Salutequità, Report on health status after 8 years, lights and shadows

“After 8 years of ‘absence’, the Report on the country’s health status is back on the scene, just published on the website of the Ministry of Health”, which presents “lights and shadows” of our system with respect to the various “open issues” in health. Tonino Aceti, president of Salutequità, underlines this in a note analyzing the ministerial document. The last report was “dated 2014 and referred to the previous 2 years. This relates to 5 years (2017-2021) and was published in 2022, although in the premises of all editions it is clearly written that the report is , for the Government, Parliament and beyond, ‘an essential component for the planning and programming of the National Health Service’ “. “The publication of the report is undoubtedly positive – remarked Aceti – which allows for an indispensable overview of the National Health Service to address critical issues such as inequalities in assistance. But leaving official documents such as these behind for so long – he specifies – affects the correct planning skills, from the financing of the NHS to health personnel, to other priority issues. Satisfaction for having found in the report the prospect of updating the indicators of the New Lea guarantee system, a priority that Salutequità has addressed and brought to the attention of the ministry of Health and Regions with a specific Gap Analysis “. Now, however, “it is also necessary to publish the data (with regional detail) on the Lea 2020-2021 guarantee, those on the state of implementation of the regional plans for the recovery of waiting lists for which the Government has committed over half a billion euros, and approve the tariff decree for the implementation of the New Lea of ​​2017 “, urges Aceti. The report just published “deals above all with the issues open in recent years, such as the renunciation of care and the new Lea guarantee system, widely addressed in the Salutequità reports”, continues Aceti, which highlights some of the passages of the text such as data on life expectancy. “In 2020, the excess mortality caused by the Covid-19 pandemic resulted in the loss of 1.3 years of life expectancy at birth for men in just one year (from 81.1 in 2019 to 79.8 in 2020) and 0.9 for women (from 85.4 to 84.5), with a significantly different impact on the territory “. The excess mortality recorded in 2021,” was a little less severe compared with that of 2020 – continues the president of Salutequità – In 2021 the North recovers 1.1 years for men and 0.8 years for women compared to the previous year. In the South, however, survival levels continue to worsen even in 2021, to the point that compared to 2019, a total of 1.3 years are lost for men and 0.9 years for women. Not even the Center recovers the decline recorded in 2020, although the loss was smaller “. As regards the updating of Lea “, two out of three requests were made by patient associations or individual citizens. Just over a fifth of the requests came from regional administrations, healthcare providers, research structures or scientific societies. The remaining tenth of the requests were proposed by drug or medical device manufacturers. As of September 2, 2021, the 61 Lea update requests examined were proposed “. Among the other topics of the report examined by Aceti, one concerns first aid: “In 2020, a year characterized by the pandemic emergency, access to the emergency room, compared to a volume of 21,117,416 in 2019, suffered a reduction of about 38%, characterized by an 86% decrease in white and green triage codes “. On the cancer screening front, “from the 2020-2021 comparison with the 2019 standard reference period, there is a relative reduction in participation of 10%, 20% and 13% in mammography, cervical and colorectal screening, respectively”. Again, “from 2019 to 2020 the rate of renunciation of treatment is growing a lot”. Chapter covering increase costs Regions 2019-2021: “The increase in the share of the 2021 indistinct fund compared to 2019, including the bonus shares, added to the additional resources made available by national regulations (Covid-19 resources 2021, Covid-19 2020 provisions to be used in 2021, an additional state contribution to cover Covid-19 costs deriving from the payback), was substantially sufficient to cover the cost increases recorded in the same period 2019-2021 “. Health deficit Regions in the repayment plan: “With reference to the year 2021, the results of the data for the fourth quarter of 2021 show a general worsening of almost all the Regions, in particular the Puglia Region, which records a deficit before coverage equal to 239 million euros “.