Waiting lists, the seesaw of prescriptions: twice as many prescriptions in Lazio as in Veneto

Those who live in Latium, Emilia or Apulia are prescribed on average almost twice as many examinations and examinations by their doctor as people from the Veneto, Tuscany or Liguria. For the former, every year there is more than one prescription (excluding those for medicines) for every inhabitant, including infants: a shower of prescriptions that is not entirely justifiable given that it seems unlikely that other countrymen need fewer check-ups because they are healthier. Are all these prescriptions therefore indispensable? The doubt is more than legitimate and one thing is certain: an excess of perhaps unnecessary requests for a CT scan, an MRI, an ultrasound or a cardiological examination - to name the most popular outpatient services - floods the system and thus lengthens waiting lists even further, the spectre of every Italian knocking at the health service.

The data from the flow of the health card, through which all SSN services pass, photograph a scissor that speaks for itself about the weight of so-called inappropriateness (unnecessary or even useless prescriptions). In Lazio in 2025, 1,569.5 prescriptions for visits and examinations per thousand inhabitants (practically 1.6 per resident) were recorded, compared to 889.7 in Veneto. Among the Regions at the top for the number of prescriptions - well above one per inhabitant - are Emilia Romagna (1,481.5 per thousand), Puglia (1,328.4), Umbria (1,319.3) and Abruzzo (1,229). Among the most 'virtuous' - those where doctors prescribe less than one prescription per inhabitant - are Veneto (889.7), Tuscany (916.4) and Liguria (966.3), while Valle d'Aosta (1,008.8) and Piedmont (1,020.1) are just above this threshold. "Twenty per cent of the visits and examinations requested in Italy are considered inappropriate. It is a prescriptive excess that costs about 20 billion a year,' Health Minister Orazio Schillaci reiterated in recent days. He has made waiting lists his number one priority, and after having had a decree approved two years ago that intervened, not without some difficulty, on the supply of care - from the opening of clinics at weekends to the overtime of health personnel - he now wants to try to put the demand for care in the crosshairs, which, as the data of the Regions show, is not always appropriate.

Of course, the numbers do not explain everything: from the weight of the large cities where more prescriptions are prescribed, perhaps with prescriptions that arrive by e-mail after sending a text message to one's doctor, to the fact that many Italians go to the private sector, but still have the prescription made to have the service reimbursed by the health funds. This is a point on which the ministry's technicians would like to clarify. But there is no doubt that, like a bull to be taken by the two horns, the answer to waiting lists cannot only be to increase supply, but also to govern demand. Hence the ministry's push with the Iss, which is currently publishing some twenty guidelines and good practices for the most requested examinations and tests (see Il Sole 24 ore of 14 April); these are indications that doctors should follow in order to prescribe better.

This is a moral suasion to which we must also associate more targeted controls and possible inspections: in the next few days, in fact, the Ministry's Health Care Control and Verification Body - envisaged by the government decree - will be set up to monitor waiting lists and intervene where there are bottlenecks or major anomalies. But a big hand will also be lent by the launching of the National Platform on Waiting Lists, which, barring new setbacks by the regions, will begin to publish data on waiting times for each individual service from mid-May. By cross-referencing waiting times with the incidence of prescriptions, it will be possible to understand, for example, where there is a problem of supply - where the waits are long but the incidence of prescriptions is not high - or of inappropriate demand with many prescriptions and long queues. Minister Schillaci will start talking about this and above all about the involvement of family doctors in the Community Homes with the regions in a meeting scheduled for tomorrow.