The National Outcomes Program (Pne), published by Agenas, sheds new light on the Italian hospital admission system. Despite a return to pre-pandemic rhythmswith almost eight million hospitalizations in a year (300,000 more than in 2022), important critical issues persist. Sardinia surprises everyone by emerging as the region with the most problems, overtaking Calabria, historically known for its health difficulties.
The report denies the traditional division between North and South: while Calabria and Sicily show timid improvements, the Friuli-Venezia Giulia register a decline in the quality of hospitalizations. Regional autonomy does not appear to be the panacea, with life expectancies ranging from 84.6 years in Trento to 81.4 in Campania (national average of 83.1 years, ISTAT 2023 data), highlighting profound disparities.
Hospitals of excellence and departments in trouble: two sides of the same coin
The hospital landscape is varied. Agenas analyzes 1,363 structurespublic and private, using 205 indicators. While hospitals like the Careggi of FlorencetheHumanitas of Milan and theMarche Hospital Company are distinguished by the high quality of hospitalizations, elsewhere the situation is less rosy. In many structures, excellent departments and sectors in difficulty coexist, creating a two-speed system.
Urgent and planned hospitalizations: chiaroscuro data
After the decline imposed by the pandemic, scheduled hospitalizations have started to grow again, bringing the system back towards pre-Covid levels. THE urgent hospitalizationshowever, they almost remain unchanged. This difference seems to indicate a more cautious management in emergency rooms, where many patients find limited access. While some interpret this as an improvement in prevention, the data suggests that urgent care may face more obstacles than scheduled care.
Oncology surgery and hospitalizations: worrying numbers
In the field of oncological surgerythe report highlights critical issues in hospitalizations. Delicate operations such as those on the colon or pancreas are often performed in facilities with limited caseloads, putting patient safety at risk. Only the 45% of operations for pancreatic cancer occurs in hospitals that perform at least 50 operations per yearminimum standard to guarantee experience and competence.
Femoral fractures: elderly people waiting
The treatment of femur fractures in the over 65s within 48 hours remains a distant goal for many regions. The national average stands at 59%, a slight increase compared to 53% the previous year, but well below the ministerial target of 60%.
While facilities such as the Umberto I in Syracuse and the Humanitas Gavazzeni in Bergamo operate more than 95% of patients on schedule, in regions such as Calabria, Liguria, Basilicata, Umbria, Molise and Sardinia the elderly wait too long.
Territorial assistance and avoidable hospitalizations: a persistent problem
The pandemic has highlighted the shortcomings of territorial assistance, and the Pne confirms that hospitalizations for avoidable pathologieslike heart failure, remain stable. One-year mortality from heart attack and stroke shows slight improvements, but territorial differences are marked. For example, mortality 30 days after hospitalization for heart attack has dropped from 7.8% to 7.1%, but in some areas it still exceeds 10% or 15%.
Resumption of surgical interventions: positive signs
Surgeries, especially oncology ones, are returning to 2019 levels, perhaps thanks to more widespread screening and early diagnosis. Prosthetic surgery (hip, knee, shoulder) continues to grow, with numbers exceeding pre-pandemic numbers as early as 2021, indicating growing demand and a possible increase in trust in the healthcare system.
