Our hospitals are so full that patients in stretchers pile up in the emergency rooms for days without finding a place in the ward. Because beds and staff have been cut over the years. But also due to the fact that half of the hospitalizations concern patients over 70 and in over 50% of cases they stay in the ward about a week longer than necessary, given that they do not have a family member who can assist them and that they do not even have such a pension rich enough to be able to pay the approximately two thousand euros of monthly tuition for an RSA. Not to mention the fact that in most cases there is a lack of intermediate health facilities in the area, and that in one out of four cases it is difficult to activate the ADI. In other words, a mix between a lack of social assistance and a failure to take charge of local health services and structures. The photograph was taken by Fadoi, the scientific society of internal medicine.
«75.5% of elderly patients remain improperly in hospital because they have no family member or caregiver able to assist them at homewhile for 49% there is no possibility of entering one Rsa. 64.3% extend hospitalization beyond what is necessary because they are not there intermediate health facilities in the territory while i22.4% have difficulty activating the ADI, integrated home care», reads a note. “It is the burden that unduly falls on public health due to the shortcomings of the social assistance system, but also of the territorial health services that are poorly equipped to take care of these patients”.
2.1 million excess days of hospitalization
The survey conducted in 98 facilities indicates that the date of discharge indicated by the doctor passes to the actual exit date over a week in 26.5% of cases; 5 to 7 days in 39.8% of patients; while another 28.6% stay two to four days longer than necessary.
Considering that hospitalizations in internal medicine wards are around one million a year and that at least half of these are over 70. And also taking into account that well over 50% of these extend their hospitalization by a week on average beyond what is necessary health care, in total there would be 2.1 million excess days of hospitalisation. “A number that has a significant impact on the clogging of hospitals and that considering the average cost of a day of hospitalization, equal to 712 euros according to OECD data, make a total a billion and a half a year of expenditure that could have been invested in real health care».
Once discharged, 24.5% of patients over 70 go directly home, 41.8% however having at least activated home assistance. 15.3% are received in an RSA, 18.4% in an intermediate structure.
“What the survey reveals is what we unfortunately experience first-hand on a daily basis, namely the need to take on social problems that end up weighing unduly on hospitals and internal medicine departments in particular”, he comments. Francesco Dentalipresident of Fadoi.
«It is a picture that should make us reflect on our social assistance system, which according to the Cnel Observatory for services employs just 0.42% of GDP, while according to INPS data over 25 billion are disbursed in the form of allowances, such as carer’s or disability allowances. This without considering the 3.4 billion disbursed directly by the Municipalities. An inverse system to that adopted by many countries, above all in Northern Europe, where the optimization of available resources passes through a greater investment in personal assistance services. Without prejudice – concludes Dentali– that there is also a clear shortage of intermediate territorial health servicesbecause we are still talking about patients who need a medium or high intensity of care at the time of admission to our wards”.