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This book presents different patient-oriented perspectives from surgeons, economic evaluation and management researchers, and business companies active in the healthcare sector, striking a balance between the appropriateness/effectiveness of treatment and efficiency/cost. It does not include technical surgical details, but instead provides the necessary knowledge regarding different groups of patients to help economic and management researchers make accurate evaluations.
Although partially based on the specific case of abdominal wall surgery in the Italian health system, the book defines a model that can, with the necessary adaptations, be applied in other national contexts. It also analyzes different reimbursement systems and methods of data collection. This approach supports the evolution from evidence-based medicine (EBM) to the future of real-world data (big data analysis). Further, it highlights the critical issue of "silos" reimbursement, which is the pillar of DRG, and proposes methodology to evaluate the direct and indirect benefit and costs of surgery (for example quality of care, costs incurred in cases of surgical complications due to the use of inappropriate, low-cost material or due to surgical procedure.
It is a valuable resource for clinicians, surgeons, policymakers and managers in the field.
Abdominal Wall Surgery: How Reimbursement Systems Can Change Surgical Evolution
PART I: Abdominal wall.- 1 Epidemiology.- 2 Anatomy.- 3 Clusters of patology & interventions.- 4 Unit of wall surgery.- 5 Organization and certification of abdominal wall surgery: the German example, the easter Europe example, the Sweden example, the Spain example.- 6 Organization and certification of abdominal wall surgery: the Eastern Europe example.- 7 Organization and certification of abdominal wall surgery: the Swedish example.- 8 Organization and certification of abdominal wall surgery: the Spanish example.- 9 Devices and biomaterials: from chemistry to certification.- 10 Assistential settings.- 11 Preventing incisional hernias: closure of abdominal wall, follow-up in abdominal surgery.- PART II: Economics.- 12 Economic Evaluation and Health Technology Assessment of Healthcare Programmes.- 13 Comparative Effectiveness in Health Technology Assessment for Medical Devices.- 14 Economic evaluation of abdominal Wall Surgery (cost benefit analysis, cost effectiveness, cost-quality analysis).- 15 Cost Containement: abdominal surgery unit.- 16 The Shouldice experience.- 17 Presurgical hidden costs: imaging, assessment clinic.- 18 Postsurgical hidden costs: neuralgia.- 19 Postsurgical hidden costs: infection.- 20 Reimbursement strategies for medical devices: the case of Abdominal Wall Surgery in Italy.- 21 Economic modelling and Budget Impact Analysis in Abdominal Surgery: the case of mesh.- PART III: Outcome.- 22 How to measure outcome in surgery.- 23 Present and future of EBM.- 24 Registries: monitoring clinical ourcomes.- 25 Registries as a source of information for the purchase of devices.- PART IV: Future perspectives.- 26 Stakeholders opinions.- 27 Evolution of abdominal wall surgery in non developed countries.- 28 How social patterns affect the development of science.- 29 Ferrying to the future.