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51
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Introduction
Organization and innovation of healthcare services, Performance management, Health technology assessment
Additional affiliations
January 2009 - present
Publications
Publications (51)
In Svizzera, il Ticino e stato uno dei Cantoni piu colpiti dalla pandemia Covid-19 e la riconfigurazione del suo sistema ospedaliero si e incentrata sulla creazione di centri-Covid. Il presente contributo analizza come l'Ospedale di Locarno "La Carita`" (ODL), dichiarato centro-Covid di riferimento a livello cantonale a meta marzo, si sia riorganiz...
Background and objectives
Anesthesiologists and hospitals are increasingly confronted with costs associated with the complications of Peripheral Nerve Blocks (PNB) procedures. The objective of our study was to identify the incidence of the main adverse events associated with regional anesthesia, particularly during anesthetic PNB, and to evaluate t...
The development of integrated care initiatives to overcome service delivery fragmentation has become a global concern. Yet, the lack of guidance in their design and delivery has led to a high risk of project failure. Several authors have proposed driving ideas and strategies to foster care integration but a comprehensive conceptual framework buildi...
Several studies have contributed to the development of theoretical frameworks for integrated care implementation. The scholarly articles and technical reports published on the topic identify factors or structures of elements fostering care integration: most often they target people suffering from chronic and/or long term conditions. In addition, th...
Background
The Scaling Integrated Care in Context (SCIROCCO) tool has been developed to facilitate knowledge transfer and learning about the implementation and scaling-up of integrated care in European regions. To adequately test the functionality of the tool in assessing the maturity for integrated care within regions, this study evaluated its str...
The healthcare sector has all the characteristics to be considered a complex system. Indeed, its extrinsic complexity is related to its openness, since the health system is affected by the political, social, and financial context where it operates.
Objective
As part of the EU-funded Project INTEGRATE, the research sought to develop an evidence-based understanding of the key dimensions and items of integrated care associated with successful implementation across varying country contexts and relevant to different chronic and/or long-term conditions. This paper identifies the core dimensions of...
Introduction
The aim of the study is to investigate the barriers and facilitators to the implementation of workforce changes implemented as part of integrated chronic care interventions.
Methods
We used a qualitative multimethod design that combined expert questionnaires, a systematic literature review, and secondary analysis of two case reports....
Introduction
Integrated care interventions introduced in response to the increased demand for long-term care entail profound changes to the health workforce. This exploratory study aims to provide an overview of the workforce changes implemented as part of integrated chronic care interventions.
Methods
An interactive and emergent research design w...
Organizational culture might influence results, especially in public healthcare organizations characterized by strong professional control. This study investigates whether a specific culture type is most effective in fostering performances. We assess organizational culture through Competing Values Framework and use multivariate regression analysis...
Background
In several health systems of advanced countries, reforms have changed primary care in the last two decades. The literature has assessed the effects of a variety of interventions and individual factors on the behavior of general practitioners (GPs). However, there has been a lack of investigation concerning the influence of the resources...
The past decades have been characterised by the growing prevalence of chronic diseases, the rising number of older and often multi-morbid patients, and changes in the definitions of health and illness. Many health systems have endorsed integrated care strategies as a means to approach the above challenges, as they are expected to lead to better out...
Background: Integrated care is seen as a promising approach to deal with the current mismatch between people’s increasing demand for complex, long-term and person-centred care and a traditional supply of acute, episodic and single-disease-focused care. Given the involvement of health professionals in all aspects of integrated care delivery, changes...
Introduction: In this paper, we provide a detailed and explicit description of the processes and decisions underlying and shaping the emergent multimethod research design of our study on workforce changes in integrated chronic care.
Theory and methods: The study was originally planned as mixed method research consisting of a pre- liminary literatur...
Background and objectives:
Same-day surgery is common for foot surgery. Continuous regional anesthesia for outpatients has been shown effective but the economic impact on the perioperative process-related healthcare costs remains unclear.
Methods:
One hundred twenty consecutive patients were included in this assessor-blinded, prospective cohort...
Aim:
To present the rationale, design and methodology of the GERAS project, which examines whether assessment of frailty and mild cognitive impairment could enhance risk prediction for biomedical, psychosocial outcomes and foster efficient resource allocation in kidney transplantation.
Background:
For the burgeoning cohort of older patients cons...
In recent decades, consensus has grown on the need to organize health systems around the concept of care integration to better confront the challenges associated with demographic trends and financial sustainability. However, care integration remains an imprecise umbrella term in both the academic and policy arenas. In addition, little substantive k...
Background: The debate about closing small hospitals located in rural and/or remote areas is not novel. However, demographic and epidemiologic trends, together with technologic advances are associated with emerging clusters of complex patients. Rural and/or remote areas tend to anticipate the national demographic forecasts. Therefore, concerns abou...
Social trends and the costs of health technologies lead to concentrate the availability of specialized services. This raises debates on the appropriate geography of healthcare. An example is the discussion about the rationality of closing small hospitals, typically located in rural and/or remote areas. We analyzed two cases of rural and/or remote a...
Understanding the interplay between informal care and formal healthcare is important because it sheds light on the financial implications of such interactions and may result in different policies. On the basis of a major database on 532 Italian stroke patients enrolled in the period 2007–2008, we investigate whether the presence of a potential care...
Reforms in several health systems of advanced countries have redesigned primary care in the last decades. The literature has assessed the effect of a variety of interventions and individual factors on the behavior of general practitioners (GPs). However, there is a lack of investigation concerning the influence of the resources embedded in the rela...
New Public Management theories and policies have pressured healthcare organizations toward structural, rather than cultural, changes to improve performance. However, in the pluralistic and complex settings of healthcare organizations, senior managers play a key role in setting the strategic direction and often lead organizations toward ambiguous an...
Objective
To examine the patterns of health care utilization by the elderly and test the influence of functional decline.Data Source and Study DesignWe used the three regular waves of the SHARE survey to estimate the influence of frailty on health care utilization in 10 European countries. We controlled for the main correlates of frailty and unobse...
Background:
Health care organizations are pressured to improve the cost-effectiveness of service delivery. Clinical governance is an important trigger to improve care quality and safety and rank high in the reform agenda of health systems. The senior management team culture plays a major role in establishing clinical governance practices, because...
It has been argued that fostering cooperation among general practitioners (GPs) and between GPs and other professional groups (e.g., nurses, hospital specialists) contributes to improve performances. A relevant factor influencing such cooperation is the social capital (Inkpen & Tsang, 2005; Reagans & Zuckerman, 2001). We interpret such factor as th...
The clinical management of intracranial aneurysms is debated in many countries because of the associated disability risk and costs. Therefore, estimating the costs and explaining their variability will provide important information for decision makers.
We aimed to evaluate the acute and post-acute health costs of intracranial aneurysm management an...
Public sector organizations are simultaneously subject to three types of environmental pressure: institutional, economic and political. How do these pressures influence the strategic behaviour of public organizations when confronted with efficiency-oriented reforms? We focus on the strategic behaviour of Swiss municipalities facing the amalgamation...
Objectives
To investigate the hospital length of stay (LOS) and total direct costs of management of patients with intracranial aneurysm in Italy. To test whether treatment choices impact LOS and total direct costs.
Design
Data were collected in a prospective, incidence-based, observational multicentre study. Patients were enrolled in a consecutive...
Over the last 20 years, hospitals have revised their organizational structures in response to new environmental pressures. Today, demographic and epidemiologic trends and recent technological advances call for new strategies to cope with ultra-elderly frail patients characterized by chronic conditions, high-severity health problems, and complex soc...
Over the last 20 years, hospitals have revised their organizational structures in response to new environmental pressures. Today, demographic and epidemiologic trends and recent technological advances call for new strategies to cope with ultra-elderly frail patients characterized by chronic conditions, high-severity health problems, and complex soc...
The NPM movement have shaped the scholarly and policy debate by associating the concept of enhancement to structural changes/reforms. Recently, a stream of literature started challenging such an approach to improvement and focused on the role of soft variables, i.e. organizational values and beliefs, as either hindering or success factors of change...
Zusammenfassung Braucht es Integration im Gesundheitswesen? Und wenn ja, welches sind die Umweltbedingungen und die Faktoren, die zum Dienstleistungserfolg einer integrierten Pflegeinitiative gehören? Das folgende Kapitel versucht diese Frage mit Hilfe von zwei Forschungsmethoden zu beantworten. Erstens, mit einer umfassenden Literaturdurchsicht zu...
Purpose – Care integration has been the hallmark of most proposed solutions to current and prospective challenges of health systems. However, it is an imprecise umbrella term encompassing heterogeneous models and little substantive knowledge exists on the basic mechanisms leading to positive outcomes. This study aims to address this gap by identify...
Introduction
An extensive body of literature deals with the complexity of providing integrated care to frail patients. However, theoretical fragmentation and a lack of substantial knowledge about success factors still abound.
Aim
To identify environmental conditions and configurations of factors associated with service delivery success in integrat...
Goal ambiguity influences the effectiveness of performance management systems to drive organizations toward enhanced results. The literature analyzes the antecedents of goal ambiguity and shows the influence of goal ambiguity on the performance of U.S. federal agencies. However, no study has analyzed goal ambiguity in other countries or in health c...
Information technology (IT) is an important enabler of organization models (OM) and of innovative strategies, as it fosters information integration and streamlines information flows. Two case studies offer evidence about the strategic use of IT innovation (i.e., digital signature) to foster successful OM and partnerships in health-care, while resul...
Information system integration is an important dimension of a company's information system maturity and plays a relevant role in meeting information needs and accountability targets. However, no generalizable evidence exists about whether and how the main integrating technologies influence information system integration in health care organizations...
Objectives: To investigate the hospital length of stay (LOS) and total direct costs of management of patients with intracranial aneurysm in Italy. To test whether treatment choices impact LOS and total direct costs. Design: Data were collected in a prospective, incidence-based, observational multicentre study. Patients were enrolled in a consecutiv...
This contribution focuses on picture archiving and communication systems (PACS) in the Italian National Healthcare System (NHS). It finally aims to test the Chiefs Radiology Department's perceptions about PACS along the main evaluation dimensions emerging from the literature. First, a brief review of the main literature concerning PACS evaluation l...
Assessing public sector ICT investments represents the premise for successful implementation of an e-health strategy. The recent literature stresses the importance of going beyond the mere financial and/or technical dimensions of the analysis. Consequently, the paper proposes an example of e-health project evaluation aiming to develop measures whic...
The prioritization of ICT investments and the assessment of technological innovations are the premises for successful implementation of e-government strategy. Therefore, objective measures to evaluate costs and benefits resulting from ICT investments are required. The chapter presents the main evaluation methods and suggests some relevant guideline...
