The Challenge Is to Focus on Intermediate Care

ACCORDING TO GIULIANA BENSA, THIS IS THE WAY TO REBALANCE PUBLIC PRIORITIES AND PRIVATE NEEDS IN CARING FOR THE ELDERLY IN MILAN AND LOMBARDY

by Andrea Celauro
Translated by Alex Foti

Pursuit of economic sustainability and a better balance to achieve a more effective care of elderly and dependent pople. These are the two priorities of Giuliana Bensa, president of the Golgi-Redaelli institute for the care of senior citizens. She holds a Master of International Health Care Management, Economics and Policy from SDA Bocconi School of Management. She thus comments her predicament: "People right now either are overreliant on public hospitalization or resort to the private nursing home industry.” She manages the daily activities of a public health firm that counts 1,500 beds and 1,500 people working there, employees (85%), professionals and consultants (15%), and runs three residential facilities for senior citizens, one in Milan and two in the city's hinterland.
 
➜ What are the difficulties of managing facilities like yours, when the shareholders are the City of Milan and the Lombardy Region?
The main difficulty is how to best valorize the different activities of the instiution. Golgi-Redaelli has with a complex governance, constituted by a steering board, the equivalent of a corporate board, which is expression of two public shareholders whose goals do not always coincide. My role is to plan, manage and evaluate, no simple tasks in a public entity that, in addition to its institutional mission to care for the elderly, is responsible for administering a large estate, which also includes art works and historical buildings accumulated since the Middle Ages by Milan's charitable orders. As president, since the beginning I have focused heavily on the search for medium-to-long-term financial sustainability, and with considerable efforts, we have managed to meet the requirement of a balanced budget, despite having made several investements to renovate buildings for health and social purposes.
 
➜ Economic sustainability is not easily achievable..
Yes, public facilities like ours, that operate in the two areas of care for the elderly and intermediate care such as rehabilitation therapy, must pay more attention to the medium term. We would like to move more into intermediate care, both for economic reasons and because in recent decades we have developed a specialization in the field. In fact, I believe there is a need for a reorganization of resources toward intermediate care on the part of Region.
 
➜ Why?
Because today there are not enough beds for this kind of assistance to the elderly, who are forced to stay in the hospital, where the cost per patient is four times more. Reallocating resources toware intermediate care would make the system more effective and sustainable.  Also in Lombardy there are very qualified residential facilities to which the task of long-term care can be  safely entrusted, leaving us free to focus on intermediate care. Moreover, as I said, long-term care is now almost completely run by private operators adopting service models that are substantially different from ours.