Statistical analysis of service demand

Federica Arnone - DISPEA, Politecnico di Torino - luglio 2010

1. Demand for ambulatory care services Healthcare services required Clinical laboratory analysis and diagnostic imaging Population mobility

2. Offer of healthcare services Provider localization Ambulatory care providers Hospitals Emergency arrivals at the hospitals Family doctor offices

2

1. Demand for ambulatory care services

3

1.1. Medical specialties required

4

nephrology cardiology ophthalmology rehabilitation obstetrics and gynecology

18%

14%

11%

9%8%

Medical branches

Demand for ambulatoty care services: main medical specialties required

Medical specialtiesN° of ambulatory

care servicesnephrology 56431cardiology 44034

ophthalmology 35704rehabilitation 27667

obstetrics and gynecology 24119psychiatry 20087neurology 12905oncology 12873

child neuropsichiatry 9615dietetics 8776

pneumology 8460radiation treatment 8029

otolaryngology 6241gastroenterology 6139

dermatology 6041general surgery 5927

odontostomatology 5601orthopedics and traumatology 4823

urology 2913allergology 2159

cardiovascular surgery 1766plastic surgery 1345

anesthesia 162neurosurgery 51endocrinolgy 9

5

1.2. Main typologies of elementary healthcare services required

electrocardiogram physical examination (1)

physical examination (2)

physical examination (3)

11%

7% 6% 6%

Elementary healthcare services

Main typologies of healthcare services required

1.3. Clinical laboratory analysis and diagnostic imaging (1)

6

About the 34% of the total demand refers to laboratory analysis tests Elementary services are recorded in the database with the center identification code where the specimens have been tested (and not where they have been taken from patients) About the 3% of the total demand refers to diagnostic imaging tests

Medical specialties N° of healthcare services per year %Clinical laboratory analysis (98) 2549350 100% 2101952: provided by the LHA of Asti to residents 82% 352723: provided by other LHAs to residents 14% 94675: required by non-residents 4%Diagnostic imaging (69) 197920 100% 145467: provided by the LHA of Asti to residents 73% 43429: provided by other LHAs to residents 22% 9024: required by non-residents 5%Diagnostic imaging (61) 3645 100%  3: provided by the LHA of Asti to residents 0%  3642: provided by other LHAs to residents 100% 0: required by non-residents 0%Total (all medical specialties) 4811300 100%Total (98,69,61) 2750915 57%

1.3. Clinical laboratory analysis and diagnostic imaging (2)

7

1.4. Population mobility

8

1.5. Medical specialties required (external providers)

9

1.6. External healthcare service providers

10

cp07 cp13 cp03 cp10 cp11 cp06 cp05 cp02 cp09 cp08 cp12 cp04 cp01

10%

8%

6%5%

5% 4% 4%3% 3% 3% 3% 2%

1%

Demand centers

Demand for ambulatory care services: contributions of individual demand centers

Asti (excluded) = 43%

11

1.7. Demand for ambulatory care services

cp07 cp13 cp03 cp10 cp06 cp11 cp05 cp02 cp04 cp09 cp08 cp12 cp01

12%10%

6% 6%5% 4%

3% 3% 3% 3% 3% 3%1%

Demand centers

Hospitalizations: contributions of individual demand centers

Asti (excluded) = 37%

12

1.8. Hospitalizations

cp07 cp13 cp10 cp03 cp11 cp05 cp02 cp06 cp12 cp09 cp08 cp04 cp01

10% 9%

6% 6%

5%4%

3% 3% 3% 3% 3%

1% 1%

Demand centers

Emergency admissions: contributions of individual demand centers

Asti (excluded) = 43%

13

1.9. Emergency admissions

2. Offer of healthcare services

14

2.1. Localization of healthcare service providers

15

2.2. Healthcare service providers: ambulatory cares

16

N° of HS HS providers TypologyN° of specialties

156303 000670-Cardinal G. Massaia Hospital-ASTI Medical office 23

25520 001125-Centro dialisi, via baracca-ASTI Dialysis center 1

21171 500077-Centro diagnostico Cernaia-ASTI Medical office 5

19653 000672- Ospedale-NIZZA MONFERRATO Medical office 16

16596 000359-via Orfanotrofio-ASTI Medical office 16

9904 040916-Centro dialisi-CANELLI Dialysis center 1

7819 500075-San Giuseppe-ASTI Medical office 4

6693 041254-Dip. Salute mentale-ASTI Mental health center 1

5280000815-S.O.C. Psicologia clinica della salute-

ASTI Clinical psychology center 2

5126040489-S.O.C. Patologia da dipendenze-

ASTI Dependence pathology center 2

3987040491-Centro di salute mentale Vallebelbo-NIZZA MONFERRATO Mental health center 1

3339 001130-Ambulatorio territoriale-ASTI Medical office 13

2897 040487-Consultorio Asti Centro-ASTI Consulting room 2

2086 041028-Consultorio-VILLANOVA Consulting room 1

2038 040498-Consultorio Asti Sud-ASTI Consulting room 2

1231040493-S.O.C. patologie da dipendenza

Vallebelbo-NIZZA MONFERRATO Dependence pathology center 2

431 000365-Ambulatorio-SAN DAMIANO Medical office 5

2.3. Percentage of healthcare services supplied per provider

17

000670-Cardinal G. Massaia Hospital-

ASTI

001125-Dyalisis center, via baracca-

ASTI

500077-Diagnostic center Cernaia-ASTI

000672- Hospital-NIZZA MONFERRATO

000359-via Orfanotrofio-ASTI

54%

9% 7% 7% 6%

Healthcare centers

Main healthcare centers of the LHA of Asti: percentage of services supplied

2.4. Number of specialties supplied per medical office

18

2.5. Hospital admissions

19

N° of hospital admissions

HS providers Localization Typology

192221000801-Pres. Osp.

Cardinal G. Massaia Asti Hospital

2381 1063800-S. Giuseppe Asti Nursing home

19991000802-Pres. Osp. di

Nizza Canelli Nizza Monferrato Hospital

6921065400- Guttuari

surgery center Asti Surgery center

484 1063900-S. Anna Asti Nursing home

1000801-Pres. Osp. Cardinal G. Massaia

1063800-S. Giuseppe 1000802-Pres. Osp. di Nizza Canelli

1065400- Guttuari surgery center

1063900-S. Anna

78%

10% 8%3% 2%

Healthcare centers

Healthcare centers of the LHA of Asti: percentage of hospital admissions

2.6. Arrivals at the emergency department

20

Admissions HS providers Localization Typology

55586

01000801- Pres. Osp. Cardinal G.

Massaia Hospital Emergency department

10048

01000802-Pres. Osp. Of Nizza

Canelli Nizza Monferrato Emergency department

1000801-Pres. Osp. Cardinal G. Massaia 1000802-Pres. Osp. di Nizza Canelli

85%

15%

Emergency departments

Healthcare centers of the LHA of Asti: percentage of arrivals at the emergency department

2.7. Admissions at the emergency department: triage codes

21

1 - white 2 - green 3 - yellow 4 - red

17%

69%

13%

1%

Codes

Admissions at the emergency department : triage codes

2.8. Percentage of ambulance arrivals per hospital

22

Asti Nizza Monferrato

26%

18%

Hospitals

Percentage of ambulance arrivals at the emergency department

2.9. Municipalities with family doctor offices

23

11

47

34

103 2

0

5

10

15

20

25

30

35

40

45

50

N°o

f mun

icip

aliti

es

none 1 from 2 to 3 from 4 to 6 from 7 to 10 more than 10

N°of family doctor offices

Municipalities with family doctor offices

N° of municipalitiesN° of medical offices with family doctor offices with pediatrician offices

none 11 95

1 47 11

from 2 to 3 34 none

from 4 to 6 10 1

from 7 to 10 3 none

more than 10 2 none