Robert Turn
ROME
As many as 288 fewer hospitals and a sharp cut to 83,231 beds. In ten years, from 1997 to 2006, public hospital structures lost weight by an average of 30%. While per capita expenditure, 1,731 euros in 2007, shot up by 77.7% recording a total deficit of 44.78 billion. And personnel increased by just 0.3%, mainly due to the 10.3% drop in technical-administrative personnel, with doctors growing in the meantime by 8.2% and nurses by 5.3%.
Here is the 1997-2006 check up of the National Health Service. While fiscal federalism is pressing and the Government and the Regions are preparing for a difficult marathon for the new "health pact" envisaged by the three-year maneuver (Legislative Decree 112, converted into law 133), the Italy of public health presents all its accounts, its strengths and weaknesses. Confirming the existence of a twenty-speed system and the effects of resistance to change in those realities under observation in these hours: Lazio, Sicily, Calabria, Campania, Abruzzo. Lazio which risks a commissioner bis, despite the summer maneuver signed by the governor (and commissioner) Piero Marrazzo, Abruzzo destined to soon end up under guardianship and Sicily, Calabria and Campania still on the shields of the commissioner from early October.
The group photo of our NHS, as shown by the elaborations of the weekly «Il Sole-24 Ore Sanità» on the very recent data of the 2006 Yearbook of the Ministry of Health compared with those of 1997, clearly testifies to the progress made in ten years, but even where the path of rationalization has remained at a standstill.
Because there have obviously been cuts. Here I am. But not always and not everywhere. Between eliminations, merging and rationalization of structures, public hospitals (654 those surveyed in 2006) lost weight by 288 units (-30.6%), with a significant peak of 59% (87 less) in Lombardy and 50.6% in Veneto and Puglia. Apart from Tuscany, which boasted an already more rational network, the much less substantial reductions stand out in the Center and in the South in general: Calabria (-2.6%) is at the bottom of the ranking. The cut in beds obviously went hand in hand with the reduction in hospitalization structures: from 295,000 in 1997, the number of beds became 211,725 in 2006, 28.2% less, with Puglia boasting the most consistent reduction (he lost 9,353 beds, a good 40%).
The overall, but not generalized, weight loss of a plethoric NHS already put on a diet starting from 1992 with the Amato-cure, has been matched by the rationalization of treatment pathways. That is to say: more day hospitals and day surgery instead of ordinary hospitalizations, and, over time, more home care. But always in the name of Italy at a thousand speeds. Day hospital admissions thus increased from 1.7 million to 3.9 million in ten years, accounting for 30.8% of ordinary acute care hospitalizations in 2006, practically double the 16% of 1997. While also the Adi (integrated home assistance) has doubled from the 200,000 cases recorded in 1997 to 414,000 in 2006. Go ahead, in short, but still too little.
Personnel policies also recorded a trend with differentiated gears between the Regions, the result of local diversity, but not only. Healthcare personnel (452,000) grew by 25,000 (+5.9%), technical and administrative personnel lost 23,000 (-10.3%). Doctors (105,860) are 8 thousand more, nurses (265,444) +13 thousand. Overall, the workforce in ten years has only increased by 1,700 units, with Puglia which has lost 10.7% of employees and Basilicata (apart from Valle d'Aos
