Hospital Community Integration: The Case of the Territorial Oncology Center at ASL 04 Teramo
Author(s)
Andrea Marcellusi, PhD1, angela Ragonese, MSc2, Andrea Marinozzi, PharmD, MSc3, Cristian Palmarini, MSc4, Francesca Perrotti, MD4, Azzurra Irelli, MD5, Alessia Di Giacobbe, MD5, Sara Di Santo, MD4, Clelia Di Carlo, MD4, Maria Catalani, MD5, Roberta Battipane, MSc5, Marco Belfiore, PharmD6, Anna Dario, Jr., MSc7, Camillo Odio, MsC8, Filippo Santarelli, MD9, Maurizio Brucchi, MD9, Maurizio Di Giosia, MD9, Carlo D'Ugo, MD4, Katia Cannita, MD5.
1Dipartimento di Scienze Farmaceutiche, University of Milan, Milano, Italy, 2CEIS - Centre for Economic and International Studies, University of Rome "Tor Vergata", Roma, Italy, 3Unità Operativa Complessa di Farmacia Ospedaliera, Ospedale G. Mazzini di Teramo, Teramo, Italy, 4Unità Operativa Complessa di Radioterapia, Ospedale G. Mazzini di Teramo, Teramo, Italy, 5Unità Operativa Complessa di Oncologia Medica, Ospedale G. Mazzini di Teramo, Teramo, Italy, 6ROCHE, Milano, Italy, 7Roche Diagnostics S.p.a., Monza, Italy, 8Dipartimento Sanità - Servizio Flussi Informativi e Sanità Digitale - Regione Abruzzo, L'Aquila, Italy, 9Direzione Strategica Aziendale ASL 04 di Teramo, Teramo, Italy.
1Dipartimento di Scienze Farmaceutiche, University of Milan, Milano, Italy, 2CEIS - Centre for Economic and International Studies, University of Rome "Tor Vergata", Roma, Italy, 3Unità Operativa Complessa di Farmacia Ospedaliera, Ospedale G. Mazzini di Teramo, Teramo, Italy, 4Unità Operativa Complessa di Radioterapia, Ospedale G. Mazzini di Teramo, Teramo, Italy, 5Unità Operativa Complessa di Oncologia Medica, Ospedale G. Mazzini di Teramo, Teramo, Italy, 6ROCHE, Milano, Italy, 7Roche Diagnostics S.p.a., Monza, Italy, 8Dipartimento Sanità - Servizio Flussi Informativi e Sanità Digitale - Regione Abruzzo, L'Aquila, Italy, 9Direzione Strategica Aziendale ASL 04 di Teramo, Teramo, Italy.
OBJECTIVES: The decentralisation of healthcare services, particularly within oncology, aims to address the increasing demand for chronic and long-term patient care. This abstract evaluates the integration of hospital and community care through the Territorial Oncology Center (CTO) at the Teramo Local Health Authority, assessing improvements in efficiency, patient quality of life, and resource management.
METHODS: Data were collected on the volume of outpatient oncology services and the healthcare resources absorbed within the ASL 04 Teramo from 2021 to 2024. Administrative and clinical data were extracted to quantify the number and type of procedures delivered in the outpatient setting, as well as associated personnel and operational costs. These data were used to estimate trends in service delivery, efficiency, and resource utilisation over time. Additionally, patient-reported data on satisfaction and financial toxicity were collected through structured surveys, including the validated PROFFIT questionnaire, administered to patients treated within the Territorial Oncology Center framework.
RESULTS: The decentralised approach significantly increased the efficiency of outpatient oncology services, handling a 76% rise in outpatient procedures from roughly 9,000 to over 15,000 annually. Despite this increase, the personnel cost per procedure decreased by 43%, from €30 in 2021 to €17 in 2024, highlighting effective resource management. Patient surveys revealed high satisfaction and reduced psychological stress, with notable improvements in accessibility and reduced economic burden related to healthcare management and logistics.
CONCLUSIONS: The CTO’s decentralisation initiative demonstrates a successful strategy to accommodate increasing oncology service demands efficiently and sustainably. To further improve and expand this approach, targeted investments in additional medical, administrative, and nursing personnel are essential. Incorporating specialised pharmacists for medication management could further optimise clinical outcomes and patient adherence. The results present a robust model scalable to broader healthcare contexts aimed at enhancing efficiency, patient experience, and economic sustainability.
METHODS: Data were collected on the volume of outpatient oncology services and the healthcare resources absorbed within the ASL 04 Teramo from 2021 to 2024. Administrative and clinical data were extracted to quantify the number and type of procedures delivered in the outpatient setting, as well as associated personnel and operational costs. These data were used to estimate trends in service delivery, efficiency, and resource utilisation over time. Additionally, patient-reported data on satisfaction and financial toxicity were collected through structured surveys, including the validated PROFFIT questionnaire, administered to patients treated within the Territorial Oncology Center framework.
RESULTS: The decentralised approach significantly increased the efficiency of outpatient oncology services, handling a 76% rise in outpatient procedures from roughly 9,000 to over 15,000 annually. Despite this increase, the personnel cost per procedure decreased by 43%, from €30 in 2021 to €17 in 2024, highlighting effective resource management. Patient surveys revealed high satisfaction and reduced psychological stress, with notable improvements in accessibility and reduced economic burden related to healthcare management and logistics.
CONCLUSIONS: The CTO’s decentralisation initiative demonstrates a successful strategy to accommodate increasing oncology service demands efficiently and sustainably. To further improve and expand this approach, targeted investments in additional medical, administrative, and nursing personnel are essential. Incorporating specialised pharmacists for medication management could further optimise clinical outcomes and patient adherence. The results present a robust model scalable to broader healthcare contexts aimed at enhancing efficiency, patient experience, and economic sustainability.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD57
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Organizational Practices
Disease
Oncology