Il governo dell’innovazione tecnologica in sanità. Il caso dell’impianto di valvola aortica transcatetere: stato dell’arte delle indicazioni e della rimborsabilità nelle regioni italiane

L'obiettivo del presente lavoro è stato di realizzare una mappatura delle politiche e degli strumenti di governo regionali che hanno guidato l'introduzione della TAVI in Italia, finalizzata a fornire raccomandazioni ai decisori pubblic

The economic burden of stroke in Italy. The EcLIPSE Study: Economic Longitudinal Incidence-based Project for Stroke Evaluation.

Stroke is the second most common cause of death in the world. The aim of this study is to estimate stroke’s direct costs and productivity losses in Italy from a societal perspective and to explain cost variability. A prospective observational multicentre cost of illness study was designed. Four hundred and forty-nine consecutive patients admitted because of acute first-ever stroke in 11 Italian hospitals were enrolled. Costs and outcomes were assessed at patients’ enrolment, and at 3, 6 and 12 months after discharge. Overall, social costs in the first six months following the attack were € 11 600 per patient; 53% of this was health care costs, 39% non-health care costs and the remaining 8% productivity losses. Age, level of disability and type of hospital ward were the most significant predictors of six-month social costs. The acute phase counted for more than 50% of total health care costs, leaving the remaining 50% to the post-acute phase, indicating that follow-up should be on the agenda of policy makers also

Adoption Patterns of Bronchoscopic Lung Volume Reduction Procedures in Germany and Predicted Procedure Volumes for Other European Countries

BACKGROUND: Bronchoscopic lung volume reduction (BLVR) using valves and coils has been approved for use since 2003 and 2010, respectively. OBJECTIVE(S): To study adoption patterns of BLVR in an early-adopting country, and to estimate potential treatment volumes in other European countries. METHODS: Therapy- and age-specific volumes for endobronchial valve and coil procedures were obtained from German federal statistics for 2007-2016. Therapy-specific and total BLVR procedure volumes and growth were computed, and patterns in treatment age and device utilization analyzed. Patient volumes for other European countries were predicted using mean German patient volumes of the last 3 data years and age-specific population and emphysema incidences. RESULTS: Over the study period, annual BLVR procedure volumes grew from 91 to 2,053 (+2,256%), reaching a peak of 2,556 procedures in 2013. Coil procedures constituted 36% of the total volume in 2016. Treatment age was stable over time, with highest procedure counts in age group 60-64 years for valves and 65-69 years for coils. A limited increase in device use per procedure was observed. For -Germany, 1,655 newly treated BLVR patients were estimated per year, approximating about 5% of the annual newly diagnosed severe emphysema cases. Predicted volume estimates for other European countries ranged from 1 for Liechtenstein to 1,226 for France. CONCLUSIONS: Analysis of -German procedure data show pronounced BLVR therapy uptake in the early years of adoption, with the more recently introduced coil therapy used in about one-third of patients. Estimated patient volumes to date constitute only a small fraction of the severe emphysema population

PENGARUH MOTIVASI DAN LINGKUNGAN KERJA TERHADAP KINERJA KARYAWAN DI PT. MADUBARU

Penelitian ini bertujuan untuk mengetahui tingkat motivasi karyawan, bagaimana penilaian karyawan pada lingkungan kerja perusahaan, tingkat kinerja karyawan dan bagaimana pengaruh motivasi dan lingkungan kerja terhadap kinerja karyawan di perusahaan PT. Madubaru. Penelitian ini menggunakan data primer dengan cara menyebarkan kuesioner sebanyak 80 kepada responden. Penelitian ini menggunakan dua alat analisis yaitu One sample t Test dan Regresi Linier Berganda. Pada alat analisis One Sample t Test memberikan hasil bahwa tingkat motivasi karyawan di PT. Madubaru masuk dalam kategori tinggi, kedua penilaian xiv karyawan pada lingkungan kerja di perusahaan PT. Madubaru masuk dalam kategori tinggi, dan tingkat kinerja karyawan di perusahaan PT. Madubaru juga masuk dalam kategori tinggi. Pada uji Regresi Linier Berganda memberikan hasil yang berbeda. Secara simultan motivasi dan lingkungan kerja berpengaruh signifikan terhadap kinerja karyawan di perusahaan PT. Madubaru. Tetapi secara parsial memberikan dua hasil yaitu motivasi berpengaruh siginifikan terhadap kinerja karyawan dan lingkungan kerja tidak berpengaruh signifikan terhadap kinerja karyawan