[Family nurses in Italy: an explorative survey]. / Gli infermieri di famiglia in Italia:indagine esplorativa.

. Family nurses in Italy: an explorative survey. INTRODUCTION: The Family and Community Nurses (FCN) are unevenly distributed throughout Italy. AIM: to describe the numbers, functions and work situation of FCNs in Italy. METHODS: A questionnaire with 24 multiple-choice questions was sent to 60 Nursing and health professions District managers, to explore numerical standards of reference, recruitment methods, training, work environments and methods, hierarchical and functional dependencies, functions performed and level of autonomy. RESULTS: 38 (63%) managers from 14 regions responded. In 26 (68%) districts, FCNs are employed with numbers ranging from 2 to 350 per district (median FCN/inhabitants ratio of approximately 1/16.000 inhabitants (IQR 10.000-40.000). Nurses with at least 2 years of work experience (in home or medical care) were selected, and all have attended or are currently attending a training course (university, regional - 40% of the districts - or internal courses). In almost all Districts FCNs hierarchically depend on the Nurse Manager while functionally from the District Nurse or Medical Director. FCNs mostly work in multidisciplinary teams and in most Districts (21, 80%) perceive good levels of autonomy. CONCLUSIONS: Although a limited number of managers responded, these data provide a cross-section of the variability of numbers and organization at district level.

Valorization of clinical trials from the Italian National Health Service perspective: definition and first application of a model to estimate avoided costs.

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.