The shift to domestic healthcare before and after COVID in South-East Tuscany

Background and Objectives: The South-Eastern area of Tuscany covers a wide surface but has a significantly low density of population. This scenario, alongside the COVID pandemic, has brought the Local Health Authority to find a solution and a governance model based on telemedicine and e-health, to treat patients in the domestic environment or close to it. Furthermore, creating a network of health professionals with different competencies and specialities proved crucial to allow them to work together. This study aims to describe how the South-Eastern Tuscany Local Health Unit tackled this issue while dealing with chronic patients before and after the COVID years. 509 POPULATION MEDICINE | Abstract Book Methods: After describing all the models created and adopted for the health governance in the area, we performed a retrospective study gathering data from our repositories, collected by the related software which were and are used during the selected timeframe, and we confronted them with the data from ARS Toscana. Results: 1/1/2020 to 31/05/2022, the LCA followed 12,6671 COVID+ patients, 32573 of whom were 65 years old or older. 976579 health services were performed, and 66 health residences were followed. Over 90% of COVID patients were treated in their own houses, with rates for mortality and lethality lower than the regional mean (197.79 vs 288.67, 0.54 vs 0.77) Conclusions: The centralization of all data in a single repository allowed our COVID Central to coordinate patients, follow them constantly, to create a multidisciplinary team of different health professionals who can discuss and help each other to treat patients in their home setting, even the unstable ones, to prevent avoidable ER accesses. In the era of the new Community Healthcare Italian law (DM77), community medicine is going in the same direction: empowering telemedicine and an increased reach of health services and health professionals.