Alvaro (Sapienza): “For Gastroenterology 1.5% of the 147 thousand beds”

“Less than 1.5% of the 147 thousand accredited hospitalization places throughout the country are destined for Gastroenterology. According to the 2017 Ministry of Health data, the ratio is one accredited bed for every 277 inhabitants. Yet, the pathologies of the digestive system are extremely heterogeneous, affecting a huge number of patients. One in 4 Italians suffer from liver disease; tumors of the digestive tract are very frequent as well as alcohol-related diseases and functional gastrointestinal disorders, which affect 50% of the Italian population. Then there are chronic inflammatory bowel and pancreatic diseases, functional diseases that affect 1 out of 2 Italians and high-intensity pathologies that require urgent interventions, such as digestive bleeding “. This was stated by Domenico Alvaro, Dean of the Faculty of Medicine of the University of Rome “La Sapienza” speaking at the online round table “National Health Service and post-Covid health management”, promoted within the 27th National Congress of Digestive Diseases Fismad , scheduled from 22 to 25 September. “From a survey conducted for a year and a half – underlined Alvaro – which allowed us to have a descriptive map of what are the complex units of gastroenterology, departmental or simple – it emerges that throughout the country we have 174 complex units of gastroenterology which are in greater numbers in the North than in the South, Center and Islands. In the North we have a complex gastroenterology unit for every 341 thousand inhabitants, in Central Italy one every 280 thousand and in the South and on the Islands one every 409 thousand. But what I would like to underline is that, when we go to see the ordinary hospital beds destined for Gastroenterology, we have absolutely frustrating numbers ”. “In the North, in the Center, as in the South and in the islands, there are very few or completely non-existent territorial services – again the dean of the Faculty of Medicine of Sapienza – The reality I know best is that of Lazio, where there is a simple unit of gastroenterology, not by chance directed by a general practitioner. As if to say that when there is personal interest, territorial structures are created. But this certainly cannot become the rule, our system absolutely cannot function only through personal initiatives ”. “We as Fismad”, added Alvaro, “started before the pandemic to manage the heterogeneity of the pathologies of the digestive system which absolutely requires the identification and implementation of appropriate, efficient and homogeneous models of gastroenterological assistance. The PNRR should therefore redesign our healthcare, starting from home care, whose goal must be to manage at least a large part of the population over 65, and therefore 15% of these patients. Hospitals should also have a structure for the management of medium and low intensity pathologies, all managed by a coordination center “.” Gastroenterology lends itself very well to this model. Until now, the ERs have been clogged with patients with gastrointestinal diseases (in 50% of cases) who would have no reason to clog an ER or request admission to a gastroenterology ward. But all of this can only be achieved by involving scientific societies, which strive to produce cost-efficient models, reducing waste ranging from 20 to 40% of all healthcare spending. Like? Rationalizing the healthcare offer, using the skills and proposals that come from scientific societies. In summary, the patient must arrive at the hospital when he is acute, all the rest must be managed on the territory with models that have a scientific and rational basis ”, concluded Alvaro.