Rome – In Italy it is estimated that there are more than 70,000 people with ostomy, over 5 million those with urinary incontinence problems and almost 2 million with fecal incontinence. And although some aspects of assistance are regulated on the basis of a State-Regions Agreement of 2018, this is still not applied in almost all Regions. Although representing about 12% of the Italian population, there are still no specific national registers. The pandemic has severely penalized their assistance: 4 out of 10 people in the center-south (41.3%) and over one in four in the north (28%) have given up on periodic checks, plus those who have given up only a few times, with a uniform value on the national territory of about one person out of 4. In the north there is the highest percentage of those who have not renounced periodic checks (46,

To better live their living conditions, they must use some medical devices (catheters, diapers, bags, etc.) which absorb an expense for the NHS equal to 798,339,222 euros, i.e. not even 1% of all resources allocated to public health, and, despite this, some of them are forced to buy often or always, also for the need for customization, the aids they need: 29.5% in the center-south and 23.4% in the North with a slight worsening due to the covid-19 pandemic in the North. This translates into private costs (out-of-pocket): approximately 40% spends up to € 300 per year (44.4% in the north, 40.6% in the center-south); just under 20% spends between 301 and 600 euros a year (21.3% in the center-south and 16.3% in the north); a percentage of about 5% spends between 601 and over 1000 euros a year.
They are well informed by health professionals on health conditions and on how to manage their condition, information on services offered by local health authorities and methods of access can be improved.

When supplies do not meet one’s needs in terms of time, quality or quantity (including accessories), they have a negative impact on social relations (61.8% Center-South compared to 56.1% North); on the psychological state (67.7% in the north and 65% in the center-south); can negatively affect the couple’s relationship, just as more than one in two people (58% in the north and 56.7% in the central south) see a strong impact on family balance and impairments in the workplace (58.7% in the north, 60% in the center-south). Analyzing their condition and proposing the priorities for intervention is the survey “Knowing the Real Needs of Incontinents-Catheterized-Ostomates”, the result of the collaboration between Salutequità and FAIS, the Federation of Incontinent and Ostomy Associations – OdV, with the methodological support of Zeta Research Srl and the Biostatistics Unit,
The results are illustrated in the Salutequità “Report on respect for the rights of people with incontinence and ostomation, including access to services”, made with the unconditional contribution of Coloplast.

Although the information offered by health professionals is of a good standard in the north, with over 70% of people giving it a score between 4 and 5, and there is greater focus on information on the rights of the incontinent and ostomate person (36.8%), in the center-south over one in 3 people received insufficient information. The percentage of those who receive adequate information to manage their condition is also high (over 50% assigns a maximum score), even if there is no lack of insufficiency scores (about one in 10 overall in every part of the country), but more than 1 person out of 5 (22.9% in the north and 23.5% in the center and south) is considered poorly informed on these aspects.
About 6 out of 10 people are satisfied with the quality of aids provided (63.9% in the north; 58% in the center and south); however, about one in three people is only partially satisfied (31% in the north and 37.6% in the center-south); about 5% are not exactly satisfied.
In the north, 54.5% never found problems in periodic supplies; about one in 4 people in the center south (24.2%) instead meets them often or always (compared to 14.3% in the north).
The main difficulties in supplies concern the timing and therefore the delays in activating the periodic supply (40% north and 34.7% center-south); the lack of accessories (more frequent in the center-south – 45.9% – compared to the north -40%); the excessive quantity of garrisons – as a recorded difficulty – is higher in the north (11.4%). The lack of accessories (eg pasta, wipes, remover) for ostomates means partial compliance with the essential levels of assistance; for people with catheterization and with diapers, on the other hand, accessories (eg skin protectors) are not yet provided and provided by the NHS.

The freedom of choice of the device / aid by incontinent, catheterized, ostomate people is partially satisfied or not present for 4 out of 10 people in the North (41.3% of which 32.2% partially satisfied) and over 1 in 2 in the south (54.4%, of which 43.7% partially satisfied).
“When personalization is not guaranteed or the possibility of choosing the most suitable device for the individual is reduced – explains the president of Fais, Pier Raffaele Spena – there is a high incidence of skin complications which can cause, in addition to physical and mental discomfort , also the need to use advanced dressings “.
“These treatments – he adds – have a high cost that can be estimated in a range between 5 and 25 euros for each daily dressing, to be repeated for a prolonged period (from 6 to over 30 weeks). Obviously, the costs are significantly increased where hospitalization is necessary (over 500 euros per day). All this against a daily expense of medical devices which, depending on the type of product, varies from 2 to 10 euros “.
“After almost two years of pandemic, within the National Health Service there is a great need to put the humanization of assistance back at the center, understood on the one hand as the primary need to immediately resume treating all people without any more any interruption, on the other hand as a fundamental commitment in guaranteeing methods of purchasing the aids that respect the right to personalization of assistance – said Tonino Aceti, president of Salutequità – capable of ensuring social inclusion and the highest level of health, to be understood, as the WHO reminds us, as a state of total physical, mental and social well-being “. (ITALPRESS).