Fewer waiting lists if specialists are networked
In order to reduce waste and inappropriateness, it is essential to redefine the organisational model of multi-chronic patient care
3' min read
3' min read
In July, the amendment of the National Plan for Chronic Diseases (NPC) broadened the range of diseases considered - also including obesity, endometriosis and epilepsy (i.e. an additional 8 million Italians) - thus bringing the number of diseases to which specific diagnostic-therapeutic pathways (Pdta) are to be dedicated to 13. Without adding resources, as in the first version of 2016, the update risks remaining on paper. Yet the document is necessary to improve care for the chronically ill, a group that absorbs 80 per cent of healthcare costs between home and hospital care. We talk about it with Riccardo Candido, president of the Association of Diabetes Physicians (Amd).
"It is clear that investments are needed, but first of all it is essential to define the organisational model of chronic diseases. Until now we have tried to give answers to chronic diseases using the healthcare models of acute diseases, confining specialists within hospitals, and this has always been the problem of fragmentation and the fracture between hospital and territory. Secondly, if the model is organised, therefore virtuous, it reduces a series of wastes, starting with inappropriateness'.
So also the waiting lists?
In virtuous realities inappropriateness linked to waiting lists is 30%, rising to 60% in less virtuous ones. Therefore, if we think we can solve the problem of waiting lists by reducing visit times or by opening on Saturdays and Sundays, it means that we have not understood how chronic conditions should be organised, and especially multicronic conditions, which are progressively increasing with the ageing of the population, and already account for around 30% of chronic patients. They are patients who place a greater burden on the SSN than others, not only in terms of health and healthcare, but also in terms of expenditure. And even though the chronicity plan is a step forward, it places little value on both multidisciplinary interventions and the organisation of the care of these patients'.
On the subject of multi-chronicity governance, what is the virtuous model?
