ROMA Calabria below the minimum threshold in all macro-areas. For regional health, the one that emerged from the data published by the Ministry of Health is yet another debacle. The monitoring of the disbursement of the Lea (Essential Levels of Assistance) for 2020 highlighted various critical issues attributable to the pandemic emergency and followed a new method which confirms, as has happened every year, the systemic difficulties in Calabria.
Calabria’s scores: below the threshold in all macro-areas
These are the contents of the survey reserved for the region. «The final assessment of the Collective Prevention and Public Health area for 2020 stands at a score of 32.73, which according to the reference range (positive result in the range 60-100) is below the compliance threshold. Critical issues are noted for all the indicators examined with the exception of P12Z – Coverage of the main control activities for food contamination, with particular reference to the search for illicit substances, residues of contaminants, drugs, pesticides and additives in processed foods animal and vegetable origin. Also for the District area low score, «equal to 48.18, which according to the reference interval (positive outcome in the range 60-100) is below the compliance threshold. Critical issues are noted for all the indicators examined with the exception of indicators D03C – Standardized hospitalization rate (per 100,000 inhab.) in adulthood (≥ 18 years) for complications (short and long term) for diabetes, COPD and heart failure; D10Z – Percentage of services, guaranteed within the times, of the priority class B in relation to the total services of class B; D14C – Consumption of sentinel/tracer drugs per 1,000 inhabitants. Antibiotics”.
The final assessment of the hospital area for 2020 marks time like the other macro-areas and “stands at a score of 48.44, which according to the reference interval (positive result in the range 60-100) is below the compliance threshold. Critical issues are noted for all the indicators examined with the exception of indicators H01Z – Standardized hospitalization rate (ordinary and daytime) in relation to the resident population and H04Z – Ratio of hospitalizations attributed to DRGs at high risk of inappropriateness (Annex B Health Agreement 2010 -2012) and hospitalizations attributed to DRGs not at risk of inappropriateness in the ordinary regime”.
Abnormal variations in the national health system
At the national level in the hospital area, the dynamics of the scores for various appropriateness indicators is altered due to the significant decrease in hospitalizations in the prevention area, the scores of four out of six indicators (screening, vaccinations, coverage of animal control activities ) underwent a marked deterioration compared to 2019. The district area also recorded anomalous changes compared to the previous year (increase in times recorded in the emergency-urgency area, reduction in antibiotic consumption, reduction in re-hospitalizations and inappropriate hospitalizations in a context of general reduction in hospitalizations).
The score of the regions
Overall, in the year 2020, Piedmont, Lombardy, the PA of Trento, Veneto, Friuli Venezia Giulia, Emilia Romagna, Tuscany, Umbria, Marche, Lazio and Puglia recorded a score above 60 (threshold of sufficient) in all macro-areas . The Regions with a score below the threshold in one or more macro-areas are: Liguria, Abruzzo, Molise and Sicily, in just one macro-area; Campania, Basilicata, Valle d’Aosta, PA of Bolzano and Sardinia, in two macro-areas; Calabria, in all macro-areas. The data validation process by the Lea Committee was concluded in the meeting of 7 November 2022. The monitoring of the provision of the Lea is carried out by the Ministry of Health (through the Lea Committee) to verify that all Italian citizens receive the treatments and services falling within the essential levels of assistance, according to the dimensions of equity, effectiveness, and appropriateness. This year for the first time it was drawn up through the New Guarantee System (NSG), but since 2020 was characterized by the Covid-19 emergency – following which the regional health services had to activate special paths to guarantee the provision of essential and urgent services and at the same time define specific measures to contain the contagion, as part of the emergency legislation – the Lea Committee established that the monitoring of the provision of the Lea for the year 2020 was carried out for information purposes. ([email protected])