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Bagnoli PF, Nehchiri F, Lucini M, Messina ME, Morlacchi A, Lenna G, Ferrante P. Management of surgical working in an Italian neighborhood hospital during the COVID-19 pandemic. MINERVA CHIR 2020; 75:462-465. [PMID: 32773749 DOI: 10.23736/s0026-4733.20.08398-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The novel SARS-CoV-2 pandemic arose in China in the late 2019 and soon after spread in the rest of the world. The management of SARS-CoV-2 is a serious challenge for all the healthcare professionals. The management of this disease has caused an epochal change in all of the hospitals. The surgical departments too were not excluded from management of COVID-19 patients, because of the disease itself, or as complication of surgical procedure. The surgeons too had to quickly adapt their skills, in order to recognize and treat this life-threatening problem. In the meantime, the surgeons had to ensure continuity of the oncall availability for the emergency procedures, meanwhile the regular scheduled surgical activities were suspended. We present here our experience in a neighborhood hospital located in Milan, Italy.
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Affiliation(s)
- Pietro F Bagnoli
- Department of General and Emergency Surgery, Istituto Clinico Città Studi, Milan, Italy -
| | - Farhad Nehchiri
- Department of General and Emergency Surgery, Istituto Clinico Città Studi, Milan, Italy
| | - Monica Lucini
- Department of General and Emergency Surgery, Istituto Clinico Città Studi, Milan, Italy
| | - Maria E Messina
- Department of General and Emergency Surgery, Istituto Clinico Città Studi, Milan, Italy
| | - Andrea Morlacchi
- Department of General and Emergency Surgery, Istituto Clinico Città Studi, Milan, Italy
| | - Giovanni Lenna
- Department of General and Emergency Surgery, Istituto Clinico Città Studi, Milan, Italy
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del Bue S, Dolci M, Tarantini L, Bollati V, Favero C, Villani S, della Valle A, Bagnoli PF, Ticozzi R, Ferrante P, Crivelli F, Bregni M. Hypomethylation and presence of human endogenous retroviruses –h and –k in the extracellular microvescicles of colon cancer patients. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e24071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Marco Bregni
- Department of Oncology, ASST Valle Olona, Busto Arsizio, Italy
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Bagnoli PF, Cananzi FCM, Brocchi A, Ardito A, Strada D, Cozzaglio L, Mussi C, Brusa S, Carlino C, Borrelli B, Alemanno F, Quagliuolo V. Peritonectomy and hyperthermic intraperitoneal chemotherapy: cost analysis and sustainability. Eur J Surg Oncol 2014; 41:386-91. [PMID: 25554680 DOI: 10.1016/j.ejso.2014.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 11/21/2014] [Accepted: 12/09/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Malignancies of the peritoneum remain a challenge in any hospital that accepts to manage them, due not only to difficulties associated with the complexity of the procedures involved but also the costs, which - in Italy and other countries that use a diagnosis-related group (DRG) system - are not adequately reimbursed. MATERIAL AND METHODS We analyzed data relative to 24 patients operated on between September 2010 and May 2013 with special regard to operating room expenditure, ICU stay, duration of hospitalization, and DRG reimbursement. The total costs per patient included clinical, operating room, procedure, pathology, imaging, ward care, allied healthcare, pharmaceutical, and ICU costs. RESULTS Postoperative hospital stay, drugs and materials, and operating room occupancy were the main factors affecting the expenditure for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. We had a median hospitalization of 14 days, median ICU stay of 2.4 days, and median operating room occupancy of 585 min. The median expenditure for each case was € 21,744; the median reimbursement by the national health system € 8,375. CONCLUSIONS In a DRG reimbursement system, the economic effort in the management of patients undergoing peritonectomy procedures may not be counterbalanced by adequate reimbursement. Joint efforts between medical and administration parties are mandatory to develop appropriate treatment protocols and keep down the costs.
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Affiliation(s)
- Pietro F Bagnoli
- Department of Cancer Surgery, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy.
| | - F C M Cananzi
- Department of Cancer Surgery, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - A Brocchi
- Department of Cancer Surgery, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - A Ardito
- Department of Cancer Surgery, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - D Strada
- Department of Cancer Surgery, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - L Cozzaglio
- Department of Cancer Surgery, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - C Mussi
- Department of Cancer Surgery, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - S Brusa
- Department of Anesthesiology and Intensive Care Unit, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - C Carlino
- Department of Anesthesiology and Intensive Care Unit, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - B Borrelli
- Management Control Unit, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - F Alemanno
- Management Control Unit, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - V Quagliuolo
- Department of Cancer Surgery, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
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