Abdominal Wall Surgery

This book presents different patient-oriented perspectives from surgeons, economic evaluation and management researchers, and business companies active in the healthcare sector, striking a balance between the appropriateness/effectiveness of treatment and efficiency/cost. It does not include technical surgical details, but instead provides the necessary knowledge regarding different groups of patients to help economic and management researchers make accurate evaluations. Although partially based on the specific case of abdominal wall surgery in the Italian health system, the book defines a model that can, with the necessary adaptations, be applied in other national contexts. It also analyzes different reimbursement systems and methods of data collection. This approach supports the evolution form evidence-based medicine (EBM) to the future of real-world data (big data analysis). Further, it highlights the critical issue of "silos" reimbursement, which is the pillar of DRG, and proposes methodology to evaluate the direct and indirect benefit and costs of surgery (for example quality of care, costs incurred in cases of surgical complications due to the use of inappropriate, low-cost material or due to surgical procedure.
It is a valuable resource for clinicians, surgeons, policymakers and managers in the field.

Dalila Patrizia Greco obtained a degree in Medicine and Surgery with honors, specializations in General Surgery and in Plastic and Reconstructive Surgery and her master's degree in health management at SDA (School of Management) Bocconi in 1995. She is a member of several national and international scientific societies, fellow of the American College of Surgeons, the G.R.E.P.A (The historical Groupe de Recherche et d'Étude de la Paroi Abdominale) and the EHS (European Hernia Society). Since 2015 she has been a member of the quality group of EHS. She has an interest in the field of abdominal wall surgery (inguinal, femoral, and umbilical hernia, eventration), and has developed day surgery for these conditions. Her research focuses on topics in the fields of biomaterials and healthcare management. Since 2006 she has been the director of the Day Surgery Centralized Departmental Unit and from 2015 also of the centralized structure of week surgery of ASST Ospedale Niguarda Milano.
Elio Borgonovi is Senior professor of Public Administration and Healthcare Management, Department of Social and Political Sciences at Bocconi University, Milan. He was full professor at the State Universities of Parma and Trento. Since the early 70s he has developed the field of management applied to public administration, healthcare and social services sector, for not-for-profit organizations and social enterprises. In 1978 he founded and was a director of CeRGAS (Centre for Research on Health and Social Care Management) to promote research and management education in order to support the implementation of the Italian national health system. Since 2004 he has been President there. He also founded the Public and Not-for-Profit Division at SDA (Bocconi School of Management). He is member of a number of scientific committees and advisory boards and he is an official reviewer for many journals both in Italy and abroad. He is a member of several national and international networks, including ASFOR (Italian Association of Schools of Management), EHMA (European Healthcare Management Association), AOM (Academy of Management - Public and Not for Profit, Healthcare Divisions), IRSPM, and EGPA.

PART I: Abdominal wall.- 1 Epidemiology.- 2 Anatomy.- 3 Clusters of patology & interventions.- 4 Unit of wall surgery.- 5 Organization and certification of abdominal wall surgery: the German example, the easter Europe example, the Sweden example, the Spain example.- 6 Organization and certification of abdominal wall surgery: the Eastern Europe example.- 7 Organization and certification of abdominal wall surgery: the Swedish example.- 8 Organization and certification of abdominal wall surgery: the Spanish example.- 9 Devices and biomaterials: from chemistry to certification.- 10 Assistential settings.- 11 Preventing incisional hernias: closure of abdominal wall, follow-up in abdominal surgery.- PART II: Economics.- 12 Economic Evaluation and Health Technology Assessment of Healthcare Programmes.- 13 Comparative Effectiveness in Health Technology Assessment for Medical Devices.- 14 Economic evaluation of abdominal Wall Surgery (cost benefit analysis, cost effectiveness, cost-quality analysis).- 15 Cost Containement: abdominal surgery unit.- 16 The Shouldice experience.- 17 Presurgical hidden costs: imaging, assessment clinic.- 18 Postsurgical hidden costs: neuralgia.- 19 Postsurgical hidden costs: infection.- 20 Reimbursement strategies for medical devices: the case of Abdominal Wall Surgery in Italy.- 21 Economic modelling and Budget Impact Analysis in Abdominal Surgery: the case of mesh.- PART III: Outcome.- 22 How to measure outcome in surgery.- 23 Present and future of EBM.- 24 Registries: monitoring clinical ourcomes.- 25 Registries as a source of information for the purchase of devices.- PART IV: Future perspectives.- 26 Stakeholders opinions.- 27 Evolution of abdominal wall surgery in non developed countries.- 28 How social patterns affect the development of science.- 29 Ferrying to the future.