Aims: The objective of this study was to perform a cost–benefit analysis of the CardioMEMS HF System (Abbott Laboratories, Abbott Park, IL, USA) in a heart failure (HF) clinic in Spain by evaluating the real-time remote monitoring of pulmonary artery pressures, which has been shown to reduce HF-related hospitalizations and improve the quality of life for selected HF patients. Particularly, the study aimed to determine the value of CardioMEMS in Southern Europe, where healthcare costs are significantly lower and its effectiveness remains uncertain. Methods and results: This single-centre study enrolled all consecutive HF patients (N = 43) who had been implanted with a pulmonary artery pressure sensor (CardioMEMS HF System); 48.8% were females, aged 75.5 ± 7.0 years, with both reduced and preserved left ventricular ejection fraction; 67.4% of them were in New York Heart Association Class III. The number of HF hospitalizations in the year before and the year after the sensor implantation was compared. Quality-adjusted life years gained based on a literature review of previous studies were calculated. The rate of HF hospitalizations was significantly lower at 1 year compared with the year before CardioMEMS implantation (0.25 vs. 1.10 events/patient-year, hazard ratio 0.22, P = 0.001). At the end of the first year, the usual management outperformed the CardioMEMS HF System. By the end of the second year, the CardioMEMS system is estimated to reduce costs compared with usual management (net benefits of €346). Conclusions: Based on the results, we suggest that remote monitoring of pulmonary artery pressure with the CardioMEMS HF System represents a midterm and long-term efficient strategy in a healthcare setting in Southern Europe.

The evaluation of integrated care programmes for high-need high-cost older people is a challenge. We aim to share the early implementation results of the ProPCC programme in the North-Barcelona metropolitan area, in Catalonia, Spain. We analysed the intervention with retrospective data from May 2018 to December 2021 by describing the cohort complexity and by showing its 6-months pre-post impact on time spent at home and resources used: primary care visits, emergency department visits, hospital admissions and hospital stay. 264 cases were included (91% at home; 9% in nursing homes). 6-month pre vs. 6-months post results were (mean, p-value): primary care visits 8.2 vs. 11.5 (p < 0.05); emergency department visits 1.4 vs. 0.9 (p < 0.05); hospital admissions 0.7 vs. 0.5 (p < 0.05); hospital stay 12.8 vs. 7.9 days (p < 0.05). Time spent at home was 169.2 vs.174.2 days (p < 0.05). Early implementation of the ProPCC programme results in an increase in time spent at home (up to 3%) and significant reductions in emergency department attendance (–37.2%) and hospital stays (–38.3%). The increased use of primary care resources is compensated by the hospital resources savings, with a result in the average total cost of –46.3%.

Background: The high failure rate of innovation projects motivates us to understand the perceptions about resistances and barriers of the main stakeholders to improving success rates. Objective: This study aims to analyze the readiness for change in the implementation of a 3D printing project in a Catalan tertiary hospital prior to its implementation. Methods: We used a web-based, voluntary, and anonymous survey using the Normalization Measurement Development questionnaire (NoMAD) to gather views and perceptions from a selected group of health care professionals at Germans Trias i Pujol University Hospital. Results: In this study, 58 professionals, including heads of service (n=30, 51%), doctors (n=18, 31%), nurses (n=7, 12%), and support staff (n=3, 5%), responded to the questionnaire. All groups saw the value of the project and were willing to enroll and support it. Respondents reported the highest scores (out of 5) in cognitive participation (mean 4.45, SD 0.04), coherence (mean 3.72, SD 0.13), and reflective monitoring (mean 3.80, SD 0.25). The weakest score was in collective action (mean 3.52, SD 0.12). There were no statistically significant differences in scores among professions in the survey. Conclusions: The 3D printing project implementation should pay attention to preparing, defining, sharing, and supporting the operational work involved in its use and implementation. It should also understand, assess, and communicate the ways in which the new set of practices can affect the users and others around them. We suggest that health officers and politicians consider this experience as a solid ground toward the development of a more efficient health innovation system and as a catalyst for transformation.

Context Medical treatment of acromegaly is currently performed through a trial-and-error approach using first-generation somatostatin receptor ligands (fgSRLs) as first-line drugs, with an efficacy of 50%. Some biomarkers can predict patient response, potentially benefiting nonresponders by using personalized treatment approaches. The ACROFAST study revealed that the probability of disease control was 2.53 times higher (CI 1.30-4.80) with personalized treatment, and insulin-like growth factor 1 (IGF1) normalization occurred in 78% vs 53% of patients, compared with standard treatment (P < .05). Objective To evaluate the cost-effectiveness of personalized medicine based on predictive biomarkers, from the results of the ACROFAST study. Methods Post hoc analysis from the ACROFAST study comparing cost-effectiveness of a protocol of medical treatment based on predictive biomarkers to fgSRLs (n = 32) vs standard treatment (n = 36) for 12 months. Costs analyzed were visits, examinations, study of biomarkers (121€/patient), and pharmacological treatment according to the prices established by the Spanish National Health Care System. Medium-term costs were evaluated, considering a projection of up to 2 years in uncontrolled cases, assuming positive and negative scenarios with additional monitoring costs and a 25% likelihood of disease progression per follow-up visit. Results The personalized protocol reduced the average cost per patient required to achieve disease control by 22% (15 127€ vs 19 420€). These results represent an annual saving of 15 263€ per patient achieving hormonal control compared to the standard treatment. Conclusion Personalized medicine, using a relatively straightforward biomarker-based protocol, enables a greater proportion of patients to attain hormonal control and proves to be a cost-effective strategy for managing acromegaly.

Innovation in healthcare is a complex process involving the creation or modification of products, services, or processes, and their successful implementation in clinical settings. University Hospital Germans Trias i Pujol (HUGTP) implemented a new innovation management model in 2018, to achieve greater impact. However, there is still a knowledge gap regarding how healthcare organizations understand and experience innovation activities. This exploratory study aims to analyze the current state and future vision of innovation at HUGTP, using the novel Innovation Map methodology to capture the perceptions of professionals engaged in innovation. A cross-sectional study was conducted at HUGTP using the Innovation Map approach, which combines quantitative and qualitative data. Professionals with roles connected to innovation were recruited via email and intranet. Data were collected through an ad hoc-developed questionnaire and focus groups. Quantitative data were analyzed using Jamovi software (95% confidence interval,p≤0.05), and qualitative data were analyzed with ATLAS.ti to identify attributes and cluster emerging themes. A total of 152 participants completed the quantitative survey and 33 participated in focus groups. The results show a high level of awareness and positive perception of the Innovation Department's activities, particularly among professionals in high-responsibility roles. While the areas of work received strong overall ratings, some statistical differences between professional categories and departments highlight the need for tailored future strategies. Participants also recognized the significant impact of emerging technologies, although perceptions varied by group. Key improvement areas were identified, particularly regarding internal communication and better integration of innovation practices across all departments. This study presents the first implementation of the Innovation Map, a novel mixed-methods tool to holistically assess innovation awareness, perceptions, and needs within a hospital. The findings provide a meaningful initial overview of the innovation landscape at HUGTP and underscore the importance of strategic, inclusive innovation management. These results offer a valuable starting point for future longitudinal and multicenter studies.

Background: While the clinical factors of the post-COVID-19 condition (PCC) are becoming clearer, the economic implications remain uncertain, posing a challenge to healthcare professionals in terms of understanding and managing this emerging phenomenon. This article aims to investigate the demographic and clinical characteristics of PCC patients and quantify the economic impact of their healthcare resource utilisation. Methods: A retrospective and case-control observational study was conducted, comparing the case group of PCC population before and after diagnosis with a control group. Demographic and clinical variables were analysed with the objective of describing the population. Economic analysis was performed to evaluate the resource costs in procedures and primary, secondary (both outpatient and inpatient) and emergency care. Findings: PCC patients (N=341) exhibited older age and elevated cardiovascular risk factors compared to controls (N=49,078). There were differences in the socio-economic distribution between male and female patients in the PCC patients. Hypertension and diabetes mellitus type 2 were the most common chronic diseases observed among the case patients. Economic analysis revealed that PCC patients were approximately four times as costly as control patients, with increased utilisation of healthcare resources. However, post-diagnosis PCC patients showed a reduction in costs, primarily driven by decreased primary care visits and hospitalisations. Conclusion: Coordinated care management for PCC patients is associated with reduced costs and improved healthcare resource utilisation. Further research is warranted to investigate long-term health outcomes and establish causal relationships between COVID-19 sequelae and healthcare resource utilisation.