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Waiting times for a social solution can exceed a year. Health units criticize the lack of social responses in a country that, in 2050, will be the oldest in Europe.
In addition to social cases, there are beds occupied with people waiting for a place in the National Continuous Care Network, where there are still some five thousand beds in the country.
“If I get to 78, I get, if I don’t get, I have spent my youth”
She is sitting on the nightstand that she has chosen for her luck. She exchanges words with her roommate while spending hours between threads and needles. Carolina Jordão learned to embroider in her youth when old age did not even pass for her ideas. She says that, at least in this way, she is distracted: “Christmas is coming, if I want to give a gift without spending money, I already have it here!”
And the fabric takes shape.
At the age of 77, a health crisis led her to a hospital where she was admitted. He was discharged soon after, but continued to live in a hospital for months..
“I never thought much. I walked and looked. It was one day at a time and it didn’t bother me. Little by little, little by little I reached 77 years old. Now, if I reach 78, I arrive, if I do not arrive, I have passed my youth. I’m ready for everything! ”, Says Carolina.
The reality that does not change from year to year
In January, the data provided by the country’s Regional Health Administrations to RTP accounted for more than 600 social cases – The people who were discharged continued to live in a hospital due to lack of responses in the community.
Maria João Correia is the director of Social Service at Hospital Penafiel and she faces this reality on a daily basis, in search of solutions.
“It is totally unthinkable and it is absolutely disastrous for a patient to spend so much time in an acute hospital for a purely social response. If a patient lives alone, has no children, arrives at the hospital and cannot return home, they must stay. We do not return patients to the community without being safe. And we already know that the patient’s departure in effective terms will be long, more than a year ”, he says.
The problem does not choose hospitals, it is common to the whole country. “Urgency is effectively a place of easy access. When he says can be discharged, families usually respond I can’t, for this reason or that, and patients end up staying, of course “. The observation is carried out by Graça Barros, director of the Social Service of the Hospital de Gaia.
“We are placing a person in a ward wearing pajamas for several months, which I do not consider worthy,” he laments.
Radiography to Portuguese hospitals
On February 18, the Portuguese Association of Hospital Administrators conducted a survey with hospitals on the number of improper admissions. Radiography showed 1,551 unnecessary hospitalizations. These are cases that, in the management accounts, caused an inappropriate expenditure of almost 40 million euros.
In addition, this problem translates into late surgeries and risk for patients, as stated by Vítor Paixão Dias, director of the Internal Medicine Service of Hospital de Gaia: “It represents insecurity for the patient and represents other patients who could be occupying those beds and they are unduly hospitalized in the emergency department, on stretchers ”.
Alexandre Lourenço, president of APAH, says that no more beds are needed: “If more beds were created, these cases would continue to creep into hospitals. We need more answers outside of hospitals “.
The pandemic has exacerbated reality
The pandemic forced adjustments in hospital circuits. At the Hospital de S. João, in Porto, Social Security resolved situations that had been happening since 2017. But even that does not mean that the problem has been eliminated. The lack of definition made the numbers worse again.
“Local institutions are closed, day centers are closed, where do people go? They resort to hospitals, which are an open door and many of the situations arrive here in a very fragile situation ”, says Alexandra Ferreira, director of Social Service at Hospital de S. João.
These days there are more than 30 hospitalized people who have already been discharged. “Today’s social responses are inadequate. The pandemic has exposed the weaknesses of the system. Generally, they think of aging as the ultimate goal of institutionalization and it doesn’t stop there “, he says.
Continuous care these days
It is not only social cases that inadequately occupy hospital beds. There are also those who wait in a hospital for a place in the National Network of Integrated Continuous Care (RNCCI). And waiting times reach half a year, sometimes longer.
“Our 2019 internal data indicates that 66 people died while waiting for a spot on the Web, probably due to some deterioration”, says Luís Baixinho, from the Senior Management Team of the Hospital de Évora.
José Cid da Silva, waiting for a vacancy in the National Integrated Care Network, at the Évora Hospital
RNCCI was born in 2006 with the purpose of helping the rehabilitation of all users who no longer need acute care in a hospital. To date, 14,000 beds have been identified for the country’s needs, but after 14 years only about 9,400 remain available, which has a direct implication for hospital beds..
In September, according to the data RTP had access to, more than 500 of the 1,500 people awaiting treatment on the Internet were hospitalized.
The RNCCI coordinator, Purificação Gandra, explains that there is work to be done, but “as much as we want to, the units cannot be opened with a snap of the finger in the places where we need it most. Often times, the deals don’t even exist and the developers have yet to build. Now, the construction takes two, three years ”.
The report Days on hold can be seen tonight, on RTP1, in the program First line.