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Addressing Inappropriate Prescribing and Increasing Resources: A Combined Strategy to Reduce Waiting Times

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Addressing Inappropriate Prescribing and Increasing Resources: A Combined Strategy to Reduce Waiting Times

New Funding and Initiatives Aim to Reduce Waiting Times in Lombardy

Last week, the Lombardy Region received an additional 20 million euros, bringing this year’s allocation to 81 million euros, in an effort to address the issue of long waiting times for medical services. The increased funding was approved by the council and is expected to improve the situation. However, it is understood that additional strategies are also necessary to effectively reduce waiting lists.

To tackle this problem, the Lombardy Region has introduced a comprehensive plan outlined in a document called “action lines.” This document serves as a handbook for doctors and aims to reduce prescribing inappropriateness while ensuring the availability of resources necessary to provide essential levels of assistance, known as the Lea. The Lea represents the set of services that the National Health Service is obligated to offer citizens.

The first area of focus highlighted in the document is radiology. The Directorate-General for Welfare has noted an increase in the percentage of patients who receive repeat MRI scans of the spine within 12 months, as well as a rise in musculoskeletal MRIs among the elderly population. To address this issue, specific guidelines have been established for doctors. For example, an MRI of the lumbosacral spine should only be prescribed after four weeks of ineffective therapy. Similarly, musculoskeletal MRIs for various body parts should be preceded by radiological investigation to ensure appropriateness.

The Lombardy Region has also suggested new criteria for magnetic resonance imaging in patients with pacemakers, as well as proposed new organizational methods for nuclear medicine services. The Region emphasizes the importance of adequate and continuous training for doctors to ensure appropriate prescribing practices. Furthermore, citizen awareness and information campaigns are being planned to promote responsible usage of medical services.

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The implementation of this combined strategy, which consists of both increased funding and efforts to reduce inappropriate prescriptions, aims to bring down waiting lists effectively. Guido Marinoni, president of the Bergamo Medical Association, believes that the two elements must be integrated. Marinoni highlights the risk of overdiagnosis and unnecessary procedures resulting from inappropriate prescribing. He emphasizes the crucial role of doctors, including general practitioners, in guiding patients and earning their trust.

In addition to the funding and policy measures, the Lombardy Region has set numerical targets for specialist outpatient services to be provided between April and December 2023. Specifically, for the Ats of Bergamo, the goal is to achieve 161,753 “first ordinary visits” and 15,640 “first additional visits.” The region also aims to provide 331,508 “ordinary diagnostic imaging and instrumental services” and 31,686 “additional” services during the specified timeframe. These targets aim to ensure a total of 493,261 “ordinary” and 47,326 “additional” services in Bergamo.

The new funding and initiatives implemented by the Lombardy Region demonstrate their commitment to addressing the issue of lengthy waiting times for medical services. Through a combination of increased resources, efforts to reduce inappropriate prescriptions, and clearer guidelines for doctors, the region is taking significant steps to improve accessibility to specialist services and enhance overall healthcare efficiency.

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