This paper examines the impact of the internet usage and knowledge intensive activities on households’ healthcare expenditures Similarly, the paper aims to recognize and understand, from a value-creation perspective, the correlation between: internet access of households (IA), individuals frequently using the internet (IU), individuals searching on internet for health-related information (HI), payments made by households for healthcare (PHH), expressed as euro per inhabitant and employment in knowledge-intensive activities (KIA). The approach utilized in the present study consists of two steps. First, a theoretical framework was conducted to determine the existing relationship between major variables. Next, the Vector Autoregressive (VAR) approach was applied in a case study at European level to prove the three hypothesis we consider. By analyzing the connection between the major variables, a positive and long- lasting impulse response function was revealed, followed by an ascending trend. This suggests that a self-multiplying effect is being generated; and it reasonable to assume that the more individuals use the Internet, the more electronic acquisitions occur. We can thus reasonably conclude that the improvement of the internet usage and knowledge intensive activities on households’ healthcare expenditures process is strongly dependent on people’s capability. Improving IU and KIA is the new reading key in the decision-making process in health system approach.
Introduction: The increasing age, the presence of different diseases that affect the health of individuals and the new opportunities of access to information are changing the process of acquisition of data on health status. Very often, the process of autonomous research of information leads to wrong self-diagnosis with consequent repercussions on health expenditures (e.g.: unnecessary hospitalization) and, generally, on sustainability of health systems. Scope: This work aims to examine the influence of Digital Divide and Internet Usage (DD/IU) on autonomous Health Information Seeking (HIC) process, in order to get useful information about its impact on Healthcare Expenditures per Individual (HEPI). Similarly, this work aims to recognize and understand, from an economical, organizational and technological perspective, the correlation between DD/IU-HIS and HEPI.Methods: To discover the link between DD/IU, HIS and HEPI, we conducted a systematic literature review in order to understand the network of behind these concepts and we applied the Panel Linear Model (PLM) approach in a case study to prove the correlation.Findings: By analysing the literature on between DD/IU and HIS ties have emerged between the research topics. These findings have been also revealed by a significative impact. This suggests that, since people live longer, the more individuals access the Internet to get information on health status, the more effective the health expenditure is. All of this has repercussions on the long-term sustainability of the health system, requiring a re-modulation of the services provided, the professionalism and the technologies adopted.
The present research intends to address in a comprehensive, transversal, and interdisciplinary manner the chronic patient management process in the research project named "PRO DOMO SUD" in order to identify operational inefficiencies, thus demonstrating that these are largely attributable to incurred costs and, thus, evaluate possible solutions for providing effective and appropriate responses by healthcare and social services. Can patients/older people be treated, monitored, and managed successfully with mobile and wearable technologies? The project involved three different groups of patients/participants: Patients with heart failure shock in "Home Monitoring Scenario"; Patients with different pathologies in "Virtual Ward Scenario"; Patients with limited mobility due to Neurological and Orthopaedic disease in "Rehabilitation Scenario". Due to the complexity of the issue, the methodological approach adopted must be multidimensional and interdisciplinary, addressing the complexity of the chronic patient from all viewpoints, not reducing it, yet analysing, understanding, rearranging, and managing it in an organic manner. The three different scenarios were allowed to identify several impacts on organizational and clinic management of chronic diseases, the tests showed significant improvements in quality of life of patients enrolled in the project. The data deriving from the three scenario demonstrate that wearable divide and ICT, in general, can empower both patients and physician personnel allowing them to be active part in the chronic disease management process. The PRO DOMO SUD experience derived from the Living Lab, this is a new paradigm for industrial research and development activities which allows the final users to actively collaborate with the designers and technicians in the development and test of new products and services aimed to them. The Living Labs stimulate social innovation by transferring research results from the closed industrial laboratory towards real life contexts where citizens and users become co-developers.
ObjectiveAn increase in breast cancer incidence has been documented in Italy and in other countries, and some women decide by themselves to undergo diagnostic examinations outside the official screening campaigns. The aim of this paper was to analyze – in terms of effectiveness, appropriate access, and related costs – the path spontaneously followed by a sample of Italian women for the early diagnosis of breast cancer.Subjects and methodsA total of 143 women who consecutively referred themselves to the breast cancer outpatient facilities at the Sant’Andrea University Hospital in Rome from May to June 2007 were enrolled in the study, gave their consent, and were screened according to their individual risk factors for breast cancer. The entire diagnostic and therapeutic path followed in the previous 2 years by each of them, either at Sant’Andrea or in other medical facilities, was reviewed and evaluated in terms of its operative efficiency and fair economic value.ResultsThe subjects’ mean age was 47.5 years (standard deviation 13.6 years); 55% of the women were <50 years old (28% <40 years), and were thus not included in the official screening campaigns; 97 women (70%) were requesting a routine control; and 49% of them had already undergone four to seven examinations before the enrollment, although no major risk factor was present in 73.5%. After enrollment in the study, nine of the patients had surgical interventions performed on them at Sant’Andrea’s, identifying five invasive carcinomas and two ductal in situ carcinomas and two benign lesions. Operative efficiency and fair economic value were found to be optimal only in diagnostic/therapeutic paths followed at Sant’Andrea.ConclusionThe diagnostic path at Sant’Andrea’s specialized center for breast cancer diagnosis and therapy is characterized by higher operative efficiency and more sustainable costs than at general hospitals, outpatient facilities run by local health authorities, or private medical centers. This result seems to confirm the present tendency to refer high-risk patients for breast cancer directly to breast units like the one at Sant’Andrea.
Globalization age led to creation of new markets and to unveil new scenarios. This contingency highlighted the existence of a broader range of tourist offerings; a factor which, frequently, has undermined the most traditionally established destinations. The model of new destinations must not ignore the peculiarities of territories on they insist creating a unique amalgam and differentiating it from other neighboring or similar destinations. Due to this proliferation of factors that destabilize the governance of tourism management models in the public and private sector, it is necessary to start an analysis of government indicators that consider peculiar aspects of destination management in the era of globalization. For these reasons we conducted an analysis of the business-economic literature about the themes of tourism and governance in tourist destinations and we selected a set of indicators to describe, assess and control extended, slow and sustainable destinations. In this work, we want to illustrate a heuristic approach to build glocal destination based on the pillars of extended, slow and sustainable tourism. From the results of the literature analysis it will be possible to create a framework to build a tourist strategy in glocal destination management, useful to implementation of territorial tourism strategies for both institutional, public and private actors. The use of the key factors of the model could favor the insertion of new tourist routes respecting the cornerstones of the tourism ecosystem of sustainability.
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