SIDeMaST alarm on the new DM 70: “Dermatological patients without assistance if the text does not change”
Return to dermatology its central role in the field of primary and secondary prevention, diagnosis, treatment and management of skin oncological pathologies and in that of dermatological pathologies that have a heavy impact on people’s lives. And, therefore, no to “slimming treatments” of the beds in the ordinary regime that must also be guaranteed in other specialties, such as internal medicine and geriatrics. On the other hand, an increase in the number of therapeutic hospitalizations in Day Hospital e in Day Surgery. Expansion of dermatological Drgs whose number is too small (there are just four), does not consider the high levels of severity of dermatological diseases and does not differentiate the levels of intensity of treatment. And then again, investments in new technologies, implementation and standardization of telemedicine to ensure continuity of care. Insertion of the dermatologist in the Emergency-Urgency network to ensure appropriate triage.
SIDeMaST dermatologists do not grant discounts, represented by Pasquale FrascioneHead of Oncological Dermatology San Gallicano Institute in Rome e Gabriella Fabbrocini (photo), director of the UOC of Clinical Dermatology of the Federico II University of Naples, presented observations and proposals to the Minister of Health on the new Ministerial Decree 70, which is being defined. The document, which intervenes on the decree that regulates hospital standards, must be corrected for dermatologists in order not to penalize patient care.
Central figure dermatologist. The dermatologist points out the SIDeMaSTis in fact still today a central figure both in the correct diagnostic and therapeutic classification of numerous pathologies that affect patients in other specialties including those of the geriatric, internist, gynecological and infectious sphere (skin ulcers, bullous pemphigoid, cutaneous autoimmune diseases, rare diseases and ITS that complicate the frameworks of strict gynecological obstetrical relevance), and in the treatment of cutaneous oncological pathologies.
Increase of therapeutic Day-Hospital admissions e Day-Surgery. For this reason, dermatology must be equated with other disciplines that cannot cope with the reduction of ordinary hospitalization beds that must always be guaranteed also in other departments (eg internal medicine, geriatrics, etc.). Not only that, admissions in therapeutic Day-Hospitals and Day-Surgeries must be increased pending the implementation of ad hoc DRGs that effectively respond to the care needs of dermatological diseases.
Revision and extension of dermatological Drg. For SIDeMaST they are too few (only four) and penalize dermatology as they do not take into account the high levels of severity of many cases in different dermatological pathologies, as well as not allowing to differentiate the various levels of intensity of care needed within even individual diseases .
Investment in new technologies. The technologies and equipment necessary for therapeutic infusions for melanoma must then be ensured, carcinoma spinocellulare, basal cell carcinoma, Kaposi’s sarcoma, rare diseases, skin ulcers. Among other things, this would make it possible to lighten and streamline the workload of medical oncology within the Regional Oncology Network. “In the multidisciplinary teams for these pathologies – SIDeMaST recalls – the figure of the dermatologist is a central coordination figure. In fact, many diseases, such as bullous ones, still have a quod vitam prognosis today and indifferently require dermatological expertise “.
Dermatologists in the emergency urgency network. Finally, the dermatologists suggest, in the new structures it is necessary to consider the inclusion of dermatologists in the Emergency-Urgency network: “They are fundamental in the management of some emergencies and are almost never present in the ED – concludes the SIDeMaST – this instead would allow to carry out a right triage reducing the care workload of the reference structures “.
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