Prevalence study of the chronic disease and severe disability in developmental age and cost analysis

Key words: Chronic disease, Severe disabilities, Developmental age, Family paediatricians, Epidemiology, Budget, Training

Background - The chronic disease and severe disability are realities that increasingly involve also the developmental age and they are going to test culture and health organization. In early 2009, a group of eleven family paediatricians began to “observe”, to explore the Disability World starting from their own territorial reality.
Aims - The aim was to acquire a deep knowledge of the phenomenon, even from a financial point of view, and simultaneously to start to understand the pathways and needs and try to improve the quality of care.
Materials and methods - The prevalence study was based on an area-based and multi-source investigation. After the record linkage, the patient cataloguing was designed according to the severity of the disease and the complexity of care. The cost analysis was carried out using the criteria of job order costing that is based on the cost inputs that directly affect Family Paediatrics health care budget.
Results and conclusions - A prevalence rate of 4.6‰ of children with severe disabilities was found on a general paediatric population of 10,195 individuals. The patients with neurological or cognitive-neurological problem represent the two more frequent categories. 3.67% of the paediatric population with chronic diseases and/or severe disability affect the variable cost of paediatrics public health care budget for 36% of its total. Direct and continuous contact with their families and patients offers family paediatricians a vantage point and allows them to process data on large population samples both quantitatively and qualitatively. In addition to the epidemiology, the Narrative Medicine instrument has helped the group to better understand the disability world and, probably, to rediscover the essence of being medical doctors.