Healthcare, 75% of the Equipment is Obsolete
75% of the equipment of the national health system has exhausted its economic cycle (depreciation concluded) and is technologically behind. But as there is no money for investment, they continue to be used - indeed, underutilized, argue the authors of the OASI Report 2015, we presented this morning at 'Bocconi University, because, above all, the machines are too widely distributed among hospitals and end up getting off too long.
If the current expenditure of the health care system is equivalent to € 1,800 a year for every Italian citizen, the investment remains at stake, and is only 60 euro, within a framework which sees the close income statement for the third consecutive year, with a small surplus at the expense of an aggregated balance sheet of the individual local structures that compiled 33.7 billion euros of accumulated losses at the end of 2013.
"A debt of this size," says Francesco Longo, who worked on the report with Patrick Armenians, Clara Carbone, Francesco Petracca, Alberto Ricci and Silvia Sommariva, "unable to cancel the benefit of a balanced budget, because it is a harbinger of administrative appeals and civil cases, in addition to absorbing time and resources. Until a solution is found, the system is doomed to continue managing the past rather than the future. "
Public health spending is now under control. Between 2009 and 2014 it grew at very moderate pace of 0.7% per year, reversing a trend that had seen her grow between 2003 and 2008 of 6% per year. Even allowing for a longer period, from 1990 to 2014, the average growth of 4.2% per year is less than that of comparable items of the budget, as the pension fund (5.2% per year). Spaces to the rationalization of expenditure seem really exhausted and today the system already used too often tactics rationing (lengthening waiting lists, reducing the budget for accredited private) that are to the detriment of its efficiency.
"The real challenge of the system," says Longo still, "is a reorganization that will enable it to cope with the change in the epidemiology, which looks more disruptive is the growth of chronicity. The number of operational units, hospitals in the first place, must inevitably be reduced, for the necessary resources to the care of chronic and elderly. " At the end of 2013 chronic patients, in Italy, it was estimated at 18 million, 8 million of which pluripatologici.
TAB. The growth of chronicity in Italy (percentage of Italians declaring a pathology)
Allergic diseases Diabetes Hypertension Osteoporosis
2005 10.7% 4.5% 13.6% 5.2%
2013 13.7% 5.6% 17.3% 7.2%
Source: Based on Istat OASI
And, instead, measures are put in place institutional and aim to review the perimeters rather than redesigning services. From 2001 to 2015 an incessant process of public mergers has reduced the number of companies from 330 to 244 (-26%) and other major groupings are in sight, as the geography of the services and manufacturing processes of the industry is transformed to a much faster rate slow. Hospitals that provide benefits only for acute conditions are still 395, 35% of the total NHS, and half of them (198) have less than 100 beds, a threshold below which you may not have the structural endowment (technology and skills) and the series enough to respond adequately to the health needs in terms of safety and quality.