On 13 April this year ended with a hearing in Senate Health Committee in a survey on the transport of the sick and the network of emergency and urgency involved with questions and questionnaires throughout the national health system including the Abruzzi.
And it is on the data for our regional reality that I want to discuss because, in the conclusion of the document in question, our region is often cited, almost always giving a really bad photo.
In what follows, I point with the Italian text excerpts directly from the document.
We start from data. In Abruzzo, 4 operating stations only 3 118 have completed the questionnaire ministerial, I'd love to know what the middle one that has compiled a document of such importance. Even with respect to the emergency room, called in the jargon DEA (Emergency Department and acceptance), only 14 out of 10 responded to this ministry.
But anyway we are in the media, bad news still to come.
The first anomaly, highlighted by the document, the number of DEA on the number of inhabitants. This index is a relatively rare bird in that, paradoxically, we seem to have too many emergency services. Finally, the document reads as follows:
"Compared to an average national per capita of DEA acceptable, seem justifiable little data on the catchment area of some in the DEA regional perspective. Namely: Tuscany is a DEA for 14,551 inhabitants, one for 14,773 inhabitants in Puglia, Abruzzo in a population of 20,000. Conversely, there are situations in Lombardy, where there is a DEA to 1,301,855 inhabitants and Lazio where a DEA is 1,200,000 inhabitants. "
The only thing that comes to mind as a justification to this index is anomalous that, in my opinion, does not reflect the reality that we are comparing the Abruzzi region with densely populated regions with sparsely populated areas. Process, such as a stock alternative to this data, not included in the document, but which I think is very representative and flip the view of the document. If we take the average of DEA per square km, we have:
- Abruzzo: a DEA every 768 sq km
- Lazio: a DEA every 594 sq km
- Lombardy: a DEA every 425 sq km
so if we look at the distributions of the DEA in the territory we see, on the contrary, that the DEA has much less of Abruzzo, Lazio and Lombardy, and then follows that an ambulance will take longer to reach a DEA Abruzzo Lazio and Lombardy. An index much more important than the number of DEA on a population that, for me, is greater than an index of economic efficiency of the health system.
But go on. 5.2% in the north of the DEA stated that it had the organizational requirements required by current legislation. In Abruzzo 20%.
On health planning in relation to the position of DEA on the basis of demographic, epidemiological ... Abruzzo, Sicily and Lazio have high percentages of apparent lack of planning. "
Average waiting time Triage / Visit: "We consider the allowable maximum waiting time of 100 minutes for the DEA in the North, while 451 minutes of waiting up for EAS in Abruzzo are objectively too many"
In Abruzzo, 50% of hospitals said not to follow procedures integrated disease.
Abruzzo claims not to have programs for monitoring and promoting quality given in 71.4% of DEA.
Same percentage for those who do not follow DEA Abruzzo specific procedures for coding standards and protocollid the patient assessment.
A negative note for the beautiful Abruzzo that in regard to guidelines for training and retraining of personnel, is not following a specific training in the 28.6 per cent of cases for the DEA.
In Abruzzo, in addition, 57.1% of the DEA, there are no procedures that involve the activation of hospital staff in emergency procedures.
With regard to an integrated network for the management of cardiac pathologies, Abruzzo has an unedifying situation: 42.9 percent of the DEA and 33.3 percent of the EAS do not.
The existence of a protocol for evaluation of chest pain, 50% of hospitals in the southern states not to follow a protocol for evaluation of chest pain. In particular, hospitals in the Abruzzo region reach tips of 66.7 percent.
With regard to the management of the transport of cardiac patients, the hospitals in the region Abruzzo declare the presence of procedures agreed in 57.1 percent ... sharing is rather more to the North.
The timing of diagnosis and treatment of acute ischemic stroke, Abruzzo registers 66.7 per cent of cases of non-compliance of the times, limited to the EAS.
In the management of major trauma, Abruzzo, Calabria, Campania, Molise, Puglia and Sicily shows more critical. And the criteria for the centralization of trauma maggioni for the Center is particularly complex situation in Abruzzo.
Regarding the organization for the transfer of trauma patients Abruzzo, Molise, Puglia and Sicily seem to have specific rules and, despite statutory holding specific documentation, it appears that about 20 percent of state facilities for such documentation is not present. A peak of 60 per cent in the South, with particular reference to Abruzzo who claims not to have specific documentation in 71.4 percent (DEA) and 100 percent (EAS) of the cases. The state is virtually non-performing relatively Abruzzo the use of management protocols defined according to different types of trauma.
With regard to the radio link between the operations center and emergency vehicles, Abruzzo, Tuscany, Campania and Sicily have the highest criticism.
About shared protocols with other institutions (112.113, Police Prefecture) is not acceptable that are not shared operating procedures, as in the case of Abruzzi, Calabria and Campania.
Issues of self-referenced testing and promoting quality of care in particular, Umbria, Tuscany, Piedmont, Abruzzo, Campania and Sicily.
About opportunities for verification of the activities, Sicily, Campania, Umbria, Abruzzo and Veneto in need of significant improvement in this regard.
Regarding the presence of a transmission system in ECG, Trentino - Alto Adige, Sicily, Puglia, Umbria, Campania, Calabria, Marche, Abruzzo have a very critical situation that requires prompt intervention.
And finally: the weak link in the chain of relief, however, is clearly and alarmingly-hospital level, with two fundamentally disturbing data: The average wait time of 241 minutes in the DEA, with the end of 451 minutes in the Abruzzo region, and preferential pathways for diagnostic testing for emergency department patients, almost non-existent, except for sporadic reality.
Very encouraging data that photographing a health Abruzzo fall behind and nearly always cited as a negative example in a number of questions performed.
If you want to read the whole document here it is below. Enjoy, and be careful not to rodervi the liver, these days, health should keep her baby, especially for us Abruzzo.
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