Homes Health and Home Care: Opportunities and risks - Catanzaro Informa

Into The NHS and, in particular, our Calabrian Regional Health Service are struggling with serious problems of sustainability. The aging population and increasing chronic degenerative diseases: you live longer, but from which there is no cure diseases (hypertension, diabetes, etc..) And you have to keep under control with medication. The new drugs, the result of advanced research, but also new tools for diagnosis and treatment are very expensive. The financial situation of our country does not allow to allocate more resources to health care. Indeed, it is a miracle if, as seems to have happened with the recent stability law, you can not cut even more health care spending.

Into The road is apparently de-sac: the costs increase, the money decrease. The easiest solution, but also the most unpopular and wrong, would be to cut performance. It is a road impassable because so serious penalize the most vulnerable people who are also the ones who are paying the highest price of the crisis.

Into The solution on which the other hand, at least in words, all converge (state, regions, industry organizations, patient organizations) is to reduce hospital costs that are very high (every day in hospital costs over 800 euro) and to focus on assistance and territorial home care, guaranteed by general practitioners, pharmacies, other players in the area, bringing health care to the citizens and at the same time cutting costs.

Into The answer on which bets have been placed are aggregations of general practitioners and home care, even in our area, is taking its first steps with the Home Care project. In essence it requires doctors to come together in a single surgery, also equipped with machinery and staff able to provide benefits for diagnosis and treatment, with a wide time, until you get to the famous H24, a service that is accessible 24 hours on 24. It also builds a system of socio-medical home care by forming ad hoc operators. It would seem the egg of Columbus to meet impossible equation + care – less expense.

Into Apparently it is the ideal solution. Rather than go to the hospital or the emergency room is the citizen in these structures calls, from time to time, UTAP, UCP or health houses, where they are treated all diseases that do not necessarily require hospitalization. The subjects dependents are cared for at home.

Into The opening in our territory of one of the houses of health and the start of the project Home Care, however, lead us to propose some reflections, but also constructive criticism, to ensure that these changes produce the desired results.

Into First of all, it should be considered that concentrate all services in one place is likely to leave the service discoveries entire areas of the territory. The people who live far away from the home health should still travel considerable distance to get even a simple recipe, which were previously going to the nearby doctor’s office and would not obtain necessarily your doctor but to turn.

Into Pharmacies which are likely to suffer significant damage from this evolution, because, as we all know, the patient is the first thing that doctor is leaving the studio to go to the pharmacy to take the medicines prescribed by your doctor. The nearest pharmacies to health houses would then be greatly advantaged, because they would have to serve more patients, and patients lose other important resources.

Into The risk, in essence, is that the territory, now widely served by doctors and pharmacies, undergoes a process of desertification. In fact, doctors would be induced to concentrate all the houses of health, pharmacies further from these facilities would ultimately impoverish further and could no longer provide those services that would be particularly useful in order to favor the process of de-hospitalization, and strengthening of community: home care, taking care of chronic patients to monitor therapies, improve the outcomes of care and reduce waste, reservation specialist visits and examinations by CUP, diagnostic tests in the first instance.

Into The fear is that the health houses do nothing but move, rather than help resolve the problem, benefiting some patients, but much more heavily penalizing others.

Into Similar considerations apply to the Home Care project which, if not integrated with the network of local services, general practitioners and pharmacies, is likely to be only a palliative and not really solve the problems of patients who are dependent. The only result is likely to be the creation of a structure in its own right, not able to give concrete answers to the multiple and complex needs of patients and their families.

these risks can cope with the pharmacy involvement in the processes of reorganization of community and home care programs, by giving them, in addition to dispensing of all medications, the task of delivering a series of performance first intervention in pharmacies and patients’ homes.

Into Thus pharmacies, which are so widespread throughout the country and thus can easily reach patients of their territorial area of ??reference, could serve as a first filter by responding to patients who require constant monitoring in ‘ assumption of therapies and small assistance, including medical checks and the other. This role, however, is delineated by the regulations on new services in the pharmacy and, in particular, by legislative decree no. 153/2009, which identifies the functions which the pharmacy can play in this area, providing a better service and lower costs for the NHS. This competitive advantage of the pharmacy in terms of quality and cost has recently been recognized by the Council of State upheld the validity and cost-effectiveness of the intervention of pharmacies, in this case, the distribution of principals for diabetics.

Into Thanks to the intervention of pharmacies, the houses of the health and other players in the area could focus on providing complex services, reducing the use of emergency and ensuring the diagnostic and therapeutic interventions that pharmacies could not provide. This would date an articulate response to a question of health of the population that is increasingly complex and, at the same time, it would be possible to control costs that are likely to become unsustainable. Everyone would have a clearly defined role, and create a efficient and widespread service network, without taking away anything to anyone and especially really putting the citizen at the center of the system.