ANCONA – In the Marche region, one third of hospitalized elderly people stay in hospital seven days longer than necessary due to lack of assistance in the area (or at home). And in 50% of cases, the extra days range between five and seven. A flaw which, in one year, translated into extra costs for the Region equal to 185 million euros. The pitiless photograph was taken by the investigation conducted on 2022 by the Federation of hospital internists in 98 structures distributed throughout the boot. And it quantifies the weight that unduly falls on public health due to the shortcomings of the social assistance system, but also of the territorial health services that are poorly equipped to take care of patients over 70.
The report indicates that, from the date of discharge indicated by the doctor to the actual date of exit, seven days pass for 33.3% of the elderly and between five and seven for one over seventy out of two. Thus, while hospitals are increasingly in trouble due to a chronic shortage of health personnel and beds, and emergency rooms are forced to keep patients stationed in waiting rooms for spaces to be freed up in the ward, “there is hospitals for a few hundred thousand days of hospitalization, which could have been used for treatment», underlines the regional Fadoi, who adds: «Instead, they end up having to guarantee assistance that could also be ensured at home or in an intermediate health facility. Extra days of hospitalization which must make up, continues the Federation, “for a social assistance system that unloads its shortcomings on health care”.
But why is this distortion created? In 45% of cases, the elderly from the Marches remain in hospital because they have no one able to assist them at home. In 20% of cases, however, the reason is due to the fact that they have not had the opportunity to enter an RSA because there are not enough places or because it costs too much. «Without family members who can assist them at home and without a pension sufficient to be able to pay the fees for residential facilities – observes Fedoi Marche – and with a healthcare system that struggles to take care of them once they leave the hospital, we end up with the figure of 33% of hospitalized over-70s who spend more than seven days in a hospital bed compared to what should be their discharge date from a clinical point of view”.
A problem that does not only concern the Marches, but which in a region with an increasingly elderly population has a significant impact. Furthermore, again according to what emerged from the Fedoi survey, the extra costs incurred by our regional health system are much higher than in other territories. To give some examples: in Abruzzo, the additional expenses to cover the improper hospitalizations of the over 70s amounted to 31 million euros, while in Puglia they amounted to 83 million. We even surpass Emilia Romagna, which had to pay out 135 million euros more in one year. However, things are decidedly worse in Tuscany, where the extra costs have shot up to 445 million euros.
At a national level, there are over 2 million days of improper hospitalization every year due to the difficulty in discharging the elderly alone. A number that significantly affects the clogging of hospitals and which, considering the average cost of a day of hospitalization, equal to 712 euros according to OECD data, make a total of one and a half billion a year of expenditure that could have been invested in real health care.