ArticleUpdates in surgery2026
Invisible assets: quantifying the hidden economic value of residency training in Italian public hospitals.
Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
11 authors.
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Abstract
backgroundGraduate medical education (GME) programmes are integral to healthcare systems, providing clinical manpower through medical residents whose compensation is externally funded in Italy. The financial impact of resident integration on public hospital budgets, particularly amid rising healthcare expenditures, remains poorly quantified.
methodsWe conducted a deterministic 12-month Budget Impact Analysis from the hospital perspective (EUR 2024), comparing an attending-only workforce with a resident-integrated configuration. Inputs included attending full-cost FTE (salary + employer on-costs), resident productivity by setting, supervision shares (translated into effective attending FTE), and departmental workload. Uncertainty was addressed through Monte Carlo probabilistic sensitivity analysis.
resultsThis Budget Impact Analysis (hospital perspective; EUR 2024; 12-month horizon) found that integrating Ministry-funded residents reduced annual personnel expenditure by 40-50%. Replacing 40% of attending FTEs produced mean savings of €240,000 (95% CI: €205,000-€275,000). Sensitivity analyses confirmed the robustness of these savings across variations in staffing mix, supervision requirements, and resident productivity rates.
conclusionExternally funded residency programmes provide substantial, direct cost savings and support flexible workforce planning in Italian public hospitals. These findings support strategic investment in GME as a driver of economic sustainability and healthcare resource optimisation. Further research should address broader impacts on care quality and workforce stability.
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