Altems: Emergency rooms closing but more doctors specialized in emergency-urgency

The number of Emergency Rooms available at a national level is decreasing (from 808 in 2011 to 693 in 2023) but at the same time the number of doctors specialized in emergency-urgency (EU) working in each single care unit is increasing, growing from 3.8 to 6.9 doctors per service, almost doubling. These are just some of the data presented on the occasion of Graduation Day, the day of proclamation for the students of the masters promoted by Altems (High School of Economics and Management of Health Systems - Faculty of Economics of the Catholic University).

According to Istat-State Accounting data, emergency doctors “went from 3,033 in 2011 to 5,217 in 2018, reaching the peak of the period (4.7% of the total), and then progressively decreased to reach 4,748 in 2023 (-9% on 2018)”. As for visits to the Emergency Room, the rate per thousand inhabitants went from 363 in 2011 to 311 in 2023.

At the regional level there is wide variability: in 2023 the share of emergency-urgency doctors compared to the total varies between 1% in Umbria to 7.2% in Abruzzo or 7% in Calabria and Tuscany (considering only the regions with ordinary statutes). There seem to be very different regional policies characterized by different "historical" paths. In fact, if Campania, Abruzzo and Tuscany in the period considered 2011-2023 always show a contingent of EU doctors higher than 6%, Umbria, Marche and Lombardy have never exceeded 2% of doctors in EU on the total number of doctors in service (also here considering only the regions with ordinary statutes).

The number of visits (per 1,000 inhabitants) to the emergency room for an emergency doctor went from an average of 18.11 in 2011 to a national average of 7.69 in 2023. Furthermore, the percentage of patients admitted to hospital after an emergency room visit went from 14.9% to 13%.

“Regional policies - underlines the Altems report - remain fragmented and reflect very different historical paths, the experts reiterate, making evident the need for national coordination to guarantee territorial equity and sustainability of the emergency system”.