Innovation technology in neurorehabilitation: introducing a hub and spoke model to avoid patient “migration” in Sicily

Abstract

PurposeIn the Italian National Health Service, hospital planning has been influenced by two aspects: patients' freedom to choose their healthcare provider and the equal distribution of centers spread throughout country. Unfortunately, while every Italian region should be able to meet the health needs of its own inhabitants, consistent migration among regions exists, especially from the southern areas of the country, including Sicily. As it has been demonstrated that a hub-and-spoke model (HSM) can provide medical care to even the most rural areas, the aim of this study is to propose a new Sicilian model to avoid patients' migration.Design, Methodology, ApproachThe IRCCS Centro Neurolesi “Bonino-Pulejo” of Messina, together with the Ministry of Health and the Sicilian government, has incorporated an HSM into a Sicilian healthcare program that provides neurological rehabilitation by means of innovative technologies such as robotics.FindingsThe authors expected, thanks to this novel HSM, that patients may benefit from advanced robotic neurorehabilitation even in rural areas, and therefore be properly treated in their own cities, avoiding unnecessary and expensive migrations to other regions and/or countries. Indeed, since the introduction of this model, there has been a reduction in patient migration, especially in the province of Messina, with a reduction of costs for admission outside the region of about 260.000 euros.Originality/valueThe use of innovative technology in the context of the promising HSM will help clinicians increase the intensity of therapies and improve working cost/efficacy, with better functional outcomes in patients.

Inter-Regional Hospital Patients’ Mobility in Italy

“…The biggest attractions were for MDC 8. The general picture of mobility was quite heterogeneous; southern regions had the greatest exports of patients and all showed negative mobility balances except for Molise, which has always had positive balances over the years [ 46 ], while the northern and central regions had the greatest attractiveness.…”

Tele-Neuro-Rehabilitation in Italy: State of the Art and Future Perspectives

“…Following this positive experience, the Italian Ministry of Health founded in 2015 a National Telerehabilitation network involving the main Research Institutes (i.e., the "Istituti di Ricovero e Cura a Carattere Scientifico, " IRCCS) and aimed at assessing the efficacy and cost-effectives analysis of telerehab in the treatment of different neurological disorders, including stroke, dementia, PD, and MS. Also, Calabrò et al (107) underlined the potential of telemedicine in guaranteeing distance training and comparison between the healthcare professionals, encouraging the relationship between the Hub center and the Spokes. In fact, these centers are constantly connected thanks to telemedicine: the different specialists support each other, both for diagnosis and for rehabilitation.…”

“…In fact, these centers are constantly connected thanks to telemedicine: the different specialists support each other, both for diagnosis and for rehabilitation. Furthermore, this program allows the application of standard protocols with fairer and uniform health services (107).…”

Improving cognitive functions in adolescents with learning difficulties: A feasibility study on the potential use of telerehabilitation during Covid‐19 pandemic in Italy

“…Various studies have shown that telerehabilitation could help supporting both physical and psychosocial needs of the individuals living at home with an improvement of motor, cognitive, or psychological disorders ( Bramanti et al, 2018 ; De Cola et al, 2016 ; Maggio et al, 2020 ; Zhou et al, 2020 ). Telerehabilitation is a field of telemedicine, consisting of systems/devices for the control of remote rehabilitation training, such as physiotherapy, speech therapy, occupational therapy, as well as assistance of patients forced to stay at home, without the physical presence of therapists or other healthcare professionals ( Calabrò et al, 2020 ; De Cola et al, 2020 ; Rosso et al, 2018 ). In particular, tele-cognitive rehabilitation involves the recovery and/or compensation of impaired cognitive and behavioral skills to improve the quality of life of the patient in his/her family and social environment.…”