Le malattie di fegato in Campania sono state e continuano ad essere una piaga sia in termini di mortalità e morbilità, sia in termini di costi (per i pazienti e per le Istituzioni). Si registrano ogni anno nella regione circa 1800 decessi per l’istituzione cirrosi epatica e/o tumore al fegato; 5 persone ogni giorno muoiono. Per fronteggiare questa emergenza si è costituita in Campania una “task force”: medici specialisti, istituzioni ed associazioni di pazienti collaborano ai tavoli tecnici regionali garantendo programmazione, il costante monitoraggio delle esigenze assistenziali nei “contesti reali” ed uno scrupoloso rispetto dei percorsi diagnostico-terapeutico -assistenziali.
“Siamo la prima regione in Italia in termini di terapia erogate/popolazione per la cura dell’epatite C – spiega il dottor Ernesto Claar, responsabile dell’ Unità Operativa di Epatologia presso l’ Ospedale Evangelico Betania di Napoli ed espressione del Network Epatologico dell’ ASL Na 1 Centro -. Abbiamo creato una rete efficiente ed efficace per la cura dell’epatocarcinoma attraverso un Percorso Diagnostico Terapeutico Assistenziale regolato dalla Rete Oncologica Campana, stiamo riuscendo a creare una organizzazione per i trapianti di fegato sempre più valida, incrementando la fiducia dei cittadini e riducendo la migrazione sanitaria”.
Di questo e molto altro si discuterà al Centro Congressi dell’Università Federico II in via Partenope il 4 e 5 dicembre nell’ambito dell’ottava edizione de “L’epatologia nel terzo millennio”, il corso di aggiornamento del Dipartimento Medicina Interna – Unità Operativa Epatologia dell’Ospedale Evangelico Betania, coordinato dal dottor Ernesto Claar.
IL PROGRAMMA DEL CORSO
Il programma prevede la partecipazione di epatologi provenienti da vari centri ospedalieri ed universitari d’Italia, di rappresentanti delle istituzioni sanitarie della Regione Campania, di associazioni dei pazienti (EpaC ed AITF). Gli esperti si confronteranno su svariati argomenti: i sistemi di organizzazione delle cure, il trattamento dell’epatocarcinoma, l’encefalopatia porto-sistemica, la steatosi epatica non alcolica, le malattie epatiche autoimmuni. Il giorno 5 dicembre è previsto un approfondimento sul tema dell’alimentazione durante e dopo la terapia antivirale per HCV , rivolto ai pazienti e ai curiosi. Risponderanno alle domande degli intervenuti i gastroenterologi Nicola Caporaso, presidente della Fondazione Italiana per la Ricerca in Epatologia Onlus (Fire), il dottor Ernesto Claar, la nutrizionista Federica Claar, specializzata in Scienze della nutrizione umana e lo chef stella Michelin, Paolo Gramaglia.
I DATI
Tra i dati che verranno approfonditi durante la due giorni, quelli che hanno visto la Campania – nel triennio 2014 -2016 – Regione con il maggior numero di positività ai marcatori delle malattie infettive trasmissibili con la trasfusione (virus dell’epatite B in primis, virus dell’epatite C , virus dell’immunodeficienza acquisita e Treponema pallidum) secondo l’Osservatorio Nazionale Buone Pratiche sulla sicurezza in Sanità pubblicato nel 2019. La maggior parte delle infezioni è diagnosticata nei donatori di sangue alla prima esperienza. L’analisi dei dati relativo alle schede di dimissione ospedaliera nel periodo 2012 -2015 registrano in Campania 21.500 ricoveri per cirrosi epatica e 2mila ricoveri per epatocarcinoma.
I COSTI
Complessivamente il costo per la gestione della cirrosi epatica è stimato pari a 108 milioni di euro in Regione Campania, equivalente a un costo medio annuo per paziente di 5mila euro. La complessità dell’assistenza sia domiciliare sia ospedaliera, nonché i costi sanitari crescono con l’aggravarsi della patologia quando non intercettata tempestivamente. Applicare i percorsi diagnostico-terapeutico-assistenziali (PDTA), come la task force della Regione Campania sta riuscendo a garantire, si traduce nell’ottenere migliori esiti per la salute dei cittadini.
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