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Il ridisegno dei processi di cura secondo l?approccio value-based: quali insegnamenti da un multiple case study?

Author

Listed:
  • Simone Laratro
  • Marco Giovanni Rizzo
  • Stefano Villa

Abstract

L?obiettivo di questo lavoro ? quello di investigare, mediante un multiple-case study, l?impatto e le condizioni organizzative dell?implementazione del modello value-based healthcare. In particolare, ? stata analizzata la condizione clinica del Mieloma Multiplo (MM), una patologia oncologica che ben rappresenta le principali sfide e criticit? dell?organizzazione dei sistemi sanitari nel post-pandemia. Per raggiungere gli obiettivi del lavoro: (i) ? stata analizzata la modalit? di organizzazione per processi del percorso di cura del MM; (ii) ? stato misurato il costo del percorso di cura mediante la tecnica del time driven activity based costing; (iii) sono state identificate le condizioni organizzative per l?implementazione del modello value-based healthcare con particolare riferimento al modello del focused-hospital e delle ?quipe multidisciplinari. I risultati dello studio possono sintetizzarsi attorno a due macromessaggi chiave. Innanzitutto, l?analisi dei costi mostra che, a parit? di case-mix clinico assistenziale, differenti scelte clinico-assistenziali hanno un impatto economico e organizzativo rilevante. Risulta, quindi, necessario standardizzare, laddove ? possibile, i processi di cura con strumenti come i Percorsi Diagnostici Terapeutici e Assistenziali. Come peraltro abbiamo appreso sul campo nella recente pandemia COVID-19, il modello delle ?quipe multidisciplinari e quello del focused-hospital rappresentano sicuramente soluzioni efficaci per la gestione di patologie complesse. Lo studio, per?, evidenzia la presenza di almeno due condizioni rilevanti, ? necessario infatti: (i) sviluppare sistemi informativi ?orizzontali? capaci di fornire dati tempestivi e accurati sui processi di cura; (ii) trasferire sul territorio, laddove possibile, anche attraverso la tecnologia (e.g. telemedicina), le competenze specialistiche del focused-hospital all?interno di una presa in carico il pi? possibile complessiva (the full cycle of care) e integrata.

Suggested Citation

  • Simone Laratro & Marco Giovanni Rizzo & Stefano Villa, 2023. "Il ridisegno dei processi di cura secondo l?approccio value-based: quali insegnamenti da un multiple case study?," MECOSAN, FrancoAngeli Editore, vol. 2023(126), pages 7-28.
    • Handle: RePEc:fan:mesame:v:html10.3280/mesa2023-126oa17279
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    References listed on IDEAS

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    1. Cristina Campanale & Lino Cinquini & Andrea Tenucci, 2014. "Time-driven activity-based costing to improve transparency and decision making in healthcare," Qualitative Research in Accounting & Management, Emerald Group Publishing Limited, vol. 11(2), pages 165-186, June.
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