The debate at the 16th National Congress of Cardiogeriatrics focuses on the need to increase hospital beds, recognise the centrality of the geriatrician and guarantee coverage for Law 33. Undersecretary Gemmato: 'We need a new idea of public health, with the citizen at the centre'
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Law 33 on non-self-sufficiency was an important milestone, longed for for more than 20 years. However, for its full implementation, we need the implementing decrees and the resources to put its policies for the care of the elderly into practice.
Among the measures needed to promote the definition of an organic strategy, a prominent role must also be given to hospitals, which are precisely the places where non-self-sufficiency arises, and to the geriatrician, the figure in charge of them. These are some of the appeals emerging from the
XVI National Congress of Cardiogeriatrics, which was held in Rome at the Ergife Palace Hotel on 15-16 November.
Presidents of the Congress:
Lorenzo Palleschi, President of the Italian Society of Hospital and Territory Geriatrics -
Sigot, Director of the Complex Operative Unit of Geriatrics of the Azienda Ospedaliera SanGiovanni-Addolorata, Rome, and Francesco Vetta, Director UOC Cardiology Hospital of Avezzano and Unicamillus Professor of Cardiology.
A round table at the opening of the congress, with the participation of Monsignor Vincenzo Paglia and Stefano De Lillo, Vice-President of the Order of Physicians of Rome, is dedicated to the new proxy law for the elderly population.
Law 33 on non-self-sufficiency was an important milestone, longed for for more than 20 years. However, for its full implementation, we need the implementing decrees and the resources to put its policies for the care of the elderly into practice.
Among the measures needed to promote the definition of an organic strategy, a prominent role must also be given to hospitals, which are precisely the places where non-self-sufficiency arises, and to the geriatrician, the figure in charge of them. These are some of the appeals emerging from the
XVI National Congress of Cardiogeriatrics, which was held in Rome at the Ergife Palace Hotel on 15-16 November.
Presidents of the Congress:
Lorenzo Palleschi, President of the Italian Society of Hospital and Territory Geriatrics -
Sigot, Director of the Complex Operative Unit of Geriatrics of the Azienda Ospedaliera SanGiovanni-Addolorata, Rome, and Francesco Vetta, Director UOC Cardiology Hospital of Avezzano and Unicamillus Professor of Cardiology.
A round table at the opening of the congress, with the participation of Monsignor Vincenzo Paglia and Stefano De Lillo, Vice-President of the Order of Physicians of Rome, is dedicated to the new proxy law for the elderly population.
Opening the proceedings was a video message from the
Undersecretary for Health Marcello Gemmato; "in 2019, the National Public Health Fund was endowed with 115 billion euros; today, with the Budget Law, this fund increases to 136 billion euros, an increase of 21 billion in just a few years. This implies a greater endowment for our SSN; in parallel, we need new organisational models, a new idea of public healthcare, which places the citizen at the centre, as Article 32 of the Constitution ensures, with universalism in the approach to care and therefore free medical and pharmaceutical services'.
Undersecretary Gemmato then reiterated the importance of the scientific community alongside politics, together with the other stakeholders in the sector, to ensure that Italy continues to have one of the best public healthcare systems in the world.
Lack of self-sufficiency in the elderly is not only a social phenomenon, but is deeply rooted in the health sector.
"Lack of self-sufficiency very often originates in hospital, with a hospitalisation that reduces autonomy and generates the need for prolonged hospitalisation.
- Lorenzo Palleschi emphasises - This phenomenon calls for a rethink of the organisation of the hospital, which is inadequate to assist this growing proportion of non-self-sufficient patients. It is estimated that, among hospitalised patients over 70 years of age, 30% are discharged in a disabled condition, which becomes 60% in the over 85s. The non-self-sufficient elderly therefore represent a very significant component of the hospital population.
clogging is mainly due to the lack of hospital beds, which have progressively shrunk over the last ten years, and to the stay in hospital of hospitalised patients, who are unable to return home because of the difficulties their families have in accommodating them.
Added to this situation is the increase in the average age, which leads to a worsening of frailty and disability: a figure from our company calculated on a sample of more than 20,000 people revealed that in the medical area the average age is over 65; over 70 in intensive care. The demographic element therefore also suggests a recognition of the specificity of geriatrics as a pivotal discipline for taking care of the complex frail elderly patient, at a time when geriatric wards are tending to shrink and many posts in specialisation schools remain vacant'.
Undersecretary for Health Marcello Gemmato; "in 2019, the National Public Health Fund was endowed with 115 billion euros; today, with the Budget Law, this fund increases to 136 billion euros, an increase of 21 billion in just a few years. This implies a greater endowment for our SSN; in parallel, we need new organisational models, a new idea of public healthcare, which places the citizen at the centre, as Article 32 of the Constitution ensures, with universalism in the approach to care and therefore free medical and pharmaceutical services'.
Undersecretary Gemmato then reiterated the importance of the scientific community alongside politics, together with the other stakeholders in the sector, to ensure that Italy continues to have one of the best public healthcare systems in the world.
Lack of self-sufficiency in the elderly is not only a social phenomenon, but is deeply rooted in the health sector.
"Lack of self-sufficiency very often originates in hospital, with a hospitalisation that reduces autonomy and generates the need for prolonged hospitalisation.
- Lorenzo Palleschi emphasises - This phenomenon calls for a rethink of the organisation of the hospital, which is inadequate to assist this growing proportion of non-self-sufficient patients. It is estimated that, among hospitalised patients over 70 years of age, 30% are discharged in a disabled condition, which becomes 60% in the over 85s. The non-self-sufficient elderly therefore represent a very significant component of the hospital population.
clogging is mainly due to the lack of hospital beds, which have progressively shrunk over the last ten years, and to the stay in hospital of hospitalised patients, who are unable to return home because of the difficulties their families have in accommodating them.
Added to this situation is the increase in the average age, which leads to a worsening of frailty and disability: a figure from our company calculated on a sample of more than 20,000 people revealed that in the medical area the average age is over 65; over 70 in intensive care. The demographic element therefore also suggests a recognition of the specificity of geriatrics as a pivotal discipline for taking care of the complex frail elderly patient, at a time when geriatric wards are tending to shrink and many posts in specialisation schools remain vacant'.
LAW 33
With a view to a new hospital paradigm, a number of scientific guidelines have emerged.
scientific guidelines, often adopted in the United States and Canada, which express the need for a reorganisation in a geriatric sense even of emergency departments. In Italy there has not yet been this type of accreditation, although the need is increasingly pressing.
A turning point could be law no. 33 of 23 March 2023 on non-self-sufficiency, which came into force on 31 March. The aim of this law is to simplify the current policies for the elderly and to promote the coordination of care, trying to reduce the great fragmentation that characterises the sector; it identifies the places where the coordination and connection of actions in support of active ageing, the promotion of autonomy and frailty, and the assistance and care of the elderly can be carried out.
However, in order to achieve an organic and effective reform of the care system for the elderly in Italy, the relevant legislative decrees and adequate funding will be needed.
"Law 33 represents a long-cherished goal, which will make it possible to initiate a comprehensive review of care policies for the elderly," Lorenzo
Palleschi - We hope that the implementation process of the law will be completed, with significant interventions both on the territory and at the hospital level'.
scientific guidelines, often adopted in the United States and Canada, which express the need for a reorganisation in a geriatric sense even of emergency departments. In Italy there has not yet been this type of accreditation, although the need is increasingly pressing.
A turning point could be law no. 33 of 23 March 2023 on non-self-sufficiency, which came into force on 31 March. The aim of this law is to simplify the current policies for the elderly and to promote the coordination of care, trying to reduce the great fragmentation that characterises the sector; it identifies the places where the coordination and connection of actions in support of active ageing, the promotion of autonomy and frailty, and the assistance and care of the elderly can be carried out.
However, in order to achieve an organic and effective reform of the care system for the elderly in Italy, the relevant legislative decrees and adequate funding will be needed.
"Law 33 represents a long-cherished goal, which will make it possible to initiate a comprehensive review of care policies for the elderly," Lorenzo
Palleschi - We hope that the implementation process of the law will be completed, with significant interventions both on the territory and at the hospital level'.
THE DATA
The most recent data on cardiovascular diseases paint an alarming picture
alarming picture, with an increase in ischaemic heart disease, heart failure and strokes.
"We are witnessing a new upsurge in cardiovascular pathologies, which is destined to become more pronounced in the coming years," Francesco Vetta emphasises. "The prevalence of atrial fibrillation, for example, was 1% at the beginning of the 2000s, is currently 2%, and it is estimated that it could double by 2050.
Cardiovascular diseases, therefore, are destined to remain the main cause of death in our country, given also the causal relationship between age and these diseases, which is part of an ageing population.
In people over 70, in fact, in more than 80 per cent of cases there are more than three comorbidities. Heart failure, for example, is a purely geriatric 3/3 disease and about 600,000 people in Italy suffer from it: its prevalence is ten times higher in the over-80 population than in the 40-59 age group; in 98% of cases it is accompanied by other comorbidities'.
'The increase in the incidence of disability and invalidity due to these pathologies must be prevented with precise strategies,' adds Vetta. 'First of all, prevention paths are needed with dynamic programmes of free screening for the over-65s; Secondly, we need to focus on enhancing precision medicine with therapeutic simplification, reducing the number of drugs to those that are essential in order to promote pharmacological adherence paths; furthermore, we need to strengthen the hospital-territory network, with second-level outpatient clinics that improve patients' prognosis and enable a faster and more efficient hospitalisation process. Finally, one must take into account the opportunities offered by technology and Artificial Intelligence, which allow constant monitoring of the patient to the point of being able to predict the risks of a heart disease flare-up well in advance.
However, technology must be implemented to foster patient-friendly prevention, maintaining a relationship with the patient and avoiding a dehumanisation of medicine'.
alarming picture, with an increase in ischaemic heart disease, heart failure and strokes.
"We are witnessing a new upsurge in cardiovascular pathologies, which is destined to become more pronounced in the coming years," Francesco Vetta emphasises. "The prevalence of atrial fibrillation, for example, was 1% at the beginning of the 2000s, is currently 2%, and it is estimated that it could double by 2050.
Cardiovascular diseases, therefore, are destined to remain the main cause of death in our country, given also the causal relationship between age and these diseases, which is part of an ageing population.
In people over 70, in fact, in more than 80 per cent of cases there are more than three comorbidities. Heart failure, for example, is a purely geriatric 3/3 disease and about 600,000 people in Italy suffer from it: its prevalence is ten times higher in the over-80 population than in the 40-59 age group; in 98% of cases it is accompanied by other comorbidities'.
'The increase in the incidence of disability and invalidity due to these pathologies must be prevented with precise strategies,' adds Vetta. 'First of all, prevention paths are needed with dynamic programmes of free screening for the over-65s; Secondly, we need to focus on enhancing precision medicine with therapeutic simplification, reducing the number of drugs to those that are essential in order to promote pharmacological adherence paths; furthermore, we need to strengthen the hospital-territory network, with second-level outpatient clinics that improve patients' prognosis and enable a faster and more efficient hospitalisation process. Finally, one must take into account the opportunities offered by technology and Artificial Intelligence, which allow constant monitoring of the patient to the point of being able to predict the risks of a heart disease flare-up well in advance.
However, technology must be implemented to foster patient-friendly prevention, maintaining a relationship with the patient and avoiding a dehumanisation of medicine'.
