ABSTRACT
Primary care represents an answer to the growing demand of an ageing population for healthcare services outside the hospital. As a support mechanism of primary care, the distribution of health technologies to chronic patients plays an important role, but it has been investigated from the operational viewpoint only, ignoring the patient's perspective. We explored patient's satisfaction in relation to the distribution processes of incontinence health technologies, investigating its antecedents and isolating the factors driving the satisfaction of patients - which could be leveraged to design better distribution processes for better primary care services. We performed a survey study on 650 patients in primary care services affected by incontinence in Italy, building on the ServQual and Kano models. Partial Least Square Structural Equation Modelling (PLS-SEM) with Multi-Group Analysis (MGA) was adopted to analyse the data. Results show that interaction of patients with the personnel delivering the service is the key driver of patient satisfaction: this is an element more important than the operational features of distribution services (such as punctuality/reliability of the service or its flexibility).
ABSTRACT
Italy was the first Western country to face a massive SARS-CoV-2 outbreak. The limited information initially available on the natural course of the disease required caution in the discharge of patients accessing health facilities. This resulted in overcrowded health facilities and emergency services. In this context, improvements of other forms of hospital care assistance were needed. This study shows the results of the first Italian remote monitoring program for COVID-19 patients. The program was implemented by the Azienda Socio Sanitaria (ASST) Lodi (Italy) by using the innovative Zcare software®. Data generated during patient recruitment, monitoring, and discharge were extracted from the Zcare software and statistically analysed. Data refer to a sample of 1196 patients enrolled in the remote monitoring program in 2020. Patients reported symptoms mainly during the first week. The most frequently reported symptoms were general fatigue, cough, and loss of taste and smell (dysosmia). More than 80% of patients reported a saturation level below 96% at least once, and more than 70% had a temperature above 37 °C. Active monitoring of reported symptoms provided valuable insights into the disease's natural history during its less severe acute phase. Only 109 individuals visited the emergency department at least once in the first 100 days of monitoring. Of these, 101 had COVID-19 infection, 69 of whom were hospitalized following a first clinical assessment at the emergency department. The ASST Lodi's telemedicine strategy for COVID patients appears to be a viable alternative to hospitalization. This strategy enables the provision of proper care while making resources available for more critically ill patients, and enhances the availability of resources available for more critically ill patients.
