IMPACT OF A HUB-AND-SPOKES HEALTHCARE MODEL FOR OBESITY TREATMENT: Improving Patient Care through Affordability in the Veneto Region, Italy.

Background: Obesity is the plague of modern society. The related healthcare costs continually clash with budget constraints, and bariatric practice with its interdisciplinary demands requires dedicated resources and expertise that are mainly institution related. No local health authority has yet implemented a plan to coordinate the bariatric activity within the administered territory. The Veneto Region of Italy has a population of more than 6 million inhabitants and a prevalence of obesity around nine percent. The Regional Administration is the primary healthcare provider and payor. Healthcare at large is delivered through dedicated networks of care. We promoted the constitution of a bariatric network involving all the regional institutions devoted, with the support of Regional Health Authority. Rationale: The establishment of a regional bariatric network, called Rete Obesità Veneto, has many advantages in terms of resource allocation, standard healthcare provision, extensive and appropriate coverage for population, risk management, and costs containment. Method: The network is based on a hub-and-spokes model, where both hub and spokes centers deliver comprehensive care to patients with obesity. Common pathways of care are shared by the affiliated centers of the network. Inpatient/outpatient activities and outcomes are assessed and recorded according to the Regional Authority requirements and subject to audits. Results: The bariatric network was approved at the end of 2016. It network currently encompasses one hub and six spoke centers scattered throughout the Region, with consolidated bariatric practice and facilities. The hub is also the Regional referral and coordination center for obesity. Conclusions: The aim of Rete Obesità Veneto is to deliver the best patterns of care for people with obesity, with the goals of improved outcomes, reduced care variability, and reduced costs. Longitudinal assessment will provide new insights on the best practices for this patient population. [ABSTRACT FROM AUTHOR]