[Perinatal and newborn care in the Emilia-Romagna Region health planning]. / L'assistenza perinatale ed al neonato nel piano sanitario della Regione Emilia-Romagna.

The report summarizes the contents of a conclusion of a document of the workshop "Neonatal and Prenatal Intensive Care" activated by the Emilia-Romagna Region to set up the third Regional Health Planning 2000-2002. The proposals, wholly taken from the Regional Program, aim to improve the care improving the outcomes in terms of mortality and maternal-infant disability. The organizing model proposed is that of integrated networks of services distributed according to a hierarchy of functions (Hub & Spoke model): 1st, 2nd, and 3rd level of functions. The network services should function as an integrated system, governed by agreed clinical and organizational guidelines, in which requirements of equipment sets and professional abilities are identified, as well as, relationship criteria among the different levels that regulate the by-directional course of the patients and/or the operators: the continuous training activity, the monitoring of a set of process indicators and results and also the clinical-organizational audit activity, are the instruments identified for results verification and for continuous actions of improvements.

[Management control and operative budget at a radiology center]. / Il controllo della gestione e il budget operativo in un centro di responsabilità di radiologia.

The laws reforming the National Health Service (SSN) (DL 30.12.92 n. 502 converted into DL 7.12.93 n.517) strongly modify the operation rules of the local sociosanitary units (USL) and imply that the rules themselves be reorganized with flexible and agile organization systems, introducing, in addition, a budget system as a tool for programming and checking the results. The essential elements for management evaluation are: -an accurate accounting system for every department, based on a detailed analysis of the productive factors directly used; -a survey of the activity data with uniform and established indices. This work deals with a radiology department as a responsible unit belonging to Imola State Administration. It is an intermediate service as its activity is for both in- and outpatients. To calculate the cost of the service provided to users and to define the use of resources, inpatients and outpatients costs were included. This involves adding the cost of the examinations requested of the intermediate service, that is, the radiology department. The operative tool used to ascribe the cost of these demands to the departments needs a transfer cost system showing the increasing value of the number of services that the intermediate service gives the final user. To evaluate the activity of the radiology department, we tried to identify an index of respective complexity for every examination: a figure which allows us to express the use of resources according to the complexity of the services given and to turn the number of examinations into significant activity.