Genovese C, DE Belvis A G, Rinaldi M, Manno V, Squeri R, LA Fauci V, Tabbi P
Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Italy.
Section of Hygiene-Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico "Agostino Gemelli" IRCCS, Rome, Italy.
J Prev Med Hyg. 2018 Dec 15;59(4):E305-E310. doi: 10.15167/2421-4248/jpmh2018.59.4.999. eCollection 2018 Dec.
Clinical Diagnostic Care Pathways (CDCP) are management tools widespread throughout the world to improve the quality of patient care through a well-organized care continuum and to enhance the patient's "risk-adjusted" outcomes; indeed they could optimize the management of resources. They are particularly effective in the management of patients with chronic degenerative diseases, such as chronic kidney disease, with increasingly incidence and prevalence, with an estimated 11-13% of the population being affected. The aim of this study is to apply the Health Services Research methods to estimate the relationship between need, demand and supply in patients with stage 5 Chronic Kidney Disease (CKD) for, then to describe the definition of a CDCP dedicated to patients in Lazio Region, so to allow an appropriate patient management, to reduce the likely complications and the patients' migration to facilities outside the region.
The study was conducted in 2017 in collaboration between the National Institute of Health, the University of Messina and the S. Giovanni Addolorata Hospital.
We analyzed the data for the CKD in Roma and in the San Giovanni Addolorata Hospital Trust and we found a drop out in the patients' attendance towards other regions and/or hospitals. So we defined a CDCP to be adopted at the San Giovanni Addolorata hospital.
To define management and care tools to provide adequate, efficient and patient centered care is a nowadays "must", to ensure the sustainability of the Italian NHS, which today is comparable to a "ship that is heading towards a perfect storm".
临床诊断护理路径（CDCP）是一种在全球广泛应用的管理工具，旨在通过有序的护理连续过程提高患者护理质量，并改善患者的“风险调整后”结局；实际上，它们可以优化资源管理。它们在慢性退行性疾病患者的管理中特别有效，例如慢性肾脏病，其发病率和患病率日益增加，估计有11% - 13%的人口受其影响。本研究的目的是应用卫生服务研究方法来估计5期慢性肾脏病（CKD）患者的需求、需求和供应之间的关系，进而描述专门针对拉齐奥地区患者的CDCP的定义，以便进行适当的患者管理，减少可能的并发症以及患者向该地区以外医疗机构的转移。
该研究于2017年由国家卫生研究所、墨西拿大学和圣乔瓦尼 - 阿多洛拉塔医院合作开展。
我们分析了罗马以及圣乔瓦尼 - 阿多洛拉塔医院信托基金中CKD患者的数据，发现患者前往其他地区和/或医院就诊的人数有所下降。因此，我们定义了一种将在圣乔瓦尼 - 阿多洛拉塔医院采用的CDCP。
定义管理和护理工具以提供充分、高效且以患者为中心的护理是当今的“必须之事”，以确保意大利国家医疗服务体系的可持续性，如今该体系就如同“一艘正驶向完美风暴的船”。
