FARB - Health and Education Systems Assessment Politecnico di Milano

Paganoni, A.

Ieva, F.

Agasisti, T., Lettieri E.

June 2014

June 2017

The core interest of this project is in improving the quality of health and educational services at local, regional and national levels, through a program of applied research and close involvement with the Italian Ministry of Health, the Italian Institute for the Evaluation of Educational Systems (Invalsi) and other healthcare/educational organizations and institutions. Studying and monitoring outcomes and process indicators in healthcare and educational processes allow decision makers to improve the system performances with an optimized resource allocation; indeed, decision-makers involved in public administration (health/education) need information about efficiency and effectiveness of provided services. In this project, we propose an innovative knowledge discovery model that takes advantage by the massive use of administrative data that have been collected only with storage and control purposes. Administrative datasets are naturally updated, complete and available with a lower cost with respect to ad-hoc data collections. Even if their use has been questioned, the recent statistical literature points out that the risks of biased results can be minimized with suitable statistical and reporting techniques. Conditionally to a field of interest (pathology or pattern of care for health care students’ achievement for education) a main outcome jointly with possibly quite secondary ones, are pointed out. To improve the outcomes is mandatory to understand the variables correlated, and eventually their causal impact on them. Specifically the variability affecting outcomes can be decomposed in many different sources. Due to the natural hierarchical structure of data (patients within divisions, divisions within hospitals, pupils within classes, classes within schools, …) they are affected by over-dispersion that can be catched and modeled by means of statistical “mixed effect models”. Despite the relevance of such research, funding is at moment very problematic. Public decision-makers need to see first results before committing in this direction. Private funding (e.g. biomedical companies interested to follow-up their technologies) need a commitment from the regional/national Institutions that allow them to proceed in this direction. Within this background, we think that FARB funding is a tremendous opportunity to seed this new research stream and create the first results useful to create the conditions for a next public and private funding context. The main objects of the project are then i) identification and study of the outcomes and process indicators for the problem of interest, ii) monitoring and analysis of these parameters, iii) supporting decisions in order to improve the process, iv) checking of the change effectiveness, or at least implementing a method for this and testing it; v) increasing the present awareness about the value of opening and using administrative databases for informing decision-making and promote both the public and the private funding of further researches in this direction. Within this background, during the three year FARB project we will start working in two specific contexts: a) the healthcare process for patients affected by heart failure, b) educational attainments of students at grades 2, 5 (primary education), 6 and 8 (lower secondary schooling). In both the cases, we have already been authorized to use the related administrative databases for this research.