AT LEAST one good thing for health care, the pandemic has done it: it has increased the positive perception on the possibility of receiving adequate care even close to home. In particular, on the part of cancer patients from Central and Southern Italy, usually the most accustomed to moving to be treated outside the region. This is what emerges from a survey on good practices implemented during the Covid emergency to combat health migration to oncology, which affects on average one patient out of ten. The results were presented at the eighth annual institutional Forum of the Group of Patient Associations ‘Health: an asset to defend, a right to promote’ (national reference event for the evaluation and debate on health policies in the oncology sector) . At the center of the debate: the need to enhance virtuous solutions.
Breast cancer in the pandemic: one in five women have had difficulty accessing treatment
by Mara Magistroni
From telemedicine to home delivery of medicines
The solutions used by hospitals, public bodies and associations to treat patients in the months when travel was not allowed include: teleconsultations to receive a second opinion, intra and extra-regional multidisciplinary networks, online reports, medical records digital, home delivery of drugs and blood draws directly to the home for patients undergoing chemo or immunotherapy. “These practices have worked well and we can enhance them to contain healthcare mobility”, explains Annamaria Mancuso, coordinator of the Group and President of Salute Donna Onlus: “The Covid emergency is not yet archived, so the issue is very relevant, so how important it is to pay close attention to the frailty of patients. Only if we put these virtuous solutions into a system and develop local medicine, with multi-specialist public clinics so as not to flood the hospitals, could we give patients more opportunities to stay in their region to be treated “.
Cancer, over 67,000 patients are treated outside the region
by Tiziana Moriconi
Enhancing regional health care: the case of Sicily
Since both the breast network and the cancer network have existed in Sicily, fewer and fewer patients move from this region for visits and treatments. “To shorten the movement of patients, each screening center was connected to the closest Breast unit. And the best breast centers have been certified with a regional quality seal to certify the high level of performance, medical staff and equipment “, explains Francesca Catalano, Multidisciplinary UOC Director of Breast Care at the Cannizzaro Hospital in Catania and coordinator of the Commission Breast cancer network of the Sicily Region Health Department: “However, there is still a lot to do: for example, effective communication that enhances regional health excellence and informs patients of the existence of qualified structures. Because it is important to make citizens understand that high-level services are also provided in their regions ”.
The example of pediatric oncohematology
A network that has been working well for some time and that can be taken as an example to follow in combating healthcare migration is that of pediatric oncohematology. The Italian Association of Pediatric Hematology and Oncology (AIEOP), which brings together all the specialists, coordinates the activities of doctors with refresher meetings, deals with the sharing of common treatment protocols, reports and centralized reviews of diagnoses. “The world of pediatric oncohematology already functions as a network, in which reports move more than patients. This has made it possible to almost completely neutralize the differences that previously existed in the treatment centers between the southern and northern regions – says Angelo Ricci, President of the Italian Federation of Parenting and Healed Pediatric Oncohematology Associations – Furthermore, to better follow the pediatric patient, once the most suitable therapy path has been identified, it is also useful to create both main regional centers and proximity ‘satellite’ centers. How is happening in Piedmont and how it could also happen in other Italian regions “.
Create oncology guidance centers
According to doctors and patients, it would be necessary to create Oncology Guidance Centers in every region. Here, the patient could be welcomed as soon as he receives the diagnosis, have indications on the therapeutic path to follow and on the most suitable and closest facility to turn to. “This could be a valid support for oncological networks, which, however, are not yet present throughout the national territory, and which in some regions do not fully function”.
Cancer, Amunni: “Less commonplaces, more empathy and a social movement for prevention”
by Irma D’Aria
Fare networking
If the measures that have allowed us to continue to treat patients during the most difficult period of the pandemic have worked, however, there remains the need for a political commitment to guarantee a homogeneous quality of care in all realities of the country. “On the part of political institutions, a commitment is needed to ensure a homogeneous approach to treatment between regions, with common guidelines, rules that are the same for all, which concern, for example, the management of the waiting list system, priorities for diseases and the availability of high-cost drugs “, explains Filippo de Braud, full professor of medical oncology, Director of the School of Specialization in Medical Oncology of the University of Milan and of the Hematological Oncology Department of the IRCCS National Cancer Institute Milan Foundation:” If this is concretized – he concludes – it would be easier to manage the migration of patients both inside and outside the region ”.