ANCC president José Bourdain told Lusa that continuing care units did not receive any reinforcement for the increased effort requested of them during the pandemic, nor for the subsequent increase in costs resulting from inflation and the increase in energy.

"At the time of the pandemic, the beds contracted at that time should have received an additional 1,500 euros due to the increase in costs we had because the government did not even give us a mask. We were discriminated against," said the official.

José Bourdain gave the example of the institution he manages, stating: "We had four private beds and we were asked if we could give some to the network. We ended up giving up two, which ceased to be private and became part of the continuing care network, and there were other units that also made this effort during the pandemic".

"In terms of budgetary impact, it is nothing extraordinary, in round numbers, it exceeds 10 million euros, which is insignificant in the State Budget," he said.

To compensate for the cost differential with more complex patients, the ANCC also suggests that the financing of the units be adjusted to the degree of complexity of the patients, either by payment by Homogeneous Diagnostic Groups (GDH) or by increasing a base value according to the complexity index (case-mix).

This payment process according to the complexity of the patient has already been tested in 2021, 2022 and 2023 in the transitional agreements between the Regional Health Administrations (ARS) and private health units, to support the treatment of acute, subacute and clinically discharged patients, awaiting a social response in hospitals.

The ANCC also advocates carrying out a cost/effectiveness analysis of this solution to allow its replication in the National Network of Integrated Continuing Care (RNCCI), recalling that this daily cost is higher in Integrated Continuing Care Units (UCCI) in the interior of the country and, therefore, proposes an increase between 10% and 15% in these situations.

Last week, the association met with the Secretaries of State for Health, to whom it delivered a document that diagnoses the functioning of the RNCCI and proposes several solutions.

One of the proposals, to adjust the occupancy of the units to the needs of the users, is to carry out a survey, by Social Security, together with the homes (Residential Structures for the Elderly -- ERPI) to assess the existence of vacancies occupied by users with criteria for integration into the RNCCI, which could be exchanged for vacancies in continuing care units without clinical criteria for permanence in the network.

To compensate the units for the increase in costs, the ANCC advocates an immediate increase in the daily values.

The proposal presented provides for an increase in the daily values by 7.8% (Consumer Price Index of 2022 resulting from the legislation) and 4.3% (CPI of 2023 resulting from the legislation) plus 10 euros per day and per user in the Long-Term and Maintenance Unit typology, eight euros per day and per user in the Medium-Term and Rehabilitation Units plus two euros per day and per user for the payment of diapers and five euros per day and per user in the Convalescence and palliative care typologies.

The association also suggests that a "study of the real daily cost per patient in the different typologies be carried out, taking into account the changes imposed by the current legislation, the change in the profile and characteristics of the users referred to the RNCCI". The intention is to find a "correct and fair calculation" of the values to be paid per user, both by the Ministry of Health and by the Ministry of Labour, Solidarity and Social Security.

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