Che l'Italia abbia un sistema sanitario molto buono (ostetricia including) the "perceived" in a few.
that women are the first and third item of expenditure of the NHS knows all the insiders but not engaged in the delivery.
And then, still buzzing atmosphere of the office on February 13, dearest ladies I want to tell a story.
Once upon a time more than ten years ago, an Italian health system strangled by expenditure overruns. Groped to predict the costs and curb the bad habit, Italy turned his eyes westward, to the country that is often model and teacher of many things (movies, fast food, music) that is America.
In America, since 1983, to predict and control health care costs, should be based on the DRG (Diagnosis Related Group), a consistent final classes of hospitalization costs (all costs, testing accommodation, the cost of food by surgery) and clinically meaningful terms.
method that excited Italian experts and was taken care of things, paro paro, in our country. So
the National Health Plan 1994-1996 (DPR1/3/94, paragraph 8) provided that all hospitals (public or private), provide services accounts on the basis of existing tariffs, set at regional level according to general criteria established at national level .
Each DRG corresponds to a rate so that today with the Federal Health reform may vary from region a regione.
Quello che molte donne ignorano è che, nella classifica dei DRG più rimborsati troviamo:
Al primo posto il parto vaginale "normale".
Al secondo l'insufficienza cardiaca.
Al terzo il parto cesareo senza complicazioni.*
Dici donna, dici danno. In effetti essere la prima e la terza causa di spesa sanitaria è un "danno" per l'economia pubblica. Spesa pubblica che va giustamente tenuta a bada riducendo il numero di cesarei (doveroso soprattutto in quelle realtà regionali dove si tocca il 60% e oltre), aumentando il numero di parti vaginali "normali" e contenendo la "moda" del parto indolore.
Sull'epidurale homogeneous classes DRG system is clear. Or better, said nothing at all. For delivery in epidural analgesia during labor does not exist for any particular DRG. There is therefore no intention of spending any effort to provide this service to pregnant women who request them. There are only
interventions spot in some hospitals, driven by regional funds, private sponsors (in the case of Venice, partoanalgesia sponsored by the local casino), the will of the medical staff involved.
course as long as the DRG did not include an item specifically for a physiological part in epidural analgesia service in labor will continue to be guaranteed in case the national map, at random in the calendar and hours.
And while women will not have understood the risks they face good standing at the top of the expenditure items, you will continue to speak for the killing of caesarean only in terms of reduction of expenditure (the equal of that of a cesarean drg spontaneous vaginal delivery), the route of demedicalization birth only in the sense of de-hospitalization and reduction in health-care hospital days (early discharge protected), decentralization of the event delivery in other places (and less expensive) hospital (home , private maternity homes).
So you've never seen that a civilized country, for an event such as natural and spontaneous delivery, should spend so much in terms of health care resources?
And what a region should provide a specific DRG for a method of painless childbirth?
* In 2008, the latest year for which you have the development of hospital discharge records (HDR) vaginal delivery without complications and cesarean section without complications, respectively, have formed the first (330,665) and third (199,678) of the top 10 DRGs of acute ordinary.
Ministry of Health, Department of Quality, Directorate General of health planning, service levels and ethical system, Office VI. Annual Report on the Activities of hospitalization. SDO Data 2008 (sd. p.5). Ministry of Health, Rome, 2008.
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