[Evaluation of ambulatory medical care in Milan]

Ambulatory procedures are an essential component of health care both for their number and for their cost. We aim therefore to identify and to quantify the volume of ambulatory procedures performed in Milan during 2003. The data come from the Outpatient Care Information Report that collect much information by characteristics of patient, health care institution and procedure categories. The analyses in this report are based on absolute measures, utilization rates and concentration index. During the year 2003 nearly 20 millions of ambulatory procedures were performed in the public and private outpatient facilities of Milan for the resident population. The average annual rate was 15 procedures per person. Utilization varied according to patient age and sex, higher in women and in the elderly group, statistically significant variability is observed (p<0.001). Outpatient care accounts for high density supply (124 specialty points for 100,000 inhabitants). Utilization rate was not homogenous both for the medical specialties and for the geographical district distribution, all that, it seems depending on the activity concentration differences and complexity supply of services than on a different distribution of health needs. This analysis may be useful as methodological starting point for further investigating current outpatient care data and for identifying those sectors in need of corrective actions.