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Infarti: meno morti nei grandi ospedali

di Alessio Cimarelli con Lou del Bello, Manuela Vacca, Maga Magò

Protestare per la chiusura dei piccoli ospedali in Italia nell’ottica della spending rewiew è sbagliato: i dati dimostrano che le performance del trattamento dell’infarto nelle strutture che trattano pochi casi sono ben al di sotto la media nazionale e di molto inferiori rispetto a quelle delle grandi strutture. Questo emerge dall’analisi dei dati Agenas (Agenzia Nazionale per i servizi sanitari regionali) relativi al 2012 riguardo l’infarto miocardico acuto con mortalità a 30 giorni dal ricovero.

Il 4,6% degli infarti vengono trattati nei piccoli ospedali, in cui si concentra l’8,2% dei decessi: la mortalità nelle piccole strutture (19,8%) è il doppio di quella di quelle grandi (9,9%).

(segue in inglese)

So smaller hospitals show higher mortality rates than bigger ones, an investigation carried out within a Dataninja workshop at the International Journalism Festival 2014 found.

Small structures account for a 28% of the total number of hospitals in Italy, but they treat just a 4.6% of the heart attack sufferers. The researchers looked at mortality rates for people hospitalised with heart attacks, and discovered that out of 8484 people who died in 2012, 694 were hospitalised and treated in small structures. That is equivalent to 8% mortality rate, almost double than the one in big structures. According to the journalists, the cause may lay in a poor infrastructure that prevents health workers in small hospitals to promptly treat more urgent cases.

The so called STEMI condition refers to a particular kind of heart attack that needs to be treated within 90 minutes from the emergence of symptoms. When a blockage of one of the heart’s arteries occurs, the required treatment is Percutaneous Transluminal Coronary Angioplasty, known as PTCA. This technique involves a wire to be inserted in the obstructed artery to open it up and restore blood circulation. Failing to treat the patients fast enough may cost their lives.

As part of the current spending review, the government have been encouraging the closure of small, redundant healthcare infrastructures, a suggestion that caused strong criticism. Citizens living in small communities fear that this may undermine local health care capacity. But the data suggest that bigger hospital are better equipped to treat emergencies and are therefore safer. It remains to be seen if big structures will be able to serve wider areas where road connection may be too poor for ambulances to cover long distances fast enough. In mountain areas, for example, transportation may be difficult and local hospitals are needed to provide emergency treatments.

The decision on whether shutting small structures or not will have to be considered on a case by case basis, but the research sheds new light on the risks of poor organisation and infrastructure in healthcare.

28 febbraio 2015

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