The experience of Family Doctors involved in the “ambulatorio Med” project at the “F.Spaziani” Hospital, Frosinone: data analysis and perspectives

Introduction: The Primary Health Care System of Lazio Region currently requires a reconfiguration of the organizational network of hospital and non-hospital care. In this regard, Lazio Region in collaboration with Fimmg Lazio (Italian Federation of General Practitioners), has proposed an experimental project called “Ambulatorio Med (AmbMed): Percorso veloce codici bianchi e Verdi”, which developed from the former project “Ambulatorio Blu” (Flu Management). In The 10th Congress of the Regional School of Training in Family Medicine and the 2nd Regional Congress of Fimmg Lazio was held on March 22-23, 2013. Here, data collected from several ASLs and hospitals involved the “AmbMed” project were presented. Objectives: The aim of “AmbMed” is to address and resolve illnesses of General Medicine in the context of Primary Care. Methods: The experimental project “AmbMed” of “F.Spaziani” Hospital in Frosinone ran from June 11, 2012 to April 23, 2013; it ensured medical care to citizens seven days a week from 8am to 8pm, extending the access to primary care at ER. Although there were 60 requests of participation to the project, 30 doctors of General Medicine joined the project and worked H12 in shifts of 6 hours. The access mode to the “Ambulatorio Med” was through the Emergency Department Triage where nurses decided the appropriate priority code for the patient, according to the project protocol. Patients with white and green codes were visited by the AmbMed doctor; then, they were discharged and addressed to their general practitioner or hospital specialist or re-evaluated and sent back to ER for reassessment of the triage. The areas of AmbMed intervention dealt with the pathologies treated in primary care and included in the AmbMed protocol. Results: The Amb Med access were 3748: 1124 (30%) white codes and 2624 (70%) green codes; males was 62% and females were 38%. The patients with < 65 years old were 80% and the ones with > 65 years old were 20%. The patients’ origin was found of 18% by Frosinone city and 75% by Frosinone province; moreover there was 30% of access of foreign patients. A clear overcoming of the protocol valuables was registered: the waiting times of white and green codes was reduced more than 50% (expected reduction of 10%) and the persistence times of white and green codes at the ER was more than 60% (expected reduction of 10%). The most frequently diseases in patients with < 65 years old were the dermatological-allergic ones (24,6%), while the most frequently ones in patients with > 65 years old were the dermatological-allergic (28,42%), oste