Oncological assistance in Av3: lights and shadows Waiting times for surgery are bad

THE INTERVENTION by Claudio Maria Maffei – The elaborations of the Scuola Superiore Sant’Anna of Pisa have been released: two are quite good, the third should be studied in depth and taken into serious consideration. One hypothesis is that, like other important surgical activities in our Region, the oncological area suffers from the lack of operating spaces in the main hospitals


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Performance 2021 of the Vast Area 3 of Macerata according to the Management and Health Laboratory of the Sant’Anna School of Advanced Studies in Pisa

from Claudio Maria Maffei*

The elaborations relating to the year 2021 of the management and health laboratory of the Scuola Superiore Sant’Anna in Pisa, with which the Marche Region has an agreement relationship, have recently come out. These elaborations analyze the data of information flows on healthcare and calculate the indicators which are then reported in a target.

claudio-maffei

Claudio Maria Maffei

The more the indicator “hits” the green center of the target, the more the phenomenon explored by that indicator goes well, while if the target is hit by the indicator far from the center in the red zone, the phenomenon to which it refers constitutes a serious problem. In the case of the Vast Area of ​​Macerata among the three synthetic indicators (that is, which combine information from several indicators on the same problem) that fare worse when hitting the red zone, there is one in the oncological area that is particularly important (the C10D) and that is the maximum waiting times for oncological surgery. This indicator calculates the percentage of patients on the waiting list operated within one month for the following oncological surgeries considered Class A due to their importance: breast, prostate, colon, rectum, lung, uterus, melanoma and thyroid. Ordinary admissions and day hospitals are included.

The objective is understood to be achieved with a quota equal to or greater than 90% of the services provided. In the Marche region in 2021, the Vast Area of ​​Macerata remained far from this goal and was the one with the worst data, so much so that it ended up in the red zone. Instead, Area Vasta 3 did quite well and very well in the other two indicators of the oncological area namely the C10 (target hit near green) and the C10R (target hit full on) respectively. The C10 collects indicators that measure other elements – and not waiting times – characterizing, for example, the oncological pathway for breast, prostate and colorectal cancer, while the C10R assesses whether in 2021 there was a reduction oncology surgery activity compared to 2019. The data on waiting times for oncological surgery in Area Vasta 3 (but that of the Region as a whole is not doing much better) must be investigated and taken seriously. One hypothesis is that, like other important surgical activities in our Region, the oncological area suffers from a lack of operating spaces in the main hospitals.

If this were the case, the news of a few hours ago of a reopening of the Pergola operating room for operations under general anesthesia should be viewed with a critical eye. Engaging a surgical team and a cooperative of “token” anesthesiologists with by definition very high costs for only 60 operations per month (this is the number reported by the local press based on the statements of the chief surgeon) really does not seem a sensible choice.

*Retired physician and healthcare manager

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Oncological assistance in Av3: lights and shadows Waiting times for surgery are bad