“IThe Pnrr does not take ophthalmology into consideration and this will eliminate all the fundamental prerequisites for that extensive organizational redesign, based on digitization and the extensive use of telemedicine: fundamental tools for overcoming the many inefficiencies and too many care inhomogeneities in the area that seriously compromise the level of health responses to eye diseases: from prevention to diagnostics to therapies “. This is the alarm launched by Teresa Petrangolini, spokesperson for the Alliance for Equal Access to Care for Ocular Diseases, promoted in 2020 by the Italian Health Policy Brief (Ihpb), which includes 7 civic organizations, with the support of the International Agency for the prevention of blindness – Iapb Italia Onlus.
He echoed her Marco Verolino, head of the Vesuvian Area Ophthalmology and scientific consultant of the Parliamentary Intergroup for the Protection of Eyesight, underlining that “today patients should be cared for according to new models resulting from a re-engineering of the entire healthcare system; a system based on new organizational models and access to care, as well as on new technological resources that only the support of the NRP could realistically make available. Applied technology and digital innovation of healthcare processes – continues the clinician – they are a fundamental step in improving the cost-quality ratio of health services, limit waste and inefficiencies, create greater interaction between patient and healthcare facilities, facilitate administrative procedures, reduce differences between territories, manage people safely “.
“Indeed, it is essential to have one single IT management platform, a national register, capable of offering and making available in real time data, information, news on previous treatments, up to the care needs of individual patients. A set of information that would really make it possible to achieve that equity of access to care still so far away “.
Another obstacle to overcome for the equity of access to care that the Alliance intends to bring to the attention of future health policy choices is that of the timely use of diagnostics and therapies that the looming Covid-19 pandemic has dramatically made even more. indispensable. “Unfortunately, there is still a lack of a ‘strong’ and technologically well-equipped territorial ophthalmology – complaint Edoardo Midena, secretary general of the Italian Society of the Retina (Sir) – also based on centers of differentiated territorial management, which allows patients to avoid, together with the sad phenomenon of health tourism, biblical waiting lists and the sad experience of being often bounced between several specialists, with the consequence of a lengthening of the times before being able to access an effective therapeutic choice and block the evolution of pathologies “.
However, a re-engineering of the health care system also passes through a more incisive prevention activity which must also be supported by adequate public resources for the launch of screening campaigns and whose role is fundamental for the early fight against these pathologies. About it, Mario Barbuto, president of Iapb Italia Onlus, reported the first results of the itinerant prevention campaign ‘View in Health‘that, thanks to a three-year funding from the 2019 Budget Law and with the patronage of the Ministry of Health and the Higher Institute of Health, is carrying out a screening activity in the main cities of the Italian regions with the aid of a mobile structure equipped with high-tech diagnostic tools. “To date, the project has touched 13 Italian regions in 35 cities, carrying out 5,400 screenings“.
“The overall data will soon be available – reports Barbuto – but a first element makes us reflect: in the population of Lombardy, Abruzzo and Campania alone that underwent diagnostic tests at our mobile facility – mainly aimed at finding the glaucoma, diabetic retinopathy and maculopathies – They were signs of disease in progress or suspected or, again, of premonition of disease in about 40% of people. A high and worrying percentage, which, even if partial and preliminary, makes us understand how widespread are the threats that weigh on the sight of Italians and of which we are not too often aware “.
Another weak point of the welfare system – according to the Alliance – is that of visual rehabilitation, because the law 284 of 1997 which would have represented, as it was conceived, an enlightened example of attention to the themes of prevention and visual rehabilitation, as well as of social and labor integration, was, in fact, almost totally disregarded by the regions. There is therefore a great deal to do, starting with the fact that visual rehabilitation is not even included in the essential levels of assistance.
About 6 million Italians are affected by the main eye diseases: glaucoma, diabetic retinopathy and maculopathies. But what is most worrying – experts report – is the anchor considerable inhomogeneity of care in the area which generates health responses that are often inadequate and inhomogeneous, because the control of ocular pathologies in terms of prevention, diagnosis and therapies is still inadequate. If already in 2006 the WHO indicated the annual economic impact in Italy of the three diseases in Italy, between health costs and indirect costs, at about 6.5 billion euros, one can well imagine what the overall burden of these eye diseases may be today. considering, in addition to the normal rise in costs, the well-known demographic dynamics of our country. These are enormous values, if compared to the vastness of this population of patients, which undermine the sustainability of our NHS and which could be better kept under control with new organizational models and more effective prevention activities.
“It is absolutely essential that, alongside prevention, our health system is able to ensure an effective and homogeneous response throughout the national territory, also in terms of access to therapies.“, he claims Paolo Russo, president of the Parliamentary Intergroup for the Protection of Eyesight. “In this sense, it is essential that the resources that make it possible to make available that economic critical mass capable of concretely translating that revolutionary process of reorganization of the ophthalmological care system based on the ‘central contribution of digitization and, more generally, of new technologies, the only ones capable of creating the conditions for a true democracy of care ”.