ROMA (ITALPRESS) – Ensuring fair access to care remains one of the most complex challenges for the National Health Service. Territorial inequalities continue to weigh on the possibility, for patients, to access appropriate diagnostic-therapeutic paths. In this context, strengthening integration between different levels of assistance and reducing regional disparities becomes decisive for improving the quality of assistance and ensuring a more uniform takeover. At the same time, the theme of waiting lists plays an increasingly central role. For years, the focus of the attention of the institutions and health professionals has been particularly affected by chronic diseases, requiring continuous monitoring, timely interventions and a structured and multidisciplinary takeover over time. Reducing time for visits and exams is not only an organizational issue, but a key element in improving the quality of patient life and making public resources more efficient. In this scenario, Tiziana Nicoletti, Head of the Coordination of Associations of chronic and rare patients of Cittadinanzactive commented: “In Italy the main health emergency does not concern the quality of care, but the possibility of accessing it. Although some effects of ongoing reforms are beginning to be seen – on waiting times, territorial assistance, Lea update, screening extension and vaccination calendar – waiting lists, staff shortages and spatial disogenity in the provision of health services still jeopardize the effectiveness of health law.” “All this – he added – outlines in an increasingly obvious way, the problems that have arisen over time for chronic patients and their families, preventing them from fully and evenly accessing care. Plans and standards are not lacking and generally define the rights of people with chronic and rare disease. But, too often, they remain suspended: in the more decisions, in the obstacles that the institutions tend to be broken, in the insufficient participation of citizens and associations. On this we ask for the full implementation of the new National Plan of Cronism 2024 and the constant monitoring of the planned objectives. The need to provide effective public policies, and the urgency of a renewed pact between the Institutions, especially in the relationship between the State and the Regions, to speed up the time of exegibility of rights and to give them fair implementation to all citizens throughout the country.” However, the management of these diseases remains complex, and this is demonstrated by the taking of patients with BPCO who in Italy are over 2 million. The welfare path, in these cases, needs synergy among health professionals, such as pneumologist and general medical specialist, who hold different but equally important roles. Strengthening this integration is therefore a strategic lever to improve the welfare outcomes for patients already diagnosed, avoid reacutting and, consequently, optimize the use of health resources. Raffaele Scala, National President of the Italian Association of Hospitaller Pneumologists (AIPO): “The taking into account of patients with chronic respiratory diseases, especially BPCO, still presents critical issues that are linked to the timely identification of pathology, prevention of disease, monitoring of it in all its stages and treatment of reacuttions, especially when pathology is advanced. The elements of improvement of the path are those linked to the greater integration between the pneumologist specialist and the doctor of general medicine, and between pneumologist specialist and other hospital professionals, also through the tools that abwe are already in place and that only in part are developed, such as those of telemedicine, that allow above all to shorten the distances between specialist and doctor of general medicine and between different specialists in order to be able to immediately give an answer to the patient with suspect or conclaimed respiratory disease both in phase of stability and acuzie”. “It’s clear – he highlighted – that all this must be associated with a team action, involving patient associations, institutions and private stakeholders. Only in this way can an application model be established that allows for equal treatment in all regions and is based on the concept of integrated and structured clinical networks. The first link of this management chain is the integration between the general medical doctor and the pneumologist specialist: this is how the patient immediately enters the network to take care of. The other components of the model concern hospital and inter-hospital integration based on the Regional and Interregional Network that must work according to the Hub & Spoke logic, where the acute part is managed, with high diagnostic and therapeutic complexity, and both subsequent complications of respiratory pathologies. Within this Hub & Spoke network, nodes are managed through a communication between the different hospital facilities. In this model, the UTIPs, the Pneumological Intensive Care Unit, play a crucial role in the hinge between the phase of acute respiratory attack and the home transition of patients with oxygen addiction development and mechanical ventilation supports. It is clear that under an operational strategy point, the management of respiratory pathologies both acute and chronic should not provide only hospital treatment, but should prefer when possible the territorial treatment and for this reason within this Network should include the Community Houses in which the pneumologist specialist works in contact with the general medical doctor to be able to manage these patients together for the first time and reduce the use of hospital facilities.” “Only in this way – he concluded – we could overcome these barriers, which prevent at the time of being able to diagnose respiratory pathologies, such as BPCO and asthma, at the early stage, where the treatments we have available, which are particularly active, are certainly more effective, and at the same time we could take charge of people in advanced phase of disease with dependence on breathing supports with the goal of obtaining a prolongation and above all an improvement of the quality of life”. The direction is outlined: strengthen spatial assistance and integration between different levels of care to build a more equitable, efficient and able to respond to the needs of patients.
– photo press office Esperia –(ITALPRESS).
