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Nel corso degli ultimi decenni, il tema della diversità di genere ha assunto un ruolo rilevante nel dibattito accademico. Invero, il recente proliferarsi di riforme sia a livello nazionale che internazionale ha promosso e favorito il coinvolgimento delle donne nelle posizioni dirigenziali delle aziende pubbliche. In tale contesto le riforme sono state orientate ad accrescere la diversità di genere, a favorire l’inclusione delle donne, nonché a migliorare la loro qualità della vita e il livello di soddisfazione negli ambienti di lavoro. Nonostante tali interventi abbiano stimolato l’interesse degli accademici, la letteratura sul tema si dimostra ancora limitata e inadeguata, soprattutto per ciò che riguarda gli studi sulle aziende di tutela della salute. Poco spazio è stato dedicato all’esame delle implicazioni, dei problemi, delle opportunità, delle sfide manageriali poste dal coinvolgimento delle donne nelle posizioni dirigenziali delle aziende pubbliche e private di tutela della salute, anche rispetto all’adozione e impiego di soluzioni digitali. Pertanto, l'articolo si pone l’obiettivo di stimolare il dibattito sul tema della diversità di genere, della leadership e della performance nelle aziende di tutela della salute, incoraggiando gli accademici a sviluppare nuove linee di ricerca e ad ampliare le prospettive di interpretazione del fenomeno, anche mediante l'impiego di diverse metodologie.

L’aumento della prevalenza delle malattie croniche rappresenta, oggi, la nuova e maggiore sfida per i sistemi sanitari che sono impegnati nella riorganizzazione di servizi da destinare non solo a persone in condizioni acute o di emergenza, ma anche a persone con patologie croniche e in particolare con multimorbosità. Si calcola, infatti, che più di un terzo delle persone con età superiore a 65 anni, abbia almeno due patologie croniche. Si pongono, quindi, riflessioni e interrogativi stimolanti rispetto alle implicazioni per i servizi sanitari, per la valutazione dei cambiamenti organizzativi da implementare e per la ricerca di tipo clinico e organizzativo. Anche la formazione, sia medica, sia delle professioni sanitarie, è ancora, in gran parte, basata su un approccio legato alla singola malattia e non ancora sufficientemente orientata a favorire il coinvolgimento dei pazienti sia nelle decisioni cliniche, sia nella gestione della patologia cronica mediante interventi di educazione terapeutica e supporto all’autocura. Il convegno si rivolge a professionisti sanitari, programmatori e gestori dei servizi socio-sanitari, formatori e ricercatori, proprio per una comune riflessione e per una ricerca condivisa di possibili soluzioni.

Objective: To assess the cost-effectiveness of the Argus® II Retinal Prosthesis System (Argus II) in Retinitis Pigmentosa (RP) patients. Design: Decision analysis model based-comparison of long term costs and health outcomes of Argus II implantation versus usual care (i.e. nursing care and rehabilitation)[for full text, please go to the a.m. URL], Artificial Vision 2013

La presente ricerca si prefigge l’obiettivo di analizzare le tendenze in atto a livello internazionale in tema di rendicontazione rivolta dalla Pubblica Amministrazione alla collettività. In particolare, il focus dell’indagine è rappresentato dagli strumenti utilizzati nel settore pubblico per fornire informazioni ai cittadini in merito all’attività svolta. Nel dettaglio, la ricerca assume per oggetto: • tutti i livelli di governo della pubblica amministrazione prendendo come riferimento un ambito di analisi internazionale; • i documenti specificamente rivolti ai cittadini ed i documenti informativi a carattere generale e, pertanto, non specificamente orientati ai cittadini; • sia le cosiddette best practice in tema di strumenti di accountability, sia le “good practice”.

AIM: Increasing ageing of the population and tumor incidence, along with worldwide rationing of the resources for public health systems, spur the use of economic analyses for the choice of strategies and technologies in the assessment and management of cancer patients. Incidence and clinical managing of tumors vary in different countries even if positron emission tomography (PET) with 2-deoxy-2-[18F]-fluoro-D-glucose (FDG) is becoming a routine clinical method for diagnosis, staging, treatment monitoring and follow-up in a variety of tumors. Available data indicate that PET can be considered a superior alternative or complementary tool to other well-established methods. However, in spite of the above and of the rapidly increasing number of PET centers in Europe, USA and Japan, only a few studies have dealt with some of the economic aspects raised by the clinical use of PET because of differences in values of reimbursements and health costs. The main aim of this study is to propose and discuss an economic model of analysis for PET applications in the field of detection and management of pulmonary tumors. METHODS: In this study 2 assessments were performed by decision tree analysis on the economic impact of the availability of PET on decision-making processes for 2 conditions: solitary pulmonary nodules assessment and non-small-cell lung cancer (NSCLC) staging. In order to define a methodology consistent with the system of reimbursement and the prevalent clinical views of the Italian National Health Service, data on costs, death probability, and life expectancy were gathered from the literature and from the Italian system of reimbursement (ROD-DRGs). RESULTS: The results of the cost minimization analysis demonstrate that the use of PET in the diagnostic path for the workup of patients with SPN reduces the overall diagnostic costs, by approximately 50 Euro per patient, by reducing inappropriate invasive diagnostic investigation and their complications. The results of the cost effectiveness analysis demonstrate that the use of PET in the diagnostic path for the staging of patients with NSCLC reduces the overall diagnostic costs by approximately 108 Euro for added year, by reducing inappropriate surgical interventions and their complications. CONCLUSION: Both analyses are based on standard methods used in the literature, so our conclusions can be compared with results and assessments of similar studies in different countries and health care systems. Also in the Italian case, the use of an economic assessment provides relevant information on the efficacy and effectiveness of PET.

AIM: Increasing ageing of the population and tumor incidence, along with worldwide rationing of the resources for public health systems, spur the use of economic analyses for the choice of strategies and technologies in the assessment and management of cancer patients. Incidence and clinical managing of tumors vary in different countries even if positron emission tomography (PET) with 2-deoxy-2-[18F]-fluoro-D-glucose (FDG) is becoming a routine clinical method for diagnosis, staging, treatment monitoring and follow-up in a variety of tumors. Available data indicate that PET can be considered a superior alternative or complementary tool to other well-established methods. However, in spite of the above and of the rapidly increasing number of PET centers in Europe, USA and Japan, only a few studies have dealt with some of the economic aspects raised by the clinical use of PET because of differences in values of reimbursements and health costs. The main aim of this study is to propose and discuss an economic model of analysis for PET applications in the field of detection and management of pulmonary tumors. METHODS: In this study 2 assessments were performed by decision tree analysis on the economic impact of the availability of PET on decision-making processes for 2 conditions: solitary pulmonary nodules assessment and non-small-cell lung cancer (NSCLC) staging. In order to define a methodology consistent with the system of reimbursement and the prevalent clinical views of the Italian National Health Service, data on costs, death probability, and life expectancy were gathered from the literature and from the Italian system of reimbursement (ROD-DRGs). RESULTS: The results of the cost minimization analysis demonstrate that the use of PET in the diagnostic path for the workup of patients with SPN reduces the overall diagnostic costs, by approximately 50 Euro per patient, by reducing inappropriate invasive diagnostic investigation and their complications. The results of the cost effectiveness analysis demonstrate that the use of PET in the diagnostic path for the staging of patients with NSCLC reduces the overall diagnostic costs by approximately 108 Euro for added year, by reducing inappropriate surgical interventions and their complications. CONCLUSION: Both analyses are based on standard methods used in the literature, so our conclusions can be compared with results and assessments of similar studies in different countries and health care systems. Also in the Italian case, the use of an economic assessment provides relevant information on the efficacy and effectiveness of PET.

The reduction in Caesarean sections (CSs) is widely considered a priority in the public decision makers agenda. Though the World Health Organisation has strongly encouraged countries to implement policies to reduce CSs to 10–15%, after almost thirty years this goal appears still far from its achievement. The literature depicts CS as a multifaceted phenomenon whose causes involve different factors, ranging from the patient sphere to the health care level of services provided, and the societal preference of CS practice. Policy makers aiming to standardise cares and to reduce CSs often implement maternity pathways (MP). By investigating the MP introduced in the Sicilian region, the authors highlight the need to adopt an outcome-based performance management approach to assess the effectiveness of CS reduction policies. The suggested perspective also reveals the necessity to frame and coordinate the interdependencies between the different actors playing a crucial role in the MP.