Il costo dell’intervento chirurgico in laparoscopia con l’Activity Based Costing

The purpose of this research is to analyze the role of the Management Control System (MCS) and of the Management Accounting System (MAS) in healthcare (HC) organizations. It aims at studying if and how managerial considerations affect the clinical culture. Results are based on the findings of a research developed within 12 Local Health Authorities (Aziende Sanitarie Locali LHAs) and 4 Teaching Hospital (Aziende Ospedaliere Universitarie THs) in Italian Tuscany Region and address the possibility to develop an alternative model from those of accountingization or legitimation proposed in literature to understand the role of these systems in healthcare. Results highlight that the economic language may assume a great importance in clinicians’ decision making and penetrates into clinical culture. Most important factor affecting results is the development of an alliance between controllers and clinicians, based trust and collaboration. The paper is a contribution to the literature about the role of MCS and MAS in healthcare and it is developed within the schemes traced by Habermas and refined by Laughlin and by Broadbent and Laughlin. The original value stands on the individuation of a model where the “integrative interactive” management model is able to penetrate clinical discourse and the conditions at which it can be developed.Management Accounting Change, Management Control Change, Healthcare Accounting, Professional organization, accountinization, legitimation, Habermas

Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS3) - SOLE/FSE (Italy) Case Study Report

SOLE (“Sanità On LinE” – “Health Care On Line”) is the integrated network of local health units, hospitals, general practitioners and paediatricians in the Emilia-Romagna region in Italy. Together, these entities constitute the physical and virtual infrastructure of all patient-centred integrated care services organised by the health actors in the region. The FSE (“Fascicolo Sanitario Elettronico” – Personal Health Record) is a software application which helps to organise, retrieve and manage the clinical history of every citizen in the region. The SOLE/FSE started about 12 years ago as an initiative of Emilia-Romagna's regional government, with an investment of about €80 million. CUP 2000 S.p.A., an in-house company, was designated to be in charge of the design, development, maintenance and continuous improvement of the system and the Integrated Care services provided. The SOLE/FSE case addresses the population of the Emilia-Romagna in its entirety and is used by all 3,700 GPs/paediatricians practicing under the 11 local health units and in the 6 hospital districts of the region. The case focuses on chronic disease management, home care management, and health and social care services integration.JRC.J.3-Information Societ

Quality Assurance Indicators of Long-Term Care in European Countries

This study reports on the quality indicators that were collected by the ANCIEN project partners in each country considered in Work Package 5 (Quality in Long-Term Care). The main contribution of this report is a classification of the quality assurance indicators in different European countries according to three dimensions: organisation type (indicators applied to formal institutional care \u2013 FIC, formal home-based care \u2013 FHBC, formal home nursing care - FHNC, and informal home care - IHC); quality dimensions (indicators about effectiveness, safety, patient value responsiveness, or coordination) and system dimensions (input, process, or outcome indicators). The countries that provided quality indicators, which are used at a national level or are recommended to be used at a local level by a national authority, are: Estonia, Finland, France, Germany, Hungary, Italy, Latvia, the Netherlands, Spain, Sweden and the United Kingdom. In total, we collected 390 quality indicators. Each quality indicator has been assigned to one or more options in each dimension

Social Media and Public Health: Opportunities and Challenges

Social media has the potential to provide rapid insights into unfolding public health emergencies such as infectious disease outbreaks. They can also be drawn upon for rapid, survey-based insights into various health topics. Social media has also been utilised by medical professionals for the purposes of sharing scholarly works, international collaboration, and engaging in policy debates. One benefit of using social media platforms to gain insight into health is that they have the ability to capture unfiltered public opinion in large volumes, avoiding the potential biases introduced by surveys or interviews. Social media platforms can also be utilised to pilot surveys, for instance, though the use of Twitter polls. Social media data have also been drawn upon in medical emergencies and crisis situations as a public health surveillance tool. A number of software and online tools also exist, developed specifically to aide public health research utilising social media data. In recent years, ethical issues regarding the retrieval and analysis of data have also arisen

Complex multidisciplinary intervention to improve Initial Medication Adherence to cardiovascular disease and diabetes treatments in primary care (the IMA-cRCT study) : mixed-methods process evaluation protocol

Medication non-initiation, or primary non-adherence, is a persistent public health problem that increases the risk of adverse clinical outcomes. The initial medication adherence (IMA) intervention is a complex multidisciplinary intervention to improve adherence to cardiovascular and diabetes treatments in primary care by empowering the patient and promoting informed prescriptions based on shared decision-making. This paper presents the development and implementation strategy of the IMA intervention and the process evaluation protocol embedded in a cluster randomised controlled trial (the IMA-cRCT) to understand and interpret the outcomes of the trial and comprehend the extent of implementation and fidelity, the active mechanisms of the IMA intervention and in what context the intervention is implemented and works. We present the protocol for a mixed-methods process evaluation including quantitative and qualitative methods to measure implementation and fidelity and to explore the active mechanisms and the interactions between the intervention, participants and its context. The process evaluation will be conducted in primary care centres and community pharmacies from the IMA-cRCT, and participants include healthcare professionals (general practitioners, nurses and community pharmacists) as well as patients. Quantitative data collection methods include data extraction from the intervention operative records, patient clinical records and participant feedback questionnaires, whereas qualitative data collection involves semistructured interviews, focus groups and field diaries. Quantitative and qualitative data will be analysed separately and triangulated to produce deeper insights and robust results. Ethical approval has been obtained from the Research Ethics Comittee (CEIm) at IDIAP Jordi Gol (codeCEIm 21/051 P). Findings will be disseminated through publications and conferences, as well as presentations to healthcare professionals and stakeholders from healthcare organisations.

Nigerian Hospital-Based Interprofessional Collaborative Patterns and Organizational Implications

Interprofessional collaboration is recognized as the innovative, evidence-based strategy that strengthens health systems and improves performance and health outcomes. While resource-rich countries have benefited much from the implementation of this initiative, literature is scarce regarding sub-Sahara Africa. This quantitative cross-sectional descriptive study described the extent of interprofessional collaborative practice at the tertiary care level in Nigeria and its implications on patient health outcomes, professionals\u27 performance, satisfaction, and healthy practice environment. The relational coordination theory (RCT) provided the conceptual framework for the study. Key research questions were on the association between the extents of interprofessional practice and each of the outcome implications. Data were collected using a questionnaire survey and were analyzed using means, standard deviations, t tests, correlation and regression statistics, and Chi-square tests. Results showed that the health professionals rated the practice of interprofessional collaboration low and perceived that the extents of the practice negatively affected patient\u27s mortality, professionals\u27 work performance, job satisfaction, and the frequency of interprofessional conflicts and strike actions. Recommendations included policy formulation and implementation, commitment and willingness by the health professionals to teamwork and patient-centered care. The implications for positive social change is that these results could be used as a tool to advocate for policy formulation and policy change for effective implementation of interprofessional collaboration; and as a database for future training intervention on collaborative practices among health professionals

What does it take to make integrated care work? A ‘cookbook’ for large-scale deployment of coordinated care and telehealth

The Advancing Care Coordination & Telehealth Deployment (ACT) Programme is the first to explore the organisational and structural processes needed to successfully implement care coordination and telehealth (CC&TH) services on a large scale. A number of insights and conclusions were identified by the ACT programme. These will prove useful and valuable in supporting the large-scale deployment of CC&TH. Targeted at populations of chronic patients and elderly people, these insights and conclusions are a useful benchmark for implementing and exchanging best practices across the EU. Examples are: Perceptions between managers, frontline staff and patients do not always match; Organisational structure does influence the views and experiences of patients: a dedicated contact person is considered both important and helpful; Successful patient adherence happens when staff are engaged; There is a willingness by patients to participate in healthcare programmes; Patients overestimate their level of knowledge and adherence behaviour; The responsibility for adherence must be shared between patients and health care providers; Awareness of the adherence concept is an important factor for adherence promotion; The ability to track the use of resources is a useful feature of a stratification strategy, however, current regional case finding tools are difficult to benchmark and evaluate; Data availability and homogeneity are the biggest challenges when evaluating the performance of the programmes

The Catalan Health Care System in a process of change: review of the 2011-2015 Health Plan for Catalonia at the halfway point

Planificació sanitària; Sistema sanitari; Línies estratègiquesPlanificación sanitaria; Sistema sanitario; Líneas estratégicasHealth planning; Health system; Strategic linesAquest document de balanç a meitat del període del Pla de salut 2011-2015 parteix de l‘orientació dels objectius de salut i se centra en aquelles línies d‘actuació que tenen major significat quant a la transformació del model assistencial (orientació a la cronicitat, major resolució i accessibilitat, qualitat en l‘alta especialització, enfocament cap a les persones, salut pública amb perspectiva interdepartamental).Este documento de balance a mitad del período del Plan de Salud 2011-2015 parte de la orientación de los objetivos de salud y se centra en aquellas líneas de actuación que tienen mayor significado en cuanto a la transformación del modelo asistencial (orientación a la cronicidad, mayor resolución y accesibilidad, calidad en la alta especialización, enfoque hacia las personas, salud pública con perspectiva interdepartamental).This review at the halfway point of the of the 2011-2015 health plan is based on the orientation of the health care objectives and focuses on those lines of action that are of greater significance in terms of transforming the model of care (orientation toward chronicity, greater resolution and accessibility, quality in high specialization, focus on people, public health from an interdepartmental perspective)

A strategic reflection for the management and implementation of CAR-T therapy in Spain: an expert consensus paper

CAR-T cell therapy represents a therapeutic revolution in the prognosis and treatment of patients with certain types of hematological cancer. However, they also pose new challenges in the healthcare, regulatory and financial fields. The aim of the RET-A project was to undertake a strategic reflection on the management of CAR-T therapies within the Spanish National Health System, to agree on recommendations that will help to better deal with the new context introduced by these cell therapies in the present and in the future. This think tank involved 40 key agents and opinion leaders. The experts identified three great challenges for implementing advanced therapies in Spain: therapeutic individualisation, with a multidisciplinary approach; acceleration of access times, by minimizing bureaucracy; and increase in the number of centers qualified to manage the CAR-T therapies in the NHS. The experts agreed on the ideal criteria for designating those qualified centers. They also agreed on a comprehensive CAR-T care pathway with the timings and roles which would ideally be involved in each part of the process.This study was funded by Gilead Sciences, Inc.Peer reviewe

Robert Wood Johnson Foundation - 2007 Annual Report: Building Bridges to Better Health Care

Contains president's message, year in review, program information, statistical highlights, distribution of funds, and grants list