expathealthinsurance: Cittadinanzattiva. Pit Health 2013: "Less health care for all. Now is ...

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July 16 – waiting lists, tickets and access to services more difficult. This is the image of our National Health Service as it emerges from the sixteenth PiT Health Report of the Tribunal for Patients’ Rights-Active Citizenship, presented today in Rome at the Ministry of Health. “Less health care for all, the reform creeping” is the title of the report, which after years of medical errors accounted problem felt by most people, this year sees just as the first entry that access to health services (18, 4% of the total of 27,491 reports of 2012).
About 12% of the reports received by the PiT Health, in 2012, covered the costs borne by the public to access some health benefits. The economic situation in our country has taken on a particular gravity because of the failure to detect stimulus measures and pushes innovation and growth. If the citizen yesterday resigned to the need to pay to make up for a lack of servic e, suspended or untimely, today I surrender.

“The picture that emerges shows that the NHS public, universal, fair , as we have always known, today, unfortunately, is a distant memory, “said Tonino Vinegars, coordinator of the Tribunal for Patients’ Rights-Cittadinanzattiva and head of the National Coordination of Associations of the chronically ill. “To those who say that we need to rethink the concept of universalism (ensuring everything to everyone), we say that what has already been achieved in practice through a reform of” non-formal “, on which neither the public nor health care providers and all other stakeholders were invited to have their say: practically a real reform “creeping” he added Vinegars.

L ‘ access to medicines is the scope most burdensome in economic terms and was reported by the citizens in 25.7% of cases. As for the drugs in group A citizens are forced to pay a greater price difference between the generic and the designer. Patients, especially those suffering from chronic and rare, they must pay out of pocket in class C drugs, arriving to spend on average € 1127 per year, or parafarmaci (1297 euro), despite the fact that for their indispensable and irreplaceable, and I must make use for a lifetime.
expenses for benefits in intramural (24.4%) appear at the same excessive manner to citizens, however forced to support them to be able to respond quickly to the needs of care that the service public is not able to meet.

The weight of the ticket diagnostic and specialist (16.3%) is the third sector reported as unduly burdensome in terms of economic and is becoming a real barrier to care. From the photo taken from CENSIS at the Welfare Day, in fact, more than 9 million Italians have complained that they can not access some health care they needed due to lack of money. Of these more than 2 million are elderly, 5 million live in couple with children and 4 million reside in the South of the country. Furthermore, a study of Agenas showed the decrease of 8, 5% of benefits provided to load the NHS: the reduction is distributed across all areas, but more marked in the laboratory tests. In the segment of the population that has no exemptions for either income or per disease (which corresponds to about half of those who make use of specialist services), the figure reached 17.2%. This suggests that a part of the citizens, given the increased costs of the services of the NHS, has d ecided not to request it or give it up altogether or purchasing by private (or intramural).
If then in a family is present an invalid or an elderly person there really is nothing to worry about: residential exorbitant costs (7.6%), for which citizens come to pay an average of € 13,946 per year. The care allowances deleted or non-existent, and inadequate home care force families to turn to private caregivers, resulting in a considerable increase in costs that comes to an average of about 8,488 Euros per year.
Regarding the prosthetic assistance and Statements (6.9%), citizens are forced to pay an average of up to 944 Euros per year for products of acceptable quality or quantity.
Today, citizens have free access to innovative devices, personalized and quality if not paying their own figures really high. If we look at people with a stoma for example, are forced to use quality devices really lacking, with a heavy impact on the health, quality of life, without considering the additional costs entailed for the NHS.

waiting lists. The difficulties inherent in long waiting lists for access to examinations, visits and surgery are the first entry (74.3%), the increased use due to its all’intramoenia excessive time in public (15.4%) and the unsustainability of the cost of the tickets (10.3%). 37.2% of reports focused on diagnostic tests, while 29.8% referred to specialist visits. Another significant part of the reports (28.1%) focused around the demands of hospitalization for surgery, while nearly 5% represents access to cancer treatments such as chemotherapy and radiotherapy.
“We are front of an inaccessible Health Service, which decides who to heal using the chronological order (impossible to get sick at the end of year, namely ‘first come first served basis’) and territorial. A selection made by a cut made through the National Health Fund unprecedented, amounting to over 30 billion euro in 2013-2015 with retroactive effect, however, wi th all that that entails, “he added Vinegars. “A longer made directly paid with the money of the citizens, obliged to bear the increasing costs or care to give it up, and replaced by its support of families, real pillar of the welfare system, in respect of which the state has implemented a real and proper care proxy. “
As part of the diagnostic tests, on average, expected more for the performance of radiology, as evidenced by the 24% of reports in 2012 (15.4% in 2011). It is a given on the rise, which emphasizes the annosità the problem. Here are two very sensitive areas, oncology with 17.5% (20.4% in 2011), and gynecology and obstetrics with 13.6% (14.3% in 2011 were). The values ??of Cardiology and Gastroenterology remain substantially unchanged, respectively, with a 9.8% and 9.7%. For the specialist is actually the eye to be reported as most at risk and alone accounts for about a quarter of reports (25.6%, whereas it was 18.5% in 2011). The cardiol ogy visits, with a figure which is also equal to 25% of the total (the value was 11, 5% in 2011), are another area of ??discomfort, together with those orthopedic (since 2012: 15.1%; since 2011: 17%). It is striking still have to count the oncology signaling between objects, a figure of 9% (consistent for 2012 and 2011) is not yet guarantee the timeliness which is necessary for such a delicate. For surgical procedures, citizens have reported, for 2012, excessive waiting for orthopedic procedures (24.7%), oncology (16.4%), general surgery (13.7%, but was 8% in 2011 ) and urology (10.3%, 14% in 2011): in the first case the value is lowered with respect to the detection 2011 (was 29%), increased in the second case (it was in fact equal to 14%).

alleged malpractice. 17.7% of people (16.3% in 2011) will appeal to the Tribunal for Patients’ Rights-Cittadinanzattiva cases of alleged medical error, with a decrease than those relating to alleged errors diagnostic and therapeutic (62.7% of 2011.57% in 2012).
The greatest number of reports of alleged diagnostic errors is found in oncology, with 27, 3%, which is a slight increase compared to 26.5% in 2011.
The second area is the most reported orthopedics, which amounted to a 14.3%, and to follow the area of ??gynecology and obstetrics with 9.1% of reports.
Instead, with regard to medication errors, orthopedics continues to be the area with the highest number of reports (32.1%), an increase over the year in which we recorded the previous 23.1%. Follows the general surgery, with a 11.2% and the gynecology and obstetrics with 8, 2% of cases.
Increased by a lot of the reports regarding the condition of the health facilities, r ising from 15% in 2011 to 23 % in 2012. It is a worrying fact, since last year we even recorded a slight decrease. The poor hygienic conditions could facilitate the emergence of infectious diseases: Italy remains one of the best healthcare systems in Europe, in terms of access and services offered, and it is unthinkable that citizens marker dilapidated structures and devoid of the minimum standards of hygiene . We must ensure both acceptable reception conditions is access to adequate medical care
reports about the carelessness of healthcare workers, as all those activities that, while not having caused damage, are unsuitable and potentially risky procedures, remain almost unchanged and are still a significant percentage of the reports in this area (12.1% in 2011, 12.5% ??in 2012).
One of the areas where there are instances of malpractice appears to be also the use of defective implants. This is 3.4% of the cases, in particular related to breast implants and hip r eplacements.
“It is imperative, now more than ever, in order to guarantee the ‘social cohesion’ of our country, Replace battery in the center of the bar between equilibrium and rights. It is clear that this relates primarily to a choice ‘policy’, which mackerel from the idea of ??the unsustainability of our NHS (produces more than 11% of GDP and absorbs only 7.1%) and instead points to adequately support compared to the real needs, “said Vinegars.

Let’s talk about support area (15.3%). It is a complex field, due to the high number of figures of reference and intervention, offices and procedures that sometimes it is necessary to activate to achieve the required performance. The comparison between vintages can also note a substantial balance between the values, with differences not exceeding two percentage points, except in the case of rehabilitation, which rose from 16.9% in 2011 to 13.6% in 2012, or voices that keep the same incidence of reports (such as Residential Care, with 18.3% in both 2011 and in the following year). Therefore, improve the basic primary care services (which are mostly of the General Practitioner, Pediatrician of the free choice and the Guardia Medica), 25.9% in 2011 and 23.4% in 2012, while keeping a trend downward for mental health services (15.5% in 2011, rising to 17% in 2012, confirming the difficulties of organization in this area). Most problematic is also getti ng the home care services (in 2012 value of 16.4%, was 14.3% in 2011), as well as the prosthetic assistance and Notes, which provides an increase in reports from 9.1% in 2011 11, 3% in 2012

There are many other items affected by the PiT Health Report. Among these, we point out aspects Humanization of care (3.8%).
In the reports there is a prevalence of rude attitudes toward patients (over a third of records: in 2012 the value is 31.5%, down from the 2011 figure, 36.6%). Followed by neglect (30.2% of the total, in 2012, an increase over the previous year, with 25.9%) and abuse themselves (14.8% in 2012, 13.4% in 2011). In 11, 3% of cases, moreover, it is difficult to receive by your health care information about their state of health (the figure was 9.8% in 2011), or are recorded incidents of violation of the right to privacy ( 5% is the data for 2012, 6.3% in 2011).

These are the main proposals of the Tribunal for Patients’ Rights-Cittadinanzattiva:
– Stop further cuts to the National Health Fund
– Update the essential levels of care (Lea) implementing the provisions of art. 5 of the Decree Balduzzi: review lists of chronic and rare exempt, revision of Tariff Nomenclature of the prosthesis;
– Act in a systematic way to govern the waiting lists, starting from:
– Updating the Plan Government of waiting lists expired more than a year
– Management of agendas for hospital admissions more transparent, promoting networking and centralization of related information;
– Transparency and consultability for all citizens of waiting times real (and not just the maximum time) for visits, tests, hospitalizations and day surgery indicating them on its website, in a special section called “waiting lists” (extensive application of the Decree 33/ 13);
– Provide the discretionary policy only within a rigid frame of certified skills, not only in the appointment of General Managers of ASL but enlarged to managers of agencies and public bodies that deal with health care anyway.
– Involve organizations of citizens and patients, shareholders and users of the NHS: for the approval of the New Covenant for Health that will track the health for the coming years and the eventual process of reform of the system of ticket.