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Hospitals and emergency rooms: the planning lines for 2023

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Hospitals and emergency rooms: the planning lines for 2023

Strengthening of territorial medicine through “widespread outpatient clinics”, economic incentives for hospital doctors who work overtime in the emergency rooms, check-ups booked directly by general practitioners or specialists and expansion of agendas, to stay within the prescribed times. It’s measures illustrated yesterday by the Councilor for Welfare of the Lombardy Region, Guido Bertolasoinserted in the «Programming lines 2023» approved by the Lombard Council.

«We are discounting delays at the national level – he was keen to specify -. There shortage of doctors and staff comes from afar, what we are proposing are even temporary solutions, waiting for the university to graduate doctors, including family doctors, to enhance health care in the area”.

Investments

The programming addresses expect to invest 180 million for the strengthening of hospital and territorial assistance. In detail, 28 million for integrated home care, 29 for the recruitment of staff for functional prevention departments, 15 for hospital staff, 80 for family nurses, 10 million to promote associations of general practitioners and for studio staff, and $18 million for day centers and therapeutic communities.

The net

Part of the interventions are concentrated on territorial medicine. Already tested in the provinces of Bergamo and Pavia, they will be the “widespread temporary clinics” extended to all regional Ats. Basically, general practitioners and paediatricians of free choice who are available are asked to take charge of the primary care of patients left without a family doctor.

They will also be in the community houses recruited retired doctors or available to work extra hours.

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The Emergency Department

Per counteract crowdingwe will work on two fronts: access and hospitalization.

Greater efficiency of the integrated medical center (which connects the regional emergency and urgency agency, practically the ambulances, and the emergency rooms) will allow refer patients to less crowded hospitals – it is already being done – and to manage the less serious cases at home, thanks to the intervention of the doctors and nurses of the Usca (Special Assistance Continuity Units).

Specific economic incentives (100 euros per hour) will be guaranteed to hospital doctors who will work in the PS after working hours, while a union agreement in this sense is being sought for nursing staff and Oss.

To guarantee the minimum stay in the emergency room and inclusion in the ward, work will be done to divert subacute patients to alternative structures (which the Ats will be authorized to contract) to make room for incoming patients. Furthermore, in the emergency rooms, i patients over 65 who are bedridden or on a stretcher can be accompanied by carers even after triage.

List of certificates

Another hot topic is that of attestation listfor which Bertolaso ​​had announced that for the ten most requested specialties, the 65,000 patients who had not managed to book specialist visits within the 10/30 days required by the prescription would be contacted by the end of the year: 17,000 were contacted in two weeks for which the appointment has been brought forward.

It will also establish a Unique regional booking center, the available slots will be increased by 10%, and check-ups will be scheduled directly by family doctors or specialists. The overtime recruitment contracts for the recovery of the lists will be extended to March 31, as will the incentives for the additional services.

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Brescia first in Lombardy for improper access

Con over 107 thousand accesses to the emergency room in white or green codeequal to 107.55 per thousand inhabitants, Ats Brescia leads the ranking of “improper” accesses in Lombardy, and ranks fifth place in the Italian classification. Behind her, al sixth place (second in Lombardy) Ats of the Mountainwhich includes Valcamonica.

A not exactly virtuous ranking, published by Il Post last Tuesday on data from Agenas, the National Agency for Regional Health Services, and referred to 2021: accesses with low or very low priority, in fact, risk on the one hand overloading the work of emergency departmentson the other they determine for the patients often very long waitsbefore accessing the medical examination and any control tests that often resolve when returning home.

The cause of the phenomenon, which often involves elderly patients or children, whose health is feared the worst, is due – according to the online newspaper – also to shortages of local health care. Basically, these “improper” accesses (which take place between 8 and 20, therefore during the day) could be avoided with the timely intervention of the general practitioner or on-call.