Local hospitals and doctors who do not speak to each other cause 70 thousand improper hospitalizations in Sardinia. The average cost of each is 3 thousand euros and the calculation is easy to do: the waste amounts to 210 million euros per year.
The results are a study conducted at a national level, and with regional reports, by Fadoi, the Federation of hospital internal medicine doctors. It emerges that Sardinian doctors operating in the area consult with hospital workers for one in three patients, 34%. And in eight out of ten cases, patients arrive at the department without knowing anything about their health history, because the electronic health record is almost never updated: only in 13% of cases is the review constant and punctual.
Furthermore, one hospitalization in 10 is of a "social" nature: patients could have received treatment at home in the presence of a home care service or a family network able to look after them. On the island in one hospital in two the 20% of hospitalizations are caused precisely by the failure to take care of the territory.
There were many actions which, in the opinion of Sardinian hospital internal medicine doctors, could have prevented patients from staying in the ward. The data on the communication blackout stands out: for 62.5%, in fact, a greater relationship between the hospital and the territory is needed. For 25%, however, new homes and community hospitals would be enough, while another 12.5% indicate the solution to avoid hospitalizations in a greater offer of home care.
The electronic health record as a possible means of exchanging information has not taken off: local doctors, also due to bureaucratic cumbersomeness, explains Fadoi's report, are only able to update it in 13% of cases and the percentage of those who do so rarely reaches 60%. The maxi clinics of the future? According to 20% of white coats, interns will not be able to avoid the recurrence of hospitalizations and improper access to emergency rooms, while according to 47% they will only be able to have a positive influence if the reform is modified. For 47% of Sardinian hospital interns, first of all there is a need for a provision, which is still missing, which provides precise indications on which local professionals and how they should work in the new structures, while for 26% there is a need for rules that design the relationship between these facilities and the hospital. Finally, for another 20% common IT platforms are needed between hospitals and local structures.
«The reality described corresponds to what hospital internal medicine doctors evaluate daily in departments throughout Sardinia», explains the regional president of Fadoi Carlo Usai, «Failure to take charge of local services negatively affects all performance indicators, but above all contributes to inappropriateness in a setting that is absolutely unsuitable from a healthcare point of view. In this panorama, some hospital companies have equipped themselves with a dedicated service, such as the Hospital Evaluation Unit in the Aou of Sassari, a multidisciplinary team made up of a geriatrician and social workers who takes care of patients identified and reported by various hospital structures and plans the individualized care plan by activating the intra-hospital, extra-hospital health and social-welfare pathways in collaboration with the local health authority district and the Pluses».
