NoDespite the increase of approximately 20 million euros in production costs (compared to the previous year) in the hospitals of Cerignola, Manfredonia and San Severo, the Foggia Local Health Authority saved its accounts thanks to the increase in the value of production – the resources transferred from the Puglia Region – of 30 million euros. In a nutshell, it is the latest result in the economic-financial management of the local health company led by Antonio Nigrias can be seen from resolution number 736 of 30 April signed by the administrative director Michelangelo Armenise and the health director Mara Masullo.
“This financial statement as of 31 December 2023 – reported in the document – shows a profit of 9,555 euros”. In detail, however, a substantial difference emerges which concerns precisely the two items that should characterize the evaluation of managerial performance. As regards the “production costs”, they went from 1,226,066,887 euros in 2022 to 1,244,145,580 euros in 2023; while the “value of production” went from 1,228,455,720 euros in 2022 to 1,257,990,169 euros in 2023. The operating result recorded a loss of 4 million euros (+8,644 euros in 2022 and -3,997,799 euros in 2023).
Among the critical points there are certainly theincrease in average hospital stay (the number of days of hospitalization per patient), passive mobility (tens of millions of euros for treatment outside the region for patients from Foggia), the pharmaceutical chasm. In the first case, ordinary activity saw an increase in the average length of stay in all three hospitals (“Tatarella”, “Masselli Mascia” and “San Camillo de Lellis”). Overall, hospitalizations grew – from 11,612 to 13,259 – in the three facilities. However, almost all hospital efficiency indicators are negative: in particular, in deliveries, which decreased from 1,148 to 1,085, we note the increase in the percentage of use of cesarean section (38.6%).
Spending on drugs continues to be a drag on healthcare companies. If the “affiliated” sector is showing slightly positive results (-0.53% – or 453 thousand euros saved – in 2023 for Foggia, the only Apulian company to respect the assigned ceiling), the same cannot be said for the “direct pharmaceuticals” , concerning the monitoring of medical specialists and purchases for internal consumption. “From the 2023 data – it is reported in the report -, although not consolidated, an excess for the ASL FG emerges of 23.18% compared to the set ceiling, in absolute terms equal to 16,896,888 euros, the best regional result, at around 12 percentage points of detachment from the second Apulian territorial company”. The overrun, this time too, was mitigated to around +20% (just over 15 million) thanks to the increase in the spending ceiling.
This last topic is particularly attentive to politics. To give battle to the government led by Michele Emiliano he is the regional councilor of Action, Fabiano Amati, which with an amendment to the “manager saving” law has provided for the forfeiture of general managers who do not respect the spending ceilings for pharmaceuticals. The issue was addressed in the Budget Committee last month. In fact, from a check of the pharmaceutical spending ceilings, according to Aifa data, Puglia is in sixth place nationally for affiliated drugs (+0.62% compared to the Italian average) while for direct purchases the incidence of increase in spending in Puglia is approximately 25% lower than the national average, placing it in seventh place. “The responsibility for all this – claimed the president of the Amati commission on that occasion – lies attributable to all healthcare companies, except the Polyclinic of Bari, the only virtuous regional reality. It follows that all general managers, except that of the Polyclinic, have been dismissed by law and as soon as the results are consolidated they will no longer be able to make any decisions.” This at least in theory. “The dismissal of the general managers – he concluded – is a tool that must be used positively, because with the necessary rotation of general directors there would be the possibility of employing the general managers who have recorded the best performances in the ASLs with the greatest waste. Just as we would do in a private company or as we would behave if the money were ours.”
