Hub-and-Spoke regional system supported by telehealth for managing coeliac disease in Liguria: a mixed-methods survey followed by an observational pilot study
- PMID: 40102818
- PMCID: PMC11917075
- DOI: 10.1186/s12913-025-12459-5
Hub-and-Spoke regional system supported by telehealth for managing coeliac disease in Liguria: a mixed-methods survey followed by an observational pilot study
Abstract
Background: Due to the need to reorganize the care network for the national screening mandated by law, a new healthcare model was required for the management of coeliac disease. The hub-and-spoke model is a new healthcare organizational system, here we describe its application (supported by telehealth), in the management of pediatric coeliac disease (CD) in Liguria. The results of the pilot phase are presented and the system's strengths and weaknesses discussed.
Methods: A mixed-methods survey followed by an observational pilot study was performed. A multiphase approach was used including preparation setting, operative planning and application. The pilot phase involves a single primary center. The reduction of families' expenditure and environmental impact was assessed using the Viamichelin calculator.
Results: A regional meeting followed by a survey (specifically developed for this study) and a needs analysis highlighted the priority to have an efficient, up to date and homogeneous model of care assistance throughout the network. A diagnostic and therapeutic care pathway (PDTC) was developed by the regional working group. The project involved 986 Ligurian families and allowed a 90% reduction in the distance traveled by families residing within the pilot center's catchment area, saving €177 and 113 kg of CO2 on average per family per year.
Conclusions: The Gaslini Diffuso hub-and-spoke system for managing CD in Liguria exemplifies a commitment to enhancing healthcare efficiency and patient care, reducing environmental impact and cost for both family and healthcare system.
Keywords: Celiac disease; Hub and spoke; Management; gluten; Telehealth; Telemedicine.
© 2025. The Author(s).
Conflict of interest statement
Declarations. Ethics approval and consent to participate: The protocol was approved by the Regional Ethics Committee (Liguria: 133/2024—DB id 13773, 29/04/2024). Informed consent to participate was obtained from all of the participants/parents in the study. Consent for publication: Written informed consent for publication of the patient’s clinical details was obtained from the patients/parents. Competing interests: The authors declare no competing interests.
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References
-
- McPherson M, Arango P, Fox H, Lauver C, McManus M, Newacheck PW, Perrin JM, Shonkoff JP, Strickland B. A new definition of children with special health care needs. Pediatrics. 1998;102(1 Pt 1):137–40. 10.1542/peds.102.1.137. PMID: 9714637. - PubMed
-
- van der Lee JH, Mokkink LB, Grootenhuis MA, Heymans HS, Offringa M. Definitions and measurement of chronic health conditions in childhood: a systematic review. JAMA. 2007;297(24):2741–51. 10.1001/jama.297.24.2741. PMID: 17595275. - PubMed
-
- Bethell CD, Read D, Blumberg SJ, Newacheck PW. What is the prevalence of children with special health care needs? Toward an understanding of variations in findings and methods across three national surveys. Matern Child Health J. 2008;12(1):1–14. 10.1007/s10995-007-0220-5. Epub 2007 Jun 14. Erratum in: Matern Child Health J. 2013;17(10):2007. PMID: 17566855. - PubMed
-
- Sacchetti A, Sacchetti C, Carraccio C, Gerardi M. The potential for errors in children with special health care needs. Acad Emerg Med. 2000;7(11):1330–3. 10.1111/j.1553-2712.2000.tb00484.x. PMID: 11073487. - PubMed
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