Long Covid doesn’t just affect people, but a bit of all Italian healthcare which, between waiting lists, difficulties in recovering screenings and lost hospitalizations, still suffers the weight of the aftermath of Sars-Cov-2. Although there was a recovery in 2021, performance levels are far from pre-Covid levels: the volume of urgent hospitalizations confirms a -13% compared to the pre-pandemic period, with 900,000 hospitalizations lost in 2020 and 2021. And ‘ what emerges from the 20th Report on hospital activity in Italy ‘Ospedali&Salute’, presented by the Italian private hospital association (Aiop), but “the double public and private soul of our healthcare can be a keystone for overcoming inequalities which persist at a territorial level”, according to the Minister of Health Orazio Schillaci”.
The report shows how “the ‘ordinary’ pre-pandemic delays are added to by the ‘extraordinary’ delays of 2020 and those caused by a pandemic impact that is struggling to end”. For planned hospitalizations, there is a recovery, but the levels are still at -16% compared to 2019. Also for specialist outpatient services, the volumes of activity remain significantly below the pre-Covid values, with variations in 2019 -2021 which reach -70% in Basilicata and -46% in the PA of Bolzano. The consequence is that in Italy, the private, or out-of-pocket, expenditure of citizens for treatment continues to grow and has increased from 37.3 billion euros in 2017 to 38.5 billion in 2021. “The National Health Service – said Barbara Cittadini, national president of Aiop – he still suffers from long Covid. The volumes of activity and the quality of care have not returned to pre-Covid levels either for scheduled or urgent services”. Private hospitals can make an important contribution but are still penalised: if 70% of accredited hospital beds are in public structures and 30% in private ones, 88% of hospital expenditure is destined for public and only 12% to accredited private companies. Rethinking an organizational model for the management of waiting lists is what was suggested by the director general of the National Agency for Regional Health Services (Agenas), Domenico Mantoan. “In Italy – he said – we have three hospital beds per thousand inhabitants, one of the lowest numbers in Europe. Last year 500 million were allocated for the recovery of waiting lists but 300 were not spent by the regions”. because “the public is overwhelmed, also due to a lack of doctors and organizational difficulties. We need single regional Cups to book both in the public and in the private sector, otherwise we will not have the pulse of real needs”. To reduce waiting lists, Schillaci recalled, “the Milleproroghe provision extends the tools available to the regions to overcome waiting lists. The law allows 0.3% of the health fund to be used to take advantage of services under the agreement with private facilities”.
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