In the sector of territorial health emergencies, time represents a decisive variable. The data collected by Agenasthe National Agency for Regional Health Services, show marked differences between the different areas of the country. In many areas, especially in the South, the time needed for an ambulance to reach a patient with a yellow or red code can exceed levels considered acceptable. In some cases the wait reaches up to 30 minutes, a value that highlights structural criticalities in emergency services. Agenas reminds us that the speed of intervention is a fundamental indicator of the effectiveness of the system. The assessment considers the entire process: the call, the activation of the vehicles and the arrival at the emergency site. The national target is set at 18 minutes, an average that takes into account urban areas with high endowments and isolated ones, where coverage is more difficult.
The differences between healthcare companies
From the analysis of the 110 healthcare companies evaluated, strong imbalances emerge. The most complex situation is recorded in Vibo Valentia, where the average ambulance arrival time reaches 35 minutes. Other areas of Calabria also have values close to half an hour. In some areas of Sardinia and Sicily, waiting times of 25-26 minutes are recorded, while in central areas such as Rome, Umbria and Grosseto the wait can exceed 20 minutes.
The category of companies with times exceeding 20 minutes is numerous: 41 structures do not meet the national target. The analysis highlights that the local health authorities with the worst performances are often those with smaller dimensions. On the contrary, larger healthcare companies show shorter times despite operating over large territories. The best results belong to the ASL Giuliano Isontina, which includes Trieste and Gorizia, with an average of 12 minutes. Followed by Piacenza, Chiavari, Reggio Emilia, Parma and Genoa, with times around 13 minutes.
The waits in the emergency room
In addition to the times of the territorial emergency, Agenas also monitors waiting times in the emergency room. The indicator taken into consideration concerns patients who are not serious or not intended for hospitalization and measures the percentage of those who remain in the facilities for more than eight hours. The picture shows very heterogeneous situations. At the Tor Vergata hospital in Rome, 25% of patients wait longer than eight hours. At Sant’Andrea, also in the capital, the figure is equal to 23%. Similar percentages also emerge in Cagliari and in the Giaccone and Cervello hospitals in Palermo. High numbers are also recorded at Cardarelli in Naples. At the other extreme is San Carlo di Potenza, where only 1% of patients last longer than eight hours. The Padua hospital also has very low values, with a percentage of 2.9%.
Patient abandonment due to waiting times
Another indicator monitored by Agenas concerns patients who leave the emergency room before being examined. Abandonment is often linked to long waits and not necessarily to serious health conditions. The highest values are found at Cervello in Palermo, where 24% of patients leave the facility without completing the course. At the Colli hospital in Naples the percentage is 23%, while at the Civico and Giaccone in Palermo it stands at around 18%. In Tor Vergata, a facility already having difficulty with waiting times, the figure is 15%. The performances of the structures with shorter waits are very different. In Padua the abandonment rate is 1%, in Pavia 1.2%, while the Santa Maria di Trapani registers 0.3%.
The timing of oncological interventions
Agenas also evaluates the punctuality of oncological interventions in hospitals. For breast cancer, the ministerial standard requires the operation to take place within 30 days. The differences between the structures are notable. Some hospitals achieve very high percentages of on-time interventions. Pisa records 100% of cases, while Modena, Verona, Siena, Padua, Ferrara, Pavia, Catania, Bologna, Florence, Rome Tor Vergata, Catania Cannizzaro, Potenza, Palermo Cervello, Milan Niguarda and Cuneo exceed 90%. Many other structures, however, are insufficient. The Brotzu of Cagliari stops at 12%, Perugia at 13%, Ancona at 20% and the Moscati of Avellino at 28%.
Interventions that can be programmed in local health authorities
For programmable interventions, such as orthopedic ones or gallbladder removal, Agenas evaluates compliance with the priority classes established based on the patient’s condition. Also in this case strong differences emerge. Numerous local health authorities exceed 90% of interventions on schedule, including Southern and Central Naples, Euganea, Trevigiana, Serenissima, Berica, Avellino, Benevento, Crotone and Polesine. Lower performances are instead recorded in Cuneo, where only 12% of interventions take place within the deadlines, in Rieti with 14%, in Matera with 20% and in ASL Torino 3 with 25%.
