Computational Formalisation of the Lazio Regional Hospital Reimbursement Pipeline: A Five-Module System for SDO Quality Control, Expected Tariff Calculation, and Regional Reconciliation

This technical note describes a five-module desktop system that implements the complete hospital reimbursement pipeline defined by the Lazio Regional Health Authority (Italy) as a computable, verifiable software application. The system encodes seven regional decrees (DGR 126/2024, DCA 310/2013, DCA 151/2019, DCA 509/2018, DCA 218/2017, DCA 332/2015, DCA 38/2015) into an integrated set of quality control, tariff calculation, reconciliation, monitoring, and audit functions — a codification that, to the author's knowledge, does not exist in any other publicly available or commercially distributed tool. The contribution of this work is in the domain, not in the technique. The software architecture is standard (Python, Streamlit, SQLite). The value lies in the systematic translation of a fragmented and complex regulatory corpus — dispersed across seven decrees spanning over a decade, with cross-references, conditional applicability rules, and implicit interdependencies — into a unified computational pipeline that produces verifiable outputs at the individual admission level. The five operational modules cover: (1) pre-submission SDO quality control at four levels of increasing specificity; (2) expected tariff calculation through the full regional pipeline (nominal tariff, four-class staging, specific abatements, repeated admissions, area budget allocation); (3) reconciliation of expected tariff against the regional SIOXL recognition, with automatic discrepancy classification into eight categories; (4) annual constraint monitoring with 13 aggregate indicators and linear year-end projection; and (5) regional audit tracking with exposure estimation. The system has been tested on real operational data with known incongruities, which were correctly identified. It is not yet in routine operational use. The SIOXL file format used in the reconciliation module is based on facility-provided specifications and has not yet been validated against the actual regional output format. These limitations are documented explicitly.