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Acronym and title of the project
ImEcAP
Economic Impact of Prosthetic Assistance in relation to the reform of the National List of Devices provided by the National Health Service
Official Start and End dates
15/02/2007 - 15/12/2009
Funding Body
Ministry of Health
Directorate General of Health Planning, Basic Levels of Care and Ethical Principles of the System
Project Leaders and partners
Project Summary
The project ImEcAP aims to determine in a realistic way the reference costs for assistive devices, according to a
calculation model especially developed on the basis of the latest scientific evidence on the subject.
Considered the vast amount of information and data to process the analysis of the economic factors involved
in prosthetic assistance, the analysis of the structure of the assistive technology market,
the definition of a mathematical model for calculating the social cost of assistive devices,
the validation of this calculation model through a properly selected sample of case studies,
the analysis of feasibility for the establishment of an observatory of market prices of the devices),
a Technical Working Group was formed and composed of specialists of Fondazione Don Gnocchi
and - by agreement - of Center of Research and Studies in Health Management
at the Catholic University of Milan, as well as a multidisciplinary Advisory Committee,
composed of specialists in the field of disability / rehabilitation, assistive technologies,
to health economics and business management to support the activities of the Technical Working Group.
The intermediate objectives of the project are the implementation of three phases, which coincides
with the definition of the model for calculating costs, the quantification of costs and the
quantification of the products:
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the definition of the model for calculation costs is based on a system of equations that include the components necessary for estimating the social costs of the benefit (clinical, technical, prescription and approval, production and supply, management and maintenance, cost savings etc. .), a special system of equations was also developed for estimating the costs of production and supply declined depending on the specific characteristics of the "categories" identified in the proposal. The calculation model makes it possible to assess the costs related to the devices itself (cost of products) and those related to the path that leads to the acquisition by the user (cost of course).
Then, the model was validated through a series of iterations in order to verify the effectiveness e l'applicability: in particular, to ensure that it allows to determine the actual costs in a accurately, effective and feasible way, and covering all the costs involved in the process. The validation led to compare, from a side, the world of producers and suppliers of equipment, which provided case studies relating to the cost of the product, and from the other side who is in charge of the stages of assessment, prescription and authorization, for what regards the cost of course.
The comparison was proved fruitful and has allowed us to formulate a model widely shared by the main actors. In several rounds of iteration, the observations and comments arose during the Advisory Committee meeting, and those formulated by the various companies involved, were used to refine the model;
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the quantification of costs of off-the-shelf is defined in a process of development and implementation of a system for collecting data on market prices of the assistive devices, done in conjunction with the Don Gnocchi Sistemi SRL and using the network of national databases of assistive devices of the 9 foreign partners (already tested in the project Eastin). It was then necessary to determine the costs of reference for the nomenclature of the devices, back to the cost of reference related to the production and delivery through the use of each analytical component of cost and the subsequent implementation of the model calculation;
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the quantification of costs of custom-made products is provided the involvement of associations of Companies involved in this area by inviting them to formulate tariff proposals on the basis of the calculation model developed during the project: this phase of work will be done once the new nomenclature related to the reform of the basic level of care will be published.
Related web sites
Team involved at DonGnocchi Foundation
Renzo Andrich, Polo Tecnologico (responsible) Valerio Gower, Polo Tecnologico Antonio Caracciolo, Dat Service Centro IRCSS Centro S.Maria Nascente Aldo Sestini, SIVA Service Centro S.Maria alla Pineta, Marina di Massa Massimo Memmola, CERISMAS, Università Cattolica, Milano
Advisory Committee
- Laura Arcangeli, Health economist - consultant of the Ministry of Health, Directorate General of Health Planning
- Enrico Arrighi, Service Control Manager, Centro S. Maria Nascente, Don Gnocchi Foundation
- Claudio Bitelli, responsible Ausilioteca Aias Bologna, GLIC President
- Gaspare Crimi, responsible of the Rehabilitation Department ULSS 20 Verona and coordinator, assistive devices SIMFER section
- Anna Eccher, ex-responsible prosthetic Central Unit ASL, Milan
- Rosa Maria Converti, medical physiatrist, responsible DAT service Don Gnocchi Foundation, Milan
- Rinaldo Sacchetti, Technical Director Prosthetic Center Inail, Budrio (BO)
Documents publicly available
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