ORIGINAL ARTICLE   

Minerva Medicolegale 2019 December;139(1-4):15-20

DOI: 10.23736/S0026-4849.20.01784-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Practice of clinical forensic medicine for disability benefits in cancer patients: a new organizational model with an integrated care approach

Maria Cristina DAVOLIO ¹, Federica BERTOLINI ², Cecilia BERGONZINI ¹, Federica BERSANI ¹, Margherita PIZZIRANI ¹, Alessandra SILVESTRI ¹, Eleonora TORE ¹ ✉, Manuela TONDELLI ³, Sabino PELOSI ¹

¹ Department of Legal Medicine and Risk Management, AUSL Modena, Modena, Italy; ² Department of Oncology, Modena University Hospital, Modena, Italy; ³ Department of Primary Care, AUSL Modena, Modena, Italy

BACKGROUND: Clinical forensic medicine includes all the medical healthcare fields which may relate to legal, juridical and police systems. The academic interest and research in clinical forensic medicine have increased in recent years. In Italy, clinical forensic medicine includes also the social-health assistance of individual with disability, i.e. disability assessment (DA: civil incapacity and handicap status), but this is rarely a topic of discussion. In Modena, the Department of Legal Medicine and Risk Management of the Local Health Authority are responsible for DA, dealing particularly with disabilities in cancer patients.
METHODS: From January 2015, a new organizational model for DA in cancer patients has been developed in Modena District. This model provides a multidisciplinary approach in which an Oncologist has to attend Commissions on Disability that work in the hospital. A total of 2904 patients have been evaluated from January 2015 to December 2017. All DAs have been prospectively collected and compared to historical data (2012-2014). The aim of the present study is to evaluate three indicators: number and rates of DAs on the total number of new diagnosed cancer patients; median time from cancer diagnosis to DA; number of DA reviews.
RESULTS: Our experience has shown positive results: an increase of 10% in the number of disability applications made by the new diagnosed cancer patients per year, a time reduction from diagnosis and disability application (from 121 days to 67 days) and a decrease in the number of DA reviews.
CONCLUSIONS: This new organizational model does not provide any additional cost for the National Health Service. The Disability Assessment Protocol in Modena is a unique experience in Italy. It is able to promote both a simplified way for cancer patients to access the benefits and to express a more specialized “multidisciplinary” judgment regarding patient’s needs.

KEY WORDS: Forensic medicine; Disability evaluation; Neoplasms; Interdisciplinary research; Workers’ compensation