Wheelchairs and walkers: 8 out of 10 patients in difficulty and 63% pay out of pocket

More than 8 out of 10 patients (84.8%) experience difficulties in obtaining aids and prostheses through the National Health Service, while 63% have incurred personal expenses to obtain or use them. This was revealed by two surveys conducted by the Confindustria Medical Devices Research Centre and promoted by Aito (Italian Association of Occupational Therapy) in collaboration with 13 other industry associations on patients/caregivers and prosthetic care professionals, which highlight widespread critical issues, but also a positive finding: 84.8% of patients say they are satisfied with the aid they received. The survey is presented at Expo Sanità in Bologna. For the president of the Aids Association of Confindustria Dispositivi Medici, Elena Menichini, the data demonstrate "the need to intervene on the Nomenclator, review the aids put out to tender, and ensure uniformity throughout the territory by simplifying processes".

Among the main difficulties reported by patients in obtaining an assistive device are long waiting times (56.5%), complex bureaucratic procedures (51.1%), while 65.2% state that they feel uninformed about the possible solutions available.Despite the fact that almost half (47.8%) carry out a prior assessment with health professionals, in 54.4% of cases the device has to be modified once received. In addition, 70.6% of patients experienced that useful accessories or adaptations were not covered by the National Health Service at least once.

The aids considered mainly include preventive and therapeutic devices (such as anti-decubitus pillows and ventilators), orthoses and prostheses, mobility aids (wheelchairs, walkers), static aids and personal care and hygiene aids.

Health professionals confirm the structural difficulties of the system. 77.5% believe that the current Nomenclator (DPCM LEA 2017) only partially allows for real customisation of aids, while 93% report inconsistencies between technical descriptions and the devices actually available. Among the main issues related to the Nomenclator: inadequate tariffs (61.8%), absence of devices or components used today (60.3%), technical errors or ambiguities (41.9%) and presence of obsolete aids (31.8%).

The tendering procedures for "near-made-to-measure" aids represent a further critical issue: 78.7% of professionals report operational or clinical problems, with effects on the reduction of choice (49.8%) and quality of available products (49.4%), time and complexity of procedures (37.5%). Almost 70% believe that tenders have had a negative impact on the quality of the aids provided, while the use of economic integration at the expense of the patient represents an obstacle to the appropriateness of supply.