Ricoveri ospedalieri potenzialmente evitabili per malattie acute durante la pandemia di COVID-19 in Italia.

This study evaluates the rates of potentially avoidable hospitalisations for selected Ambulatory Care Sensitive Conditions (ACSC) in Italy during the COVID-19 pandemic. This is a retrospective cohort study analyzing in patient hospital admissions across Italy. Data from the prepandemic period (2017-2019) were compared with data from the pandemic years (2020-2021). Poisson regression models were used to estimate the expected rates of ACSC for selected acute conditions. These rates were adjusted for sex, age, propensity for hospitalisation, and deprivation index, based on pre-pandemic conditions. For cases of acute appendicitis with complications, observed hospitalisation rates exceeded expected values in 2020-2021 (+0.18 in 2020, +0.28 in 2021), particularly in southern Italy. Conversely, for other conditions, observed avoidable hospitalisation rates were lower than expected, even after adjusting for the overall decline in hospital admissions during the pandemic. This trend was especially evident in regions such as Liguria, Umbria, and Lazio. The study highlights the limitations of using ACSC as a proxy for the quality of primary healthcare during systemic crises such as the COVID-19 pandemic. The findings of this study emphasize the importance of a systemic and coordinated approach that engages all levels of a healthcare system during crises and disasters, particularly in countries with limited healthcare resources and overburdened higher levels of care.