La Ricerca AGENAS.
La presa in carico degli anziani non autosufficienti

[Autom. eng. transl.] The World Health Organization and the European Community support the adoption of strategies to ensure access to care for all, a high degree of quality and the financial sustainability of the system and, moreover, the enhancement of the role of the family and the community in the context of long term care policies. In several Italian regions, some organizational models have been recently developed with the aim of facilitating access to the territorial services of people with complex social and health needs and to guarantee their continuity in assistance. The Single Access Point or the Access Health Door to the network of local services, the territorial units of primary care, are examples of experiments conducted in some regions (for example FriuliVenezia Giulia, Puglia , Tuscany, Veneto, Sardinia). The use of the programming function as a tool for governing is necessary and mandatory, to decide, to manage the health system at the various institutional levels, as well as the monitoring function through a unique reproducible system of indicators that checks and verifies the results in terms of health production, thus safeguarding the guarantee of protecting the health of citizens, the uniformity and fairness of access to the services that follow. The general objective of the research was to define and test a system of indicators to monitor the organizational process of taking on persons aged 65 or over with a complex social and health need, that is to say older people with non-self-sufficiency condition4 detected by a multi-dimensional assessment5, through the integrated use of current information flows relating to the New Health Information System (NSIS), from the more traditional and consolidated ones (discharge card ospe - Daliera - SDO, first aid - PS) to those more recently activated, in particular the flow of home care (SIAD) and the flow of residential and semi-residential assistance (FAR). The population under study is distributed in different territories: of the metropolitan type for the Milan ASL and the Florence Health Society, mainly urban for the Pisan Health Society and for the Ulss of Vicenza, of an extra-urban type for the Alto-Vicentino Ulss (table 5). The elderly over sixty-four represent about 17% in the Veneto Ulss, 26.8% in the Health Society of Florence, 24.3% in the Pisan health society and 23.4% in the ASL of Milan. lano (table 5). In the reference period, 7,759 records were identified in the FAR and SIAD flows, corresponding to 7,237 persons in charge of age ≥ 65 years and resident in the local realities of the three regions involved. 47% of the subjects are ≥ 85 years old and about 65% are women. In the FAR flow, subjects with ages ≥ 85 years are 53.0% with values ranging from 42.5% in the Veneto Ulss to 56.3% in the Milan ASL (table 6). In all the realities studied, women have an average age higher than that of men. In the SIA Disorders subjec- tions ≥ 85 years are 39.9% with values ranging from 24.9% in the USSR to 49.1% in the Tuscan health companies (table 7). As with the FAR flow, at all times the female mistress has an age greater than that of men.