Benedetto Vera, De Vita Erica, Nuti Sabina
Interdisciplinary Research Center "Health Science", Scuola Superiore Sant'Anna, Via Cardinale Maffi 27, Pisa, Italy.
Res Health Serv Reg. 2024 Aug 7;3(1):11. doi: 10.1007/s43999-024-00047-9.
Universal healthcare systems orient their actions towards promoting, restoring, and improving public health with a particular focus on the need to guarantee equitable access to care. Unwarranted variation in healthcare delivery poses significant challenges to health systems globally, impacting quality of care, financial sustainability, and equity of access. It is therefore important to assist healthcare management in measuring unwarranted variation in order to prioritise intervention strategies to ensure continuity of care and equity. Through an investigation of geographical variation in visit rates and waiting times, the study identifies vulnerable health districts which need priority interventions for patients with cardiovascular disease in the Tuscany region (Italy). Furthermore, a benchmarking-based method for identifying a quantitative estimate of the supply gap to be reduced is proposed. Results illustrate variation in visit rates and waiting times across local health districts in 2021, with some districts experiencing substantially lower rates and longer waiting times compared to the regional median. To address this gap, two targeted interventions aimed at increasing visit volumes and reduced waiting times through advanced training activities, technology integration, and multidisciplinary collaborations are presented. This study contributes to the topic of unwarranted variation by highlighting the necessity of tailored interventions to address diverse healthcare challenges across heterogeneous geographical areas. As healthcare systems globally navigate evolving complexities, the findings and tools presented here offer valuable guidance for policymakers and managers, aiming towards more equitable, efficient, and responsive healthcare services.
全民医疗保健系统将其行动方向定位于促进、恢复和改善公众健康，尤其关注保障公平获得医疗服务的需求。医疗服务中存在的不合理差异给全球卫生系统带来了重大挑战，影响着医疗质量、财务可持续性和医疗服务可及性的公平性。因此，协助医疗保健管理部门衡量不合理差异，以便优先制定干预策略以确保医疗服务的连续性和公平性非常重要。通过对就诊率和等待时间的地理差异进行调查，该研究确定了意大利托斯卡纳地区需要对心血管疾病患者进行优先干预的脆弱卫生区。此外，还提出了一种基于标杆管理的方法，用于确定需要缩小的供应差距的定量估计。结果表明了2021年各地方卫生区就诊率和等待时间的差异，与地区中位数相比，一些地区的就诊率显著较低，等待时间较长。为了弥补这一差距，提出了两项有针对性的干预措施，旨在通过开展高级培训活动、技术整合和多学科合作来增加就诊量并减少等待时间。本研究通过强调针对不同地理区域应对各种医疗挑战的量身定制干预措施的必要性，为不合理差异这一主题做出了贡献。随着全球医疗系统应对不断变化的复杂性，此处呈现的研究结果和工具为政策制定者和管理人员提供了宝贵的指导，目标是实现更公平、高效和响应迅速的医疗服务。
