scholarly journals The Italian Patients’ Mobility as Hospital Policies Assessment

2021 ◽  
Vol 4 (6) ◽  
Author(s):  
Nante N
Keyword(s):  
Health Planning ◽  
Management Control ◽  
Access To Health Services ◽  
Financial Flows ◽  
Italian Regions ◽  
Graphical Tool ◽  
Catchment Areas ◽  
Perceived Equity ◽  
Hospital Patients ◽  
Hospital Networks

Background: The analysis of mobility flows (movement of patients to hospital away from the place of residence) involves aspects of services quality (real/perceived), equity of access to healthcare and considerable financial flows. This work has a methodological meaning and summarizes the author’s experience over the years in order to demonstrate the usefulness of Gandy’s Nomogram (Cartesian graphic tool) to evaluate hospital patients’ mobility at MACRO, MESO and MICRO level. Materials and Methods: We analysed data of Hospital Discharge Cards (HDCs) produced by Italian hospital and provided by the HDCs Database of General Directorate for Health Planning of Ministry of Health from 1998 to 2019. We used also data produced by Management Control of Polyclinic of Siena from 1988 to 2007. The subjects of the analysis (catchment areas) were hospital networks of single Italian regions and in particular the Province of Siena. The study of flows was developed through Gandy’s Nomogram. The trend analysis was carried out through STATA 14. Results: Gandy’s Nomogram of inter-regional mobility showed that there was a concentration of critical situations, especially in southern Italy, where only Basilicata seemed to have embarked on a clear path for enhancing hospital supply during the studied period. The regions of Centre-North, in particular Lombardy, Emilia Romagna and Friuli-Venezia Giulia appeared to be in virtuous conditions. Conclusion: Gandy’s Nomogram, used to represent health mobility flows, has proven to be a practical graphical tool that can provide a geographical interpretation of access to health services and it is useful for health policy evaluation and planning

scholarly journals Inter-Regional Hospital Patients’ Mobility in Italy

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1182
Author(s):  
Nicola Nante ◽  
Giovanni Guarducci ◽  
Carlotta Lorenzini ◽  
Gabriele Messina ◽  
Flavia Carle ◽  
...  
Keyword(s):  
Market Model ◽  
Care Needs ◽  
Catchment Areas ◽  
Graphic Representations ◽  
Northern Regions ◽  
Hospital Patients ◽  
Italian National Health Service ◽  
Hospital Networks ◽  
Italian National Health ◽  
Autonomous Province

Background: The federalization of the Italian National Health Service (NHS) gave administrative, financial, and managerial independence to regions. They are in reciprocal competition according to the “quasi-market” model. A network of independent providers replaced the state monopoly. The NHS, based on the Beveridge model in which citizens are free to choose their place of treatment, was consolidated. The aim of our research was to analyze the fulfillment of need for hospital services on site and patients’ migration to hospitals of other regions. Material and Methods: We analyzed data from 2013 to 2017 of Hospital Discharge Cards (HDCs) provided by the Ministry of Health. The subjects of the analysis (catchment areas) were the hospital networks of every Italian region. The study of flows was developed through Internal Demand Satisfaction, Attraction, Escape, Attraction, Absorption, and Escape Production indexes. Graphic representations were produced using Gandy’s Nomogram and Qgis software. Results: In the studied period, the mean number of mobility admission was 678.659 ± 3.388, with an increase of 0.90%; in particular, the trend for ordinary regime increased 1.17%. Regions of central/northern Italy have attracted more than 60% of the escapes of the southern ones. Gandy’s Nomogram showed that only nine regions had optimal public hospital planning (Lombardy, Autonomous Province of Bolzano, Veneto, Friuli V.G., Emilia-Romagna, Tuscany, Umbria, Latium and Molise). Conclusion: The central/northern regions appear more able to meet the care needs of their citizens and to attract patients than the southern ones.

The Post-Amputation Rehabilitation Experience of People Living in Rural Settings

2001 ◽  
Vol 7 (1) ◽  
pp. 23-37
Author(s):  
Amanda Young ◽  
Gregory Murphy ◽  
Sandra Kippen ◽  
Peter Foreman
Keyword(s):  
Surgical Intervention ◽  
Health Planning ◽  
Rural Setting ◽  
Access To Health Services ◽  
Counselling Services ◽  
Access To Health ◽  
Rural Settings ◽  
Social Support Services ◽  
Depth Interviews ◽  
Initial Focus

This paper reports the results from a qualitative study aimed at identifying the factors influencing the rehabilitation experience of people living with an amputation in a rural setting. Following the conduct of an initial focus group, 24 rural-based individuals responded to an invitation to participate in the study's in-depth interviews. Fourteen of those interviewed lived in a ‘regional’ setting (the regional group) and the other ten lived in more remote locations (the ‘distant’ group). Consistent with this population's demography, the sample was comprised mainly of older people (mean age of 66.8 years) who had suffered their amputation as a result of vascular disease. While the groups differed with respect to two aspects of their rehabilitation experience (with the distant group reporting more problems with accommodation and access to health services), many common themes emerged from the interviews, including an overall positive acceptance of the surgical intervention, the call for increased post-operative counselling services, and an endorsement of the usefulness of peer-support (and more generally of social support) services. Results are discussed in terms of their implications for service delivery and endorsement is made of the suggestion that rural health planning be more community-focussed.

scholarly journals Preference for Subcutaneous Injection or Intravenous Infusion of Biological Therapy Among Italian Patients With SLE

2018 ◽  
Vol 6 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Marina Falanga ◽  
Augusta Canzona ◽  
Davide Mazzoni
Keyword(s):  
Lupus Erythematosus ◽  
Intravenous Infusion ◽  
Subcutaneous Injection ◽  
Biological Therapy ◽  
Injection Device ◽  
Online Questionnaire ◽  
Subcutaneous Injections ◽  
Italian Regions ◽  
Hospital Patients ◽  
Patients Acceptance

This article focuses on the patients’ acceptance of a subcutaneous injection device for patients with systemic lupus erythematosus, which in the upcoming years could be introduced beside the intravenous infusion of biological therapy. An online questionnaire was completed by 548 patients from different Italian regions. The preference for subcutaneous injection was 41.2%, for intravenous infusion was 36.9%, and 21.9% were uncertain. Patients with previous experience of biological therapies were less uncertain ( P = .001). The reported motivations for the preference were analyzed through a lexicometric approach with the software T-LAB. Results revealed that respondents who preferred subcutaneous injections reported motivations that were more related to convenience, avoiding the discomfort of reaching the hospital. Patients who preferred intravenous infusion emphasized the importance of safety feelings related to the presence of qualified assistance during the therapy administration. In conclusion, patients appreciated the convenience that characterizes subcutaneous injections but also emphasized the importance of feeling safe during the administration. The study suggests that the choice of prescribing subcutaneous injections or intravenous infusions should be shared with patients, discussing possible resistances and avoiding preconceptions about patients’ preferences.

scholarly journals Hospital patients mobility trends among the Italian regions: 1998-2008

2013 ◽  
Vol 23 (suppl_1) ◽  
Author(s):  
G Messina ◽  
G Prisco ◽  
L Gialluca ◽  
C Bedogni ◽  
F Moirano ◽  
...  
Keyword(s):  
Italian Regions ◽  
Hospital Patients

scholarly journals The effects of medicines availability and stock-outs on household’s utilization of healthcare services in Dodoma region, Tanzania

2020 ◽  
Vol 35 (3) ◽  
pp. 323-333 ◽  
Author(s):  
August Kuwawenaruwa ◽  
Kaspar Wyss ◽  
Karin Wiedenmayer ◽  
Emmy Metta ◽  
Fabrizio Tediosi
Keyword(s):  
Health Services ◽  
Health Facility ◽  
Healthcare Utilization ◽  
Low Income ◽  
Essential Medicines ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health ◽  
Catchment Areas ◽  
Medicine Availability

Abstract Low- and middle-income countries have been undertaking health finance reforms to address shortages of medicines. However, data are lacking on how medicine availability and stock-outs influence access to health services in Tanzania. The current study assesses the effects of medicine availability and stock-outs on healthcare utilization in Dodoma region, Tanzania. We conducted a cross-sectional study that combined information from households and healthcare facility surveys. A total of 4 hospitals and 89 public primary health facilities were surveyed. The facility surveys included observation, record review over a 3-month period prior to survey date, and interviews with key staff. In addition, 1237 households within the health facility catchment areas were interviewed. Data from the facility survey were linked with data from the household survey. Descriptive analysis and multivariate logistic regressions models were used to assess the effects of medicine availability and stock-outs on utilization patterns and to identify additional household-level factors associated with health service utilization. Eighteen medicines were selected as ‘tracers’ to assess availability more generally, and these were continuously available in ∼70% of the time in facilities across all districts over 3 months of review. The main analysis showed that household’s healthcare utilization was positively and significantly associated with continuous availability of all essential medicines for the surveyed facilities [odds ratio (OR) 3.49, 95% confidence interval (CI) 1.02–12.04; P = 0.047]. Healthcare utilization was positively associated with household membership in the community health insurance funds (OR 1.97, 95% CI 1.23–3.17; P = 0.005) and exposure to healthcare education (OR 2.75, 95% CI 1.84–4.08; P = 0.000). These results highlight the importance of medicine availability in promoting access to health services in low-income settings. Effective planning and medicine supply management from national to health facility level is an important component of quality health services.

scholarly journals Gestão em saúde: avaliação do acesso ao sistema regional

2019 ◽  
Vol 13 (4) ◽  
pp. 933
Author(s):  
Priscila Balderrama ◽  
Josué Souza Gleriano ◽  
Silvia Helena Henriques ◽  
Janise Braga Barros Ferreira ◽  
Larissa Roberta Alves ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Health Management ◽  
Health Planning ◽  
Study Data ◽  
Access To Health Services ◽  
Microsoft Excel ◽  
Organization Of Care ◽  
Access To Health ◽  
El Sistema ◽  
La Red

RESUMOObjetivo: avaliar o acesso ao sistema regional de saúde a partir das ações de atenção aos agravos cardiovasculares. Método: trata-se de um estudo misto, descritivo. Coletaram-se dados a partir dos Sistemas de Informação Ambulatorial e Hospitalar do SUS, armazenados em planilhas Microsoft Excel e analisados utilizando-se estatística descritiva. Posteriormente, selecionaram-se 41 participanetes (gestores e reguladores) para responderem um questionário semiestruturado sobre acesso em cardiologia na rede regional. Optou-se pela Análise Temática de Conteúdo para análise dos dados qualitativos. Resultados: registrou-se o incremento da produção de consultas e exames, indicando a ampliação da oferta de serviços, a redução das internações clínicas e o crescimento das internações cirúrgicas em Cardiologia. Revelaram-se, em entrevistas, aspectos da organização da atenção no sistema regional que favorecem o acesso à atenção integral em Cardiologia. Conclusão: conclui-se que houve uma melhoria do acesso à atenção cardiovascular. Aponta-se que a coordenação do cuidado e a melhoria da resolubilidade da Atenção Básica favorecem o acesso à saúde, que também requer a implantação de estruturas sólidas de gestão, envolvendo planejamento, controle, regulação e avaliação. Descritores: Acesso aos Serviços de Saúde; Avaliação em Saúde; Doenças Cardiovasculares; Gestão em Saúde; Planejamento em Saúde; Regionalização.ABSTRACTObjective: to evaluate the access to the regional health system from the actions of attention to cardiovascular diseases. Method: this is a mixed, descriptive study. Data were collected from UHS Ambulatory and Hospital Information Systems, stored in Microsoft Excel spreadsheets and analyzed using descriptive statistics. Subsequently, 41 participanetes (managers and regulators) were selected to answer a semi-structured questionnaire about access in cardiology in the regional network. The Thematic Content Analysis was used to analyze the qualitative data. Results: there was an increase in the production of consultations and examinations, indicating the expansion of the service offer, the reduction of clinical hospitalizations and the increase of surgical hospitalizations in Cardiology. In interviews, aspects of the organization of care in the regional system that favor access to comprehensive care in Cardiology were revealed. Conclusion: it was concluded that there was an improvement in access to cardiovascular care. It is pointed out that the coordination of care and the improvement of the resolubility of Primary Care favor access to health, which also requires the implementation of solid management structures, involving planning, control, regulation and evaluation. Descriptors: Access to Health Services; Health Evaluation; Cardiovascular diseases; Health Management; Health Planning; Regionalization.RESUMENObjetivo: evaluar el acceso al sistema regional de salud a partir de las acciones de atención a los agravios cardiovasculares. Método: se trata de un estudio mixto, descriptivo. Se recolectó datos a partir de los Sistemas de Información Ambulatoria y Hospitalaria del SUS, almacenados en hojas de cálculo de Microsoft Excel y analizados utilizando estadística descriptiva. Posteriormente, se seleccionaron 41 participantes (gestores y reguladores) para responder un cuestionario semiestructurado sobre acceso en cardiología en la red regional. Se optó por el Análisis Temático de Contenido para el análisis de los datos cualitativos. Resultados: se registró el incremento de la producción de consultas y exámenes, indicando la ampliación de la oferta de servicios, la reducción de las internaciones clínicas y el crecimiento de las internaciones quirúrgicas en Cardiología. Se revelaron, en entrevistas, aspectos de la organización de la atención en el sistema regional que favorecen el acceso a la atención integral en Cardiología. Conclusion: se concluye que hubo una mejora del acceso a la atención cardiovascular. Se señala que la coordinación del cuidado y la mejora de la resolución de la Atención Básica favorecen el acceso a la salud, que también requiere la implantación de estructuras sólidas de gestión, involucrando planificación, control, regulación y evaluación. Descriptores: Accesibilidad a los Servicios de Salud; Evaluación en Salud; Enfermedades Cardiovasculares; Gestión en Salud; Planificación en Salud; Regionalización.

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