[Hospital expenditure for the elderly in Italy

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.