Italian Health Service, midway between collapse and modernity

 National Health Service, known as Servizio Sanitario Nazionale (S.S.N.) is hard to comprehend for those who are not Italian, or live outside the borders of this beautiful country. Once a crown jewel of Italy, often taken as a comparison by other countries for its undisputable efficiency, in the last decades it has, unfortunately, shown all its defects and flows. A wrong sanitary politics, along with (maybe) unnecessary cutouts, have deeply affected the quality of services, even if, on a general basis, it still maintains a high quality standard.  Let’s see how it works.

Global sustainment for population

Every Italian citizen enjoys the right of a global sanitary assistance, guaranteed through Art. 32 of the Italian Constitution, which enshrines “the right to health” of all individuals. It provides equal sanitary assistance in terms of visits, furniture of medicines and hospitalization, both in public or privately accredited structures.  The possibility to move from one region to another to choose the best treatments is a valuable extra, and making no difference from employed and unemployed.  A point of honor of National Health Service is to also provide equal assistance to all immigrants living on italic soil. All patients are equally treated. 

Examples of excellence

All throughout its territory, Italy boasts some excellent public research structures, as well as hospitalization institutes, well-known even outside borders for their values and capabilities, over-the-top advanced machinery, as well as internationally-acclaimed doctors; here are some, from north to south:

·       Centro Cardiologico Monzino, the first and only European hospital completely devoted to heart diseases only, with the most innovative therapies, prevention and the most advanced researches, with an excellent e-medicine service (Milano).

·        Istituto Europeo di Oncologia (I.E.O.), directed by Italy’s primary Oncologist, Dr. Umberto Veronesi, home of continuous international study exchanges with worldwide-renowned oncologists, in order to develop, care and assist Italian and foreign patients in the diagnosis and treatment of cancer (Milano).  

·       Ospedale San Matteo, best transplant structure in Italy, as well as haematological research center, where, following an international exchange project, children from Chernobyl were welcomed to be treated (Pavia).

·       Spedali Civili, the ones discussed by stamina therapies, results as excellence in oncology and cardiac surgery (Brescia).

·       Ospedale Sant’ Orsola, crown jewel for medical assisted conception (Bologna)

·       ISMETT - Istituto Mediterraneo per i Trapianti e le Terapie ad Alta Specializzazione, born in 1997 thanks to the partnership from the Sicilian region (hospital Cervello) and the University of Pittsburgh Medical Center - UPMC (Palermo).

North is not south

Unfortunately, a trip to Italian hospitals has not always a happy end. Northern hospitals are generally known for their efficiency, which translates in short-terms waiting lists, the most innovative treatments and, sometimes, even better doctors. Statistics say that a patient has double chances to be better treated in northern hospitals, than in any other region.

There’s an excellence resisting, beside everything, that is the San Raffaele hospital, in Milan, even plagued by scandals and debt, is still the best Italian hospital for quality of care, as well as Niguarda, for its excellence in cardiovascular surgery and intensive care treatments.

Rome, the capital, doesn’t not shine for efficiency, for it is quite given for granted that a passage to emergency rooms can last up to several days, with patients waiting to be examined left alone in waiting rooms in less than manageable conditions, often encamped all together, with no distinction between men and women, in a sort of awful mess. And where dignity is, therefore, not always preserved. Gemelli hospital, where the Pope is usually hospitalized, is a clear example of roman inefficiency.

Things go from bad to worse if we move to the bottom of the boot. 

From top to bottom, six hundred and fifty kilometers to the south, you come in Campania with the Federico II of Naples, still Italy’s biggest hospital, until not so long ago the pride of the city. Now at minimum terms, it has closed departments of ophthalmology and plastic surgery, and up to now they have never reopened.

It is a structure with 2500 employees, including medical staff, 140 temporary workers, but still understaffed by 800 units.

Sicilian hospitals are in an even worse situation in terms of understaffing, with the worst ever quality of care.

General considerations

In the Italy of reliable structures and black holes, where resources are slim, the and widespread waste, Lombardy, Tuscany, Veneto, Piedmont and Emilia Romagna, are able to provide adequate care, even among ups and downs. And then there are the Calabria, Sicilia, Lazio and Campania, where the situation is below the acceptable level. 

Especially in Campania, where in some hospitals the data on the mortality of patients are alarming. Agenas, l’Agenzia Nazionale per I Servizi Sanitari Regionali (National Agency for Regional Health Services), published a research on “outcomes” of health of 2012, based on discharge records. The 1440 Italian public and accredited private hospitals were ranked on the basis of forty indicators, ranging from death from heart attack, as for cardiac surgery or stroke, as to name ones.

In practice, it is an X-ray of the quality of care. The agency has taken into account, for all indicators, the structures of all Italian regions, that were the average, or above, or below level. It turns out that the best for healthcare quality is Tuscany. E-medicine is taking a fast step forward in most northern hospitals, especially in cardiac sectors. Within a few years, it is hoped to be widespread in all regions, from north to south, where digitalization is still to be improved on a large basis.

Besides, a note is to be mentioned as far as the many private insurances providing full-spectrum assistance, to cover lacks of sanitary system, nowadays more and more on the market to cover black holes of the National Health Services.

Conclusion

National Health Service is at a point of a new step, providing more and more efficient services, being an example for other countries for its worldwide recognized excellences, with new technologies helping population in a better standard of life.

Article Authored by Sonia Russo : sruss@hotmail.com

Source : Agenas - 2012