Central Venous Catheter procedures performed at the outpatient clinics of San Giuliano Hospital of ASL Napoli 2 Nord with a brief overview of pharmacoeconomic evaluations on the procedure

Abstract

The following work concerns a retrospective, single-center analysis of the data cohort collected between January 2022 and December 2023 regarding outpatient services provided by the Vascular Access Management Service at the Giugliano Hospital in Campania, part of the ASL Napoli 2 Nord. The devices used in these practices are essential for the treatment of both hospitalized and non-hospitalized patients. Their widespread use is justified both due to the particular complexity of the therapeutic regimens to which the patient is subjected, and the frequent need for pharmacological support, hydration, periodic blood draws, nutrient and blood product infusions, and hemodynamic monitoring to safeguard their vascular health. The ASL Napoli 2 Nord area records a significant presence of chronic-degenerative and oncological diseases, therefore, to meet the needs of the population and the numerous requests made by hospital departments and districts, it was decided to activate outpatient clinics for the implantation and management of vascular accesses. It is appropriate that every healthcare operator is adequately trained and involved in the various stages of patient recruitment, device implantation, and management. Therefore, in the ASL Napoli 2 Nord area, it was deemed necessary for these professional figures to be involved in drafting procedures to define the correct use of these devices. The cost of individual outpatient procedures in terms of materials used and specialized personnel involved is an indicator of company expenditure. The amount received by the company for each individual service in terms of patient copayments and reimbursement from the Region represents the revenue of the ASL in relation to the services provided. From the results obtained, there is a slight disproportion regarding regional reimbursement; in particular, the data shows that revenue in terms of dressings is lower than that of irrigations despite the direct costs in the former being much higher than in the latter. These outpatient procedures represent an important source of income in relation to the numbers generated solely at the Giugliano Hospital and still find correspondence and proportionality compared to those recorded in the outpatient clinics of other company facilities.