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This chapter gives an account of some recent debates on subsidiarity and social sustainability, maintaining that in complex and entangled societies, adaptivity to emergence is key to sustainability and that subsidiarity is the driving... more
This chapter gives an account of some recent debates on subsidiarity and social sustainability, maintaining that in complex and entangled societies, adaptivity to emergence is key to sustainability and that subsidiarity is the driving principle for generating and adaptively promoting well-being and contrasting social issues. The starting point is the consideration that societal sustainability is a process and not a condition attainable once and for all and that the complexification of our societies and economies go hand in hand with the never-ending emergence of new social needs. These flow out of the individuals' and social groups' lives, intertwining and dynamically taking new shapes that cannot be predicted, computed in advance, and reduced to past schemas, making any purely normative, bureaucratic, or "algorithmic" approach inherently inappropriate for recognizing and tackling them. This unveils the essential role of social players and communities (e.g., nonprofit networks), the only ones able to interpret novelties, to timely catch emerging needs and to adaptively activate contrasting processes. Subsidiarity then becomes the societal living tissue where new needs get flexibly harbored and the setting where social actors and institutions cooperate, to
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The 2nd Health Econometrics Workshop took place at the Catholic University of Rome in Italy on 15-17 July 2010. The purpose of this meeting was to provide a forum where policy makers, economists and econometricians could discuss the use... more
The 2nd Health Econometrics Workshop took place at the Catholic University of Rome in Italy on 15-17 July 2010. The purpose of this meeting was to provide a forum where policy makers, economists and econometricians could discuss the use of statistical and econometric methods to address issues in the field of health economics. There were seven keynote speakers - leading scholars in the subject - invited to give their contributions: Alberto Holly, Stephen Hall, Badi Baltagi, William Greene, Andrew Jones, John Mullahy and Edward Norton. The meeting was attended by 50 participants from around the world, and 17 scientific papers were presented. Some of these works will be published in the forthcoming special issue of Empirical Economics.
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Background: Media communication during the covid-19 pandemic has been relevant for the population to receive information about the ongoing number of cases, deaths, and social restriction measures. Notably, the effects of the communication... more
Background: Media communication during the covid-19 pandemic has been relevant for the population to receive information about the ongoing number of cases, deaths, and social restriction measures. Notably, the effects of the communication methods on young adults during the covid-19 pandemic have not been studied. Therefore the present study aimed to investigate the influence of communication modality about covid-19 on the perception of risk and judgment among young adults. Methods: A double-blind cross-sectional study was designed. Three hundred four subjects (age range19-25 years old) saw a 4-minute video concerning data communication on the covid-19 pandemic and compiled an online questionnaire about their perceptions. Two videos were randomized, one presenting the covid-19 data negatively (HARD video) while the other showed a positive ongoing resolution of the pandemic (SOFT video). Association tests and nominal logistic regression were used to evaluate differences in responses among the two groups. Results: The two videos lead to different reactions. Participants showed higher disagreement concerning the video content in the "SOFT" group compared to the "HARD" group. The responses of the "SOFT" group were more to be optimistic (OR=2.87, 95% CI 1.311-6.27) than those who had seen the "HARD" video. The sense of helplessness was lower in the "SOFT" compared "HARD" group (OR=3.02, 95% CI 1.311-6.96). The perception of fear was higher for the "HARD" group (OR=2.91, 95% CI 1.21-7-02). Discussion: The modality of data presentation influenced the perception and feelings about the covid-19 pandemic. Likely, pre-existing perception of a pessimistic perspective was present in both groups; thus, the video did not lead to any change in the behavior. Conclusions: The phobic or counter-phobic reactions shown in the study participants highlighted the importance of the reliability of the information received and how previous feelings may influence the perception of the information.
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Research Interests: Mathematics, Econometrics, Statistics, Structural Equation Modeling, Decomposition, and 12 moreStructural Analysis, Model Identification, Factor analysis, Identification, Latent variable, LISREL, Structure Analysis, Statistical Model, Boolean Satisfiability, Component, Statistical Regression, and Structural model
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In this paper we study the impact of competition on hospital performance, and how this is related to information gathered by patients on hospital quality, using data on patients’ admitted to hospitals located in the Lombardy region,... more
In this paper we study the impact of competition on hospital performance, and how this is related to information gathered by patients on hospital quality, using data on patients’ admitted to hospitals located in the Lombardy region, Italy. To this end, we first estimate a model of patients’ hospital choice, and include among the determinants a variable capturing social interaction, which represents a proxy for the quality of hospitals perceived by patients. In the Lombardy region, although risk-adjusted hospital rankings are estimated yearly, these are only provided to hospital managers, while they are not available to GPs and citizens. This is a clear source of asymmetric information. Using patients’ predicted choice probabilities we construct a set of indices of competitiveness and measure their impact on health outcomes. We then move a step forward and try to explain the mechanisms underlying the impact of competition on hospital quality. In particular, we investigate the channels through which patients gather information on where to be admitted, and examine how these affect hospital competition, ultimately impacting on quality. The lack of publicly available information on the quality of hospitals may exacerbate the influence of information gathered locally, and may result in reduced freedom of choice of patients, lower degree of competition among hospitals and lower quality. Such analysis may shed light of why empirical literature often rejects the theoretical result that more competition should lead to better health, when prices are fixed.
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Over the past three legislative periods, the Lombardy government has based much of its action on the affirmation of subsidiarity. This has been translated into policies having different forms and solutions, affected both by the degree of... more
Over the past three legislative periods, the Lombardy government has based much of its action on the affirmation of subsidiarity. This has been translated into policies having different forms and solutions, affected both by the degree of innovation of the concept - largely unknown in the Italian and international political panorama in the early nineties - and by many institutional and administrative contingencies. Sometimes there have been structured and structural solutions, other times bold intuitions, and still other times adjustments, adaptations and necessary approximations. The result has been a rich and complex panorama of political, legislative and administrative initiatives, which we considered worth discussing in order to better understand their reach and limits. For this purpose, since autumn 2006 a programme has been in place to define and theoretically systemize the experience underway, involving the highest management levels of the Lombardy Government. "Defining" and "systemizing" the experience has meant reflecting critically upon the policy actions promoted, understanding their constituent elements (aims, beneficiaries, objectives, methods, etc.), their results and prospects. The objective was to increase awareness concerning the model of subsidiarity among those involved in its application and thus to develop their capacity for implementation, discussion and communication of that model. The text goes on to consider the subsidiarity model in Lombardy in three sectors: education, training and labour; social care services; and healthcare, but above all to explore future solutions.
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Abstract The goal of this contribution is to shed light on the benefits for research in health care coming from the use of administrative data, especially in terms of measuring hospitals’ outcomes. The main approaches to health outcome... more
Abstract The goal of this contribution is to shed light on the benefits for research in health care coming from the use of administrative data, especially in terms of measuring hospitals’ outcomes. The main approaches to health outcome evaluation are reviewed and the possible improvements deriving from the use of administrative data are highlighted. Administrative data may be an essential element in the process of gathering to the public true rankings of health care organizations, reducing the degree of asymmetric information that typically arises in health care. Patients will be more aware of the best institutions, which will induce most of them to demand to be admitted in them, taking into account the costs associated with distance and with the severity of the illness. This in turn may ask for a reorganization of the sector, closing some organizations and expanding others, having as final goal to improve the health status of the population, without income barriers. This is one of the first attempts to provide an overview of the advantages that administrative data may gather in health care.
Research Interests: Business and Health Care
We study the sign of the trade-off between hospital effectiveness in achieving health outcomes and efficiency on a data set regarding Lom- bardy during the period 2008-2010. The pressure to increase hospital efficiency may affect their... more
We study the sign of the trade-off between hospital effectiveness in achieving health outcomes and efficiency on a data set regarding Lom- bardy during the period 2008-2010. The pressure to increase hospital efficiency may affect their performances in terms of population health status. We build a three-stage econometric model using, differently from previous contributions, as unit of observation not consider the hospital as a whole by the ward level. This implies that the same hospital is compared with the other ones when providing more homo- geneous treatments. In the first-stage we apply a multilevel approach to estimate hospitals’ effectiveness. In the second-stage we estimate a hospitals production function. In the third stage we estimate the sign of the trade-off. We show that there is negative trade-off in the wards where physicians have high degree of discretion in setting the treat- ments provided to patients (e.g., general medicine). On the contrary, a positive trade-off is identified in those wards where treatments fol- low tighter procedures (e.g., heart surgery and neuro surgery). Last, we find that specialization has a positive effect on health outcomes, that private not-for-profit hospitals tend to have better performances, while there is a positive reputation effect in case of teaching hospitals.
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In order to evaluate the effect of a policy or treatment with pre- and post-treatment outcomes, we propose an approach based on a transition model, which may be applied with multivariate outcomes and accounts for unobserved heterogeneity.... more
In order to evaluate the effect of a policy or treatment with pre- and post-treatment outcomes, we propose an approach based on a transition model, which may be applied with multivariate outcomes and accounts for unobserved heterogeneity. This model is based on potential versions of discrete latent variables representing the individual characteristic of interest and may be cast in the hidden (latent) Markov literature for panel data. Therefore, it can be estimated by maximum likelihood in a relatively simple way. The approach extends the difference-in-difference method as it is possible to deal with multivariate outcomes. Moreover, causal effects may be expressed with respect to transition probabilities. The proposal is validated through a simulation study, and it is applied to evaluate educational programs administered to pupils in the sixth and seventh grades during their middle school period. These programs are carried out in an Italian region to improve non-cognitive skills (CSs...
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Abstract We propose a new approach with which to measure school efficiency by including student Non-Cognitive Skills in the analysis. In classical analysis, efficiency is measured separately from effectiveness. In our framework, we... more
Abstract We propose a new approach with which to measure school efficiency by including student Non-Cognitive Skills in the analysis. In classical analysis, efficiency is measured separately from effectiveness. In our framework, we jointly consider efficiency and effectiveness, including both Cognitive Skills and Non-Cognitive Skills. We call our approach “Non-Cognitive Skills Efficiency” and we propose two analyses. The first is called “Static Non-Cognitive Skills Efficiency” and measures the efficiency of transforming Non-Cognitive Skills into Cognitive Skills, by means of a Stochastic Frontier Approach. We verify that some Non-Cognitive Skills have effect on Cognitive Skills and contribute to increase school efficiency. The second is defined “Dynamic Non-Cognitive Skills Efficiency” and measures the efficiency of school educational programmes aimed at improving Non-Cognitive Skills. The statistical method is a Difference-in-Differences model based on a Stochastic Frontier Approach. We find that these educational programmes (treatment) have a positive effect on Non-Cognitive Skills. The survey concerns 8th grade students attending 25 schools in the Provincia Autonoma di Trento, in Italy. The dataset comprises both survey data and the administrative data of local authorities, thus providing a complete set of information at student level on CS and NCS skills, social capital variables, in particular the socioeconomic background of families, and teaching parameters. We measure school efficiency at class level, because this level is less affected by unobserved environmental factors. The results provide new perspectives on education in schools.
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Research Interests: Psychology and LISREL
... Bassiri D., & Schulz, EM (2002) Using Adjusted GPA and Adjusted Course Difficulty Measures to Evacuate Differential Grading Practices in College. ... Gori E., Romano MF (1990) I risultati dell'istruzione... more
... Bassiri D., & Schulz, EM (2002) Using Adjusted GPA and Adjusted Course Difficulty Measures to Evacuate Differential Grading Practices in College. ... Gori E., Romano MF (1990) I risultati dell'istruzione universitaria: il ruolo dei fattori individuali e di struttura. ...
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En este texto, el autor abordará la situación actual en relación a tendencias mundiales dentro de la economía, tecnología y relaciones sociales. Así, frente a cada época tecnológica, se afirmará que el deseo empujará al hombre a buscar el... more
En este texto, el autor abordará la situación actual en relación a tendencias mundiales dentro de la economía, tecnología y relaciones sociales. Así, frente a cada época tecnológica, se afirmará que el deseo empujará al hombre a buscar el pan y el agua, a interesarse por sus problemas y los problemas de los otros, a mejorar sus condiciones y la de sus hermanos hombres. Cabe agregar que este texto se trata de una traducción del italiano.
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Carlo Borzaga, Preside della Facoltà di Economia e Presidente di Issan (Istituto Studi sviluppo aziende nonprofit) dell'Università di Trento. Luca Fazzi, insegna Politica economica e sistemi di welfare e Sociologia della cooperazione... more
Carlo Borzaga, Preside della Facoltà di Economia e Presidente di Issan (Istituto Studi sviluppo aziende nonprofit) dell'Università di Trento. Luca Fazzi, insegna Politica economica e sistemi di welfare e Sociologia della cooperazione presso la Facoltà di Economia dell'Università di Trento e Politica sociale Corso avanzato presso la Facoltà di Sociologia del medesimo Ateneo. Laura Balbo, professore ordinario di Sociologia presso l'Università di Ferrara - già Presidente dell'Associazione Italiane di Sociologia e Ministro per le pari opportunità. Giovanni Cerulli, ricercatore ...
The analysis of what human capital (HC) is has a long history and culminates in the acknowledgment that HC and its growth are very important for both cognitive education (cognitive skills (CSs)) and personal life (noncognitive skills... more
The analysis of what human capital (HC) is has a long history and culminates in the acknowledgment that HC and its growth are very important for both cognitive education (cognitive skills (CSs)) and personal life (noncognitive skills (NCSs)) and that CSs and NCSs have a strong reciprocal relationship, as studies by Heckman demonstrated. The present contribution (following Heckman’s approach) analyzed the relationship between CSs and NCSs in a sample of middle school students in the Autonomous Province of Trento. The second goal of the research was to verify whether educational teaching behaviors improved students’ personalities. Aside from the use of administrative data (INVALSI data, 2015 and 2018), one survey was administered in the 2018–2019 schooling year to verify the relationship between NCSs and CSs. Moreover, we sought to determine whether education teaching behavior improved the students’ personalities (1522 students in 25 schools) and whether programs could enhance NCSs. M...
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We present the results of the study entitled “The development of non-cognitive skills in Trentino pupils”, carried out on middle school pupils in the Autonomous Province of Trento. The aim was to verify whether non-cognitive skills lead... more
We present the results of the study entitled “The development of non-cognitive skills in Trentino pupils”, carried out on middle school pupils in the Autonomous Province of Trento. The aim was to verify whether non-cognitive skills lead to an improvement in cognitive skills, as measured by school performance, and whether appropriate educational programmes increase non-cognitive skills, through two analyses, the first related to the 2017-2018 school year, and the second to the following year. The results confirm that the presence of more robust non-cognitive skills promotes growth in cognitive skills as well. Furthermore, various aspects of non-cognitive skills can be improved through specific educational programmes conducted in school settings. Keywords: Cognitive skills; Non-cognitive skills; Human capital; Linear model; Difference-indifferences causal model.
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The goal of this contribution is to shed light on the benefits for research in health care coming from the use of administrative data, especially in terms of measuring hospitals’ outcomes. The main approaches to health outcome evaluation... more
The goal of this contribution is to shed light on the benefits for research in health care coming from the use of administrative data, especially in terms of measuring hospitals’ outcomes. The main approaches to health outcome evaluation are reviewed and the possible improvements deriving from the use of administrative data are highlighted. Administrative data may be an essential element in the process of gathering to the public true rankings of health care organizations, reducing the degree of asymmetric information that typically arises in health care. Patients will be more aware of the best institutions, which will induce most of them to demand to be admitted in them, taking into account the costs associated with distance and with the severity of the illness. This in turn may ask for a reorganization of the sector, closing some organizations and expanding others, having as final goal to improve the health status of the population, without income barriers. This is one of the first...
Research Interests: Business and Health Care
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This chapter gives an account of some recent debates on subsidiarity and social sustainability, maintaining that in complex and entangled societies, adaptivity to emergence is key to sustainability and that subsidiarity is the driving... more
This chapter gives an account of some recent debates on subsidiarity and social sustainability, maintaining that in complex and entangled societies, adaptivity to emergence is key to sustainability and that subsidiarity is the driving principle for generating and adaptively promoting well-being and contrasting social issues. The starting point is the consideration that societal sustainability is a process and not a condition attainable once and for all and that the complexification of our societies and economies go hand in hand with the never-ending emergence of new social needs. These flow out of the individuals' and social groups' lives, intertwining and dynamically taking new shapes that cannot be predicted, computed in advance, and reduced to past schemas, making any purely normative, bureaucratic, or "algorithmic" approach inherently inappropriate for recognizing and tackling them. This unveils the essential role of social players and communities (e.g., nonprofit networks), the only ones able to interpret novelties, to timely catch emerging needs and to adaptively activate contrasting processes. Subsidiarity then becomes the societal living tissue where new needs get flexibly harbored and the setting where social actors and institutions cooperate, to
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Background and aims COVID-19 pandemic lockdown and restrictions had significant disruption to patient care. We aimed to evaluate the impact of COVID-19 restrictions on hospitalizations of patients with alcoholic and non-alcoholic... more
Background and aims COVID-19 pandemic lockdown and restrictions had significant disruption to patient care. We aimed to evaluate the impact of COVID-19 restrictions on hospitalizations of patients with alcoholic and non-alcoholic cirrhosis as well as alcoholic hepatitis (AH) in Alberta, Canada. Methods We used validated international clinical classification (ICD-9 and ICD-10) coding algorithms to identify liver-related hospitalizations for non-alcoholic cirrhosis, alcoholic cirrhosis, and AH in the province of Alberta between March 2018 and September 2020. We used the provincial inpatient discharge and laboratory databases to identify our cohorts. We used elevated ALT or AST, elevated international normalized ratio (INR) or bilirubin to identify AH patients. We compared COVID-19 restrictions (April-September 2020) to prior study periods. Joinpoint regression was used to evaluate the temporal trends among the three cohorts. Results We identified 2,916 hospitalizations for non-alcoholic cirrhosis, 2,318 hospitalizations for alcoholic cirrhosis, and 1,408 AH hospitalizations during our study time. The in-hospital mortality rate was stable in relation to the pandemic for alcoholic cirrhosis and AH. However, non-alcoholic cirrhosis patients had lower in-hospital mortality rate post March 2020 (8.5% vs. 11.5%, p=0.033). There was a significant increase in average monthly admission in the AH cohort (22.1/ 10,000 admissions during the pandemic vs. 11.6/10,000 admissions prior to March 2020, p<0.001). Conclusion Pre- and during COVID-19 monthly admission rates were stable for non-alcoholic and alcoholic cirrhosis, however, there was a significant increase in AH admissions. As alcohol sales surged during the pandemic, future impact on alcoholic liver disease could be detrimental.
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The Lisrel model (LM), a linear model for the analysis of the causal relationships between two sets of latent variables, is not identifiable under general conditions and without restrictions. Moreover, even when the model is identified,... more
The Lisrel model (LM), a linear model for the analysis of the causal relationships between two sets of latent variables, is not identifiable under general conditions and without restrictions. Moreover, even when the model is identified, its latent variables (LV) are indeterminate. These problems can be solved with the alternative methods of the "soft modelling with partial least squares" (PLS) and of the "regression component decomposition" (RCD). All the same, in both cases, the solutions are obtained not as causal factors like in the LM, but as linear combinations of the observed variables: in PLS by means of an iterative process, in RCD by means of a decomposition of the data matrix. In any case, the RCD solutions, contrary to those of the PLS, satisfy all the other properties of the LM's LVs.
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Background: Surfactant protein-D (SP-D) is a lung-resident protein that has emerged as a potential biomarker for COVID-19. Previous investigations on acute respiratory distress syndrome patients demonstrated a significant increment of... more
Background: Surfactant protein-D (SP-D) is a lung-resident protein that has emerged as a potential biomarker for COVID-19. Previous investigations on acute respiratory distress syndrome patients demonstrated a significant increment of SP-D serum levels in pathological conditions. Since SP-D is not physiologically permeable to alveolicapillary membrane and poorly expressed by other tissues, this enhancement is likely due to an impairment of the pulmonary barrier caused by prolonged inflammation. Methods: A retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio was conducted to assess differences of the hematic SP-D concentrations among COVID-19 patients and healthy donors and if SP-D levels resulted a risk factor for disease severity and mortality. Results: The first analysis, using an ANOVA-model, showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors. Significant variations were also found between dead vs survived patients. Results confirm that SP-D concentrations were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. Further analysis conducted with Logistic Mixed models, highlighted that higher SP-D levels at admission and increasing differences among follow-up and admission values resulted the strongest significant risk factors of mortality (model predictive accuracy, AUC = 0.844). Conclusions: The results indicate that SP-D can be a predictive marker of COVID-19 disease and its outcome. Considering its prognostic value in terms of mortality, the early detection of SP-D levels and its follow-up in hospitalized patients should be considered to direct the therapeutic intervention.
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S = Residential; COMM-DC-HOSP = Community – Hospital – Day-care; CLIN = Clinical.<b>Copyright information:</b>Taken from "Does community care work? A model to evaluate the effectiveness of mental health... more
S = Residential; COMM-DC-HOSP = Community – Hospital – Day-care; CLIN = Clinical.<b>Copyright information:</b>Taken from "Does community care work? A model to evaluate the effectiveness of mental health services"http://www.ijmhs.com/content/2/1/10International Journal of Mental Health Systems 2008;2():10-10.Published online 5 Jul 2008PMCID:PMC2488329.
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This chapter gives an account of some recent debates on subsidiarity and social sustainability, maintaining that in complex and entangled societies, adaptivity to emergence is key to sustainability and that subsidiarity is the driving... more
This chapter gives an account of some recent debates on subsidiarity and social sustainability, maintaining that in complex and entangled societies, adaptivity to emergence is key to sustainability and that subsidiarity is the driving principle for generating and adaptively promoting well-being and contrasting social issues. The starting point is the consideration that societal sustainability is a process and not a condition attainable once and for all and that the complexification of our societies and economies go hand in hand with the never-ending emergence of new social needs. These flow out of the individuals' and social groups' lives, intertwining and dynamically taking new shapes that cannot be predicted, computed in advance, and reduced to past schemas, making any purely normative, bureaucratic, or "algorithmic" approach inherently inappropriate for recognizing and tackling them. This unveils the essential role of social players and communities (e.g., nonprofit networks), the only ones able to interpret novelties, to timely catch emerging needs and to adaptively activate contrasting processes. Subsidiarity then becomes the societal living tissue where new needs get flexibly harbored and the setting where social actors and institutions cooperate, to
Report di sintesi Report di sintesi a cura del gruppo di ricerca CRISP a cura del gruppo di ricerca CRISP
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The goal of this contribution is to shed light on the benefits for research in health care coming from the use of administrative data, especially in terms of measuring hospitals’ outcomes. The main approaches to health outcome evaluation... more
The goal of this contribution is to shed light on the benefits for research in health care coming from the use of administrative data, especially in terms of measuring hospitals’ outcomes. The main approaches to health outcome evaluation are reviewed and the possible improvements deriv- ing from the use of administrative data are highlighted. Administrative data may be an essential element in the process of gathering to the pub- lic true rankings of health care organizations, reducing the degree of asymmetric information that typically arises in health care. Patients will be more aware of the best institutions, which will induce most of them to demand to be admitted in them, taking into account the costs associ- ated with distance and with the severity of the illness. This in turn may ask for a reorganization of the sector, closing some organizations and expanding others, having as final goal to improve the health status of the population, without income barriers. This is one of the first attempts to provide an overview of the advantages that administrative data may gather in health care.
ABSTRACT We propose a general methodology for evaluating the quality of public sector activities such as education, health and social services. The traditional instrument used in comparisons of institutional performance is Multilevel... more
ABSTRACT We propose a general methodology for evaluating the quality of public sector activities such as education, health and social services. The traditional instrument used in comparisons of institutional performance is Multilevel Modeling (Goldstein, H., Multilevel statistical models, Arnold, London, 1995). However, rankings based on confidence intervals of the organization-level random effects often prevent to discriminate between institutions, because uncertainty intervals may be large and overlapped. This means that, in some situations, a single global model is not sufficient to explain all the variability, and methods able to capture local behaviour are necessary. The proposal, which is entitled Local Multilevel Modeling, consists of a two-step approach which combines Cluster-Weighted Modeling (Gershenfeld, N., The nature of mathematical modeling, Cambridge University Press, Cambridge, 1999) with traditional Multilevel Modeling. An example regarding the evaluation of the “relative effectiveness” of healthcare institutions in Lombardy region is discussed.
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Il calcolo degli indicatori per le quattro misure di esito è stato realizzato tramite l'applicazione di un modello di regressione logistica multilivello a due livelli: il livello individuale del paziente e il reparto di dimissione. Le... more
Il calcolo degli indicatori per le quattro misure di esito è stato realizzato tramite l'applicazione di un modello di regressione logistica multilivello a due livelli: il livello individuale del paziente e il reparto di dimissione. Le caratteristiche dei pazienti incluse nel modello (vedi Tabella 3) hanno funzione di risk adjustment e consentono di garantire una valutazione ceteris paribus che non sia condizionata dal diverso case-mix trattato dai reparti. Sia gli indicatori di outcome che le variabili di risk adjustment sono definiti sulla popolazione dei pazienti ricoverati negli ospedali, con informazioni desunte dalla fonte amministrativa delle SDO. Viene inoltre utilizzata l'Anagrafe degli assistiti per ricavare le informazioni circa la mortalità successiva alla dimissione. Per garantire una maggiore equità di valutazione, sono previste alcune selezioni a priori sul database delle ospedalizzazioni: si considerano i ricoveri ordinari per acuti, escludendo i ricoveri dei pazienti non residenti nella Regione dell'ospedale di dimissione (pazienti extraregionali). Si escludono inoltre i ricoveri per pazienti con età alla dimissione inferiore a 18 anni. "La valutazione degli esiti per specialità di dimissione con la metodologia CRISP-MeS" in Il sistema di valutazione della performance dei sistemi sanitari regionali I risultati delle Aziende Ospedaliero-Universitarie a confronto