FROM THEORY TO PRACTICE: FROM COST TABLES TO A REAL-TIME MONITORING AND PLANNING TOOL FOR DIGESTIVE ENDOSCOPY ACTIVITIES

Background and aim: Italian Endoscopy is increasingly subject to the influence of two opposing factors: on the one hand, considerable pressure to control costs in an attempt to achieve an economic balance with the insufficient resources, on the other, the necessary search for health care appropriate to the levels of a developed country and able to satisfy ever greater and increasingly more demanding health care requirements, especially for patients willing to pay for the procedure. Material and methods: In order to meet these demands we have devised a software programme that not only records patient data and iconographic documentation but also calculates and analyzes in real time two fundamental parameters for the construction and the respect of the Budget: costs and revenues, also allowing the analysis of other performance parameters, such as the BEP (break even point) and Forecasting. Results: The BEP represents the point in the annual activities in which the revenues balance the costs. It is important to identify the BEP, since from that point onwards the activity of the Endoscopy Service produces assets on the balance sheet (which before the BEP was therefore in the red), and it is therefore possible to plan, and modify if necessary, both the type and the volume of the activities of the Service. It is also possible at any time and in real time to calculate the exact cost of a procedure. Conclusions: Forecasting, on the other hand, makes it possible to compare the planned activities with the service actually provided over the year, and to make activity forecasts for the entire year and thus predict whether or not the planned objectives will be met. The software is extremely versatile and easy to use, and the automatic data "loading" and display of the results make it a tool that is interesting and, we would venture to say, indispensable for a modern Endoscopy Service.