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Care Settings

  • Dalila Patrizia GrecoEmail author
  • Claudia Abbati
Chapter

Abstract

Health care services and their related costs are continuously increasing, due to an ageing population and the spread of chronic conditions. Since the resources are limited, the only way to allow a sustainable system is to modify current protocols and regimes, improving organizational policies and procedures.

This has led to an evolution of conventional hospital stay, and to the birth of Day Care Services and Day Surgery. Moreover, the adoption of new surgical pathways, such as ERAS and fast track, and a careful patient selection have contributed to reduce post-operative complications and length of hospital stay, decreasing hospitalization costs.

Abdominal wall surgery gave an important impulse to this evolution, thanks to its innovations and specific characteristics, as the advent of prosthetic and tension-free techniques, and the use of local or peripheral nerve block anaesthesia. These improvements have allowed to achieve early recovery of function, shortening length of hospital stay.

The Italian reimbursing system, based on DRG, still has to adapt to these new pathways, in order to preserve the standards achieved today.

The hope is that through an appropriate management of care settings, a strong prevention policy and a wise use of high-tech, day surgery will be safe for more and more people, and sustainable for the health care system.

Keywords

Health care delivery Surgical care Day surgery Hospital costs 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Day&Week Surgery UnitOspedale Niguarda Ca’ GrandaMilanoItaly
  2. 2.Department of SurgeryNiguarda HospitalMilanItaly
  3. 3.University of MilanMilanItaly

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