“The social and health priorities concern the falling birth rate and social inequalities, the need to reform the pediatric care system, integration, highlighted in the pandemic period, territory-hospital and a new training of the pediatrician of the future”. So Annamaria Staiano, president of the Italian Society of Pediatrics (Sip) and professor of pediatrics at the Federico II University of Naples, in her speech to the General States of Pediatrics, convened today at the Ministry of Health.
In this regard, “the SIP – continues the president – proposes the regulatory recognition of pediatric sub-specialties for the assistance of patients who need it most: 1 out of 4 hospitalized children is in adult wards. For this, an expansion of the training networks of specialization schools, to adequately treat children with chronic diseases and disabilities that require multidisciplinary, territorial care and also frequent hospital visits”.
Chronicities are on the rise. “Out of 10 million subjects in developmental age, 18% have at least one chronic disease – recalls Staiano – There are 1.8 million fragile children who require specialist multi-professional assistance. Chronic diseases in children have different characteristics from those in adults. We cannot allow adult specialists to take care of children due to completely different physical and functional peculiarities. We need to create diagnostic-therapeutic-assistance pathways and manage innovative therapies, which change from child to child. Unfortunately, these assistance needs are not guaranteed”.
The reorganization of pediatric care “cannot disregard the concept of the specific skills of the pediatrician – recalls Staiano – The new demographic and socio-economic scenarios lead to a change in the training needs of the doctor of the future where well-trained sub-specialists are able to manage complex patients with chronic diseases, palliative care, digital health and telemedicine, abuse and maltreatment, foreign and migrant children, as well as health emergencies”.
“Training – reiterates the Sip president – plays a central role in the reorganization processes of health care which can no longer be postponed, but must lead to the integration of primary secondary and specialist care to guarantee the child’s right to be treated by personnel with specialist skills. Unfortunately – he underlines – this right is not guaranteed today. To the significant number of hospitalizations for children in adult wards is added a quality of health care that depends on the region in which one has the luck, or misfortune, to be born and live.Istat 2017 data show that, compared to a child residing in the Centre-North, the one in the South has a 50% greater risk of dying within the first year of life, especially if born from foreign parents”.
Unfortunately, “the reforms of the training courses are not helping us – reflects the Sip president – and the survival of the pediatric structures is at risk. Furthermore, there is a shortage of pediatricians in the area. Hospitals are on the run due to shifts exhausting, aggression, little gratification. To this situation impromptu solutions have been found, such as token doctors, which fortunately the current government is trying to fight. There is a lack of specialists – concludes Staiano – and even sub-specialists. These are not recognized in Italy, it is one of the few European realities where they are not recognized, yet they would be better suited to cope with adolescents with chronic diseases and to manage the transition to adulthood”.