Epidemiologia dei ricoveri riabilitativi in Regione Lombardia: diagnosi, comorbilità e disabilità

The progressive aging of industrialized countries leads to consider rehabilitation as an essential component to reduce emerging burden of disability and improving quality of life in frail elderly with chronic comorbidities. The present study aimed to describe patients of the Rehabilitation Wards in Lombardia, focusing on their major diagnoses, comorbidities and disability at the admission and at discharge, emphasizing that outcome predictors could influence rehabilitation efficiency. Due to the considerable number of patients, an appropriate system collecting data was made. This system, called “ESPERTO”, provides data from 77 Rehabilitative Units, on the whole 6.671 patients divided between two courses: “Percorso Specialistico” including 5991 patients, and “Percorso Generale Geriatrico”, 680 patients. The court considered was consecutively admitted to rehabilitation from June to September 2008. The system ‘ESPERTO’ provides detailed information about disability, functional independence, comorbidity, timing and setting, through standardized scales, like CIRS,FIM and Barthel. The main diagnoses at the admission were musculoskeletal diseases (49% for “Percorso Generale Geriatrico” and 46% for “Percorso Specialistico”) and neurological (19% and 26% respectively); the most common comorbidity were cardiovascular and musculoskeletal, while some classes of chronic diseases were underestimated, unlike internationals previsions (cancer, dementia and diabetes). The average of the age shows frail elderly patients: 78 years for “Percorso Generale Geriatrico” e 68.9 years for “Percorso Specialistico”. Most patients have a severe disability, which reflects a complex condition and a need for appropriate rehabilitation  manage care. Some patients have an high potential of improvement; the attainment is depending on the pre-morbid disability and the severity of the injury. More compromised patients have a lower rate of improvement, an high risk of better outcomes and frequent occurrence of istitutionalization.