Background: Chronic back pain stands as the most common musculoskeletal disorder and a primary cause of disability in people under 45 years old. Multidisciplinary consultation offers an efficient approach to chronic back pain management compared to traditional therapeutic-rehabilitative paths. This paper aims to show the benefit of a diagnostic-therapeutic multidisciplinary program pathway for patients with chronic back pain. Methods: Twenty-six patients who underwent a second-level multidisciplinary consultation with a neurosurgeon and a pain therapist at our University Hospital were retrospectively identified from April 2023 to September 2023. The second-level multidisciplinary consultation is a second step consultation after a first consultation with a single specialist doctor (neurosurgeon, orthopedic, and pain therapist) who did not get the diagnosis and/or did not solve the painful symptom after medical or surgical treatment. Clinical outcomes, patient experience, and cost-effectiveness analysis were assessed using lean healthcare tools. Results: With the introduction of second-level multidisciplinary consultation, patients were assessed by multiple physicians during a single visit, reducing the costs of individual visits, reducing the time to obtain the diagnosis, and facilitating early agreement on a diagnostic-therapeutic plan. The lean value-based healthcare approach showed an average of 45 working days lost per single patient and a total cost per single patient with chronic back pain of € 1069 for the national health system for an average Lead time of 18 months. Questionnaire analysis on service quality and utility, along with overall satisfaction, revealed excellent resolution of back pain in 53.8% of cases and partial resolution of back pain in 11.5% of cases after second-level multidisciplinary consultation. Conclusion: Our multidisciplinary approach to chronic back pain has significantly improved healthcare efficiency. This new proposed clinical model reduces waiting times and costs and improves patient experience by improving clinical outcomes in the management of chronic back pain.

Objectives: Italy often experiences major events, such as earthquakes, floods, and migrant shipwrecks. Current and future global challenges for health workers are made up by climate change, pandemics, and wars. In this work, we will assess the state-of-art of training and interest towards these challenges among Italian post-degree public health schools. Methods: A cross-sectional survey was conducted in Italy in June 2023 among Italian public health residents. The study investigated training levels and updates regarding emergencies in Italian residencies. It also analyzed interest and importance of topic, impact of the COVID-19 pandemic, and sources of information. Results: Of 289 respondents, 86.2% deemed the topic important and 74.4% expressed interest. 90.1% pointed out the lack of dedicated courses and 93.1% of specialized master’s programs. Perceived importance in the topic was associated with the desire to attend dedicated conferences. As for COVID-19, 24.6% recognized the importance of this topic pre-pandemic, while 50.9% raised awareness during the pandemic. Conclusions: This survey shows the need for the offer of emergency training programs in Italian public health schools. Professionals in public health can make a great contribution to emergencies, not only in preparedness, but also in response and recovery phases.

Background and Aims: Acute respiratory infections (ARIs) have a relevant impact on public health in terms of prevalence and costs associated with the diseases. While the COVID‐19 pandemic highlighted the need to adopt accurate surveillance systems to face new emergencies, the aim of our work is to describe ARIs other then COVID‐19 and their impact on healthcare facilities. Methods: This retrospective study used an ecological approach to connect emergency department records and laboratory test results from a University Hospital in Italy. A time‐series analysis has been performed to assess the association between weekly pathogen‐specific positivity counts and ARI‐related ED admissions. Results: During the study period, 33,101 ED presentations for ARI were registered, resulting in 7426 hospital admissions. ARI cases and viral diagnoses showed a seasonal peak during the late weeks of the year and early weeks of the following one. A reduction in ED admissions has been found in 2020, while the average weekly rate was 30.8% in 2020, as compared with 21.7% in 2017–2019. Analysis by age group showed a peak of accesses in the last weeks of 2021 for the < 1 and 1–4 years old. Conclusions: Data on ARI‐related admissions highlight seasonal trends and age‐related vulnerabilities, providing evidence to guide public health policies and support health system preparedness to respond to future epidemic waves.

Background: Readmissions are hospitalizations following a previous hospitalization (called index hospitalization) of the same patient that occurred in the same facility or nursing home. They may be a consequence of the progression of the natural history of a disease, but they may also reveal a previous suboptimal stay, or ineffective management of the underlying clinical condition. Preventing avoidable readmissions has the potential to improve both a patient’s quality of life, by avoiding exposure to the risks of re-hospitalization, and the financial well-being of health care systems. Methods: We investigated the magnitude of 30 day repeat hospitalizations for the same Major Diagnostic Category (MDC) in the Azienda Ospedaliero Universitaria Pisana (AOUP) over the period from 2018 to 2021. Records were divided into only admissions, index admissions and repeated admission. The length of the stay of all groups was compared using analysis of variance and subsequent multi-comparison tests. Results: Results showed a reduction in readmissions over the period examined (from 5.36% in 2018 to 4.46% in 2021), likely due to reduced access to care during the COVID-19 pandemic. We also observed that readmissions predominantly affect the male sex, older age groups, and patients with medical Diagnosis Related Groups (DRGs). The length of stay of readmissions was longer than that of index hospitalization (difference of 1.57 days, 95% CI 1.36–1.78 days, p < 0.001). The length of stay of index hospitalization is longer than that of single hospitalization (difference of 0.62 days, 95% CI 0.52–0.72 days, p < 0.001). Conclusions: A patient who goes for readmission thus has an overall hospitalization duration of almost two and a half times the length of the stay of a patient with single hospitalization, considering both index hospitalization and readmission. This represents a heavy use of hospital resources, about 10,200 more inpatient days than single hospitalizations, corresponding to a 30-bed ward working with an occupancy rate of 95%. Knowledge of readmissions is an important piece of information in health planning and a useful tool for monitoring the quality of models of patient care.

Disasters have always been part of Italy’s history and the constant threat in our territory is represented above all by seismic and hydrogeological hazards, but technological risks can’t be underestimated, too. Italian civil defense is articulated in a central organ, directly linked to Prime...

Background and Objective: Acute Respiratory Infections (ARIs) have a relevant impact on public health in terms of prevalence and costs associated with the diseases. This concern highlighted the need to adopt accurate surveillance systems to respond to new emergencies and meet the demand for...