La costruzione di Reti e l'emersione dei Percorsi per l'ipovisione/cecità attraverso l'approccio dei Sistemi di assistenza basati sulla Popolazione: il Progetto Value of Blindness Care

The main challenge for healthcare systems is to respond effectively to increasing health needs of people, through efficient resource allocation and creation of value for the individual and the community. This challenge manifests itself in multiple scenarios such as those of low vision and blindness, whose disease load and disability are constantly increasing. The “Value of Blindness Care” project aim was to study, from the viewpoint of the Value-based Medicine, the processes that should characterize the ideal pathway of low vision/preventable blindness management – with particular reference to the Age-related Macular Degeneration (AMD). The project goal is to facilitate the application of Better Value HealthCare and enable to shape effective governance of innovation and resources. A retrospective observational analysis was conducted using the data extracted from the regional health information flow of an Italian region for the years 2007-2016. Our results confirm the current data of scientific literature, according to which the major ocular diseases that require healthcare interventions are cataracts and glaucoma. Data analysis of a region, also, allowed us to outline a real-world scenario useful to understand the main difficulties in the governance of AMD, characterized by a large variability in the diagnostic- therapeutic pathways of patients with this disease. Research advances have improved our knowledge of this pathology, but there are still major critical issues in these patients management. Therefore, it is necessary to identify new organizational models and a system-based programming to ensure the universality of the right to health and the economic sustainability of the Italian National Health Service.