[Implantation of Reveal LINQ in Different Italian Scenarios: How to Further Improve?]

Abstract

INTRODUCTION: The manuscript describes the long-term cardiac rhythm monitoring system, known as Reveal LINQ, along with an analysis of the evolution in the Italian cardiology practice that its introduction has brought and may still bring given the smaller size and the implantable procedure, performed even by nursing personnel.

METHODS: The project was articulated, firstly, to understand how the Reveal LINQ implantation is organized in 4 different Italian hospital facilities and to estimate the associated costs. For each of the involved facilities, data on the operating room type, length of hospital stay, resource consumption, and unit costs associated with the implantation procedure were collected. Direct costs for the hospital were calculated, including personnel work, materials used, and overhead. After that, we identified the ideal pathway (IP) that may enhance and optimize efficiency and resources consumption, without compromising the quality of care. The hypothetical cost savings resulting from the adoption of IP were estimated.

RESULTS: According to our analysis, total cost per procedure ranges between 2,500 and 3,100 Euros, depending on the hospital facility. The IP is based on the use of an outpatient setting in which trained nursing personnel performs the implantation procedure. The shift from current clinical practice to ideal setting has the potential to decrease administrative costs, overhead expenses, and working time, leading to an average cost saving of 333 euros per procedure. It varies between 115 and 650 Euros, according to the starting background of each facility.

CONCLUSIONS: The article concludes by emphasizing the introduction of a dedicated outpatient tariff as key incentive for the transition toward the ideal pathway and, consequently, for enhancing the overall efficiency of the Health Service.