# Setting priorities in outpatient cardiovascular care to guarantee equitable access: the case of Tuscany region

## TL;DR

This study examines healthcare access for cardiovascular patients in Tuscany, identifying areas needing improvement to ensure equitable care.

## Contribution

The study introduces a benchmarking method to quantify and address unwarranted variation in cardiovascular care access.

## Key findings

- Geographical variation in visit rates and waiting times was identified across Tuscany's health districts in 2021.
- Some districts had significantly lower visit rates and longer waiting times compared to the regional median.
- Tailored interventions like training and technology integration are proposed to reduce disparities.

## Abstract

Universal healthcare systems orient their actions towards promoting, restoring, and improving public health with a particular focus on the need to guarantee equitable access to care. Unwarranted variation in healthcare delivery poses significant challenges to health systems globally, impacting quality of care, financial sustainability, and equity of access. It is therefore important to assist healthcare management in measuring unwarranted variation in order to prioritise intervention strategies to ensure continuity of care and equity. Through an investigation of geographical variation in visit rates and waiting times, the study identifies vulnerable health districts which need priority interventions for patients with cardiovascular disease in the Tuscany region (Italy). Furthermore, a benchmarking-based method for identifying a quantitative estimate of the supply gap to be reduced is proposed. Results illustrate variation in visit rates and waiting times across local health districts in 2021, with some districts experiencing substantially lower rates and longer waiting times compared to the regional median. To address this gap, two targeted interventions aimed at increasing visit volumes and reduced waiting times through advanced training activities, technology integration, and multidisciplinary collaborations are presented. This study contributes to the topic of unwarranted variation by highlighting the necessity of tailored interventions to address diverse healthcare challenges across heterogeneous geographical areas. As healthcare systems globally navigate evolving complexities, the findings and tools presented here offer valuable guidance for policymakers and managers, aiming towards more equitable, efficient, and responsive healthcare services.

The online version contains supplementary material available at 10.1007/s43999-024-00047-9.