Local hospitals and doctors who don’t talk to each other cause 70 thousand improper hospitalizations in Sardinia. The average cost of each is 3 thousand euros and the calculation is easy to do: the waste amounts to 210 million euros per year.
The results are a study conducted at a national level, and with regional reports, by Fadoi, the Federation of hospital internal medicine doctors. It emerges that Sardinian doctors operating in the area consult with hospital workers for one in three patients, 34%. And in eight out of ten cases, patients arrive at the ward without anything being known about their health history, because the electronic health record is almost never updated: only in 13% of cases is the review constant and punctual.
Furthermore, one hospitalization in 10 is of a “social” nature: patients could have received care at home in the presence of a home care service or a family network capable of caring for them. On the island, in one hospital out of two, 20% of hospitalizations are caused precisely by the failure to take care of the territory.
There were many actions which, in the opinion of Sardinian hospital internal medicine doctors, could have prevented patients from staying in the ward. The data on the communication blackout stands out: for 62.5%, in fact, a greater relationship between hospital and territory would be needed. For 25%, however, new homes and community hospitals would be enough, while another 12.5% indicate the solution to avoid hospitalizations in a greater offer of home care.
The electronic health record as a possible means of information exchange is not taking off: local doctors, also due to bureaucratic cumbersomeness, explains Fadoi’s report, are able to update it only in 13% of cases and the percentage of those who do so rarely reaches 60%. The giant clinics of the future? For 20% of white coats interns will not be able to avoid the repetition of hospitalizations and improper access to the emergency room, while for 47% they will only be able to have a positive influence if the reform is modified. For 47% of Sardinian hospital interns, first of all there is a need for a provision, which is still missing, which provides precise indications on which local professionals and how they should work in the new structures, while for 26% we need rules that design the relationship between these structures and the hospital. Finally, for another 20% common IT platforms are needed between hospitals and local structures.
«The reality described corresponds to what hospital internal medicine doctors evaluate daily in departments throughout Sardinia», explains the regional president of Fadoi Carlo Usai, «Failure to take charge of territorial services negatively affects all performance indicators, but above all it contributes to inappropriateness in a setting that is absolutely unsuitable from a healthcare point of view. In this panorama, some hospital companies have equipped themselves with a dedicated service, such as the Hospital Evaluation Unit in the Aou of Sassari, a multidisciplinary team made up of a geriatric doctor and social workers who takes care of the patients identified and reported by the various hospital structures and plans the Individualized care plan by activating intra-hospital pathways, extra-hospital health and social care services in collaboration with the Local Health Authority district to which they belong and the Plus».
© All rights reserved
