Papers by Gabriele Lapini
Group versus single handed primary care: A performance evaluation of the care delivered to chronic patients by Italian GPs
Health Policy, 2013
In family medicine contrasting evidence exists on the effectiveness of team practice compared wit... more In family medicine contrasting evidence exists on the effectiveness of team practice compared with solo practice on chronic disease management. In Italy, several experiences of team practice have been introduced since the late 1990s but few studies detail their impact on the quality of care. The aim of this paper is to evaluate the impact of team practice in family medicine in six Italian regions using chronic disease management process indicators as a measure of outcome. Cross-sectional studies were performed to assess impact on quality of care for diabetes, congestive heart failure and ischaemic heart disease. The impact of team vs. solo practice was approximated through performance comparison of general practitioners (GPs) adhering to a team with respect to GPs working in a solo practice. Among the 2082 practitioners working in the 6 regions those assisting 300+ patients were selected. Quality of care towards 164,267 patients having at least one of three chronic conditions was estimated for the year 2008 using administrative databases. Quality indicators (% of patients receiving appropriate care) were selected (4 for diabetes, 4 for congestive heart failure, 3 for ischaemic heart disease) and a total score was computed for each patient. For each disease the response variable associated to each physician was the average score of the patients on his/her list. A multilevel model was estimated assessing the impact of team vs. solo practice. No impact was found for diabetes and heart failure. For ischaemic heart disease a slightly significant impact was observed (0.040; 95% CI: 0.015, 0.065). No significant difference was found between team practice and solo practice on chronic disease management in six Italian regions.
Modelli a Equazioni Strutturali per la Valutazione dell'Esperienza Universitaria nell'Ateneo Fiorentino
Research Papers in Economics, 2010
Every student who has studied at the University of Florence is supposed to fill in a questionnair... more Every student who has studied at the University of Florence is supposed to fill in a questionnaire prepared by the interuniversity consortium "Almalaurea". This survey concerns the general quality of the college and makes it possible to express the level of satisfaction about many aspects of the University experience. In this paper we wish to evaluate the relationship between observed variables and latent variables of interest: The structural equation models (SEM) is the methodology which suits best our needs. By means of a SEM we aim at building a model that reproduces the determinants of students’ satisfaction. Like any other statistical tool, the SEM is not suitable for causal analysis. However, under certain assumptions, it turns out that the model employed is an adequate representation of the reality under study.
Modelli a Equazioni Strutturali per la Valutazione dell'Esperienza Universitaria nell'Ateneo Fiorentino
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Papers by Gabriele Lapini