Valencia (EFE).- Establish a triage system in all health centers to refer primary care patients who do not require truly urgent assistance to scheduled appointments, or that Continuous Care Points (PAC) are open 24 hours a day hours, are some of the measures that could prevent the current health collapse.
This has been revealed in the forum “Diálogos EFE Salud”, in which the president of the Health Law Association of the Valencian Community (ADSCV), Carlos Fornes, together with the president of the Council of Medical Associations ( CCMV), Eva Suárez, and the president of the Council of Nursing Colleges of the Valencian Community (CECOVA), Juan José Tirado.
As has been highlighted, 80% of the consultations that are attended to both in hospital emergency services and in primary care are not really urgent, but if the patient has to wait up to 15 days to be seen by their GP , many decide to go to the health center without an appointment or to the emergency room of a hospital.
a chronic malady
Fornes recalls that 30 years ago it was already warned that primary care was failing “remarkably” and that if it improved, hospital admissions would decrease and overcrowding would be partly eliminated, which sometimes leads to physical or verbal attacks on health workers by of patients or their families.
Although the speakers at the forum, held at the Ateneo de Valencia, do not believe it is necessary to reach a co-payment to be treated by the doctor, something that is done in other European countries, Eva Suárez, pediatrician at a health center in Burriana ( Castellón) and president of the Valencian Society of Pediatrics, has pointed to two systems that could ease the schedules of doctors in health centers and would allow them to better care for patients who arrive with an appointment already scheduled and begin to overcome the collapse sanitary.
Triage in health centers
One of them would be to carry out, in the same health center, a triage of patients who arrive without an appointment so that a trained health professional can carry out a first preliminary examination and take constants (blood pressure, temperature…) and, in case of do not require urgent attention, give them an appointment scheduled for another day.
According to Suárez, this system would only be viable if the health professional who made this classification had the full support of the management or the direction of Primary Care, given the possibility that the patient presents a claim if they are appointed for another day.
Extend PACs hours
Another targeted measure would be for the Continuing Care Points (PAC) and the Health Care Points (PAS) to be open from 8 in the morning -currently they open from 3 or 5pm depending on the municipality- and that “work 24 hours” so that they can absorb most of the demand without an appointment that reaches primary care, in such a way that the physicians can meet the maximum number of appointments on their calendar.
Currently, the only emergencies open in the morning are the hospital ones, and if a patient arrives at a health center without an appointment because they consider that the care they need is urgent, the primary care physician has to treat them among the 28 patients who do. They have been summoned and are scheduled, “and the schedule is what it is.”
“In the working day, in theory two and a half hours are for assistance, another percentage to do research, another to train you and another to make bureaucratic reports. In the end, the seven and a half hours become assistance, with which the rest must be done outside of working hours ”, he points out.
Better manage what we have
Carlos Fornes believes that the problem of healthcare today is one of “management and resources” and what the administrations should do is “better manage what we have” and rely on professionals for this.
The president of the ADSCV has wondered if we are prepared to deal with another pandemic such as covid-19, to which Eva Suárez has replied that if a situation like that of recent years were to occur again “the worst would happen, because we are not prepared. People are very burned, especially family doctors.
Education in the face of health collapse
In the opinion of Juan José Tirado, health education should be promoted from the earliest ages, with the inclusion of a school nurse in each school year, because the current health problems will not be solved “if we do not change that palliative mentality for a preventive one”.
He also advocates promoting home care, which is currently “a disaster”, and affirms that it has been shown that monitoring patients in their homes avoids income and, most notably, health spending produced by people who get out of control (hypertensives, people with high cholesterol or joint pathologies…)
In his opinion, given the progressive aging of the population and chronicity, planning would be necessary because, many times, the distribution of the workload is done by the number of people and not by the morbidity and mortality that they may have. EFE