Sustainability innovation in the era of ‘spending review’ – LiberoQuotidiano.it

In surgery, the new technology are constantly evolving and it is very difficult to keep up with other European or American countries at a time when the Italian health system is still in full ‘recovery plan’. “On the other hand there is the problem of the low international competitiveness – comments Professor Giorgio De Toma , Director of the General Surgery Chair of the University ‘La Sapienza’ in Rome, speaking at the sixth congress national CO.R.TE. – Italian Conference for the Study and Research on Ulcers, sores, wounds and repair tissue chaired by Professor Nicolo Scuderi – in the absence of new instruments or devices that need to be purchased and used for large investments; all this leads to the paradox that the multinationals come to present or advertise in Italy the latest device, by referring to other European countries, the middle or the Far East, where there are far more receptive markets. And the fact of being forced to close the need to reduce costs leads to so-called ‘Dutch auction’, where the lowest financial offer becomes predominant and priority over quality or innovation. If not, at times, safety … “

In the surgical field has witnessed in the last decade to a big boost in technological innovations, from laparoscopy to robotic surgery until the transluminal endoscopic surgery and endovascular techniques , the latter, which in many cases are almost supplanting the traditional open surgery, confined or limited to special cases. These new technologies use laser sources, radio and the latest generation of ultrasound, in miniaturized systems, of which the high costs, it is understandable that the purchase of exercise. And what about the radio-guided surgery with radionuclides and fluorescence techniques, up to the robotics, the highest expression of minimally invasive surgery. But, as often it happens in Italy, the advent of new technologies is not used in a rational manner, with precise indications of diseases and already codified clinical cases in countries that have used before and already have terms of comparison of the results. In Italy you are acting in a completely ‘anarchist’, often linked to leadership inherent in the personality of the surgeons. This leads to improper leavening of operating costs that limit the use or are disadvantageous purchase of the last device , with the result that sometimes it is much easier to have this technological availability and privately owned, .

What is the solution? “Obviously a National Health Service ‘virtuous’, even in a difficult economic time, should adopt divestment models from waste and inefficiency – claims De Toma – should quantify the over-use of technology to inappropriateness of competence, guidance and organization in so that the cutting waste can be re nell’acquisizioni and use of new technologies. In the absence of new economic income in health care, therefore, the only solution is the rationalization of expenditure, the purchase and prudent use of expensive technologies and controlled so that they are used in the relevant centers and rigid control of the indications for use. In surgery, where there are high purchase and operating costs, larger studies are needed to justify the validity of a new technology over another. Only this can lead to not deprive us of the new acquisitions and limit reckless use “. ( CARLOTTA DONNINI )