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Reimbursement summary for angioplasty of arteries of lower extremities

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.
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Italian Ministry of Health releases report on guaranteed benefits - essential levels of care (LEA) among Regions

The analyses were performed on the 2015 data from 16 Regions, on the basis of 35 indicators. According to the score assigned, Regions were classified as “compliant” (i.e., score ≥ 160 or between 140 and 160 with no critical values in any of the indicators) or “non-compliant” (i.e., score < 140 or between 140 and 160 with at least one critical value in one of the indicators). Overall results showed that the Country is split into two sections: Regions in the north were all compliant while those in the south, with the only exception of Basilicata, showed suboptimal performances.

  • Compliant Regions (final ranking): Toscana, Emilia-Romagna, Piemonte, Veneto, Lombardia, Liguria, Marche, Umbria, Abruzzo, Lazio, Basilicata.
  • Non-compliant Regions (final ranking): Molise, Puglia, Sicilia, Calabria, Campania.

Among the Regions, critical values were mostly assigned to indicators belonging to the following areas:

  • Vaccination plans

Low compliance was registered in 4 Regions on the vaccination against poliomyelitis, diphtheria, tetanus, hepatitis B, whooping cough, and Hib. Vaccination against measles, parotitis, and rubella showed a decreasing trend in all the regions while the one against influenza in elderly people showed a slowly increasing trend.

  • Screening programmes

Adherence to screening programmes for cervical cancer, breast cancer, and colorectal cancer showed a big gap between the Regions in the north and those in the south (with the exception of Basilicata) in which values are very low.

  • Hospital care

While overall hospital admissions showed a decreasing trend in all the Regions, the number of Caesarean sections performed was still high (especially in Campania). Even if still low, the number of patients with hip fracture receiving surgery within 2 days showed an increasing trend in all Regions.

  • Community care

Admissions of elderly people in dedicated facilities showed critical values, especially in the southern Regions and also hospital admissions for asthma and gastroenteritis among pediatric patients.

The historical analysis presented in the report showed also which Regions are following a positive trend, being always compliant in the time frame 2012-2015 (Toscana, Emilia-Romagna, Piemonte, Veneto, Lombardia, Liguria, Marche, Umbria) and those Regions not being able to improve (e.g., Calabria and Campania).

Link to the full-text of MoH report (in Italian) is here

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