Il finanziamento delle reti cliniche. Il caso della rete metropolitana di endoscopia toracica

Journal title MECOSAN
Author/s Aldo Bonadies, Edoardo Bevini, Chiara Gibertoni, Anna Maria Petrini
Publishing Year 2021 Issue 2020/116 Language Italian
Pages 14 P. 75-88 File size 230 KB
DOI 10.3280/MESA2020-116005
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The implementation of network organizational models, for example Hub & Spoke, creates high specialty centers (hubs) characterized by a high absorption of resources that differentiates them from the other nodes of the network (spoke), also in terms of cost structure, which, for the definition of the role assumed within the model, are certainly characterized by a different cost structure. In this way, therefore, the bias deriving from the adoption of the DRG system as a financing system in the context of network models is highlighted. In order to evaluate this implication, a cost analysis was conducted - with the use of activity based costing - estimating the cost differentials associated with some procedures provided at the hub of the Bologna metropolitan network of thoracic endoscopy. Keywords: costs, clinical network, Hub & Spoke organizations, endoscopy, innovation, integration.

Keywords: Costi, rete clinica, Hub & Spoke, endoscopia, innovazione, integrazione.

  1. Alberti F., Tozzi V., Pinelli N., & Sartirana M. (2012). Il ruolo delle Aziende Sanitarie nelle Reti Cliniche in Italia. Milano: Osservatorio FIASO.
  2. Bojke C., Grašič K., & Street A. (2018). How should hospital reimbursement be refined to support concentration of complex care services?. Health Economics, e26-e38.
  3. Busse R., Geissler A., & Quanetin M. (2011). Diagnosis-related groups in Europe: moving towards trasparency, efficiency and quality in hospitals. Buckingham: Open university press and WHO office fo Europe.
  4. Cinquini L. (2004). Elementi critici per un uso progredito dell’Activity-Based Costing. In: Strumenti per l’analisi dei costi. Torino: Giappichelli.
  5. Cylus J., & Irwin R. (2010). The Challenges of hospital payement systems. EuroObserver, 1-12.
  6. Del Vecchio M., Ferrara L., Longo F., Prenestini A. (2019). Le nuove strategie aziendali tra specializzazione delle competenze, diffusione e concentrazione dei servizi: un’analisi empirica. In: Cergas Bocconi (a cura di). L’aziendalizzazione della Sanità in Italia. Rapporto OASI 2019. Milano: Egea.
  7. Direttiva UE/24/2911 del 9 marzo 2011 concernente l’applicazione dei diritti dei pazienti relativi all’assistenza sanitaria transfrontaliera.
  8. Dranove D. (1987). Rate-setting by diagnosis related groups and hospital specialization. Rand Journal of Economics, 417-427.
  9. Gentili A., Lega F. (2020). Integrazioni istituzionali e reti tra aziende sanitarie. Evidenze, problemi, soluzioni. Milano: Egea.
  10. Hopper A., Cropper S., & Spencer S.A. (2002). Manahed clinical networks. BMJ journals, 1-5.
  11. Imison C., Sonola L., Honeyman M., Ross S. (2014). The reconfiguration of clinical services: what is the evidence?. London: The King’s Fund. --
  12. Kimberly J., de Pouvourville G., & D’Aunno T. (2008). The globalization of managerial innovation in heath care. Cambridge: Cambridge University Press.
  13. Lega F. (2002). Gruppi e Reti Aziendali in Sanità. Milano: Egea.
  14. Mayes R. (2007). The origins, development and passage of Medicare’s revolutionary prospective payment system. Journal of the History of Medicine and Allied Sciences, 22-55.
  15. NHS England (2014). Five year forward view. --
  16. NHS England (2017a). Next steps on the NHS Five year forward view. --
  17. NHS England (2017b). Sustainability and transformation partnerships progress dashboard – baseline view. --
  18. Nucleo Tecnico di Progetto (2018), “Forme di integrazione nell’area metropolitana di Bologna”, Bologna
  19. OCSE (2016). Better ways to pay for health care. June.
  20. Rapporto Conclusivo del Nucleo Tecnico di Progetto (2018). Area Metropolitana di Bologna.
  21. Shleifer A. (1985). A Theory of Yardstick Competition. Rand Journal of Economics, 16(3): 319-327.
  22. Turrini A., Cristofoli D., Frosini F., & Nasi G. (2010, June). Networking literature about determinants of network effectiveness. Public Administration, 528-547.
  23. Vannozzi D., & Fedeli G. (2010). La distinta base applicata all’azienda sanitaria. Mecosan, 3-27.

Aldo Bonadies, Edoardo Bevini, Chiara Gibertoni, Anna Maria Petrini, Il finanziamento delle reti cliniche. Il caso della rete metropolitana di endoscopia toracica in "MECOSAN" 116/2020, pp 75-88, DOI: 10.3280/MESA2020-116005