Health care for older people in Italy: The U.L.I.S.S.E. project (Un Link Informatico sui Servizi Sanitari Esistenti per l'anziano - a computerized network on health care services for older people)

Introduction. The U.L.I.S.S.E. study is an observational multicenter prospective 1-year study aimed at describing older patients cared for in hospitals, home care or nursing homes in Italy. Methods. Overall, 23 acute geriatric or internal medicine hospital units, 11 home care services and 31 nursing homes participated in the study. The only exclusion criterion was age lower than 65 years. The patient's evaluation was performed using comprehensive geriatric assessment instruments, i.e. the interRAI Minimum Data Set, while data on service characteristics were recorded using ad-hoc designed questionnaires. Results. The older subjects who are in need of acute and long term care in Italy have similar characteristics: mean age is higher than 80 years, they have a high level of disability in ADL, complex multimorbidity, and receive several drugs. The prevalence of cognitive impairment is especially high in nursing homes, where almost 70% of residents suffer from it and 40% have severe impairment. On the other hand, there is a shortage of health care services, which appear heterogeneous and fragmented. Discussion. Health care services for older people in Italy are currently inadequate to manage the complexity of older patients. An important effort should be undertaken to create a more integrated health care system.