On December 31, 2022, there were 1562 users waiting for a place in continuous care, 252 more people than in the previous year. Due to the aging of the population, the demand for the services that make up the National Network of Integrated Continued Care (RNCCI) is increasing.
In a report released in October, cited by Publicthe Health Regulatory Entity (ERS) reported that, even with the network offer growthwhat exists is not enough to satisfy the needs.
Citing data released by the Central Administration of the Health System (ACSS), ERS said that on 31 December 2021 there were 1.16% more users waiting for a vacancy at the RNCCI than in the previous year. In absolute terms, there were 1310 people. December values confirm an upward trend.
According to data from the Transparency Portal, on January 3 there had already been a small decrease in the number of people waiting (1521), but the number rose again to 1543 the very next day.
“The EGA [Equipas de Gestão de Alta dos hospitais] do a daily job, in articulation with health professionals, users and family members, of support and referral of all cases eligible for the RNCCI”, he told the Public Filomena Cardoso, from the executive board of the National Health Service (SNS).
“Waiting time” for a vacancy is not a criterion for “non-referral”, said the person in charge, in an allusion to the criticism that has arisen, namely from the National Association of Continuous Care (ANCC).
“The waiting time for placement at the RNCCI not the same for all typologiesnot in all regions, being greater in the Long Term typology and in large urban centres, leaving no place in the network to be occupied with patients waiting”, he continued.
In the case of the Long Duration and Maintenance Units (ULDM), there were 707 users waiting at the end of 2022. The second service with the most users waiting for a vacancy, the Medium Duration and Rehabilitation Units (UMDR), had 377 people waiting.
The ERS report, which analyzes data for the year 2021, also states that ULDM are also the services with the longest waiting times.
However, “it is noted that the median waiting time per vacancy in the ULDM showed, compared to previous years, a reduction in all regions, with emphasis on those in Alentejo and the centre. Also in UMDR there was a reductionalbeit less expressive, with the exception of the North region, whose median waiting time increased by around 8% compared to 2020″, says the report.
Vacancies in the network have increased: in November 2022 there were 15,800, 22 more than in the previous year and 1530 more than in 2018. The beds available in hospitalization increased from 9797 in 2021 to 9783 at the end of November.
José Bourdain, president of the ANCC, guarantees that, in the last two years, the losses of places in the whole network were much greater. Data from the association, which collected information from five institutions, indicate that in the last two years 207 beds have closed, 155 in ULDM and the remaining 55 in UMDR.
For the president of the ANCC there is only one reason for this, which is why he distrusts the effectiveness of the iGovernment’s intention to create 5500 new beds by the end of 2025 under the PRR.
“Just a year ago, two continuing care units went bankrupt, because the money that the Government pays to provide services is below the cost price. We asked the Faculty of Economics of the University of Porto for a study that tells us that the network is highly underfunded, even with the last update in November” he stated.
And he questioned: “if the Government does not take care of the ongoing care that already exists, what is the logic of giving non-refundable money to open more beds? Who in their right mind is going to go into debt in millions to build something that they know will be a loss?”.
Filomena Cardoso, in turn, recalled that the commitment to strengthening and expanding the units and teams of the RNCCI was “expressly inscribed in the program of the current Government”, believing that there will be no lack of interest the construction of new spaces and the opening of new vacancies.
“We are aware of several promoters who have already expressed their interest in responding to this challenge”, he said, indicating that “the price ordinance” that concerns him “is reviewed periodically and that consistent work is being carried out, with elements of the Ministry of Health, the Ministry of Labour, Solidarity and Social Security and the Ministry of Finance, for reviewing and updating the existing table”.
According to the daily newspaper, a user should not stay longer than 30 days in a convalescent unit, but ERS data show that, on average, this period was exceeded in all regions, even reaching double (60 days) in Alentejo. The North is the region that appears with an average hospital stay of 37 days.
ERS concludes that the regions of the country where there is a longer waiting time to find a vacancy are also those where, afterwards, users spend more time in hospital.
“These results show difficulties in identifying an adequate response for downstream users of the RNCCI, conditioning network discharges, which, consequently, decreases your responsiveness to admit new users in a timely manner”, added the entity.
ZAP // 
