devastating flood disasters claiming high death toll and causing vast but underestimated economic, social and environmental damage. The responses to major flood and landslide disasters such as the Polesine (1951), Vajont (1963), Firenze (1966), Valtelina (1987), Piedmont (1994), Crotone (1996), Sarno (1998), Soverato (2000), and Piedmont (2000) events have contributed to shaping the country's flood risk governance. Insufficient resources and capacity, slow implementation of the (at that time) novel risk prevention and protection framework, embodied in the law 183/89 of 18 May 1989, increased the reliance on the response and recovery operations of the civil protection. As a result, the importance of the Civil Protection Mechanism and the relative body of norms and regulation developed rapidly in the 1990s. In the aftermath of the Sarno (1998) and Soverato (2000) disasters, the Department for Civil Protection (DCP) installed a network of advanced early warning and alerting centres, the cornerstones of Italy's preparedness for natural hazards and a best practice worth following. However, deep convective clouds, not uncommon in Italy, producing intense rainfall and rapidly developing localised floods still lead to considerable damage and loss of life that can only be reduced by stepping up the risk prevention efforts. The implementation of the EU Floods Directive (2007/60/EC) provides an opportunity to revise the model of flood risk governance and confront the shortcomings encountered during more than 20 yr of organised flood risk management. This brief communication offers joint recommendations towards this end from three projects funded by the 2nd CRUE ERA-NET (http://www.crue-eranet.net/) Funding Initiative: FREEMAN, IMRA and URFlood. © 2013 Author(s).

Francisci S.,Centro Nazionale Of Epidemiologia | Guzzinati S.,Registro Tumori del Veneto | Mezzetti M.,University of Rome Tor Vergata | Crocetti E.,Registro Tumori della Regione Toscana ISPO | And 4 more authors.
BMC Cancer | Year: 2013

Background: Due to changes in cancer-related risk factors, improvements in diagnostic procedures and treatments, and the aging of the population, in most developed countries cancer accounts for an increasing proportion of health care expenditures. The analysis of cancer-related costs is a topic of several economic and epidemiological studies and represents a research area of great interest to public health planners and policy makers. In Italy studies are limited either to some specific types of expenditures or to specific groups of cancer patients. Aim of the paper is to estimate the distribution of cancer survivors and associated health care expenditures according to a disease pathway which identifies three clinically relevant phases: initial (one year following diagnosis), continuing (between initial and final) and final (one year before death).Methods: The methodology proposed is based on the reconstruction of patterns of care at individual level by combining different data sources, surveillance data and administrative data, in areas covered by cancer registration.Results: A total colorectal cancer-related expenditure of 77.8 million Euros for 18012 patients (corresponding to about 4300 Euros per capita) is estimated in 2006 in two Italian areas located in Tuscany and Veneto regions, respectively. Cost of care varies according to the care pathway: 11% of patients were in the initial phase, and consumed 34% of total expenditure; patients in the final (6%) and in the continuing (83%) phase consumed 23% and 43% of the budget, respectively. There is an association between patterns of care/costs and patients characteristics such as stage and age at diagnosis.Conclusions: This paper represents the first attempt to attribute health care expenditures in Italy to specific phases of disease, according to varying treatment approaches, surveillance strategies and management of relapses, palliative care. The association between stage at diagnosis, profile of therapies and costs supports the idea that primary prevention and early detection play an important role in a public health perspective. Results from this pilot study encourage the use of such analyses in a public health perspective, to increase understanding of patient outcomes and economic consequences of differences in policies related to cancer screening, treatment, and programs of care. © 2013 Francisci et al.; licensee BioMed Central Ltd.

Nobile M.,CNR Institute for Research on Population and Social Policies | Pecoraro F.,CNR Institute for Research on Population and Social Policies
GL-Conference Series: Conference Proceedings | Year: 2013

This paper presents IRPPS Editoria Elettronica, an e-publishing service developed by the Institute for Research on Population and Social Policies (IRPPS) of the Italian National Research Council (CNR). Its aim is reorganize the Institute scientific editorial activity, manage its in-house publications and diffuse its scientific results. In particular this paper focuses on: the IRPPS editorial activities, the platform used to develop the service, the publishing process and the web portal developed.

Francisci S.,Centro Nazionale Of Epidemiologia | Robin Yabroff K.,U.S. National Cancer Institute | Gigli A.,CNR Institute for Research on Population and Social Policies | Mariotto A.,U.S. National Cancer Institute | And 2 more authors.
Annali dell'Istituto Superiore di Sanita | Year: 2013

Objectives: Cancer accounts for a major proportion of national health expenditures, which are expected to increase in the future. This paper aims to identify major challenges with estimating cancer related costs, and discuss international comparisons, and recommendations for future research. Methods: It starts from the experience of an international workshop aimed at comparing cancer burden evaluation methods, improving results comparability, discussing strengths and criticisms of different approaches. Results: Three methodological themes necessary to inform the analysis are identified and discussed: data availability; costs definition; epidemiological measures. Conclusions: Cost evaluation is applied to cancer control interventions and is relevant for public health planners. Despite their complexity, international comparisons are fundamental to improve, generalize and extend cost evaluation to different contexts.

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