Second level principals: catchment area between 600,000 and 1,200,000 inhabitants. They are equipped with level IIfacilities. These aids refer to hospitals, university hospitals and some main areas. The aids in question have all the characteristics of those of the first level but in addition they are equipped with structures that are able to deal with more complex disciplines and pathologies.In regions with less than 600,000 inhabitants, the activation or confirmation of the presence of level II units is subject to the signing of an interregional agreement with neighboring regions urgent care san antonio.
Private hospitals: minimum accreditation threshold of 80 beds. A minimum threshold of 80 beds is envisaged for the accreditation of private hospitals.
The minimum and maximum standards of the structures for each discipline
The scheme defines how it will be possible to meet the standards set by law (3.7 pl x 1,000 inhabitants) and hospitalization rate of 160 x 1,000 inhabitants. First of all, the standards are achievable by intervening on the place / bed occupancy index which must be around 90% and on the average length of stay for ordinary hospitalizations which must be less than 7 days. Using a table the expected hospitalization rates by discipline and catchment areas were defined on the basis of the Regions with the best performance. And on the basis of these rates, the hospitalization structures and services that will make up the hospital network will have to be identified. The scheme also defines the application path: identification of the need for hospital services; calculation of the corresponding number of public and private beds; design of the public and private hospital network.The introduction of a minimum volume threshold will also result in a reduction for complex surgical structures. For the Regions in the return plan the reduction will be 25% while for the others it will be 10%. Volumes and results will be used to evaluate the structures for the purpose of the reorganization.
The decisive elements (great novelty of the document) for the reorganization of the hospital network are the volumes of activities for specific processes and the appropriateness of hospitalizations and services. The reference measurements and estimates. Within 6 months from the issue of the regulation, the threshold values for specific activity volumes, correlated to the best outcomes, and thresholds for outcome risks, will be defined by a commission composed of the Ministry of Health .
In any case, the regulation identifies for the three-year period some minimum thresholds for the volume of activity (for example at least 100 annual cases of heart attacks or at least 150 bypass operations) and the risk outcome thresholds (for example at least 60 % of femur surgery on over 65s within 48 hours).
On the basis of these criteria, the Regions will have to implement the procedures for the conversion and accreditation of the hospital network.