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N. 123 (2022)

I dati amministrativi per la governance dei tempi di attesa delle prestazioni ambulatoriali: l’esperienza dell’Azienda Sanitaria dell’Alto Adige

DOI
https://doi.org/10.3280/mesa2022-123oa15593
Inviata
marzo 13, 2023
Pubblicato
2023-05-09

Abstract

Per governare i tempi di attesa delle prestazioni è imprescindibile utilizzare i dati amministrativi nella pianificazione dell’offerta e nel governo della domanda di servizi. L’articolo illustra l’esperienza della ricerca-intervento realizzata dall’Azienda Sanitaria dell’Alto Adige per la stima dei fabbisogni futuri e l’analisi retrospettiva dei consumi della specialistica ambulatoriale. Viene presentato il modello quantitativo predittivo sviluppato dall’azienda per la definizione del fabbisogno di prestazioni con dettaglio per singola prestazione, e vengono esposte le scelte strategiche aziendali per ridurre i tempi di attesa. Rispetto ad alcune prestazioni di particolare rilevanza sono invece proposte analisi retrospettive per verificare l’appropriatezza dei consumi, con particolare riferimento agli indici di consumo per area di residenza, MMG, o fasce di età; alla mobilità intraprovinciale; alle modalità di accesso alle prestazioni; ai codici di priorità. Tale approccio si presta a esser facilmente applicabile ad altre aziende sul territorio italiano data la semplicità dello strumento e la crescente disponibilità e granularità di dati sul consumo di prestazioni sanitarie a disposizione delle aziende.

Riferimenti bibliografici

  1. AAVV (2022). Liste e tempi di attesa in sanità. Academy of health care management and economics. Milano: Egea.
  2. Bachelet V.C., Goyenechea M., Carrasco V.A. (2019). Policy strategies to reduce waiting times for elective surgery: A scoping review and evidence synthesis. The International journal of health planning and management, 34(2): e995-e1015.
  3. Berwick D.M., Nolan T.W., Whittington J. (2008). The triple aim: care, health, and cost. Health affairs, 27(3): 759-769.
  4. Bettelli C., Vainieri M., Vinci B. (2016). Dieci anni di studi nella gestione dei tempi di attesa nella diagnostica per immagine. Quali prospettive per un governo di sistema?. Mecosan, 100(4): 7-25.
  5. Bird V., Premkumar P., Kendall T., Whittington C., Mitchell J., Kuipers E. (2010). Early intervention services, cognitive-behavioural therapy and family intervention in early psychosis: Systematic review. The British Journal of Psychiatry, 197(5): 350-356.
  6. Boscolo P., Fenech L., Giudice L., Lecci F., Rotolo A., Tarricone R. (2021). Tempi di attesa: trend e politiche di risposta durante e dopo la crisi Covid-19. In Cergas Bocconi (a cura di). L’aziendalizzazione della sanità in Italia. Rapporto OASI 2021. Milano: Egea.
  7. Coghlan D., Brydon-Miller M. (2014). The SAGE encyclopedia of action research. Thusand Oaks: Sage.
  8. Cusini M., Auxilia F., Trevisan V., Visconti U., Castaldi S. (2008). A telephone survey on the reasons for non-attendance in a dermatological clinic. Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia, Dec; 143(6): 353-357. PMID: 19169207.
  9. D’Sa M.M., Nakagawa R.S., Hill D.S., Tan J.K. (1994). Exponential smoothing method for forecasting drug expenditures. American Journal of Hospital Pharmacy, 15, 51(20): 2581-2588.
  10. Erro-Garcés A., Alfaro-Tanco J.A. (2020). Action Research as a Meta-Methodology in the Management Field. International Journal of Qualitative Methods, 19.
  11. Fait A., Agnello M., Scirè C., Merlino L., Schiatti S., Mazzone A., Bergamaschi W. (2015). Improvements in care co-ordination of chronic patients associated with a new primary care payment system in Lombardy: updated results of the CreG (Chronic Related Group) model. Proceedings of the Second International Conference on Public Policy (ICPP ’15). Milano: Edward Elgar.
  12. Gravelle H., Dusheiko M., Sutton M. (2002). The demand for elective surgery in a public system: time and money prices in the UK National Health Service. Journal of Health Economics, 21(3): 423-49.
  13. Gupta S., King W.D., Korzeniowski M., Wallace D. L., Mackillop W.J. (2016). The effect of waiting times for postoperative radiotherapy on outcomes for women receiving partial mastectomy for breast cancer: a systematic review and meta-analysis. Clinical oncology, 28(12): 739-749.
  14. Hajizadeh M. (2018). Does socioeconomic status affect lengthy wait time in Canada? Evidence from Canadian Community Health Surveys. The European Journal of Health Economics, 19(3): 369-383.
  15. Landi S., Ivaldi E., Testi A. (2018). Socioeconomic status and waiting times for health services: An international literature review and evidence from the Italian National Health System. Health Policy, 122(4): 334-351.
  16. Lucifora C., Russo A., Vigani D. (2021). Does prescribing appropriateness reduce health expenditures? Main effects and unintended outcomes (No. 103). Working Paper.
  17. Mariotti G., Siciliani L., Rebba V. et al. (2014). Waiting Time Prioritisation for Specialist Services in Italy: The Homogeneous Waiting Time Groups Approach. Health Policy, 117(1): 54-63.
  18. Martin S., Smith P.C. (2003). Using panel methods to model waiting times for National Health Service surgery. Journal of the Royal Statistical Society, 166(3): 369-387.
  19. Mazzali C., Duca P. (2015). Use of administrative data in healthcare research. Internal and emergency medicine, 10(4): 517-524.
  20. McIntyre D., Chow C.K. (2020). Waiting time as an indicator for health services under strain: a narrative review. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 57, 0046958020910305.
  21. Mikkelsen C.M., Andersen S.E. (2016). A Regional Drug and Therapeutics Committee-led Intervention to Reduce the Hospital Costs of Expensive HIV Drugs. Basic and Clinical Pharmacology and Toxicology, 119(3): 278-283.
  22. Moscelli G., Siciliani L., Tonei V. (2016). Do waiting times affect health outcomes? Evidence from coronary bypass. Social Science & Medicine, 161: 151-159.
  23. Moscelli G., Siciliani L., Gutacker N., Cookson R. (2018). Socioeconomic inequality of access to healthcare: Does choice explain the gradient?. Journal of Health Economics, 57: 290-314.
  24. Muka T., Imo D., Jaspers L., Colpani V., Chaker L., van der Lee S. J., Mendis S., Chowdhury R., Bramer W. M., Falla A., Pazoki R., Franco O.H. (2015). The global impact of non-communicable diseases on healthcare spending and national income: a systematic review. European journal of epidemiology, 30(4): 251-277.
  25. Naiker U., FitzGerald G., Dulhunty J.M., Rosemann M. (2017). Time to wait: a systematic review of strategies that affect out-patient waiting times. Australian Health Review, 42(3): 286-293.
  26. Nolte E., McKee M. (Eds.) (2008). Caring for people with chronic conditions: a health system perspective. London: McGraw-Hill Education (UK).
  27. Nuti S., Vaineri M. (2021). Managing Waiting Times in Diagnostic Medical Imagining. British Medical Journal Open, 2012.
  28. OECD Health Policy Studies (2020). Waiting times for health services. -- www.oecd.org.
  29. Ordu M., Demir E., Tofallis C. (2019). A comprehensive modelling framework to forecast the demand for all hospital services. The International Journal of Health Planning and Management, 34(2): e1257-e1271.
  30. Pomey M.P., Forest P.G., Sanmartin C., DeCoster C., Clavel N., Warren E., ... Noseworthy T. (2013). Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times. Implementation Science, 8(1): 1-16.
  31. Ray K.N., Chari A.V., Engberg J., Bertolet M., Mehrotra A. (2015). Opportunity costs of ambulatory medical care in the United States. The American journal of managed care, 21(8): 567.
  32. Reichert A., Jacobs R. (2018). The impact of waiting time on patient outcomes: Evidence from early intervention in psychosis services in England. Health Economics, 27(11): 1772-1787.
  33. Riganti A., Siciliani L., Fiorio C.V. (2017). The effect of waiting times on demand and supply for elective surgery: Evidence from Italy. Health economics, 26: 92-105.
  34. Segal J.B., Nassery N., Chang H.Y., Chang E., Chan K., Bridges J.F. (2015). An index for measuring overuse of health care resources with Medicare claims. Medical care, 53(3): 230-236.
  35. Siciliani L. (2015). Waiting Times: Evidence of Social Inequalities in Access for Care. In: Data and Measures in Health Services Research. New York: Springer US.
  36. Siciliani L., Borowitz M., Moran V. (eds.) (2013). Waiting Time Policies in the Health Sector: What Works?. OECD Health Policy Studies.
  37. Siciliani L., Moran V., Borowitz M. (2014). Measuring and comparing health care waiting times in OECD countries. Health policy, 118(3): 292-303.
  38. Siciliani L., Stanciole A., Jacobs R. (2009). Do waiting times reduce hospital costs?. Journal of Health Economics, 28(4): 771-780.
  39. Sobolev B., Fradet G. (2008). Delays for coronary artery bypass surgery: How long is too long?. Expert Review of Pharmacoeconomics and Outcomes Research, 8(1): 27-32.
  40. Venturelli F., Ottone M., Pignatti F., Bellocchio E., Pinotti M., Besutti G., ... Giorgi Rossi P. (2021). Using text analysis software to identify determinants of inappropriate clinical question reporting and diagnostic procedure referrals in Reggio Emilia, Italy. BMC health services research, 21(1): 1-13.
  41. Windmeijer F., Gravelle H.S., Hoonhout P. (2004). Waiting Lists, Waiting Times and Admissions: An Empirical Analysis at Hospital and General Practice Level. Health Economics, 14: 971-985.
  42. Xie Z., Or C. (2017). Associations between waiting times, service times, and patient satisfaction in an endocrinology outpatient department: a time study and questionnaire survey. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54.

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