V Restivo1, A Orsi2, S Ciampini3, G A Messano4, C Trucchi2, G Ventura1, A Casuccio1, F Vitale1. 1. Department of Health Promotion, Mother-Child Care, Internal Medicine and Specialties of Excellence "G. D'Alessandro", University of Palermo, Italy. 2. Department of Health Sciences, University of Genoa, "Ospedale Policlinico San Martino IRCCS" Teaching Hospital, Genoa, Ital. 3. Freelance physician, Rome, Italy. 4. Department of Public Health and Infectious Diseases, Sapienza University of Rome, Ital.
Abstract
BACKGROUND: Quality improvement is an increasingly recognized approach to maximize service effectiveness and minimize costs in public health. However, the Italian law never provided for the institutional accreditation of vaccination services. Furthermore, a recently approved law added six more compulsory vaccinations to the original four, which has led to a considerable increase in vaccination efforts, without any previous resources evaluation. The aim of the study was to investigate structural, organizational and managerial characteristics of the Italian vaccination services, in order to suggest the adoption of adequate quality standards. STUDY DESIGN: A survey involving the representatives of the Italian Regions and Autonomous Provinces was performed between September 2017 and September 2018. METHODS: An online questionnaire, including 26 items, designed to evaluate the structural, organizational and managerial characteristics of vaccination services was administered. The correlation between the number of vaccination centres and the coverage for each region was used to evaluate the performance of the vaccination services. RESULTS: Respondents from seven Regions, totaling >15,000,000 inhabitants, answered the questionnaire. Overall, each vaccination service was potentially accessed by an average of 519 children aged zero to 24 months, with a β-coefficient of -0.87 (p = 0.01) for infant vaccination coverage in 2016. Eighty-five percent of vaccination services were provided with architectural features to accommodate the disabled but only 49% provided reserved parking lots. An average of 0.4 physicians and 0.6 other healthcare workers per 10,000 inhabitants were employed in vaccination services, with complete computerization in 74% of them. CONCLUSION: The inverse relation between vaccination services' spatial accessibility and vaccination coverage suggests that distance and accessibility of vaccination services should be considered in planning. This survey constitutes a baseline data for Italian vaccination services that could be useful for decision makers in establishing minimum requirements to provide high-quality preventive healthcare service.
BACKGROUND: Quality improvement is an increasingly recognized approach to maximize service effectiveness and minimize costs in public health. However, the Italian law never provided for the institutional accreditation of vaccination services. Furthermore, a recently approved law added six more compulsory vaccinations to the original four, which has led to a considerable increase in vaccination efforts, without any previous resources evaluation. The aim of the study was to investigate structural, organizational and managerial characteristics of the Italian vaccination services, in order to suggest the adoption of adequate quality standards. STUDY DESIGN: A survey involving the representatives of the Italian Regions and Autonomous Provinces was performed between September 2017 and September 2018. METHODS: An online questionnaire, including 26 items, designed to evaluate the structural, organizational and managerial characteristics of vaccination services was administered. The correlation between the number of vaccination centres and the coverage for each region was used to evaluate the performance of the vaccination services. RESULTS: Respondents from seven Regions, totaling >15,000,000 inhabitants, answered the questionnaire. Overall, each vaccination service was potentially accessed by an average of 519 children aged zero to 24 months, with a β-coefficient of -0.87 (p = 0.01) for infant vaccination coverage in 2016. Eighty-five percent of vaccination services were provided with architectural features to accommodate the disabled but only 49% provided reserved parking lots. An average of 0.4 physicians and 0.6 other healthcare workers per 10,000 inhabitants were employed in vaccination services, with complete computerization in 74% of them. CONCLUSION: The inverse relation between vaccination services' spatial accessibility and vaccination coverage suggests that distance and accessibility of vaccination services should be considered in planning. This survey constitutes a baseline data for Italian vaccination services that could be useful for decision makers in establishing minimum requirements to provide high-quality preventive healthcare service.
Authors: Sara Boccalini; Elena Pariani; Giovanna Elisa Calabrò; Chiara DE Waure; Donatella Panatto; Daniela Amicizia; Piero Luigi Lai; Caterina Rizzo; Emanuele Amodio; Francesco Vitale; Alessandra Casuccio; Maria Luisa DI Pietro; Cristina Galli; Laura Bubba; Laura Pellegrinelli; Leonardo Villani; Floriana D'Ambrosio; Marta Caminiti; Elisa Lorenzini; Paola Fioretti; Rosanna Tindara Micale; Davide Frumento; Elisa Cantova; Flavio Parente; Giacomo Trento; Sara Sottile; Andrea Pugliese; Massimiliano Alberto Biamonte; Duccio Giorgetti; Marco Menicacci; Antonio D'Anna; Claudia Ammoscato; Emanuele LA Gatta; Angela Bechini; Paolo Bonanni Journal: J Prev Med Hyg Date: 2021-09-10