It is a homogeneous map that emerges from the Regions on the ticket for the white and green code services, non-urgent cases, in the Italian emergency rooms. On average the 'tax' is 25 euros, in line with the national legislation envisaged by the 2017 decree which opened up tickets. However, it can also reach 50 euros if diagnostic tests are also carried out during the stay in the emergency room. However, the priority code, or color, is attributed at the end when the patient is leaving and not during triage. If a white code is confirmed, and there are no exemptions, the patient will then have to pay the ticket.
White code tickets in the emergency room, how much does it cost region by region
In Piedmont the ticket is 27 euros; in Lombardy 25; in Liguria it starts from 25 but can reach 36.15 with an additional diagnostic service. In Veneto it is 25 euros as in Valle d'Aosta and Friuli Venezia-Giulia. If you go to an emergency room in the autonomous province of Trento, a white code varies from 25 to 75 euros if there are diagnostic tests. In Bolzano it is 25 euros and 12.50 for dependent children.
The Emilia Romagna project
Emilia Romagna has instead launched a unique and innovative emergency-urgency project: in every province they are opening the Cau, the assistance and emergency centres, where citizens with urgent but less serious problems will be taken care of and treated. Precisely the white codes that end up in hospital if they don't find an answer from local medicine. There are already over 30 thousand accesses in the first 19 Cau – confirmed by the Region to Adnkronos Health – The centers include an adequately trained medical and nursing team.
Returning to the map, in Tuscany the ticket can reach up to a maximum of 50 euros based on income. In Umbria it is 25 euros, as in the Marche where, however, the clinical evaluation and any tests are also included. In Lazio the ticket is 25 euros, in Abruzzo also but with exams it reaches 36.15. Going towards the South, in Campania, Puglia, Sicily and Basilicata the ticket is 25 euros. In Calabria also but it can reach 45 euros if there are specialist services. Finally, in Sardinia it is 25 euros for white codes and 15 for green ones.
But do tickets really serve to avoid overcrowding?
“There is no precise and detailed framework on this mechanism, each region decides a tariff and does it in its own way. What we can certainly say is that this measure absolutely does not avoid overcrowding in emergency rooms. Paying 20-30 euros is not certainly a deterrent, because they are often not paid and it is up to the company to recover them but above all because there are so many exemptions”. Thus at Adnkronos Salute Fabio De Iaco, president of Simeu, the Italian Society of Emergency Medicine, rejects the request of the doctors in Tuscany who have asked the Region to reintroduce the payment of the ticket for the white and blue codes to avoid the overloaded with the flu and Covid.
But why doesn't the ticket work in the emergency room? “It is a fact that there are various problems – replies De Iaco – There are many disputes, people who protest about the assigned code, others who highlight how they left an emergency room with a white code then went to another hospital and they received a different color. There are those who perhaps have waited many hours and don't want to pay.” There is a fundamental step in this mechanism: the code is not given when a patient enters the emergency room but upon exit. “There is a doctor who subjectively decides whether the person in front of him has a white or green code – explains President Simeu – it is not the triage that establishes it, it is in fact a severity code that is given at the end and often many colleagues, in order to avoid hassles, decide for a green code and not a white one, for example”.
In short, the ticket in the emergency room becomes an obstacle game. Where between exemptions, the 'ballet' between white and green codes, and then the receipt only after the person is leaving, means that few people pay. “In Piedmont where I work it's 27 euros, can it work? I don't know, maybe to raise cash yes but to avoid chaos and queues no. I don't think it can be increased to 50-100 euros for a moral question given that we're talking about public service – he warns – Another reasoning could be to also associate the name of the treating family doctor with the white code. It seems to me that they have experimented with it in Veneto. But – he concludes – I imagine this could raise quite a hornet's nest for local medicine” .
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