Suligoi Barbara, Aiello Andrea, Atzori Laura, Bordonaro Patrizia, Capra Giuseppina, Caraglia Anna, Cellini Andrea, Chessa Mariangela, Comar Manola, Cusini Marco, Dal Conte Ivano, Fasciana Teresa, Galano Angelo, Giammanco Anna, Lucchini Anna, Rossolini Gian Maria, Salfa Maria Cristina, Vaggelli Guendalina, Palamara Anna Teresa
Centro Operativo AIDS, Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Roma;
Università degli Studi di Firenze e Azienda Ospedaliero Universitaria Careggi, Firenze.
Epidemiol Prev. 2024 Nov-Dec;48(6):456-465. doi: 10.19191/EP24.6.A764.136.
The project "Experimentation of new integrated hospital-territory organizational models for the prevention and control of sexually transmitted infections: facilitated diagnostic-care pathways and offer of free targeted screening" was developed as part of the CCM 2019 programme, funded by the Italian Ministry of Health, being coordinated by the Italian National Health Institute (ISS), in collaboration with Sapienza University of Rome. Three clinical units located in Turin, Milan, and Cagliari, specialized in sexually transmitted infection (STI) diagnosis and treatment, and three highly specialized microbiology laboratories located in Trieste, Florence, and Palermo were involved.The objectives were to develop an innovative network model for the treatment of STIs based on multidisciplinary centres with high quality of care for STIs (hub-IST) and territorial structures (spoke-IST), to plan and test integrated facilitated care pathways for STIs, to evaluate the priorities, feasibility, and sustainability of prevention interventions.A focus group of 12 experts, together with other members from the participating units, defined the characteristics of hub-IST and spoke-IST centres and outlined the integrated care pathway (PIC) for STIs based on the hub&spoke model.A 4-month field trial was subsequently started, applying the proposed PIC in 3 participating units. Improvements were immediately observed in care (increased access to the centre, reduced waiting times, increased number of visits), in the direct connection with intrastructure specialists, in prevention interventions, and in the information provision.The hub&spoke model applied to STIs proved to be innovative, transferable, and adaptable to different Italian regional situations, establishing itself as the currently most functional model for modern care for this type of infections. By reducing barriers to healthcare access, expanding the number of attendees, reducing costs for the community, and implementing targeted and effective prevention interventions, the epidemic chain can be interrupted and the spread of STIs reduced. Based on these results, in Italy, it is urgent to develop an STI strategic prevention plan at a national level.
“新型医院 - 地区综合组织模式预防和控制性传播感染的实验：便捷诊断 - 护理路径及免费针对性筛查服务”项目是作为2019年CCM项目的一部分开展的，由意大利卫生部资助，由意大利国家卫生研究所（ISS）协调，与罗马第一大学合作。该项目涉及位于都灵、米兰和卡利亚里的三个专门从事性传播感染（STI）诊断和治疗的临床单位，以及位于的里雅斯特、佛罗伦萨和巴勒莫的三个高度专业化的微生物实验室。目标是开发一种基于多学科中心的创新性性传播感染治疗网络模式，该中心具备高质量的性传播感染护理服务（枢纽性性传播感染中心）和地区结构（分支性性传播感染中心），规划并测试性传播感染的综合便捷护理路径，评估预防干预措施的优先级、可行性和可持续性。一个由12名专家组成的焦点小组与参与单位的其他成员共同确定了枢纽性性传播感染中心和分支性性传播感染中心的特征，并勾勒出基于枢纽 - 分支模式的性传播感染综合护理路径（PIC）。随后启动了为期4个月的实地试验，在3个参与单位应用提议的PIC。在护理方面（增加了中心就诊机会、减少了等待时间、增加了就诊次数）、与机构内部专家的直接联系、预防干预措施以及信息提供方面立即观察到了改善。事实证明，应用于性传播感染的枢纽 - 分支模式具有创新性、可转移性且能适应意大利不同地区的情况，成为目前针对这类感染的现代护理最有效的模式。通过减少医疗服务获取障碍、增加就诊人数、降低社区成本以及实施有针对性且有效的预防干预措施，可以中断疫情传播链并减少性传播感染的传播。基于这些结果，在意大利，迫切需要在国家层面制定性传播感染战略预防计划。
