La gestione della cronicità nelle aziende sanitarie: una rassegna della letteratura

Journal title MECOSAN
Author/s Maria Chiara Demartini, Valentina Beretta
Publishing Year 2021 Issue 2020/116
Language Italian Pages 24 P. 7-30 File size 388 KB
DOI 10.3280/MESA2020-116002
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One of the main current challenges in the healthcare sector is related to the integrated management of chronic diseases. Estimates report that two thirds of retired people are destined to have at least two chronic diseases. In 2014, 68% of deaths were caused by chronic diseases, which are mainly responsible for morbidity, disability and mortality. In this regard, several countries have developed new models, or approaches, to better coordinate the services provided to chronic patients. It is common, therefore, to find different approaches to care, implemented in different countries, according to local needs. In this context, healthcare companies should balance the effective management of chronicity, on the one hand, with the containment of costs linked to austerity policies, on the other. The aim of this study is to conduct a systematic literature review of previous studies focusing on the management of chronic conditions. Methodology. The systematic literature review has been conducted by searching relevant articles in the following databases Cochrane, PubMed, Web of Science. Results have been classified according to an adaptation of the classification system proposed by the European Union composed by the following areas: organizational models; change management; workforce development, education and training; risk stratification; care pathway implementation; patient/user empowerment, health education and health promotion; electronic care records, ICTs and teleservices; finance and funding; performance evaluation. Findings. The analysis of the literature highlights how health and socio-health services should be increasingly integrated in order to guarantee the patient a path as continuous and effective as possible, simultaneously overcoming two limits of previous studies: the focus on a single chronic pathology, and the limitation in the dimensions under investigation. The classification model proposed by the European Union favors a holistic analysis of chronicity management models, including different strategic investigation dimensions. Relevance and implications for research and policy/practice. From the results of the literature review, some areas that have not yet been widely investigated and which may offer ideas for future research emerged. In particular, the following may represent areas of interest for studies aimed at advancing knowledge in the context of the management of chronicity by healthcare organizations: the definition of clear objectives and the measurement of outcomes, organizational change paths for an improvement in management and chronic patient care, systemic considerations of the patient pathways, multidisciplinary skills and services, fundamental role of technologies, key performance measures to improve efficiency in patient management and health outcomes.

Keywords: Chronic diseases, healthcare organizations, literature review.

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Maria Chiara Demartini, Valentina Beretta, La gestione della cronicità nelle aziende sanitarie: una rassegna della letteratura in "MECOSAN" 116/2020, pp 7-30, DOI: 10.3280/MESA2020-116002