An increasingly elderly population to be assisted, skyrocketing bills, the rubble left by Covid with arrears of care to be recovered. And also a reform of the Health Trusts still to be fully operational, as well as hospitals to be transformed into community facilities. The approval of the 2023-2025 multi-year budget for the manager of Asl 8, Marcello Tidore, becomes an opportunity to outline the challenges for the immediate future and list the critical elements to be addressed.
Something of no small importance, if in the report attached to the tables full of figures the general manager states that it is necessary to "radically rethink the institutional models, the organizational structures and the needs for skills and professionalism of the various branches of the administrations that operate in the social healthcare".
The demographic picture is the factor that affects the most. The inhabitants of the Cagliari district went from 548,912 in 2020 to 545,190 in 2021. 64% of residents are over 40 years old.
“The progressive and tendential aging of the population has important repercussions on the costs linked to health care”, writes Tidore, “and it is amply demonstrated in the literature that the population groups under 50 have average costs of around 1,120 euro/resident while the over 50 have average assistance costs of 4,750 euros/resident”.
The demographic and epidemiological transition of recent years have "redesigned the structure of needs and demand. In fact , the transition from predominantly acute pathologies to situations of widespread chronicity has gradually fueled ".
Meanwhile, surgical admissions fell by 31%, while those in the medical area (especially due to the virus) grew by 18%. It means that the interventions have not been carried out.
In 2022, the ASL dedicated itself "to the resumption of company production processes", or at least it tried, "with the provision of hospital assistance and specialist outpatient services, compatibly with the current epidemiological situation".
Into this scenario are grafted "the heavy economic consequences linked to the energy crisis which significantly affect the sustainability dynamics of the health system, as amply set out in the document drawn up by the Health Commission of the Conference of Regions and Autonomous Provinces of 7 November".
For this reason, according to the manager, it is necessary "to provide for the adaptation of the organic structure of the Isili and Muravera Hospitals, so that they represent a point of reference in the Emergency-Urgency network, enhancing the assistance function". Furthermore, also through the conversion of Binaghi and Marino into community hospitals, with the funds of the Pnrr, proximity healthcare must be strengthened.
And "the provision of social and health services that are as close as possible to the citizens' living and working places" must be strengthened. But it is also essential to "reactivate the lines of activity relating to the main cancer screening programs such as breast, colorectal, uterine cervix". At least there is a plan.