Healthcare services & knowledge economy: economy and social development

SWG HealthY Economy – Matera, June, 26th, 2007

Healthcare services & knowledge economy: Healthcare services & knowledge economy: economy and social developmenteconomy and social development

INTERREG IIIC “Grip – It”: SWG HealthY Economy

GIANLUIGI CARLINI

University of Trieste (Italy)

- Project Coordinator -

PROJECT OUTCOMES AND THE FUTURE I.P.PROJECT OUTCOMES AND THE FUTURE I.P.

HEALTH NUMBERS: DATA HEALTH NUMBERS: DATA ——VOCI 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 Milioni di euro

Spesa pubblica 47.898 51.706 55.712 57.569 60.520 67.574 74.744 78.826 81.181 88.497 - Assistenza ospedaliera 21.617 23.132 25.383 25.999 26.447 29.050 31.360 33.080 33.955 37.468 - Assistenza farmaceutica 4.995 5.468 6.017 6.628 7.372 8.743 11.661 11.723 11.096 11.982 - Prestazioni medico-generiche 2.854 3.161 3.437 3.485 3.735 4.019 4.505 4.613 4.792 4.993 - Prestazioni medico-specialistiche 2.379 2.535 2.865 3.003 2.236 2.569 2.715 2.969 3.134 3.347 - Assistenza ospedaliera convenzionata * 3.870 4.093 4.417 4.331 5.115 5.630 5.783 6.298 7.011 7.475 - Assistenza protesica e riabilitativa 2.716 2.995 2.856 3.143 3.272 3.799 3.743 3.612 3.687 3.807 - Altre spese 9.467 10.322 10.737 10.980 12.343 13.764 14.977 16.531 17.506 19.425 Spesa delle famiglie 17.300 18.572 19.957 21.055 21.624 22.363 21.317 22.618 23.748 24.037 - Servizi ospedalieri 1.944 1.948 1.933 2.145 2.105 2.156 2.215 2.125 2.140 2.128 - Prodotti medicinali e farmaceutici 8.794 9.590 10.404 10.902 11.373 11.750 10.300 11.441 12.308 12.242 - Servizi medici e paramedici non ospedalieri 6.562 7.034 7.620 8.008 8.146 8.457 8.802 9.052 9.300 9.667 Totale spesa sanitaria corrente 65.198 70.278 75.669 78.624 82.144 89.937 96.061 101.444 104.929 112.534 Numeri indici (1995=100)

Spesa pubblica 100,0 108,0 116,3 120,2 126,4 141,1 156,0 164,6 169,5 184,8 - Assistenza ospedaliera 100,0 107,0 117,4 120,3 122,3 134,4 145,1 153,0 157,1 173,3 - Assistenza farmaceutica 100,0 109,5 120,5 132,7 147,6 175,0 233,5 234,7 222,1 239,9 - Prestazioni medico-generiche 100,0 110,8 120,4 122,1 130,9 140,8 157,8 161,6 167,9 174,9 - Prestazioni medico-specialistiche 100,0 106,6 120,4 126,2 94,0 108,0 114,1 124,8 131,7 140,7 - Assistenza ospedaliera convenzionata * 100,0 105,8 114,1 111,9 132,2 145,5 149,4 162,7 181,2 193,2 - Assistenza protesica e riabilitativa 100,0 110,3 105,2 115,7 120,5 139,9 137,8 133,0 135,8 140,2 - Altre spese 100,0 109,0 113,4 116,0 130,4 145,4 158,2 174,6 184,9 205,2 Spesa delle famiglie 100,0 107,4 115,4 121,7 125,0 129,3 123,2 130,7 137,3 138,9 - Servizi ospedalieri 100,0 100,2 99,4 110,3 108,3 110,9 113,9 109,3 110,1 109,5 - Prodotti medicinali e farmaceutici 100,0 109,1 118,3 124,0 129,3 133,6 117,1 130,1 140,0 139,2 - Servizi medici e paramedici non ospedalieri 100,0 107,2 116,1 122,0 124,1 128,9 134,1 137,9 141,7 147,3 Totale spesa sanitaria corrente 100,0 107,8 116,1 120,6 126,0 137,9 147,3 155,6 160,9 172,6

+80,79%

HEALTH OPERATORS KNOWS WELL THESE DATA… AND THEIR REASONS …

• OBJECTIVEs REASONs: STRUCTURALs, DEMOGRAPICs, CULTURALs…

• AND COMMONPLACEs (CULTURALs TOO)


HealthY Economy PROJECTHealthY Economy PROJECT

HOSPITALS & SMEs FOR HEALTHCARE ECONOMIC CLUSTERS:

OPPORTUNITIES FOR THE LOCAL ECONOMY, QUALITY OF CARE

AND COST OF CARE REDUCTION

AIM (GOAL): STARTING A CULTURAL PROCESS STARTING A CULTURAL PROCESS

IN OPPOSITION TO ONE COMMONPLACE IN OPPOSITION TO ONE COMMONPLACE ON HEALTHCARE:ON HEALTHCARE:

HEALTH COSTS ARE NOT ONLY A CHARGE FOR HEALTH COSTS ARE NOT ONLY A CHARGE FOR THE CITIZENS HEALTHTHE CITIZENS HEALTH

BUT ALSO AN ECONOMIC AND CULTURAL INVESTMENT FOR THE REGION


We will breefly considerWe will breefly consider

GENERAL ECONOMIC FOREWORDs

A CASE STUDY (an italian district)

THE NOWADAY PROJECT OUTCOME

FUTURE OUTLOOKs & AN INTEGRATED PROJECT PROPOSAL


HEALTH NUMBERS: DATA +HEALTH NUMBERS: DATA +

How and how much the activities for producing goods and services for the healthcare sector contribute to the country economy ?

THE HEALTHCARE VALUE CHAIN


HEALTH NUMBERS: DATA +HEALTH NUMBERS: DATA +

THE HEALTHCARE VALUE CHAINTHE HEALTHCARE VALUE CHAIN

Hospital services, social healthcare services etc.

Fabrication of pharmaceuticals and chemicals for medical purposes

Fabrication of biomedical devices, surgicals, orthopedics etc.

Great and little distribution/commercial related activities

Companies and cooperatives providing healthcare services


HEALTHCARE NUMBERS +HEALTHCARE NUMBERS +

(Italy)(Italy)

250.000 economic local units for healthcare related activities

1.400.000 labour places (6% of the total)

5,4 % GDP

138.000 € added value for each worker (106 k€ average)

Highly qualified labour places

High ratio Added Value vs GDP 5,44 % (60% + of the food sector)

Positive impact on formation and

territory culture

… YES, BUT IT WORKS JUST IN THE GREAT

INDUSTRIAL AREAS … OR NOT ?

PARTLY YES AND PARTLY NO

AND ON THE “PARTLY NO” IT’S POSSIBLE TO WORKAND ON THE “PARTLY NO” IT’S POSSIBLE TO WORK


A PROVINCE CASE STUDYA PROVINCE CASE STUDY

23 years ago: activation of the new hospital in Trieste

Update of the hospital “offer”re-qualification

investment in technologies:- 15%15% of the total new hospital costs- new trained personnel for the technology new trained personnel for the technology

management management (clinical engineering services)(clinical engineering services)

developmentIT WAS A REPLY TO THE BIG MEDICINE CHANGE OF THAT TIME, ABOVE ALL IN THE FIELD OF NEW DIAGNOSTIC DEVICES AND METHODOLOGIES:

THE EFFORT DONE BECAME AN “INVESTMENT” that enriched the territory of the province

ECONOMIC-CULTURAL-TRAINING CONSEQUENCESECONOMIC-CULTURAL-TRAINING CONSEQUENCES19841984

20072007

• research projects (CNR, MURST…)

• technology transfer in Area Science Park

• faculty development at the University of Trieste• CLINICAL ENGINEERING MASTER (2 YEARS)• NEW RADIOLOGY (TAC ’81 – operative in the new hosp.)

• support to Ministry of Health for the regulation of biomedical devices

• industrial spin-off with a European size company700 employees, 100 milions € turnover+ induced

•Molecular Biomedicine District


BUT HEALTHCARE WORLD IS STILL CHANGINGBUT HEALTHCARE WORLD IS STILL CHANGING

• Tecnical/scientific

• Demographic

• Socio-cultural

• Politic – organization –

economic

• New clinical protocols• High pressure for technology and pharmaceutical innovation

• Increasing cronic and elderly cares

• Higher expectation for the quality of care• Valorisation of the person and of the individual rights

• decision partecipations -sharing• Responsability condivision (diffusa)• Compatibility between healthcare demand and available resources


• new technologies of genetic-genomic-proteomic

• enhanced imaging technologies

• telemedicine development

• tele-surgery, tele-consulting

• increasing ambulatory and surgery day-hospital

• increasing endovascular surgery

• increasing laparoscipic and mini-invasive surgery

SIGNIFICATIVE PREDICTABLE CHANGESSIGNIFICATIVE PREDICTABLE CHANGES


ONCE MORE HEALTHACARE OPERATORS HAS TO ONCE MORE HEALTHACARE OPERATORS HAS TO DRIVE CHANGESDRIVE CHANGES

AND ONCE MORE THIS EFFORT COULD BECOME AN OPPORTUNITY FOR THE CULTURAL AND ECONOMIC DEVELOPMENT OF THE TERRITORY

THIS TIME WE HAVE ONE MORE OPPORTUNITY:

EUROPEAN UNIONEUROPEAN UNION

ONCE MORE HOSPITAL AND TERRITORY CAN EXCHANGE AND SHARE COMPETENCES


The new Hospital District of TriesteThe new Hospital District of Trieste

Trainig Area

10.000 mq for molecular medicine and innovation (ICT, elderly)

New street

New Children Hospital

Food and restoration area

ACTION OF SWG HEALTHY

HRADEC KRALOVE

MATERA

• SURVEY OF COMPETENCES IN HEALTHCARE, TRAINING, SCIENCE AND INDUSTRY (common and complementar)

• DEFINITION OF AREAS OF COOPERATIVE DEVELOPMENT

• DESIGN OF COMMON PROJECT TO LAUNCH IN 2007- 2013 PROGRAMMES


MateraMatera

TriesteTriesteHradec KraloveHradec Kralove

Integrated Project

Elderly care

Elderly care

ICT

ICT

ICT

Healthcare training

Healthcare training

Integrated Project

+ NEW PARTNERs

Areas of cooperative development for I.P.Areas of cooperative development for I.P.

“STROKE” PILOT


“Integrated Home Care” PILOT

Extending the partnership for the I.P.Extending the partnership for the I.P.

MateraMatera TriesteTrieste HradecHradec

Villach Villach HospitalHospital

ICT - “STROKE”

Strasbourg Strasbourg BiovalleyBiovalley

NEW ANTIBIOTICS (peptides)

Izola Hosp.Izola Hosp.(SLO)(SLO)

ICT - “STROKE”

… … and so on: clustering European life scienecsand so on: clustering European life scienecs


AN EXAMPLE: For ICT platform – eHealth, AN EXAMPLE: For ICT platform – eHealth, we meanwe mean

A COMMON PLATFORM TO:

EXCHANGE THE BEST PRACTICES FOR HEALTHCARE COSTS CONTROL

SHARE THE BEST PRACTICES - CLINICAL PROTOCOLS (pilot experim. on stroke)

TRAIN PHYSICIANS AND NURSES

IMPLEMENT MODULES OF ELECTRONIC PATIENT RECORD (EPR) AND HOSPITAL INFORMATION SYSTEM (HIS) + TRAINING MODULES

TOGETHER WITH

ICT COMPANIES LOCATED IN THE AREA – KNOWLEDGE ECONOMY DEVELOPMENT

What we are going to integrate in the I.P.What we are going to integrate in the I.P.

INTEGRATE EU-FUNDING TOOLS (META-PROJECT ENGINEERING)

INTEGRATE DIFFERENT KIND OF PARTICIPANTS

•HOSPITALS

•UNIVERSITIES

•INDUSTRY ASSOCIATIONS – DEVELOPMENT AGENCIES

INTEGRATE PROJECT MANAGEMENT TOOLS

INTEGRATE TERRITORIAL COOPERATION OBJECTIVES

•SHARING REGIONAL EXPERTISES FOR HEALTH

•ICT & eHEALTH

•RESEARCH

•IMPLEMENTING KNOWLEDGE ECONOMY PROCESSES

•TRAINING

PROJECT ENGINEERINGPROJECT ENGINEERING

“Particular attention should be paid to ensuring complementarity, synergy and consistency among all Community policies, and in particular the Seventh Framework Programme, ERDF and cohesion policies, European Social Fund (ESF)” [1]

[1] REGULATION (EC) No 1080/2006 OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 5 July 2006 on the European Regional Development Fund

INTERREG IV C

Interreg IV AITA-SLO

Interreg IV AITA-AUT

Interreg IV ACZE-POL

…….. MED

FP 7 ESF CEUS

ONE OBJECTIVE, DIFFERENT TOOLSONE OBJECTIVE, DIFFERENT TOOLS

IV A – HOSPITALS COOPERATION & eHEALTH - ICT

IV C – KNOWLEDGE ECONOMY, TRANS-NATIONAL CLUSTERING

(coordination tool)

FP 7 – RESEARCH & DEVELOPMENT

ESF – TRAINING


COMMON METHODOLOGY, DIFFERENT COMMON METHODOLOGY, DIFFERENT PILOT PROJECTS, DIFFERENT EU PILOT PROJECTS, DIFFERENT EU

PRIORITIESPRIORITIES

Method: INTEGRATING funding tools, partners typology,

management tools, cooperation objectives

Pilots: integrated home care, stroke therapy, new antibiotics et al.

all pilots ICT – eHealth based

EU priorities: healthcare best practices, eHealth, knowledge

economy, training


THE STROKE PILOTTHE STROKE PILOT

OBJECTIVES:

ADAPT STROKE MODELS TO DIFFERENT SOCIO-ECONOMIC CONTESTS

BENCHMARK CLINICAL EFFICACY AND COST OF CARE

DEVELOP E.P.R. & H.I.S. MODULES FOR STROKE (INVOLVING INDUSTRY)

EXCHANGE CLINICAL PRACTICES

EXCHANGE PERSONNEL FOR TRAINING

TELE - TRAINING


3 STROKE MODELS TO BENCHMARK3 STROKE MODELS TO BENCHMARK

1 - ACUTE STROKE UNIT – “German model”

Hyper-intensive care

t < 3-5 gg

Rehabilitation

2 - COMPREHENSIVE STROKE UNIT – “English model”

intensive care Rehabilitation

3 - STROKE TEAM

No stroke unit, a team follows the patient in the different hospital departments


ARCHITECTURE OF THE STROKE PILOTARCHITECTURE OF THE STROKE PILOT

F (model, socio-economic contest) =

clinical outcomes

cost-effectiveness

WP1 – Methodology for comparison

WP 2 – Tools development eHealth / ICT

WP 3 – Training and exchange of personnel

SMEs involvement


INTERESTED IN PARTICIPATINGINTERESTED IN PARTICIPATING

UNIVERSITY OF TRIESTE (ITA)

INDUSTRY ASSOCIATION OF TRIESTE (ITA)

MEDICAL HOLDING HRADEC KRALOVE (CZE)

A.S.L. 4 – MATERA (ITA)

VILLACH HOSPITAL (AUT)

IZOLA HOSPITAL (SLO)

UNIVERSITY OF KLAGENFURT (AUT)

…………ET AL.…………………….


SAME IDEA ON THE OTHER SAME IDEA ON THE OTHER PILOTSPILOTS

Thank you very much


Healthcare services & knowledge economy: economy and social development

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