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ENGLISH MINI-VERSION (ITALIAN VERSION)
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INTRODUCTION
The RIHOIR® project arises from a particularly successful corporate consulting experience in 2005 in the field of healthcare Risk management , involving the Hospital Trust “Carlo Poma” in Mantua, in the wake of the initial implementation of Circular n. 46/SAN/2004 issued by Regione Lombardia - Direzione Generale Sanità (entitled “Indirizzi sulla gestione del rischio sanitario” - Policies concerning the management of sanitary risks).
On this occasion - which coincided with the tender for the three year 2005-2008 insurance contract - the Hospital Trust was able to fully comprehend and document its risk class - in actual fact lower than that historically applied - thus saving around €1m over the following three contract years.
This result - so unexpected and clearly moving in a direction contrary to the rest of the Lombard market - didn't fail to be perceived, officialised and released by General Healthcare Director Dr. Carlo Lucchina (Circ. DGS Prot. H1.2005.0037648 dated 03/08/2005) to all 29 Hospital Trusts and 15 ASL (local health authorities), along with the IRCCS (Scientific Institutes for Healthcare) governed by public law taking part in the initiative.
 
Since then the project mission has concentrated on the first stage of the Risk management process, involving risk-knowledge management. We believe that this is anything but obvious, and indeed has not yet been sufficiently acknowledged as the true key to the effectiveness of the process (we might say it represents the cornerstone of the overall Risk Management strategy).
 
Of course, not all projects of this kind will obtain such flattering results, especially in the short term. I believe, however, that the more scrupulous companies should have their efforts acknowledged and not be “lumped in with the rest” at the time of taking out an insurance policy; the less virtuous, nevertheless, have the right - as well as the duty - to recuperate and to refuse to keep on transferring the risk instead of preventing it; unless we accept adverse selection for the entire healthcare and insurance market. 
 
So far - despite the little information available concerning the difference in levels of quality performance and patient safety, which would allow us to make accurate distinctions in terms of hospital risk rating - as we have all come to know, and as is clearly reported on a daily basis in the newspapers, it is an undisputable fact that the general situation is anything but good news. The average number of accidents and the relating unit price is rapidly increasing on the strength of growing public and legal awareness, as well as of the general growth in the expectations of the healthcare service users, inevitably linked with scientific and technical progress. 
 
Oddly enough, in a case of car insurance - a market that is certainly less sophisticated than ours - an experienced driver would be rather shocked at the mere idea of not being assessed within the context of his/her own risk class. Indeed, the definition of the various risk classes is common knowledge. This paradox should form the basis of a lengthy deliberation by those organisations that are undoubtedly and considerably more equipped to tackle rational economic decisions such as those concerning healthcare, all the more so if we consider that today these organisations are pressurised by the problem of waste and the need to promote the competitive development of service supply.
 
 
Claudio Solarino
(Founder RIHOIR®)
 
Translation by
Fiona Tarsia
(SOGET S.r.l.)
 
 
 
* English translation available only by using
Google.com automatic Italian/English translator
 
 
 
 
 
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RIHOIR® - Risk Intelligence for the Healthcare Organization Insurance Rating                                                                                                           Last updated: 22/03/2010 12.17.44