How to avoid waiting list delays

Waiting lists are one of the biggest scandals, and associated waste, in Italy's public healthcare system. Millions of people are forced to pay (by turning to private, non-affordable facilities) or to forgo treatment if they cannot afford private services (on average, 1 in 10 Italians does so). But we mustn't resign ourselves to this scandal, especially since the law gives patients the right to request that the service be offered privately at public facilities or at a private, accredited facility. In this case, the patient only has to pay the co-pay.

Waiting lists are not the same everywhere and for all pathologies.

These are some examples of tests that, in some Italian health companies, have been recorded with waiting times over 1 year:

• Cardiac Doppler ultrasound – up to ~735 days wait in some territories.
• Total colonoscopy - beyond 600 days in various local health authorities.
• Magnetic resonance imaging (MRI) of the spine - beyond 500 days in some areas.
• Bilateral mammography – even beyond 480 days in some facilities.

Even many visits to specialists are followed by significant delays:

• Eye examination - beyond 600 days in some areas.
• Endocrinological visit - beyond 600 days in some cases.
• Pulmonological visit - beyond 350 days in some areas.

Classification of services by emergency

Urgent visits or examinations are classified according to priority codes, often indicated with

• U – Urgent: service within 72 hours
  • Conditions that are potentially life-threatening or have severe symptoms
  • Examples: suspected heart attack, stroke, serious fractures
• B – Short: performance within 10 days
  • Pathologies with intense pain or risk of rapid complications
  • Examples: suspected appendicitis, minor hemorrhages, some acute respiratory conditions
• D – Deferrable: performance within 30 days
  • Chronic conditions that require monitoring but are not immediate
  • Examples: diabetes, hypertension, non-urgent dermatological problems
• P – Scheduled: performance within 60 days or more
  • Check-ups, screenings, routine tests

Categories with priority rights

Some categories may have faster access to the services, regardless of the clinical code:

1. Children and adolescents
   • Vaccinations, pediatric visits, and mandatory screenings
2. Pregnant women
   • Obstetric visits, ultrasounds, and prenatal screening
3. Elderly and vulnerable people
   • Chronic or multipathological pathologies
   • Priority for vaccinations and cancer screening
4. People with disabilities or recognised disabilities
   • Priority access for specialist visits and treatments
5. Serious or rare chronic diseases
   • Often placed in dedicated paths with quicker access
   • Examples: multiple sclerosis, cystic fibrosis, leukemia
6. People with oncological pathologies
   • Rapid diagnostic and therapeutic pathways, especially in the suspicion or follow-up phase

If the wait for a healthcare service extends beyond the maximum time limit set by the local health authority (ASL) – that is, beyond the time limits set by the priority class of the prescription – the patient has the right to request that the same service be provided within the scope of intramural freelance professional activity (in practice by doctors from the same hospital or healthcare authority), paying only the ticket due for that service. or even in a private affiliated facility, and even in this case the only expense is the ticket.

The rule, which dates back to 1998, works like this:

1. The doctor's prescription must indicate the priority class (U, B, D, P) and the diagnostic question.
2. If the CUP offers you a date beyond the maximum times foreseen for that priority class, you can ask your local health authority:
   • to activate the protection path and provide you with the service within the timeframe (even in another public or accredited facility),
   • o, if he fails to respect the limits, to make use of theintramural freelance activity (or from a private affiliated facility) charging only the ticket.