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Healthcare, a breakthrough in practice: general practitioner exams



ROME A spot on the skin that does not convince, or a strange heartbeat that does not pass. Or even a feeling of shortness of breath, possibly due to a few extra cigarettes. And here we are ready to book a visit to a specialist or, good vouchers, wait for hours at the reception of the nearest emergency room. However, starting next year, dying can be reduced to get the first diagnosis. In fact, this will be enough to contact your therapist directly.

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According to the bill on the budget, which must be approved by December 31, by 2020 general practitioners will receive a series of medical equipment with which they will be able to conduct first-level diagnostics. These are mainly devices, such as electrocardiograms, cardiac holters, which record the electrical activity of the heart 24 hours a day, and then retinography devices that can study and track the development of possible retinal pathologies. With others, it will be possible to perform polysomnography to assess changes in the activity of the brain, muscles, heart, respiration that occur during sleep. Doctors' research will also be able to provide telemedicine, telemedicine, telemonitoring, teledermatology services by connecting to a database and consulting a specialist. To purchase this tool, the budget law provided a contribution of 235.834 million euros. Devices, however, will not be purchased by individual physicians. Clause 2 of Article 55 of the law actually establishes that "the medical equipment referred to in Clause 1, owned by health authorities, is provided to general practitioners in accordance with methods determined by the companies themselves."
EVALUATION In essence, the amount was estimated taking into account that 46.243 general practitioners are working in the country, as shown in the 2017 ENPAM statistical yearbook. The recipient audience is not indifferent: according to the statistical yearbook According to the estimates of the National Health Service for 2017, on average at the national level, each general practitioner has a load of about 1211 adult residents. In particular, for the northern regions, with the exception of a few cases, deviations from the national average are positive. In all countries of the South, with the exception of Sardinia, the potential burden of general practitioners is lower than the national average. The lowest is the Basilicata region, where 1,037 adult residents per doctor.

TARGET
The new first-level diagnostic pathway entrusted to general practitioners has a clear goal: according to the illustrative report to the bill on the comprehensive budget for 2020 and 2022, it should actually “reduce the burden on medical facilities and at the same time reduce the list phenomenon. expectations. " That is why "economic resources are provided for the technological heritage aimed at providing first-level primary care services to citizens through the professional activities of physicians." Therefore, the government intends to focus more and more on local medicine. “Changes in the demand for health and social well-being associated with changes in the living conditions of the current and future population, the social context (technological / demographic / epidemiological revolution), emphasize – emphasizes in the report – the need for a radical change in the paradigm of assistance, more and more developing an approach to activity and proximity, capable of preventing and anticipating the adverse evolution of disease and in maintaining health. ”
Transfers in favor of the regions will be organized on the basis of a needs plan, which must be approved by decree of the Minister of Health by January 31, 2020. However, for the success of the plan, timeliness will be fundamental. “The effectiveness of the measure,” the Accounts Chamber warns, “of course, will depend on the speed of its implementation.”

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