The healthcare system in the Marche region is trying to raise the level with the entry into operation of the 15 Territorial Operations Centers (COT) financed with the Pnrr. The news was given during the press conference attended by the vice-president and health councilor Filippo Saltamartini, the undersecretary to the presidency of the regional council, Aldo Salvi, the director of ARS Marche Flavia Carle, the director of the Health Department Antonio Draisci and the general managers of the Territorial Health Authorities (AST) who operationally created and started the COT activity in the territory.
From the PNRR resources equal to over 2.5 million euros for the creation of the COT, which have the task of coordinating all the territorial activities of the districts, playing the role of ‘control room’ between the various actors involved in the network, with the aim of ensuring accessibility, continuity and integration of health and social health care.
The Territorial Operations Centers coordinate and optimize interventions, activating subjects and resources of the care network, organize and coordinate the care and transition of people residing in the district between the services and health professionals involved in the different care settings (territorial, health and social health activities, hospital, emergency network) and in the different organizational levels of the health, social health and social care system. The COTs, for example, are able to monitor the movement of patients from one place of care to another and from one clinical-care level to another, the availability of places in territorial or hospital facilities, and organize the Integrated Home Care (ADI) services.
Through the COTs, socio-assistance, social and health services and pathways are activated, and the transition processes of patients between hospital and territory, territory and hospital, territory and territory are managed. The 15 Territorial Operations Centers (COT) activated in the Marche are organized into two levels: 1 REGIONAL COT (COT-R) identified in a COT of the AST of Ancona and 14 DISTRICT COTs (COT-D). The Regional Territorial Operations Center is operational 7 days a week, 12 hours a day, extendable to 24 hours a day, while the 14 District COTs are operational 6 days a week, 12 hours a day and are closely interconnected with the Regional COT.
The Institutions
Undersecretary Salvi emphasized how “these structures are the real innovation in patient management: a control room that guides the hospital-territory care pathway. These structures will facilitate discharge from acute hospitals by finding an appropriate care placement. Another fundamental step will be the strengthening of home care”.
“We have created a system capable of coordinating all health services – said vice-president Saltamartini – a big step forward to overcome the deficiencies in the area of local assistance and waiting lists. The 15 COTs are all operational, not only from an infrastructural point of view, but also from a personnel point of view: each of these Operations Centers has the necessary staff to guarantee their coordination activity. We are working to guarantee healthcare that is closer to citizens and is also capable of providing answers to fragility and chronic conditions linked to the aging of the population. This new organizational model, which makes use of the most cutting-edge technologies to support the management and coordination of the various services, contributes to alleviating the pressure on hospital structures and reducing improper admissions, by networking professionals and services in a optimization logic. After having carried out a courageous and epochal reform for the reorganization of the Regional Health System and defined the strategies in the Regional Social Health Plan, we are giving concrete implementation to community medicine. We are starting to see the fruits of a healthcare system that is radically changing its face and from 2026, thanks to the investments made by this Council for the training of specialists, we will finally also have the doctors we were lacking until now due to the lack of turnover planning in the past”.
An additional 1,066,071.88 euros of PNRR resources finance an information system for the interconnection of COTs with other health services. Key figures in this new organizational model that intercepts citizens’ care and assistance needs are the District Director and the Nursing Coordinator, together with the nursing staff (from 3 to 5 units) and the administrative support staff (1-2 units).
The activated COTs
In the AST of Ancona there are two COTs in the capital: in via Cristoforo Colombo 106, one in Jesi in via dei Colli 52; one in Senigallia in via Campo Boario 4; one in Fabriano in via Marconi 9.
In the AST of Pesaro Urbino in Pesaro in via Vatielli 5, in Fano in via Quattro Novembre 63 and in Urbino in viale Comandino 21.
In the AST of Macerata in Macerata in largo Belvedere Sanzio, San Severino Marche in via del Glorioso 8 and Civitanova Marche in via Abruzzo.
In the AST of Ascoli Piceno the COT is active in Ascoli Piceno in via delle Zeppelle 84 and in San Benedetto del Tronto in via Silvio Pellico 32.
In the AST of Fermo there are the COT of Fermo in via Zeppilli 18 and of Montegranaro in Contrada Santa Maria.
The COTs active in the territory make use of a dedicated common technological IT platform, integrated and interoperable with the Regional Health System Companies and with the regional information systems, with the possibility of consulting the Electronic Health Record (FSE) 2.0. Telemedicine will also be implemented. The COT is accessed by health professionals, access or a direct request for activation by the citizen is not foreseen.
