Crocco Marco, Malerba Federica, Gandullia Paolo, Zampatti Noemi, Corona Maria Franca, Barrani Monica, Leoni Massimiliano, Ceresoli Sara, Gazzolo Andrea, Gaiero Alberto, Borea Riccardo, Curto Alessandro Giorgio Lo, Ierardi Maria Paola, Scelsi Silvia, Spiga Giuseppe, Spiazzi Raffaele, Botti Renato, Alberti Marisa
Pediatric Gastroenterology and Endoscopy Unit, IRCCS Istituto Giannina Gaslini, Genoa, 16147, Italy.
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy.
BMC Health Serv Res. 2025 Mar 18;25(1):398. doi: 10.1186/s12913-025-12459-5.
Due to the need to reorganize the care network for the national screening mandated by law, a new healthcare model was required for the management of coeliac disease. The hub-and-spoke model is a new healthcare organizational system, here we describe its application (supported by telehealth), in the management of pediatric coeliac disease (CD) in Liguria. The results of the pilot phase are presented and the system's strengths and weaknesses discussed.
A mixed-methods survey followed by an observational pilot study was performed. A multiphase approach was used including preparation setting, operative planning and application. The pilot phase involves a single primary center. The reduction of families' expenditure and environmental impact was assessed using the Viamichelin calculator.
A regional meeting followed by a survey (specifically developed for this study) and a needs analysis highlighted the priority to have an efficient, up to date and homogeneous model of care assistance throughout the network. A diagnostic and therapeutic care pathway (PDTC) was developed by the regional working group. The project involved 986 Ligurian families and allowed a 90% reduction in the distance traveled by families residing within the pilot center's catchment area, saving €177 and 113 kg of CO2 on average per family per year.
The Gaslini Diffuso hub-and-spoke system for managing CD in Liguria exemplifies a commitment to enhancing healthcare efficiency and patient care, reducing environmental impact and cost for both family and healthcare system.
由于需要对法律规定的全国性筛查护理网络进行重组，乳糜泻的管理需要一种新的医疗模式。中心辐射模式是一种新的医疗组织系统，在此我们描述其在利古里亚地区小儿乳糜泻（CD）管理中的应用（由远程医疗支持）。介绍了试点阶段的结果，并讨论了该系统的优缺点。
进行了一项混合方法调查，随后进行了一项观察性试点研究。采用了多阶段方法，包括准备阶段、操作规划和应用阶段。试点阶段涉及一个单一的初级中心。使用米其林计算器评估家庭支出和环境影响的减少情况。
一次区域会议，随后进行了一项调查（专门为本研究制定）和需求分析，突出了在整个网络中建立一个高效、最新且统一的护理援助模式的优先性。区域工作组制定了诊断和治疗护理路径（PDTC）。该项目涉及986个利古里亚家庭，使试点中心服务区内家庭的出行距离减少了90%，平均每个家庭每年节省177欧元和113千克二氧化碳。
利古里亚地区用于管理乳糜泻的加斯利尼扩散中心辐射系统体现了提高医疗效率和患者护理水平、减少对家庭和医疗系统的环境影响及成本的承诺。
