[Autom. eng. transl.] Introduction The sustainability of health systems is a serious public health problem and the adoption of value-based approaches is essential to improve patient centrality, appropriateness, quality and allocation of resources in health. The general objective of this project was to develop an innovative and transferable tool to evaluate the value of hospital care by monitoring the costs and outcomes of the care pathways. Specific objectives were: to evaluate the variability of costs and outcomes in homogeneous groups (by age, comorbidity, type of access, etc.) of patients; evaluate the contribution of clinical activities to the hospital budget; identify and monitor critical issues. Materials and methods In 2018, a Business Intelligence System powered by different hospital datasets was developed and tested in a Roman University Hospital to quantify and integrate data on the efficacy and costs of clinical-care pathways. The tool is based on an algorithm consisting of 20 indicators relating to the clinical-care pathways for Women's and Children's Health. Results The preliminary results showed a high variability for the same intervention / procedure relating to the length of stay (3-8 days), waiting times (1-4 days) and the costs of innovative technologies (€ 2,000-6,000) , and the presence of obsolete reimbursement rates (€ 2,000- € 5,000), which do not guarantee adequate margins for economic contributions. These data led to the definition of improvement actions regarding the activity flows of the courses and the organizational appropriateness. There was also the need to activate discussion / negotiation tables with the Ministry of Health for updating the DRGs. Conclusions The tool, built on a value-based vision of the processes - a new paradigm of public health - made it possible to simultaneously analyze hospital outcomes and cost data aggregated by clinical-care pathway, benchmark results, identify critical issues and define strategies and solutions aimed at improving quality and rationalizing the allocation of resources. Its application has therefore proved to be an innovative methodology - also applicable in other care settings / countries - to trigger changes in clinical-care management and pursue the quality and efficiency of health care.
|Translated title of the contribution||[Autom. eng. transl.] Costs and outcomes of hospital care: a value-based assessment tool for clinical governance [Poster]|
|Journal||JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE|
|Publication status||Published - 2019|
- Assistenza ospedaliera
- Governance clinica