The emergency rooms are the infernal funnel in which waiting is eternal, the elderly remain on stretchers even for days, the doctors flee (or go to work on tokens where they pay better). The system is imploding in all Regions, albeit with different degrees of gravity. Says the Minister of Health, Orazio Schillaci: «Today from 60 to 80 percent of those who go to the emergency room, go there inappropriately. To avoid this, we must offer territorial health care, as emerged in the pandemic. We are working on this, even with Pnrr funds that we must use correctly. But the real transformation will be the digitization of healthcare, which will also allow us to overcome the many inequalities that exist today in the healthcare service”. At the Ministry of Health there is a table established that is working for the reform.
What the bill provides for the elderly, from Leps to telemedicine: here is all the news
NOTE
But the infernal overcrowding has a side effect: in 3 years there have been 5,000 episodes of aggression in Italian hospitals and, very frequently, they have been in emergency rooms, given that it is the first line. But are accesses really too often inappropriate as the minister says? Do we really go to the DEA for trivial ailments for which we once would have called the family doctor? Let’s see the numbers: in 2021 there were 14.5 million accesses (and in 2022 they increased), of these the red codes (therefore very serious) were only 366 thousand, the yellow ones almost 4.5 million. But whites and greens (therefore really for trivial requests) were respectively 1.8 and 7.8 million. In a perfect world these nearly 10 million citizens would not have gone to crowd the emergency rooms, but would have been visited by their family doctor. The problem is that the system of general practitioners has effectively collapsed (there are fewer and fewer, they have many patients and are unable to take care of everyone) and a citizen who has a health problem simply does not know where to ask for help, except in emergency room. For this reason Schillaci, in this case in continuity with his predecessor Speranza, is focusing heavily on the creation throughout Italy of “community houses”, which will be built with funds from the Pnrr, within which the patient must find a doctor or nurse responding to non-urgent requests. The other instrument must be that of the “community hospital”, already functioning in some regions, in some cases managed by nurses, which must help to free up the beds in the wards. Nino Cartabellotta, president of the Gimbe Foundation which deals with analysis and research on the health system: «Some regions are further ahead, I am thinking of Emilia-Romagna, Veneto, Tuscany, Marche. They have organized a territorial health system which therefore offers an alternative to emergency rooms. But there is a general culture that needs to be changed, because the hospital-centric approach prevails in Italy. The future must be that of “community houses”, previously called “health houses”, which however in a large part of the territory, especially in the central-south, have never taken off. But the role that general practitioners will have within them still remains to be resolved, that is a still unresolved problem ».
THE FRONT
Among those who work in emergency rooms, however, there are those who warn: it is right to offer alternatives in the area, but let’s not pretend we don’t see the elephant in the room. Today patients, especially the elderly, are often stuck in emergency rooms for days because there are no beds available for admissions. Massimo Magnanti is the head of a Dea of a large Roman hospital, San Filippo Neri, but for years he has also been the leader of Spes, the union of health emergency professionals. He recounts: «Let’s review the numbers. In Italy between 1996 and 2019 the number of beds were halved due to the cuts, there are 160 thousand fewer. In summary: today there are 189,826, one bed for every 314 inhabitants; in 1996 there were 347,297, one for every 163 inhabitants. All this happened with the number of inhabitants that has increased and, above all, with the average age of the population that is higher, and therefore there are more pathologies that justify going to the hospital. It is right to strengthen healthcare in the area, but it is also necessary to get closer to the numbers of other countries for bed places. France has twice as many beds as Italy, Germany three times as many. The United Kingdom has planned an increase of over 20,000 beds.
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