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The money for home care is there but the doctors (and the Regions) are not

The money for home care is there but the doctors (and the Regions) are not

The Pnrr has allocated 2.7 billion for home care, however not only is there a lack of staff but half of the Regions have not done their homework and achieving the goal of reaching 10% of over 65s at home by 2026 seems really an impossible mission. All the details

The home as the first place of care and telemedicine. This is the title dedicated to the chapter on home care provided for by Mission 6 – Health of the National Recovery and Resilience Plan (Pnrr), to which more than 2.7 billion are allocated, in addition to the 280 million for the territorial operations centers (Cot ) and 1 billion for telemedicine.

A tidy sum to spend between now and the next four years to bring home care to 10% of the over 65s – almost 1.4 million Italians. Today only 400,000 people benefit from it.

But where are we?

WILL IT BE A FLOP?

Given all the difficulties facing the National Health System (NHS), for Il Sole24Ore the mission risks being a flop. The refrain is always the same: there is a shortage of doctors, who run away from the few contracts of public structures preferring cooperatives which transform them into token holders , but even those who would like a permanent job often collide with the hiring ceiling, which sets a limit to number of permanent contracts.

Not only. With regards to the use of Pnrr funds, the economic newspaper states that "only a dozen Regions are in compliance with the accreditation which could open the doors to private entities and cooperatives which have already been protagonists of the Adi for years (the assistance integrated home care)”, a service for people of all ages with one or more chronic diseases or a terminal medical condition that requires continuous and highly specialized professional health care.

CONDITIONS FOR OBTAINING FUNDS

However, explains Il Sole , the disbursement of resources is linked "to the achievement of intermediate objectives of the assisted population – year by year – until mid-2026 (expiration of the Pnrr) when the target of 10% of over 65s treated at home".

"And so – the article continues – already in 2023, in order to have 50% of the resources allocated for this year, the Regions will have to demonstrate that they have added 296 thousand over 65s more cared for at home – from 41 thousand in Lombardy to 1,391 in Molise – and next year as many as 525,000 up to 808,000 in 2026”.

WANTED NURSES

But even if mission impossible were to be achieved, there is no shortage of nurses who would play a key role in home care. According to Il Sole , 70,000 are missing and the number of enrollments in university courses continues to drop since it has become a profession that no longer attracts.

WHICH REGIONS HAVE DONE THEIR HOMEWORK AND WHICH NOT

As anticipated, half of the Italian regions have not implemented the Agreement "which on 4 August 2021 had set the requirements for the accreditation of home care to public and private operators, in implementation of the 2021 Budget Law", says Il Sole , where we also read that “at the moment Lombardy, Sardinia, Puglia, Calabria, Abruzzo, Lazio, Umbria, Piedmont, Sicily and Basilicata would have done it. With Veneto, Emilia and Tuscany which have opted only for accreditation within the public service”.

But only three – Lombardy, Lazio and Sicily – are well advanced in the implementation of this new system.

WHAT SCHILLACI SAID

“The investment envisaged within the Pnrr pursues the objective of increasing the volume of services rendered in home care until, in line with the best European practices, by 30 June 2026, 10% of the population of aged over 65, compared to the current average of around 5% for the various Italian regions. The national average level of the value of 10% to be achieved with the contribution of all regions or autonomous provinces will take into account specific regional difficulties,” said Health Minister Orazio Schillaci.

“In recent days – he added – I have started the work of a table to address the critical issues that have been registered for some time for the activities of the Emergency Department. It will be my care to keep you informed of the outcome of the work”.


This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/i-soldi-per-le-cure-domiciliari-ci-sono-ma-i-medici-e-le-regioni-no/ on Thu, 19 Jan 2023 06:15:25 +0000.