Emergency room, 4 million avoidable visits according to Agenas. Local responses are (also) needed

In 2023 there were more than 18 million requests for urgent care to Emergency roomone million more than in 2022. 68 percent of patients (around 12 million) received the white code (not urgent) or green (minor urgency). Of these, according to the National Agency for Regional Health Services (Agenas), «about four million can be considered improper“, Therefore avoidableMeaning what there could be health problems resolved by the general practitioner, by the continuity of care doctor (former medical guard) or at the clinics in the area, without contact the emergency emergency facilities.

These are some data presented by Agenas during the event «Access to the emergency room and implementation of Ministerial Decree 77/2022 for better patient care».

How long does it take to reach the emergency room

In an emergency, getting to the emergency room immediately can make the difference and save the patient's life. According to Agenas' study, if the 99 percent of the population manages to get to the emergency room in 45 minutesgoes down to 94 percent the share of people able to reach, within 30 minutes, emergency services; it means that 3.4 million Italians are unable to arrive at the emergency room within half an hour.

This share of the population (5.8%), according to the Agenas study, could be reduced with the correct implementation of Regulation on standards for the development of home care (DM no. 77/2022), which identifies the definition of models and standards for the development ofterritorial assistance in the National Health Service, through the taking care of patients inside the new structures provided for by the National Recovery and Resilience Plan (Pnrr), such as Community Homes and Hospitals. In the Regions where the Decree has been implemented, Agenas points out, a improvement of patient care and more efficient use of healthcare personnel.

Standards not respected

According to Law no. 70/2015 «Regulation defining the qualitative, structural, technological and quantitative standards relating to hospital care»), the function of Emergency room is guaranteed within the emergency hospital networkwith structures of different healthcare and organizational complexity. Basic hospital facilities with catchment area between 80,000 and 150,000 inhabitantsI am emergency room location with the presence of a limited number of specialties. The number of appropriate accesses must be greater than 20 thousand units a year.
Level I hospitals, with a catchment area of ​​between 150,000 and 300,000 inhabitants, I am home to Level I Emergency Reception Department (DEA).which deals with pathologies of greater complexity. The number of annual accesses appropriate must be above 45,000.

At level II hospitals, with a catchment area between 600 thousand and 1,200,000 inhabitantsthere are the Level II DEAhome to reference disciplines for the networks of complex pathologies, such as Cardiac Surgery, Neurosurgery, Spinal Units, Transplant Center, Burn Center. The number of appropriate annual accesses And above 70 thousand.

Well, by comparing the accesses to emergency emergency facilities with the standards set by Ministerial Decree 70, he finds that Agenas study, around 75 percent of emergency rooms have a below-standard number of accesses. In 29% of cases, less than 15 thousand accesses per year are recorded.
First-level DEAs record a better performance.

The experience of the Cau in Emilia Romagna

During the event organized by Agenas, theexperience started in Emilia Romagna as part of the reorganization plan of the emergency-urgency network, i.e. the creation of the Assistance and Urgency Centers (CAU), distributed throughout the territory to respond, day and night, to urgent but not serious health problems. Since November 2023, approximately 120 thousand patients have been visited in the over thirty Caus already open.

For over 2,600 questionnaires compiled by the clients, it appears that for 85% of users the experience is judged positive or very positive; the waiting time they are judged optimal or adequate by 86 percent of the assisted. Following the soon activation of the Single European number for non-urgent careyou can call the number 116117: the operators will evaluate the patient's health needs and direct him towards the CAU or another structure more suited to his needs (including the emergency room).