Vollständiger Titel
MECOSAN
Verlag
FrancoAngeli
ISSN
1121-6921 (Gedruckte Zeitschrift)
2384-8804 (Online-Zeitschrift)
Nummer der Ausgabe
126
Andere Beschreibung der Ausgabe
126
Erscheinungsdatum der Ausgabe
2023
Vollständiger Titel
Il ridisegno dei processi di cura secondo l'approccio value-based: quali insegnamenti da un multiple case study?
Von (Autor)
Erste Seite
7
Letzte Seite
28
Erscheinungsdatum
2024/04
Copyright
2023 FrancoAngeli srl
Abstract/Hauptbeschreibung
L'obiettivo di questo lavoro è quello di investigare, mediante un multiple-case study, l'impatto e le condizioni organizzative dell'implementazione del modello value-based healthcare. In particolare, è stata analizzata la condizione clinica del Mieloma Multiplo (MM), una patologia oncologica che ben rappresenta le principali sfide e criticità dell'organizzazione dei sistemi sanitari nel post-pandemia. Per raggiungere gli obiettivi del lavoro: (i) è stata analizzata la modalità di organizzazione per processi del percorso di cura del MM; (ii) è 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 équipe multidisciplinari. I risultati dello studio possono sintetizzarsi attorno a due macromessaggi chiave. Innanzitutto, l'analisi dei costi mostra che, a parità di case-mix clinico assistenziale, differenti scelte clinico-assistenziali hanno un impatto economico e organizzativo rilevante. Risulta, quindi, necessario standardizzare, laddove è 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 équipe multidisciplinari e quello del focused-hospital rappresentano sicuramente soluzioni efficaci per la gestione di patologie complesse. Lo studio, però, evidenzia la presenza di almeno due condizioni rilevanti, è 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 più possibile complessiva (the full cycle of care) e integrata.
Unstructured Zitierung
Abernethy M.A., Stoelwinder J.U. (1995). The role of professional control in the management of complex organizations. Accounting
Organization and Society, 20(1): 1-77.
https://doi.org/10.1016/0361-3682(94)E0017-O
Unstructured Zitierung
AIOM (2015) – Associazione Italiana di Oncologia Medica. Linee Guida Mieloma.
Unstructured Zitierung
Andreatta P.B. (2010). A typology for health care teams. Health Care Management Review, 35(4): 345-354.
https://doi.org/10.1097/HMR.0b013e3181e9fceb
Unstructured Zitierung
Anessi Pessina E., Cantù E. (2007). L’aziendalizzazione delle sanità in Italia. Rapporto OASI. Milano: Egea.
Unstructured Zitierung
Anessi Pessina E. (2017). Assetto economico-finanziario. In: Osservatorio Nazionale Sulla Salute Nelle Regioni Italiane. O. N. S. S. N. R. I. (ed.). Rapporto Osservasalute 2017. Milano: Prex Spa Milano (Italy): 343-344 -- [http://hdl.handle.net/10807/120087].
Unstructured Zitierung
Armeni P., Bertolani A., Costa F. (2017). La spesa sanitaria: composizione ed evoluzione. Rapporto OASI, Capitolo 5. Milano: Egea.
Unstructured Zitierung
Atwal A., Caldwell K. (2005). Do all health and social care professionals interact equally: A study of interactions in multidisciplinary
teams in the United Kingdom. Scandinavian Journal of Caring Sciences, 19(3).
https://doi.org/10.1111/j.1471-6712.2005.00338.x
Unstructured Zitierung
Badash I., Kleinman N.P., Barr S. et al. (2017). Redefining Health: The Evolution of Health Ideas from Antiquity to the Era
of Value-Based Care. Cureus, 9(2).
https://doi.org/10.7759/cureus.1018
Unstructured Zitierung
Bensa G., Prenestini A., Villa S. (2008). La logistica del paziente in ospedale: aspetti concettuali, strumenti di analisi e leve di cambiamento. Rapporto OASI, Capitolo 11. Milano: Egea.
Unstructured Zitierung
Birkmeyer N.J.O. et al. (2005). Do cancer centers designated by the National Cancer Institute have better surgical outcomes?.
CANCER, 103(3).
https://doi.org/10.1002/cncr.20785
Unstructured Zitierung
Borgonovi E. (1990). Il controllo economico nelle aziende sanitarie. Milano: Egea.
Unstructured Zitierung
Boyer K., Pronovost P. (2010). What Medicine can teach operations: What operations can teach medicine. Journal of Operations
Management, 28: 367-371.
https://doi.org/10.1016/j.jom.2010.08.002
Unstructured Zitierung
Bucci S., De Belvis A.G. (2018). Come organizzare l’assistenza del paziente per percorsi di cura. Milano: Vita e Pensiero.
Unstructured Zitierung
Brugnoli A., Zangrandi A. (2021). Anziani e disabili: un nuovo modello di assistenza. Milano: Fondazione per la Sussidiarietà.
Unstructured Zitierung
Campanale C. et al. (2014). Time-driven activity-based costing to improve transparency and decision making in healthcare:
A case study. Qualitative Research in Accounting & Management, 11(2): 165-186.
https://doi.org/10.1108/QRAM-04-2014-0036
Unstructured Zitierung
Cannavacciuolo L., Illario M., Ippolito A., Ponsiglione C. (2015). An Activity – Based Costing approach for detecting inefficiencies
of healthcare processes. Business Process Management Journal, 21(1): 55-79.
https://doi.org/10.1108/BPMJ-11-2013-0144
Unstructured Zitierung
Casati G. (2000). Programmazione e controllo di gestione nelle aziende sanitarie. Milano: McGraw-Hill.
Unstructured Zitierung
Casati G., Vichi M.C. (2002). Il percorso assistenziale del paziente in ospedale. Milano: McGraw-Hill.
Unstructured Zitierung
Dabhilkar M., Svarts A. (2019). From general to specialty hospitals: operationalizing focus in healthcare operations. Operations
Management Research, 12: 94-111.
https://doi.org/10.1007/s12063-018-0137-8
Unstructured Zitierung
Eastaugh S.R. (2014). Hospital Specialization: Benefits-Focused Product Line Planning. Healthcare Finance, 41(3).
Unstructured Zitierung
Edmondson A.C., McManus S.E. (2007). Methodological fit in management field research. Academy of management review, 32(4):
1246-1264.
https://doi.org/10.5465/amr.2007.26586086
Unstructured Zitierung
Fattore G. (1999). Clarifying the scope of Italian NHS coverage: Is it feasible? Is it desirable?. Health Policy, 50: 123-142.
https://doi.org/10.1016/S0168-8510(99)00068-8
Unstructured Zitierung
Furnari A., Gugiatti A., Petracca F. (2016). La struttura e le attività del SSN. Rapporto OASI, Capitolo 4. Milano: Egea.
Unstructured Zitierung
García-Goni et al. (2012). Pathways towards chronic care-focused healthcare systems: Evidence from Spain. Health Policy, 108(2-3):
236-245.
https://doi.org/10.1016/j.healthpol.2012.09.014
Unstructured Zitierung
Guthrie J., Olson O., Humphreys C. (1998). International experiences with new public financial management reforms: new world? Small world? Better world?. Global Warning: Debating International Developments in New Public Financial Management, 17-48.
Unstructured Zitierung
Hood C. (1991). A public management for all seasons?. Public Administration, 69(1): 3-19.
https://doi.org/10.1111/j.1467-9299.1991.tb00779.x
Unstructured Zitierung
Hyer N. L. et al. (2009). Performance analysis of a focused hospital unit: The case of an integrated trauma center. Journal
of Operations Management, 27: 203-219.
https://doi.org/10.1016/j.jom.2008.08.003
Unstructured Zitierung
Kaplan R.S., Anderson S.R. (2004). Time-driven activity-based costing. Harv Bus Rev., Nov, 82(11): 131-8, 150.
Unstructured Zitierung
Kaplan R.S., Porter M.E. (2011). How to solve the cost crisis in Healh Care. Harvard Business Review, 47.
Unstructured Zitierung
Keel G., Savage C., Rafiq M., Mazzocato P. (2017). Time-driven activity-based costing in health care: A systematic review
of the literature. Health Policy, 121(7).
https://doi.org/10.1016/j.healthpol.2017.04.013
Unstructured Zitierung
Kesson E. M. et al. (2012). Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative,
interventional cohort study of 13722 women. BMJ, 344.
https://doi.org/10.1136/bmj.e2718
Unstructured Zitierung
Lapsley I. (2008). The NPM Agenda: Back to the Future. Financial Accountability & Management, 24(1): 77-96.
https://doi.org/10.1111/j.1468-0408.2008.00444.x
Unstructured Zitierung
Lee S.J., Abbey J.D., Heim G.R., Abbey D.C. (2016). Seeing the forest for the trees: Institutional environment impacts on
reimbursement processes and healthcare operations. Journal of Operations Management, 47-48: 71-79.
https://doi.org/10.1016/j.jom.2016.09.001
Unstructured Zitierung
Litvak E., Long M. (2000). Cost and quality under managed care: irreconcilable differences?. The American Journal of Managed Care, 6(3): 305-312.
Unstructured Zitierung
Marino M., de Belvis A.G., Tanzariello M. et al. (2018). Effectiveness and cost-effectiveness of integrated care models for
elderly, complex patients: A narrative review. Don’t we need a value-based approach?. International Journal of Care Coordination,
21(4): 120-139.
https://doi.org/10.1177/2053434518817019
Unstructured Zitierung
Marsilio M., Torbica A., Villa S. (2017). Healthcare Multidisciplinary Teams: The Sociotechnical approach for an integrated
system-wide perspective. Health Care Management Review, 42(4): 315-327.
https://doi.org/10.1097/HMR.0000000000000115
Unstructured Zitierung
McDermott C.M., Stock G.N. (2011). Focus as emphasis: Conceptual and performance implications for hospitals. Journal of Operations
Management, 29: 616-626.
https://doi.org/10.1016/j.jom.2011.02.002
Unstructured Zitierung
McGill M., Felton A.M. (2007). New global recommendations: A multidisciplinary approach to improving outcomes in diabetes.
Primary Care Diabetes, 1(1): 49-55.
https://doi.org/10.1016/j.pcd.2006.07.004
Unstructured Zitierung
Morelli M., Lecci F. (2011). Governo dei costi e cambiamento aziendale. La lunga strada verso l’integrazione. Mecosan, 80: 59-75.
Unstructured Zitierung
Nuti S. (2018). Performance Measurement at Work: How Can It Be an Effective Management Tool. In: Adinolfi P., Borgonovi E. (edited by). The Myths of Healthcare – Towards New Models of Leadership and Management in the Healthcare Sector. AG, Cham (ZG): Springer International Publishing, pp. 183-187.
Unstructured Zitierung
Pillay B. et al. (2016). The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology
settings: A systematic review of the literature. Cancer Treatment Review, 42: 56-72.
https://doi.org/10.1016/j.ctrv.2015.11.007
Unstructured Zitierung
Porter M. (2008). Value-Based Health Care Delivery. Annals of Surgery, 248(4): 503-509.
https://doi.org/10.1097/SLA.0b013e31818a43af
Unstructured Zitierung
Porter M.E., Teisberg E.O. (2006). Redefining Health Care: Creating Value-based Competition on Results. Cambridge: HBS press.
Unstructured Zitierung
Praetorius T. (2016). Improving care coordination using organisational routines Care pathways as a coordination mechanism.
Journal of Health Organization and Management, 30(1): 85-108.
https://doi.org/10.1108/JHOM-07-2013-0141
Unstructured Zitierung
Sacco P., Villa S. (2018). Impatto organizzativo ed economico dell’introduzione dei PCA, Capitolo V – Come organizzare l’assistenza del paziente per percorsi di cura. Milano: Vita e Pensiero.
Unstructured Zitierung
Simons R. (1995). Control in an age of empowerment. Harvard Business Review, 73(2): 80-88.
Unstructured Zitierung
Skinner W. (1974). The focused factory. Harvard Business Review, 52(3): 113-121.
Unstructured Zitierung
Stephens M.R. et al. (2006). Multidisciplinary team management is associated with improved outcomes after surgery for esophageal
cancer. Diseases of the Esophagus, 19(3): 164-171.
https://doi.org/10.1111/j.1442-2050.2006.00559.x
Unstructured Zitierung
Vagnoni E., Potena G. (2003). L’activity based costing in sanità: il caso dell’ossigenoterapia. Mecosan, 47: 149-161.
Unstructured Zitierung
Vendramini E. (2003). Il modello di balanced scorecard per la valutazione della performance delle aziende pubbliche. Azienda Pubblica, 4.
Unstructured Zitierung
Villa S. (2012). L’operations management a supporto del sistema di operazioni aziendali. Modelli di analisi e soluzioni progettuali per il settore sanitario. CEDAM.
Unstructured Zitierung
Villa S. (2021). Operations Management for Healthcare Organizations: Theory, Models and Tools. New York: Routledge Taylor
& Francis Group.
https://doi.org/10.4324/9781003227021
Unstructured Zitierung
Villa S., Barbieri M., Lega F. (2009). Restructuring patient flow logistics around patient care needs: implications and practicalities
from three critical cases. Health Care Management Science, 12: 155-165.
https://doi.org/10.1007/s10729-008-9091-6
Unstructured Zitierung
Willian J. et al. (2016). Multiple myeloma in the very elderly patient: challenges and solutions. Clinical Interventions in
Aging, 1: 423-435.
https://doi.org/10.2147/CIA.S89465
Unstructured Zitierung
Yin R.K. (1994). Case Study Research Design and Methods: Applied Social Research and Methods Series. Second edn. Thousand Oaks, CA: Sage Publications Inc.
Unstructured Zitierung
Yin R.C. (2009). Case study research: design and methods. 4th ed. California: SAGE Publications.
Unstructured Zitierung
Yin R.K., Pinnelli S. (2005). Lo studio di caso nella ricerca scientifica: progetto e metodi. Roma: Armando.