The entrance to the ASP of Catanzaro and the former Pugliese (where there is a significant part of Dulbecco’s administrative staff)
06 May 2024 19:37
by GABRIELE RUBINO
One of the greatest Italian evils is the bureaucracy, or rather its excesses. If this characteristic national connotation is combined with Calabrian healthcare, which has never shone for efficiency and this is confirmed by the repeated insufficiencies in the provision of essential levels of assistance, then the mix becomes deadly. The two elements found themselves crossed in the same coordinate: extensive out-of-hospital rehabilitation services and Asp of Catanzaro. The first are the set of assistance necessary for the physical recovery (and not only) in the post-acute phase of patients who have suffered major pathologies, including strokes, severe degenerative diseases and serious traumas. The second is the third regional provincial health company and is the only one in Calabria to interpret the reference legislation in a certain direction unlike all the others. A fact that causes, at the minimum, delays, but more often than not, healthcare migration. As if it were needed.
THE ‘SOLITARY’ INTERPRETATION OF THE DISTRICTS OF THE ASP OF CATANZARO– In the solitary and ancient vision of the districts of the ASP of Catanzaro, hospitalization for extensive out-of-hospital rehabilitation services should be authorized in advance by the offices of the same district, following a visit to theMultidimensional Evaluation Unit (UVM), and not, as happens in the other regional ASPs, where hospitalization also takes place with a prescription from the general practitioner or the specialist doctor or the doctor of a public facility (or from the department) in the case of protected discharge. In these cases, as soon as admitted to the private facility, the user will be subjected to a specialist examination by the physiatrist who will draw up a rehabilitation project to be sent at the same time to the UVM which will have the task of verifying whether the times of the rehabilitation project are compatible with the itself and to express its opinion on any changes to the project and its extension. The procedures carried out in the Catanzaro area (which perhaps do not apply to the ‘Pugliese’ unit of the Dulbecco di Catanzaro where protected discharges are admissible but only for a Catanzaro facility, another paradox), involve the extension of treatment times to the complete detriment of the rehabilitation process and the recovery of impaired functions with consequent disabling outcomes that could be avoided or limited by an immediate rehabilitation approach. The authorization regime followed by the ASP of Catanzaro is provided for by law no. 833 of 1978, it’s a shame that it was superseded by Legislative Decree 502 of 1992 and DCA n. 81 of 2016, whose approach was confirmed by the Regional Administrative Court of Reggio Calabria with ruling no. 1725 of 2010. In this circumstance, the administrative judges had censured the ASP of Reggio which was attempting to return to the previous authorization regime, the one now followed by the ASP of Catanzaro.
FOR A PROTECTED DISCHARGE A WOMAN HAD TO WAIT ABOUT 20 DAYS – So far we have talked about laws and bureaucracy, but what matters more are patients and their respective suffering and difficulties in receiving adequate care despite having a full right to it. There was talk of the (negative) reverberation of the interpretation of the distracted ASP of Catanzaro on protected resignations. A woman from Santa Caterina dello Jonio and being treated in an intensive rehabilitation department in Lamezia Terme had requested extensive hospitalization (drawing up the relevant programme) but, due to the length of the ASP, she was discharged not to the home facility but At home. The patient’s family had to request a physiatric visit, which took place in Soverato a few weeks later, and only on 19 February – therefore after a total of 20 days – was there authorization for hospitalization. All with ambulance transport to the various towns in the Catanzaro area (therefore burdening the healthcare system) and, above all, with delays in the patient’s rehabilitation (quick times are essential) without any valid technical, scientific and administrative reason.
FEW AFFILIATED PLACES AND PATIENTS FORCED TO TREAT OUTSIDE THE REGION– So far we have talked about delays, but there are those who do not wait and prefer, indeed they are forced to seek treatment in other territories or even in other regions. The node is represented by numbers. The ASP of Catanzaro despite having 20 accredited places it has only 9 affiliates (and only in one structure although there are others). Not even 50%. To be precise, there were even fewer. The actual ones in recent days were 7, only tomorrow will the threshold of 9 be reached. All concepts that have been exposed several times by trade associations (which have sent numerous official letters). It goes without saying how important this type of performance is in terms of the LEA score, but above all for Calabrian patients who cannot be reduced to cold numbers. A thought that should touch the heads of the Catanzaro ASP who would have all the elements to change the register.
