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Italy is one of the most exposed countries worldwide to COVID-19, and Lombardy is the most affected region in Italy. In this context, Fondazione IRCCS Policlinico San Matteo in Pavia, one of the largest University hospitals in the region, has been involved in the management of the outbreak since its inception. Immediately after the communication of the first Italian COVID-19+ patient, the Pediatric Unit has been completely reorganized to face the approaching outbreak. The optimization of the Pediatric Unit resources for COVID-19 emergency is reported as an example to safely preserve health activity during the pandemic.
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Betacoronavirus , Infecciones por Coronavirus/epidemiología , Manejo de la Enfermedad , Servicio de Urgencia en Hospital/organización & administración , Unidades de Cuidado Intensivo Pediátrico/organización & administración , Neumonía Viral/epidemiología , COVID-19 , Niño , Infecciones por Coronavirus/terapia , Humanos , Italia/epidemiología , Pandemias , Neumonía Viral/terapia , SARS-CoV-2RESUMEN
We evaluated SARS-CoV-2 RNA and neutralising antibodies in blood donors (BD) residing in the Lodi Red Zone, Italy. Of 390 BDs recruited after 20 February 2020 - when the first COVID-19 case in Lombardy was identified, 91 (23%) aged 19-70 years were antibody positive. Viral RNA was detected in an additional 17 (4.3%) BDs, yielding ca 28% (108/390) with evidence of virus exposure. Five stored samples collected as early as 12 February were seropositive.
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Anticuerpos Neutralizantes/inmunología , Betacoronavirus/inmunología , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adulto , Anciano , Donantes de Sangre , COVID-19 , Prueba de COVID-19 , Vacunas contra la COVID-19 , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/terapia , Femenino , Humanos , Inmunización Pasiva , Italia/epidemiología , Masculino , Persona de Mediana Edad , Pruebas de Neutralización , Pandemias , Neumonía Viral/inmunología , Neumonía Viral/terapia , Prevalencia , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , SARS-CoV-2 , Estudios Seroepidemiológicos , Adulto Joven , Sueroterapia para COVID-19RESUMEN
Introduction: From the perspective of healthcare organizations and public health care systems, the value of a clinical trial can be assessed from a clinical and economical perspective. However, to date, there is no standardized model for systematically capturing the economic value of clinical trials at organizational and system levels. The aim of this study was to develop and test a methodology for estimating the avoided costs deriving from the management of patients as part of a clinical trial. Methods: Our methodology is based on the assumption that the economic value of a clinical trial derives from 1) the funding received by the experimental site from a trial's sponsor, and from 2) the cost avoided by the experimental site with the treatment of patients within a study and not according to standard care by the experimental site. Results: By applying the methodology to onco-hematological clinical trials conducted in two academic hospitals from 2011 to 2016, we demonstrate that savings between 2 million and 4 million euros were achieved over a five-year period. Thus, for every 1,000 euros invested by the pharmaceutical company into the clinical studies conducted at these hospitals, the hospitals saved on average 2,200 euros due to costs not incurred as a result of the trials. Conclusions: The study has proposed and tested a methodology for estimating the economic value of clinical trials by taking into account avoided costs deriving from the treatment of patients enrolled in sponsored trials. The study has proposed a management tool for healthcare institutions to govern clinical trials.
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AIM: The aim was to evaluate cost-effectiveness of yttrium-90 transarterial radioembolization (TARE) in comparison to sorafenib treatment. PATIENTS & METHODS: A single-center, retrospective, observational study was performed, 166 patients with intermediate-/advanced-stage hepatocellular carcinoma were treated with sorafenib and 19 with TARE. The patients out of the sorafenib group matching the inclusion criteria for TARE, were reassigned to a subgroup SOR3. RESULTS: Mean costs for SOR3 patients amounted to 27,992 per patient, instead for TARE treatment, mean expense per patient was 17,761 (p = 0.028). Overall survival was similar between the two groups, while midterm survival rates (p = 0.012) were significantly higher with TARE treatment. CONCLUSION: TARE causes significantly lower treatment costs than sorafenib with better outcome in midterm survival.
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Carcinoma Hepatocelular/tratamiento farmacológico , Neoplasias Hepáticas/tratamiento farmacológico , Niacinamida/análogos & derivados , Compuestos de Fenilurea/administración & dosificación , Radioisótopos de Itrio/administración & dosificación , Anciano , Carcinoma Hepatocelular/economía , Carcinoma Hepatocelular/patología , Quimioembolización Terapéutica/economía , Quimioembolización Terapéutica/métodos , Análisis Costo-Beneficio/economía , Femenino , Humanos , Neoplasias Hepáticas/economía , Neoplasias Hepáticas/patología , Masculino , Persona de Mediana Edad , Niacinamida/administración & dosificación , Niacinamida/economía , Compuestos de Fenilurea/economía , Estudios Retrospectivos , Sorafenib , Radioisótopos de Itrio/economíaRESUMEN
After the 1993 healthcare reform, all public hospitals in Italy were changed into public firms. The increasing commitment to pursue efficiency has introduced the need for a managerial responsibility in healthcare organizations. However, activities and resource use in hospitals driven by professionals and senior management often has a limited insight on business processes. We developed a three-dimensional evaluation system based on: (a) personal support to the overall team output, (b) assessment of organizational behavour and (c) individual goals setting (MBO). According to the position held, personal goals are negotiated with direct reports across three domains: managerial attitude, professional skills and organizational behaviours.