Schillaci: “Inappropriate hospitalizations due to lack of hospital-territory integration cost 1 billion a year”

“We are all aware of how much priority the territorial assistance reform is, which constitutes the citizen’s first point of contact with the Health Service, also to avoid inappropriate use in hospitals. But we must at the same time complete the update of DM 70 keeping into account the recent lessons that have emerged in the management of the pandemic and the requests of those who work in hospital wards every day”. Thus the Minister of Health speaking at the Fadoi Congress.

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During the pandemic period, doctors and nurses in internal medicine departments have been among the front lines in the fight against the Coronavirus, treating around 70 percent of patients with Covid. These years have seen you play a coordinating and directing role in team work, leveraging on the peculiarity that distinguishes your discipline from other branches: the overall vision of the patient. Today we have technological tools that allow us to explore every single organ and return detailed information, but to work best with big data medicine, it also needs professionals capable of interpreting and putting this large amount of information in a row”.

Thus the Minister of Health, Horace Schillacispeaking via video link at the 38th Fadoi Congress.

“In fact – he continued – in the era of the super specializations that characterize contemporary medicine and which have made it possible to make so much progress on a clinical level, it is also necessary to recover an overview. The risk is to concentrate too much on the pathology, while it is the person as a whole who must be at the center of treatment. A global vision is all the more necessary in the face of the progressive aging of the population and the consequent increase in subjects suffering from various pathologies. On the other hand, it was precisely the pandemic experience that taught us how much decisive, in the process of care and assistance, to go beyond the old barriers, such as those of a rigid departmental subdivision, in favor of a multidisciplinary and team approach”.

“I am firmly convinced – added the minister – that continuity plays a central role among the drivers that must guide the redefinition of new healthcare models. First of all, between hospitals and local structures, which we are building and which should not be understood as separate bodies within the system but they must be able to communicate with the hospitals.As also emerged in your survey a few months ago, without the integration between the hospital and the local area we will continue to have internal medicine beds inappropriately occupied by the elderly who cannot be discharged from the internal medicine departments due to the absence of intermediate structures, caregivers or family members who take care of them. An inappropriateness that costs the National Health Service about 1 billion euros a year”.

“In that same survey, the need to overcome an outdated classification that labels internal medicines as low-intensity care wards was underlined. A classification that does not consider how the vast majority of patients in your wards are made up of complex patients, many of which require a high intensity of care.

We are all aware of the priority of the territorial assistance reform which constitutes the citizen’s first point of contact with the Health Service, also to avoid inappropriate use in hospitals. But we must simultaneously complete the update of DM 70 taking into account the recent lessons that have emerged in the management of the pandemic and the requests of those who work in hospital wards every day. Professionals who deserve to be able to work with serenity and to see recognized prospects for economic and professional growth.

The survey you are presenting today reveals that 50% of doctors and nurses who work in internal medicine departments present a state of “burnout” and a similar percentage would like to quit within the year. But there is also a large majority who report that they feel rewarded by their work with patients and have, despite everything, achieved many good things in their working life”.

“As you well know, the enhancement of healthcare personnel is an issue that I have brought back to the center of the government’s political agenda. The measures included in the bill decree are a first step in this direction and we will take others during the legislature. But the commitment is to be able to ensure that all our health personnel feel gratified in their professionalism, that no doctor or nurse feels overwhelmed by stress.For this reason, in addition to economic valorisation, it is necessary to make the National Health Service more attractive by intervening on the reorganization of the models, working towards a greater prescriptive appropriateness and a better use of the beds.A challenge that requires everyone’s contribution and which I hope we will carry on together”, concluded Schillaci.

08 maggio 2023
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