UDINE. Reduce waiting lists lengthened by the inevitable consequences of the pandemic which resulted in a 24 percent drop in scheduled surgeries, 16 percent in outpatient activity and lengthened second-level screening times.
If we add to all this that Friuli Venezia Giulia spends, not from today, about 91 million euros a year to reimburse the accredited private structures of other regions to which Friulian patients undergo cataract, hip prosthesis and magnetic resonance without contrast, the maneuver which is worth a total of 109 million euros 271 thousand.
In percentage it exceeds 5 percent of regional health expenditure. The Riccardi reform has brought the limit to 6 per cent when in other regions it also exceeds 30 per cent.
Faced with unacceptable waiting times – cataract surgery requires a wait of two years -, the Region, in renewing the three-year agreements with individuals, compared to the historic buget, has decided to invest an additional 16 million euros by assigning them to three health agencies, Burlo Garofolo and Cro di Aviano, to increase the number of oncological interventions especially in the breast, prostate and colon, cardiovascular, in particular the aortocoronary bypass, and orthopedic interventions including hip and knee prostheses.
The same fund is also used for outpatient services and therefore to recover cardiological and audiometric exams, digestive endoscopy and eye interventions such as cataracts and intravitreal injections.
“In addition to the 16 million euros allocated to the purchase of services performed by private individuals for the public, we allow companies to spend 20 million more in the private sector and, shortly, we will make a maneuver for the recruitment of personnel of 5 million euros above all for the vaccination campaign “explains Riccardo Riccardi, deputy governor with responsibility for Health, after having obtained the green light from the Executive to implement the regional operational plan for the recovery of waiting lists and the three-year agreement (2021-23) signed between Region and the representative associations of accredited private providers.
Two three-year agreements have been signed with the associations of accredited private health facilities, Anisap, Aris, Assosalute and Aiop: the first involves the accredited nursing homes which, in addition to the historical annual budget of 72 million 355 thousand euros, have obtained a further 14 million 471 thousand euros to reduce waiting lists and thus avoid the flight of patients, especially in the nearby Veneto.
Similarly, the commitment of accredited private outpatient structures which, with the historical budget of 14 million 800 thousand, obtained 1 million 395 thousand euros more for the newly accredited sectors including gastroenterology, cardiology, dermatology, endocrinology, physical medicine and rehabilitation, diagnosis for images, ophthalmology and collection centers, and a further 5 million 792 thousand euros to break down the waiting lists and ease the flight beyond regional borders.
Having the possibility to perform a greater number of surgical interventions, accredited private individuals are able to guarantee post-operative rehabilitation as well.
“There are three tools through which the Region aims to recover waiting lists and cope with the flow for care outside the region: the hiring of temporary staff or self-employment (including coordinated and continuous collaboration), the purchase of additional services from dependent healthcare personnel and, in a residual way, the purchase of extra-budget services from an accredited private individual against a specific agreement “Riccardi reiterates in pointing out that” as regards the relationship with the private ‘accredited hospital activity, per capita expenditure in Friuli Venezia Giulia is 54 euros, compared to 111 euros in neighboring Veneto and 146 in Italy.
Friuli Venezia Giulia also spends 43 euros per capita in the accredited specialist sector, Veneto 68 and in Italy 79 ”. The commissioner also reiterated that “we are not talking about highly specialized services, but about activities that can also be commonly provided in the region”.
This is to remember that, very often, the specialist visits the patient in accredited private clinics in the region, but not having the budget available, invites them to undergo the operation in accredited private clinics in the Veneto region.
“Friuli Venezia Giulia reimburses the expenses to accredited private clinics in the Veneto or other regions” Riccardi underlines to point out that, even outside the region, Friulian patients do not turn to public facilities.
“The goal – insists the commissioner – is to bring back the private service that I still pay for and I can’t keep it under control”.
On average, the Region already spends from 90 to 95 million a year at the bottom of the list, 56 only in Veneto, on reimbursements. Now the health authorities, as part of the project already illustrated to Cgil, Cisl and Uil, will be able to contract with accredited private individuals the services with a high waiting list that affect the flight outside the region.
The health authorities, with the regional health coordination agency (ARCS) and the central health management, will monitor the data and verify the effectiveness of the actions.