Valutazione di Impatto Sanitario (HIA) nell’impiego della Teleradiologia sul territorio montano: un caso di studio
Matteo Scardino, Giovanni Digiacomo, Matteo Perusia, Marika Giacometti, Alessandro Martino, Stefano Cerutti,
Antonio Guida, Elisa Di Biase, Giorgio Provenzale, Marco Glisoni, Stefano Tibaldi, Marco Grosso, Ottavio Davini
Background The aging of the population is a major challenge for the socio-economic health system. With aging nations, the prevalence of disability, fragility, and chronic illness (Alzheimer’s disease, tumors, cerebro-vascular diseases…) is intended to increase dramatically. The hospital, which is the “gold standard” for medical care in the acute phase, is not the ideal environment for frail patients, especially if they are elderly.
Objectives In addition to the primary outcome of a public mobile teleradiology service feasibility and effectiveness assessment, the project poses the cost and patient satisfaction evaluation as a secondary outcome.
Methods With stakeholder and community engagement, we conducted a mixed HIA, HTA, SWOT evaluation that included qualitative and quantitative data collection and analysis, a review of existing literature, and future projections.
Results A home radiology service can be useful to deal with the challenges posed by the aging of the population from clinical, ethical and economical point of view, provided that the interventions appropriateness, the models sustainability, the citizens enjoyment, the professional quality, the effectiveness and efficiency will be kept at the highest level, always ensuring the best possible care path.
Limits of the study The size, convenience, and homogeneity of the sample limit the generalizability of this study as much as the duration of the analysis.
Future developments A Webapp has been developed that will soon be accessible from PC, tablet or smartphone. This will be able to streamline the various steps and speed up possible communications between the various practitioners.
Conclusions Fragile patients, especially older people living in RSA or being home looked after, are often comorbid and have cognitive deficits: hospital transportation to perform radiological examinations can be tiring and can cause or aggravate cognitive and behavioral disorders already in place (they must be transported by ambulance or taxi, and obliged to move away from their usual living environment). In addition, as a support to clinical practice, teleradiology can represent a possible tool for the spread of territorial care models, in favor of an ever-present greater flexibility in hospital structures and an ever-closer integration between Hospital and territory.
Key words: telemedicine, teleradiology, Health Impact Assessment (HIA), SWOT analysis