EN
ITRSY Lombardia updated at November 2022
04 - SOCIAL SECURITY
Dettagli:
Contents
1. Structure of the health care system
2.3 Morbid states and causes of death
3. Welfare and social security
3.1 Users of services against drug addiction
3.3 Expenditure of heath care and welfare agencies
5. Insurance against occupational accidents and professional diseases
6. Social cooperatives and voluntary service
Statistics on the structure of the health care system, on population health, on welfare and social security, and on social cooperatives and voluntary work are partly provided by Istat. Additional information is provided by Regione Lombardia and by the Ministry of health.
Data on pensions are of source INPS (National Institute for Social Security) and those on occupational accidents and professional diseases are of source INAIL (National Institute for the Insurance against Occupational Accidents).
1. Structure of the health care system
Statistics on the structure and activity of health care institutions presented in this yearbook are of source Istat when related to the entire national territory (broken down by region) and of source Regione Lombardia when related to the regional territory (broken down by province).
Such statistics are produced starting from data collected by the Ministry of Labour, Health and Social Policies. The Ministry collects information on the characteristics of health care institutions, hospital beds (ordinary and day hospital), biomedical appliances, and activity of hospital wards.
The main variables used in Italian health statistics are defined as follows:
Public hospitals: they include independent hospitals, hospital depending from a Lhu (Local health unit), the university polyclinics, the public and private health institutes of research, the classified or assimilated hospitals, the psychiatric institutes, the private qualified hospitals depending from a Lhu, and the research institutions.
Private accredited hospitals:they include the private hospitals accredited with the National health service. The data referred to the characteristics and activities of these institutions do not include private activities against payment.
Day hospital beds:they indicate the available beds in day hospital, in other words the beds declared on the first of January of the data’s reference year.
Standard hospital acute beds: they indicate hospital beds intended for the activities of persons suffering from acute illnesses that, under provisions of Law n.382 of 18/7/1996, each region must have in order to respect the parameter of standard equipments equal to 4.5 hospital beds per every 1,000 inhabitants.
Unless otherwise stated, data on hospital beds, in-patients and days of hospitalization relate only to ordinary hospitalisations.
Data on admissions exclude transfers between different wards of a same hospital.
Data on staff refer to employees, both with open-ended and fixed-term contracts (either part- or full-time) and to collaborators.
Some of the main indicators used in health statistics are the following:
Average days of hospitalisation: ratio between bed-days and in-patients. It indicates the time (in days) that elapses on average between the moment in which the patient arrives to the hospital and the moment the patient is discharged, in other words the average number of days requested for the treatment.
Hospitalisation rate: ratio between the number of in-patients and the average resident population (1,000). It indicates the average number of hospitalisations every 1,000 residents.
Occupancy rate: it is the ratio between the bed-days and the potential bed-days multiplied by 100. The potential bed-days are calculated by multiplying the number of hospital beds per days of the year in which the ward was active (365 or 366 in case of the whole year). It indicates in percentage the effective occupancy of the beds compared to the available beds.
Admission rates to the emergency ward: ratio between the number of admissions to the emergency ward and the average resident population (per 1,000). It indicates the average number of admissions to the emergency ward per every 1,000 residents.
Since 1979 Istat collects data on induced abortions, through a specific form that must be filled-in by the specialist doctor performing the abortion
The information concerning the woman that is collected through the form comprises:
- date of birth;
- commune of birth and of residence;
- province where the abortion is performed;
- citizenship;
- marital status;
- highest level of education attained;
- professional or non-professional condition (women in non-professional condition are housewives, students, retired from work, seeking first job; women in professional condition are women in employment or unemployed seeking employment);
- professional status;
- branch of economic activity where work is performed;
- events prior to the abortion: number of live births, number of still births, number of spontaneous abortions, number of induced abortions;
Information concerning the abortion includes
- date of the operation;
- date of the certificate;
- authorisation certificate;
- urgency;
- type of consent for minors;
- place and type of operation;
- analgesic therapy;
- type of hospitalisation and duration;
- complications.
In order to better monitor the events, Istat requires that the Regions transmit monthly communications on the total number of abortions that were performed in each province.
The main indicators used in statistics on induced abortions are:
Specific abortion rate: ratio between the number of abortions carried out by women at age x and the average resident female population of the same age.
Crude abortion rate: ratio between abortions carried out by women from 15 to 49 years of age and the average resident female population of the same age.
Standardised abortion rate: weighted average of the specific abortion rates. The weights are obtained from the ratio between the resident female population of age x at the 2001 Census and the resident female population (15-49 years of age) at the same date.
Total abortion rate: sum of the specific abortion rates. Its meaning is similar to the total fertility rate.
Another survey conducted by Istat refers to spontaneous abortions for which hospitalisation was necessary. Spontaneous
The data are collected through a specific form and refer to the woman and to the characteristics of the abortion.
Data concerning the woman comprise:
- date of birth;
- commune of birth and of residence;
- province where the abortion is performed;
- citizenship;
- marital status;
- highest level of education attained;
- professional or non-professional condition (women in non-professional condition are housewives, students, retired from work, seeking first job; women in professional condition are women in employment or unemployed seeking employment);
- professional status;
- branch of economic activity where work is performed;
Data concerning the abortion are:
- date of the operation
- place of the abortion (hospital or dwelling)
- cause of the abortion
- type of operation
- analgesic therapy;
- type of hospitalisation and duration;
- complications.
The indicators generally used in the analysis of spontaneous abortions are the same as those used in the analysis of induced abortions.
2.3 Morbid states and causes of death
Data on causes of death are collected by Istat through specific forms that are filled in by the specialist doctor.
Statistics on mortality are based on one single cause of death, the so-called initial cause as defined by the World Health Organisation (WHO) in the International Statistical Classification of Diseases, 10th Revision (Icd-10), I Edition 1992:
Since 2003 information on causes of death is encoded according to the 10th revision of the International Classification of Diseases (lcd-10). Due to changes in the classification, data relating to 2003 and subsequent years are not comparable to data relating to previous years.
3. Welfare and social security
3.1 Users of services against drug addiction
Statistics on users and services against drug addiction are compiled and released by the Ministry of the Interior.
Data on users of services are collected through the survey “Drug addicts under treatment in rehabilitation structures”, which has the aim to obtain statistical information on drug addicted population under treatment.
The field of observation of the survey is represented by drug addicted persons under treatment in rehabilitation structures (residential, semi-residential, outpatient)
The survey has total coverage and is conducted every quarter (31/3 - 30/6 - 30/9 and 31/12).
The data are released on a yearly basis; the number of users of services is broken down by gender, territory (province) and type of structure
Data on the structures are collected through the survey “Census of social-rehabilitation structures for drug addicted persons”, which has the aim to obtain information on the number and location of such structures.
The field of observation of the survey is represented by the social-rehabilitation structures (residential, semi-residential, outpatient). The information collected comprises the number of structures, their name, address, as well as some characteristics, number of persons under treatment.
The survey has total coverage and is conducted every year (with reference to 31 March).
The statistics are released approximately six months after the data are collected.
Data on social welfare are collected by Istat through a survey on Residential Structures for Social Assistance.
The information collected refers to all residential structures for people in need: old-aged persons (ill or lone), disabled persons, minors without guardian, foreigners or Italian citizens with economic problems, etc. Given the heterogeneity of users, there is a variety of different types of structures, either public or private, either non-profit or commercial.
The data are collected every year since 1999 through postal questionnaires; final data relating to the 2006 survey (31 December) were released in February 2010.
The contents of the survey were broadened in 2010 (for data relating to 2009), in collaboration with experts from the Ministry of Health, From the Ministry of Labour and Social Policies, and from Cisis – Working Group on Social Policies. The information collected through the survey refers to the supply of structures and to the types of users. The survey questionnaire can be answered also via the Web.
3.3 Expenditure of heath care and welfare agencies
ISTAT conducts an annual survey of the final balances of social insurance institutions in order to construct profit and loss statements for the public administrations. These statements are prepared according to the accounting procedures of the European System of integrated profit and loss statements (Sec95) and the profit and loss statement for social protection, which is constructed in accordance with the criteria of the European System of integrated statistics for social protection (Sespros).
The baseline data are identified through survey models. The units of analysis are represented by revenues and expenditures in the final accounting phase, expressed in both accrual values and cash values. The revenue and expenditure items are also analyzed at the regional level.
The social insurance institutions - public or private legal entities whose principal activity consists in the distribution of social insurance benefits in favour of individuals covered by specific administrations - have been regrouped on the basis of the primary social services provided (invalidity, old-age and survivors) and the sector to which the covered population belongs (public or private), as defined on the basis of the Sec95 criteria. For the private sector, the entities that distribute benefits for invalidity, old-age and survivors have been further subdivided into three groups, since the coverage for such workers is managed by (in addition to the national social security institute (general regime)) additional entities with dedicated competencies for specific categories of employees (substitute regime) and autonomous workers (regime of professionals).
Pension is intended as the payment made on a regular basis by public or private entities to pension fund members (or dependants) after retirement
Pensions are classified into
- old-age pensions, retirement pensions, disability pensions, allowances after occupational accidents or professional diseases (i.e. pensions related to the work activity);
- survivors’ benefits;
- war pensions;
- pensions paid to citizens aged over 65 without income, to the blind, to the deaf and to the civilian invalids.
Also included in pensions are perpetual annuities paid to ex- servicemen and veterans.
INPS manages all the forms of compulsory insurance against the risk of disability, old age and death for most employees in the private sector, for some categories of employees of the public sectors, and for some self-employed workers: craftsmen, traders, farmers, share-croppers, para-subordinate workers.
Statistics on pensions presented in this yearbook are released by INPS (National Institute of Social Security) through the Observatory on Pensions.
The data in the Observatory are derived from administrative information contained in the social security registers and are updated every year. Time series are available, starting from 1993.
The statistics refer to pensions in force on 1 January of the reference year (stock data) and to pensions paid during the reference year (flow data) and are available at the province level.
The variable “territory” refers to the province where the INPS office responsible for the pension is located.
Some of the other variables surveyed are:
- gender of the person entitled to the pension;
- age of the person entitled to the pension
- year then the pension started;
- average monthly amount paid (before taxes);
- average monthly amount of integrations, if any;
- type of integration, if any;
- average monthly amount of social surcharges, if any;
5. Insurance against occupational accidents and professional diseases
The source of the data presented in this section is INAIL (National Institute for the Insurance against occupational accidents and professional diseases.
This type of insurance is mandatory for all employers that engage employees in activities identified as dangerous by the law. Craftsmen and agricultural workers must make their own insurance.
The regulations on compulsory insurance against occupational accident provide that occupational accidents at work involving workers (employees and self-employed), and that require more than three days for the complete recovery, be reported to INAIL.
With particular regard to the industry, trade and service sectors, also reported are deaths that occurred within 180 days after the accident (excluding those who are not of occupational reason).
Also for this reason, data for the most recent year are to be considered as provisional, and are not comparable to the information relating to previous years.
Professional diseasesmust be reported to INAIL by the employer within 5 days after the employee informs about the illness. The disease can be reported by the patients themselves in case they are self-employed.
The information contained in INAIL’s databases refers to occupational accidents and professional diseases that occurred in each of the five years preceding the current year, and are available separately for the following insurance sections:
- Industry, trade and services,
- Agriculture,
- Government account
The data are broken down by gender of the worker and by province.
For the section “Industry, trade and services” data are also broken down by:
- Sector of economic activity;
- INAIL fee code
Accidents occurred and compensated are classified according to the type of consequence:
- temporary disability
- permanent disability
- death.
The amounts for the “average compensations” refer to temporary disability and are expresses in Euro.
The same benefits paid in case of occupational accidents are paid in case of professional diseases (provided that it is established that the disease is due to the work activity).
Classifications, breakdowns and details used for statistics on professional diseases are the same as those used for statistics on occupational accidents.
6. Social cooperatives and voluntary service
Social cooperatives have the aim to promote the social integration of citizens through:
- the management of social, health and educational services;
- the conduction of agricultural, industrial, commercial or service activities aimed at the vocational integration of disadvantaged persons.
Social cooperatives are classified into two broad categories: type A and type B
Type Asocial cooperatives provide services to the community, such as:
- home care for old age persons, minors and disabled persons;
- management of structures (social and educational centres, day-centres for the elderly, communities for minors, day nurseries, reception centres for migrants, etc.)
- ambulance services.
Type Bsocial cooperatives operate in the field of vocational integration, and create job opportunities for disadvantaged persons within the following types of activity:
- maintenance of parks and gardens;
- cleaning of industrial and commercial buildings;
- information technologies.
There are also cooperatives that may carry out both the types of activities (A+B cooperatives) and social consortia, i.e. consortia where cooperatives account for at least 70%.
For what concerns voluntary service, during the 2004-2005 period Istat conducted the 5th survey on voluntary service organisations. The survey covered organisations that were registered in the regional and provincial registers on 31 December 2003.
Data aggiornamento:
November, 2010
