Gatto Virginia, Longo Emanuele, Lamberti-Castronuovo Alessandro, Forni Sauro, Russo Giulia
EMERGENCY NGO ONLUS, Milan, Italy.
J Prev Med Hyg. 2025 May 31;66(1):E56-E60. doi: 10.15167/2421-4248/jpmh2025.66.1.3337. eCollection 2025 Mar.
This paper presents a case study of the barriers to care faced by a 44-year-old patient from Ivory Coast who has been living in Italy for 15 years. The patient visited his general practitioner (GP) in his neighborhood in southern Italy, seeking treatment for a complex workplace-related hand injury for which parenteral antibiotic therapy was recommended. During the medical examination, the physician also diagnosed the patient with diabetes mellitus and prescribed specialist examinations (i.e., diabetology, physiatry, surgery). Even if the patient was a regular resident in Italy, he encountered difficulties in navigating the health system to obtain the recommended services (i.e., administration of parenteral antibiotic therapy, serial dressings for the wound, booking several medical appointments). The local office of the Italian non-governmental organization EMERGENCY (EMR) stepped in to support the patient in facilitating the health system navigation and collaborated with his GP on a diagnostic and therapeutic strategy. The course was regular and the patient did not develop any complications (i.e., gangrene, sepsis). The synergy between EMR, the patient, and his GP has resulted in (1) an effective clinical pathway, (2) reduced barriers to access, and (3) increased patient empowerment. However, this approach proved to be extremely resource-intensive. Organizing these resources with more planning and forethought would have granted many more patients access to care. If the SSN were to provide comprehensive healthcare to all patients without relying on the presence of NGOs, outcomes for marginalized individuals would improve significantly, and healthcare resources would be utilized more efficiently and sustainably.
本文介绍了一个案例研究，对象是一名来自科特迪瓦的44岁患者，他已在意大利生活了15年，面临着就医障碍。该患者前往意大利南部社区的全科医生（GP）处就诊，寻求治疗因工作场所复杂手部受伤而推荐的肠胃外抗生素治疗。在体检过程中，医生还诊断出该患者患有糖尿病，并开了专科检查（即糖尿病学、物理医学与康复学、外科）的医嘱。即使该患者是意大利的常住居民，他在就医过程中仍遇到困难，难以获得推荐的服务（即肠胃外抗生素治疗、伤口的连续换药、预约多次医疗预约）。意大利非政府组织“紧急救援”（EMR）的当地办事处介入，支持患者就医，并与他的全科医生合作制定诊断和治疗策略。病程正常，患者未出现任何并发症（即坏疽、败血症）。EMR、患者及其全科医生之间的协同作用产生了以下结果：（1）有效的临床路径；（2）减少了就医障碍；（3）增强了患者的自主权。然而，这种方法被证明资源消耗极大。如果能更有计划和前瞻性地组织这些资源，将会让更多患者获得医疗服务。如果国家卫生服务体系（SSN）能在不依赖非政府组织的情况下为所有患者提供全面医疗服务，边缘化个体的治疗结果将显著改善，医疗资源也将得到更有效和可持续的利用。
