Outgoing Lazio Region Health Councillor, Alessio D’Amato, presented the results of the six-monthly update of the regional programme PreVale 2022 data on treatment volumes and outcomes on Tuesday: “The volume indicators of the PReVale Report activity in Lazio confirm an increase, which takes us back to the pre-Covid stage”.
PreVale, developed by the Department of Epidemiology, is an activity of the Lazio Region through which the strengths and weaknesses of the health system are monitored and then shared with companies and professionals to promote continuous improvement in the quality of healthcare.
“The snapshot of the National Outcomes Programme for the year 2021 shows the Lazio facilities in the forefront and always among the top 10 facilities for the various categories. For example, as for 30-day mortality after coronary artery bypass surgery, there are three facilities with the highest volumes and best results, namely Policlinico Gemelli, Campus Biomedico, and the San Camillo hospital.
As for timely access to angioplasty in serious heart attacks, among the top 10 Italian facilities are the Tor Vergata University Hospital and the Spaziani hospital in Frosinone.
As far as the volume of operations for femur fractures is concerned, we find the San Giovanni hospital, the Sandro Pertini hospital, the Campus Biomedico and the San Camillo hospital with regards to the proportion of fractures operated within 24 hours.
In terms of volumes of oncological surgery, the Sant’Andrea University Hospital is the facility in Italy which does the most surgeries for lung cancer, the Regina Elena Institute (IFO) is among the top 10 facilities in terms of volume of surgeries for prostate cancer, and the Policlinico Gemelli is the Italian facility which does the most surgeries for ovarian cancer.
These are therefore not only facilities in Rome, but also in the province, both public and private, a sign of the great work done to improve quality. For example, in 2020 and 2021, there was a reduction in hospitalisations for femur fracture (from an average of 9,800 per year in 2017-2019 to 8,800 in 2020-2021) and acute myocardial infarction, which are further reduced (9,800 in 2019, 8,060 in 2020 and 7,660 in 2021). In the first half of 2022, on the other hand, an increase is observed for both volumes (4,495 and 4,074 hospitalisations in the analysed period, respectively).
Both hip and knee prosthetic replacement surgeries, after decreasing in 2020, grow again in 2021, exceeding even the 2019 volumes for the hip (9,830 in 2019, 8,570 in 2020 and almost 10,000 in 2021) and still slightly lower for the knee (7,220 in 2019, almost 6,000 in 2020 and 6,800 in 2021).
The upward trend in volumes of activity is also confirmed in the first half of 2022 for both hip prosthesis (5,598 hospitalisations in six months) and knee prosthesis (4,236 hospitalisations in six months); the latter figure would also seem to exceed the 2019 volumes in the full-year projection of activity.
Heart valve surgery, which had declined in 2020, also picked up again in 2021, especially transcatheter surgery. Lazio is the first region to be able to measure separately the volume and outcomes of open-heart and transcatheter operations.
The upturn in volumes is also observed in the first half of 2022 for total operations (1,469 hospitalisations in six months) and for operations performed via transcatheter (508 hospitalisations in six months), which have increased proportionally more.
Lazio is the first region to make data on heart valve operations available by separating the type of operation (transcatheter or open-heart). Operations for malignant breast cancer also increased in 2021; they had fallen sharply in 2020 (5,770 compared to a stable average of 6,300 per year in the period 2017-2019), before rising again to 6,350 in 2021. In the first half of 2022, the volume of hospitalisations remained substantially stable compared to the previous period (3,162 hospitalisations in six months).
The number of deliveries in Lazio is continuously decreasing, in line with the national trend, with about 17,400 fewer deliveries in the last year of analysis compared to 2012 (from about 55,000 deliveries in 2012 to 37,079 in 2021), a reduction of about 1,500 deliveries from 2019 to 2020 and a further decrease of about 800 deliveries in 2021 compared to the previous year. The way in which data on deliveries are provided does not allow reliable estimates for the first half of the year to be produced.