Hospital expenditure for the elderly in Italy [La spesa ospedaliera per gli anziani in Italia.]

The consequences of demographic and epidemiological transition have deeply involved the health care systems of western countries. Both the highest burden of care and the higher costs of in-patient services are due to the elderly patients. The aim of this paper is to evaluate the percentage of in-patient care due to the elderly patients and the role played by this care on affecting costs. To this purpose all the Italian 1996 discharge reports referred to in-patient care longer than one day, have been analysed. About 40% of in-patient care expenditure is due to over-65 patients while the percentage of the elderly of total Italian population is roughly 17%. The highest age-specific hospitalisation rate are due to cardiovascular and neurological diseases. Only 4 out of 30 most frequent DRGs among elderly patients are surgical pathologies, while the others are medical ones. The implementation of day-hospital care or out-of-hospital care addressed to the elderly will have to take in account these pathologies in order to be effective in both meeting treatment needs and reducing hospital expenditure.