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Risvolti aziendali e di sistema della regolamentazione degli accessi non urgenti nei Dipartimenti di Emergenza-Urgenza: l?esperienza dell?Azienda Ospedaliera "Spedali Civili" di Brescia

Author

Listed:
  • Andrea Francesconi
  • Massimo Amato

Abstract

Lo scopo di questo studio e stato quello di esplorare il fenomeno delle visite di pazienti adulti non urgenti nell?ambito del Dipartimento di Emergenza di uno dei piu grandi ospedali del Nord Italia: gli "Spedali Civili" di Brescia. Si e condotto uno studio trasversale volto a indagare le caratteristiche dell?intera popolazione che si e riferita al Dipartimento per problemi non urgenti in un arco temporale di 24 mesi al fine di comprendere se e come l?appropriatezza organizzativa sia migliorata alla luce dell?entrata in vigore nel periodo analizzato della Delibera Regionale IX/3379 volta a disciplinare l?accesso dei pazienti ai servizi di pronto soccorso ospedaliero. I dati analizzati si riferiscono alle 45.087 visite non urgenti che hanno caratterizzato i servizi dei tre presidi ospedalieri in cui e strutturato il Dipartimento di Emergenza e che rappresentano, approssimativamente, il 37% del totale degli accessi, il cui numero totale, paradossalmente, e in questo periodo diminuito. I dati analizzati sono dati ufficiali forniti dal sistema informativo aziendale e il numero di visite inappropriate rende conto immediatamente della dimensione del problema. L?analisi di regressione lineare e l?analisi di trend effettuate dimostrano come, nel caso esaminato, non si possa rilevare alcun miglioramento nell?appropriatezza correlabile all?implementazione della politica regionale e il problema rimanga, pertanto, irrisolto. In conclusione si e anche analizzato il fenomeno dei pazienti classificabili come frequent users e calcolato il costo sostenuto per tutti gli accessi non urgenti al fine di evidenziarne l?impatto economico sul servizio sanitario regionale.

Suggested Citation

  • Andrea Francesconi & Massimo Amato, 2015. "Risvolti aziendali e di sistema della regolamentazione degli accessi non urgenti nei Dipartimenti di Emergenza-Urgenza: l?esperienza dell?Azienda Ospedaliera "Spedali Civili" di Brescia," MECOSAN, FrancoAngeli Editore, vol. 2015(94), pages 97-113.
    • Handle: RePEc:fan:mesame:v:html10.3280/mesa2015-094006
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    References listed on IDEAS

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    1. Lega, Federico & Mengoni, Alessandro, 2008. "Why non-urgent patients choose emergency over primary care services? Empirical evidence and managerial implications," Health Policy, Elsevier, vol. 88(2-3), pages 326-338, December.
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