Overbooking for 58% of the Medicine departments, lack of beds and staff

SOS beds and staff in over half of the Italian Internal Medicine departments. In fact, 58% are overbooked, that is, they have a bed occupancy rate of over 100% while 40.28% of the departments occupy between 70 and 100% of the available beds. This means having patients assisted even on a stretcher in the corridor, with only one partition to guarantee privacy. This emergency situation is also exacerbated by the chronic shortage of staff, found in 85.65% of the departments from the North to the South of Italy. This is the picture that emerges from the survey conducted by the Federation of Italian Hospital Internal Medicine Doctors (Fadoi) on 216 operating units in all Italian regions.

The Internal Medicine departments of our hospitals, internists emphasize, are those that assist almost half of the hospitalized patients, especially the elderly and chronic patients with comorbidities. Patients who require increasingly complex care, which would require adequate supplies of beds and staff. This, while about a third of hospitalizations could instead be avoided with better management of territorial health services and if only a little more prevention were done, but the reform of territorial health "is still struggling - says Fadoi - even if patients are less alone today after discharge and the percentage of those who go home but with integrated home care activated has risen to 43.98%".

"The increasingly critical situation in which the internal medicine departments, strategic for the entire hospital care system, find themselves operating, depends not least on the incorrect classification of our departments as low, rather than medium-high intensity care - explains the president of Fadoi, Francesco Dentali -. This translates into a lower provision of personnel and diagnostic instruments that increasingly put internal medicine in difficulty". Staff shortages and overwork for the doctors who are in the departments also determine another consequence: almost half of the professionals no longer have time to do research and 43% do less than they would like.

Intern doctors, Community homes are 72% useful if done well. Fadoi, 'territorial reform is struggling to take off. Hopes and skepticism'

A mix of hope and skepticism on the part of internal medicine doctors about the new Community Homes and Hospitals. The new facilities, the cornerstone of the reform of territorial healthcare that "is struggling to take off", will have to open their doors by June 2026 in order not to lose the two billion of the Pnrr allocated specifically for these services. For 72.22% of doctors, in fact, the new Community Homes will actually be able to reduce the number of hospitalizations, "but we will have to see how they will be implemented".

Community Houses - a sort of large clinic where family doctors, outpatient specialists from the ASL and other health professionals should work in teams - are structures where, in addition to being examined, patients should also be able to undergo first-level diagnostic tests, such as ECGs or ultrasounds. For 72.22% of doctors, the new Community Houses will therefore actually be able to reduce hospitalizations, "but we will have to see how they will be implemented". The same answer was given by 72.69% of doctors with respect to community hospitals managed by nurses, which would be responsible for facilitating discharges from the wards, taking charge of those patients who no longer need the actual hospital, but who are not even in a condition to return home. For 20.37% of those interviewed, however, no benefit will come from Community Houses, just as 12.04% of doctors do not see any improvements on the horizon from Community Hospitals.

It should be noted that for 32.87% between 11 and 20% of hospitalizations could be discharged more quickly with these new well-functioning intermediate structures. A percentage that rises to between 21 and 30% for 33.33% of those interviewed, while for 24.54% more than 30% of patients could leave the department more quickly.