Intention to be vaccinated for COVID-19 among Italian nurses during the pandemic

Background: While the COVID-19 pandemic has spread globally, health systems are overwhelmed by both direct and indirect mortality from other treatable conditions. COVID-19 vaccination was crucial to preventing and eliminating the disease, so vaccine development for COVID-19 was fast-tracked worldwide. Despite the fact that vaccination is commonly recognized as the most effective approach, according to the World Health Organization (WHO), vaccine hesitancy is a global health issue. Methods: We conducted a cross-sectional online survey of nurses in four different regions in Italy between 20 and 28 December 2020 to obtain data on the acceptance of the upcoming COVID-19 vaccination in order to plan specific interventions to increase the rate of vaccine coverage. Results: A total of 531 out of the 5000 nurses invited completed the online questionnaire. Most of the nurses enrolled in the study (73.4%) were female. Among the nurses, 91.5% intended to accept vaccination, whereas 2.3% were opposed and 6.2% were undecided. Female sex and confidence in vaccine efficacy represent the main predictors of vaccine intention among the study population using a logistic regression model, while other factors including vaccine safety concerns (side effects) were non-significant. Conclusions: Despite the availability of a safe and effective vaccine, intention to be vaccinated was suboptimal among nurses in our sample. We also found a significant number of people undecided as to whether to accept the vaccine. Contrary to expectations, concerns about the safety of the vaccine were not found to affect the acceptance rate; nurses’ perception of vaccine efficacy and female sex were the main influencing factors on attitudes toward vaccination in our sample. Since the success of the COVID-19 immunization plan depends on the uptake rate, these findings are of great interest for public health policies. Interventions aimed at increasing employee awareness of vaccination efficacy should be promoted among nurses in order to increase the number of vaccinated people

Osteoporosis : economic burden of disease in Italy

Background and Objective Today, osteoporosis is the most common bone disease and an important public health problem in all developed countries. The objective of this study was to estimate the costs associated with the management and treatment of osteoporosis in order to assess the economic burden in Italy for 2017, in terms of direct medical costs and social security costs. Methods A cost of illness model was developed to estimate the average cost per year sustained by the NHS (National Health Service) and Social Security System in Italy. A systematic literature review was performed to obtain epidemiological, direct and indirect costs parameters where available. Hospitalisation costs were calculated considering the administrative database of the hospital discharge records for the period 2008-2016. Patients were enrolled in the analysis if they report the subsequent inclusion criteria: age >= 45 years and presence of osteoporosis in primary or secondary diagnosis (ICD9-CM 733.0) and/or presence of a major fracture in primary or secondary diagnosis (excluding road accidents) in the following locations: spine (codes ICD9-CM: 805;806), femur (codes ICD9-CM: 820; 821), radius and ulna (codes ICD9-CM: 813.4; 813.5), humerus (codes ICD9-CM: 812.0-812.5), pelvis (code ICD9-CM: 808), tibia and fibula (codes ICD9-CM: 823), ankle (code ICD9: 824) and ribs (codes ICD9-CM: 807.0; 807.1). Costs were estimated considering the diagnosis-related group (DRG) national tariff associated with each hospitalisation. Finally, the administrative databases of the Italian National Social Security Institute (INPS) (2009-2015) were analysed for the estimate the pension and disability costs from the social perspective. Results The model estimated an average annual economic burden of osteoporosis in Italy of euro2.2 billion. Of this cost, approximately 80% (euro1.8 billion) was associated with hospitalisations, 16% (euro351 million) for pharmacological treatments, 3% (euro71 million) for ambulatory visits, and 0.6% (euro13 million) for social security costs. The average yearly cost per patient was equal to euro8691 (euro8591 for hospitalisations). Analysing severe patients, hospitalisation costs increase to euro12,336 (+ 44% if compared to non-severe osteoporosis patients). Conclusions The analysis showed that osteoporosis represents one of the main health problems in Italy and the ability to maintain patients in a non-severe health state could decrease the economic burden from both NHS and social perspective

An analysis of the social and economic costs of breast cancer in Italy

Background: Breast cancer is the most prevalent cancer affecting women and it represents an important economic burden. The aim of this study was to estimate the socio-economic burden of breast cancer (BC) in Italy both from the National Health Service (NHS) and the government perspectives (costs borne by the social security system). Methods: The economic analysis was based on the costs incurred by the NHS from 2008 to 2016 (direct costs related to hospitalizations) and by the National Social Security Institute (INPS) from 2009 to 2015 (costs of social security benefits) for patients with breast cancer. The analysis was based on the Hospital Information System (HIS) and Disability Insurance Awards databases. For both databases, patients affected by a malignant neoplasm of the female breast, carcinoma in situ, or secondary malignant neoplasm of the breast were considered. Results: Results show that more than 75,000 women were hospitalized for breast cancer every year, with an overall cost for hospitalization of about €300 million per year. From the Social Security analysis, a number of 29,000 beneficiaries each year was estimated. Considering per patient social costs, breast cancer at the primary stage cost €8828 per year, while secondary neoplasms cost €9780, with an average total economic burden of €257 million per year. Conclusions: This analysis focused on the economic impact of breast cancer in Italy, showing that an advanced stage of the disease was associated with a higher cost

Hikikomori: la sofferenza silenziosa dei giovani [Hikikomori: the silent suffering among young people]

Il termine giapponese hikikomori è usato per descrivere i giovani che vivono una condizione caratterizzata da isolamento e ritiro sociale per un prolungato periodo di tempo. È un fenomeno particolarmente diffuso in Giappone, soprattutto tra adolescenti e giovani adulti, ed è oggetto di attenzione crescente da parte dei professionisti della salute mentale di molti altri Paesi, tra cui l’Italia. Lo scopo del presente lavoro è quello di approfondire il costrutto di hikikomori inquadrandolo all’interno del contesto socioculturale di riferimento, analizzando contemporaneamente gli aspetti epidemiologici, i fattori di rischio e le caratteristiche cliniche. Inoltre, vengono discussi alcuni modelli teorici che consentono possibili interpretazioni di tale condizione che caratterizza i giovani che veicolano sempre più silenziosamente la loro sofferenza. Pur fornendo una lettura piuttosto articolata del fenomeno, si sottolinea la mancanza di una chiara definizione che possa inquadrarlo al fine di pianificare interventi preventivi.The Japanese term hikikomori is used to describe young people who lives a condition characterized by social withdrawal and isolation for an extended period of time. It is a particularly widespread phenomenon in Japan, in particular among adolescents and adults, and it represented the focus of an increasing attention from mental health professionals in many other countries, including Italy. The aim of this paper review is to explore the concept of hikikomori within Japanese sociocultural context, epidemiological aspects, risk factors clinical characteristics. Moreover, some theoretical models are discussed which allow possible interpretations of this condition which characterizes young people who convey their suffering more and more silently. A detailed review of the phenomenon is given considering the lack of a clear definition of the hikikomori that doesn’t allow to plan preventive interventions

Economic impact of schizophrenia from hospital and social security system perspective in Italy

Background Schizophrenia is one of the mental disorders with the highest economic and social costs, with an important burden on patients, caregivers, and society. Objective The objective of this study was to estimate the direct and social security costs of schizophrenia in Italy. As far as direct costs are concerned, those related to hospitalizations and pharmaceutical expenditure have been analyzed, while disability benefits (DBs) and incapacity pensions (IPs) have been considered for the social security costs. Methods In order to provide annual economic burden of schizophrenia using the real-world data, we analyzed the main regional and national databases related to hospitalizations and pharmaceuticals. Hospitalizations have been analyzed considering the Hospital Information System, which collects all the information regarding hospital discharges from all public and private hospitals (psychiatric wards or residential facilities have not been considered). Hospitalizations with a discharge date between 2009 and 2016, and with a primary or secondary diagnosis of schizophrenia (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 295.xx) were selected. Hospital costs have been estimated considering the national tariffs associated with each selected hospitalization. In addition, using the same inclusion criteria, the average DBs (for workers with reduced working capacity) and IPs (for workers without working capacity) provided each year have been analyzed from the social security benefit applications database. The estimate of pharmaceutical expenditure was prepared based on the OsMed 2018 Report (Italian Medicines Agency, latest issue 18 July 2019). A one-way deterministic sensitivity analysis was conducted to examine the robustness of the results. Results In Italy from 2009 to 2016, schizophrenia had an important economic impact from a social perspective. On average, 13,800 patients were hospitalized, with an average of 2.98 hospitalizations per patient. From a National Health Service (NHS) perspective and with specific reference to hospitalizations, the annual economic burden was euro101.4 million, with an average cost per patient of euro7338. On the other hand, pharmaceutical expenditure amounts to over euro147 million each year, while residential, semi-residential, and specialist facilities amount to approximately euro1 billion. Again, schizophrenia led to approximately 15,000 recipients of social security benefits (DBs and IPs) yearly from 2009 to 2015, with an average annual expenditure of euro160.1 million (average cost per patient = euro10,675). Conclusions Our study estimates an economic burden of schizophrenia of euro1250 million per year in direct costs, of which 20% is related to hospitalizations and pharmaceutical expenditure. With regard to social security benefits, an average annual expenditure of euro160.1 million was calculated (average cost per patient = euro10,675)

Applications for social security benefits related to diabetes in the working age in Italy between 2009 and 2019: a nationwide retrospective cohort study

The aim of this study is to estimate the average number of claims for social security benefits from workers with diabetes-related disability