Vertical integration and contractual network in the cardiovascular sector: the experience of the Italian region Emilia Romagna
<b>Objective:</b> We analysed the integrated planning model adopted by the Italian region Emilia Romagna in year 2000 to cover the entire range of treatment of cardiovascular disease. This model, called “hub and spoke”, provides for the transfer of patient care and treatment from periphe...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Ubiquity Press
2003-06-01
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| Series: | International Journal of Integrated Care |
| Subjects: | |
| Online Access: | http://www.ijic.org/index.php/ijic/article/view/82 |
| _version_ | 1811307767381622784 |
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| author | Cristina Ugolini Lucia Nobilio |
| author_facet | Cristina Ugolini Lucia Nobilio |
| author_sort | Cristina Ugolini |
| collection | DOAJ |
| description | <b>Objective:</b> We analysed the integrated planning model adopted by the Italian region Emilia Romagna in year 2000 to cover the entire range of treatment of cardiovascular disease. This model, called “hub and spoke”, provides for the transfer of patient care and treatment from peripheral units (the spokes) to central units (the hubs) once a certain complexity threshold has been reached.<br><br> <b>Methods:</b> We examined inter-temporal variations in patients flows for the selection/referral and follow-up phases between cardiac surgery and cardiology units during two periods characterised by different organisational set-ups, in order to reflect on the progress being made in the organisation of the network. The database consisted of regional records of hospital discharges during the 1997–2001 period.<br><br> <b>Results:</b> The investigation pointed to the achievement of a good degree of coordination between structures at different levels of specialisation in the case of cardiac surgery, for which six centres were selected already in 1996. On the other hand, the more recent introduction of a hierarchical system for interventional cardiology points to the prevalence of operations on patients previously treated within the same centre, to admissions by direct access, and to follow-up mainly conducted within the hub providing the initial service.<br><br> <b>Conclusions:</b> Despite the progress made towards the more effective rationalisation of the health care network, there is still room for improvement in relations between different centres, in particular with regard to the clearer definition of the roles and interdependence of those intermediate-level centres located between the hub centres and basic healthcare facilities. |
| first_indexed | 2024-04-13T09:10:02Z |
| format | Article |
| id | doaj.art-98ed5f04ed4a492997cf5dcd3fd139c8 |
| institution | Directory Open Access Journal |
| issn | 1568-4156 |
| language | English |
| last_indexed | 2024-04-13T09:10:02Z |
| publishDate | 2003-06-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | International Journal of Integrated Care |
| spelling | doaj.art-98ed5f04ed4a492997cf5dcd3fd139c82022-12-22T02:52:53ZengUbiquity PressInternational Journal of Integrated Care1568-41562003-06-013282Vertical integration and contractual network in the cardiovascular sector: the experience of the Italian region Emilia RomagnaCristina UgoliniLucia Nobilio<b>Objective:</b> We analysed the integrated planning model adopted by the Italian region Emilia Romagna in year 2000 to cover the entire range of treatment of cardiovascular disease. This model, called “hub and spoke”, provides for the transfer of patient care and treatment from peripheral units (the spokes) to central units (the hubs) once a certain complexity threshold has been reached.<br><br> <b>Methods:</b> We examined inter-temporal variations in patients flows for the selection/referral and follow-up phases between cardiac surgery and cardiology units during two periods characterised by different organisational set-ups, in order to reflect on the progress being made in the organisation of the network. The database consisted of regional records of hospital discharges during the 1997–2001 period.<br><br> <b>Results:</b> The investigation pointed to the achievement of a good degree of coordination between structures at different levels of specialisation in the case of cardiac surgery, for which six centres were selected already in 1996. On the other hand, the more recent introduction of a hierarchical system for interventional cardiology points to the prevalence of operations on patients previously treated within the same centre, to admissions by direct access, and to follow-up mainly conducted within the hub providing the initial service.<br><br> <b>Conclusions:</b> Despite the progress made towards the more effective rationalisation of the health care network, there is still room for improvement in relations between different centres, in particular with regard to the clearer definition of the roles and interdependence of those intermediate-level centres located between the hub centres and basic healthcare facilities.http://www.ijic.org/index.php/ijic/article/view/82integrated health care networkscardiac surgeryinterventional cardiologypatient flows |
| spellingShingle | Cristina Ugolini Lucia Nobilio Vertical integration and contractual network in the cardiovascular sector: the experience of the Italian region Emilia Romagna International Journal of Integrated Care integrated health care networks cardiac surgery interventional cardiology patient flows |
| title | Vertical integration and contractual network in the cardiovascular sector: the experience of the Italian region Emilia Romagna |
| title_full | Vertical integration and contractual network in the cardiovascular sector: the experience of the Italian region Emilia Romagna |
| title_fullStr | Vertical integration and contractual network in the cardiovascular sector: the experience of the Italian region Emilia Romagna |
| title_full_unstemmed | Vertical integration and contractual network in the cardiovascular sector: the experience of the Italian region Emilia Romagna |
| title_short | Vertical integration and contractual network in the cardiovascular sector: the experience of the Italian region Emilia Romagna |
| title_sort | vertical integration and contractual network in the cardiovascular sector the experience of the italian region emilia romagna |
| topic | integrated health care networks cardiac surgery interventional cardiology patient flows |
| url | http://www.ijic.org/index.php/ijic/article/view/82 |
| work_keys_str_mv | AT cristinaugolini verticalintegrationandcontractualnetworkinthecardiovascularsectortheexperienceoftheitalianregionemiliaromagna AT lucianobilio verticalintegrationandcontractualnetworkinthecardiovascularsectortheexperienceoftheitalianregionemiliaromagna |