Sassari The emergency rooms on the island are a time bomb. The number of accesses to Sassari it’s at Cagliari it is increasing by an average of 25%, and waiting times for non-serious patients are also expanding dramatically. The difficulties experienced by smaller hospitals, including those in Nuoro and Oristano, have repercussions on the main hubs, which see their catchment area widen. «Compared to 2022 – explains the head of the emergency room of the AOU of Sassari Paolo Pinna Parpaglia – we are recording a thousand more accesses per month. We went from 3200 to 4200, with an average of 35 more users per day. This situation forces us to make an enormous organizational effort, to strengthen shifts, to resort to overtime hours, because our structure must still guarantee high-level standards”. The problem is this: the emergency room staff is sized on a catchment area calibrated to the population of northern Sardinia. When patients from other areas also pour in, including Nuoro, Olbia and Oristano, the blanket becomes very short and the balance is thrown off. «The greatest difficulties are due to the closure of the Orthopedics – continues Pinna Parpaglia – the traumatology that Nuoro and Oristano are unable to manage, because the departments are closed, arrives in Sassari, and overwhelms both the emergency room and the Orthopedics of the Clinics and of the Santissima Annunziata”. Just think what it means to have to treat an elderly person with a fractured femur, who passes through the emergency room, then goes to Orthopaedics, perhaps needs surgery, and occupies the bed in the department for a few weeks, since it is a long-term patient. «Last year – says Pinna Parpaglia – with huge sacrifices we managed to halve the waiting times, and also the percentage of users giving up the service, from 14% was reduced to 7%. Now this unsustainable mass of new accesses is nullifying all the efforts made in the past.”
On the other side of the island, that is, in the three emergency rooms in Cagliari, the scenario is mirrored. Even the Santissima Trinità of the ASL of Cagliari has to deal with the closed orthopedics of Carbonia and Iglesias, and with the difficulties of the San Gavino garrison in managing emergencies: «In the last two weeks accesses have increased by 23 percent – says the head of the emergency room Anna Laura Alimonda – while for the first four months of 2024, compared to the same period in 2023, the increase in users who turn to us is 9.4%. The failure to filter local orthopedics, recently closed due to lack of doctors or technical problems, has a clear impact. Let’s not forget that traumatology represents 25% of emergency room visits. At Santissima Trinità the percentage of admissions to Orthopedics in the first quarter of 2024, compared to the same period in 2023, increased by 10%. And in the vast area of Cagliari there are several beds missing compared to the catchment area.”
In fact, during the pandemic, the Marino hospital in Cagliari, which housed the orthopaedics, was converted into a covid outpost. But in 2023 it was unable to reopen as an acute care facility due to lack of structural requirements, and its destiny is to be reborn as a community hospital. But without its 54 now abandoned beds, the Orthopedics places foreseen in the vast area of Cagliari have dropped from 132 to 78. A completely insufficient number, with negative repercussions on the main hospitals. At the Brotzu emergency room, the percentage of increase in accesses from 2020 to 2024 was 40%. The closure of orthopedic departments in the area has had an impact on Arnas with a percentage increase in the first quarter of 2024 of 15% more than in the first quarter of 2023.
The trend is also similar at the Aou Monserrato Polyclinic. The previous council had allocated almost 3 million euros to pay for additional services on a voluntary basis to orthopedists in the greater Cagliari area. In practice, 100 euros gross per hour to work overtime in the Carbonia department (now closed due to staff shortages), in order to bring the 18 beds to 30. But at the moment this stopgap maneuver has been frozen by the Todde administration. At present, therefore, the photograph is as follows: orthopedics in Carbonia, Iglesias, closed Nuoro, Oristano, Lanusei and Tempio which operate on a half-service basis, the garrisons in Cagliari (with saturated beds) which have great difficulty in hospitalising. Result: Brotzu’s fractured patient often arrives in Sassari, and Alghero turns into the terminal for Nuoro patients. The front door for the sick, of course, remains the emergency room, which continues to overflow.
«I am very worried – says Professor Pinna Parpaglia – because so far we are managing to hold on, but what will happen in the summer, when 10 million tourists will arrive on the island, and two thirds will be distributed between Nuoro and Olbia, in such a critical moment for these structures? It means that 7 million tourists risk converging on Sassari, which is already operating at the limits of its possibilities. I can strengthen shifts and motivate my staff, but the stress becomes unbearable. I fear the domino effect: all it takes is for one doctor to collapse, and the thread breaks.”
