Home Health How health services in the Regions are changing with the new decree on territorial assistance

How health services in the Regions are changing with the new decree on territorial assistance

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How health services in the Regions are changing with the new decree on territorial assistance

Healthcare will be revolutionized in the Regions with the new decree on territorial assistance, which has just entered into force: all Regions will have to adapt to these standards by January 2023.

On 7 July, the decree of 23 May 2022, n. 77, published in number 144 of the Official Gazette, which defines the models of territorial assistance in the National Health Service. The legislative decree gives indications to the Regions on the standards of the healthcare offer, and clearly states that all the Regions will have to offer an adequate territorial service by January 2023: the defaulting Region will lose 2-3% of the supplementary financing of the National Health Fund. In theory, in this way all citizens will be ‘covered’ and will have less difficulty in finding a general practitioner, of which there is a shortage in many territories, such as Lombardy and Emilia-Romagna.

Article 1 of the text reads:

The regions and autonomous provinces of Trento and Bolzano shall adopt the general planning provision for territorial assistance within 6 months of the date of entry into force of these Regulations pursuant to this provision.

And further down:

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The regions and autonomous provinces of Trento and Bolzano adapt the organization of territorial assistance and the prevention system on the basis of the standards referred to in this decree, in line with the investments envisaged by Mission 6 Component 1 of the PNRR.

What are Community Houses

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In concrete terms, how will health services change? In practice they will be born Community Houses (Cdc), understood as “a physical and easily identifiable place to which citizens can access for health care, social and health care needs and the organizational model of proximity care for the reference population”. One for every 40,000-50,000 inhabitants is expected.

They will be open 7 days a week h24, and there will be general practitioners and pediatricians (30-35 in rotation) and nurses, but also psychologists, obstetricians, social workers, rehabilitation technicians available. In particular we speak of “7-11 nurses, 1 social worker, 5-8 support staff (social health, administrative)”. A sort of first aid, or even a filter, to avoid crowding the hospitals, as happened in the critical phases of the pandemic. Case by case, health professionals will be able to assess whether the patient needs a hospital, or, if the complaints are mild, they will be able to manage the situation and provide the required assistance. In the case of more serious pathologies, it is also possible to resort to an intermediate level, namely the community hospital, not a real hospital, but a smaller center.

What is the Community Hospital

The Community Hospital is an inpatient health facility, which carries out a intermediate function between home and hospitalizationin order to avoid hospital admissionsthe “improper or to favor protected discharges in places more suitable for the prevalence of social and health needs, clinical stabilization, functional recovery and autonomy and closer to home”. The implementation of a community hospital is planned, with 20 beds available, for every 100 thousand inhabitants; the Decree then specifies that the standard of 0.2 beds per 1000 inhabitants will be implemented “progressively | according to regional planning”.

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For what concern personaleach Community Hospital with 20 beds, must have: 7-9 nurses (including 1 Nursing Coordinator), 4-6 Healthcare Operators, 1-2 units of other health personnel with rehabilitation functions and a Doctor for 4.5 hours a day 6 days a week.

The figure of the family nurse

The decree also introduces another figure, namely the Family Nurse. One is expected for every 3 thousand inhabitants. The family nurse is defined as “the professional figure of reference who ensures nursing assistance at different levels of complexity in collaboration with all the professionals present in the community in which it operates, pursuing the interdisciplinary, health and social integration of services and professionals and placing the person at the center “.

It also deals with prevention: “The Family or Community Nurse is not only the provider of assistance care, but becomes the figure who guarantees the assistance response to the onset of new expressed and potential health needs that persist in a latent way in the community”.

Home care

Home care must also be ensured. The 10% of the population over 65. It is defined as “a district service aimed at providing home-based interventions characterized by a varying level of assistance intensity and complexity within specific care pathways and a personalized assistance plan”.

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