ArticleInternational journal of integrated care2003
Vertical integration and contractual network in the cardiovascular sector: the experience of the Italian region Emilia Romagna.
Article in International journal of integrated care, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Toward social-health integration in Sicily: description of the first hub and spoke model to improve the diagnostic therapeutic care paths for neurorehabilitation.Frontiers in public health · 2023Article
- Non-commutability of results of highly sensitive troponin I and T immunoassays.Biochemia medica · 2012Article
- A managed clinical network for cardiac services: set-up, operation and impact on patient care.International journal of integrated care · 2005Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe 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.
methodsWe 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.
resultsThe 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.
conclusionsDespite 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.
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