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Because a national law aims to curb rising health care costs and declining use of some services, Cagli’s hospital is being downgraded to an emergency care unit, officials said. Now the Cagli hospital deals with only acute cases.

Cagli Ospedale is one of the many small hospitals affected by the national law, which was passed more than 10 years ago. Cagli used to be a much more important hospital, said AnneMarie Ricci, the head nurse at the Cagli hospital. Since the population of Cagli is mainly elderly, the demand for some services, such as gynecology, has fallen below quotas, triggering the downgrade.

Ricci said the downgrade means that:

• The gynecology unit has been closed because the law requires a unit that deals with at least 150 births per year.

• An orthopedist now only visits Cagli once a week instead of three times a week.

• Health care workers now make house visits to the elderly rather than allow them to come to the hospital, because the elderly were staying in the hospital for long periods. They would take up a bed for the day just to rest.

There is still a specific ward for the elderly in Cagli, divided into two sections. One is for emergencies such as heart attack, and the other for chronic care such as diabetes. Many elderly people complain because they were used to coming to the hospital to rest. They would stay a while and are no longer able to do this because it is too costly for the hospital.

Cagli residents said they are feeling the loss of hospital services. Now pregnant women have to deliver their babies at the nearest hospital, in Urbino, 40 minutes away, said Theo, a male nurse at the Cagli hospital who declined to give his last name. Some of the women are upset that the birth certificate will say that the child was born in Urbino and not Cagli.

Maria Grazia, a 28- year- old woman, was disappointed at the closing of the gynecology ward. She said she won’t have to deal with the issue unless she becomes pregnant, but the closing is difficult for pregnant women because they have to travel 40 minutes away for their frequent checkups.

Bler Hajinolli, a 25-year-old man who lives in Cagli, was hit by a motorcycle. Hajinolli was brought to the hospital by a friend, and his arm was put into a cast. Although he said the care he received was good, the orthopedist that he needs to see weekly now only comes once a week instead of three times a week. This makes scheduling an appointment difficult.

An elderly woman in the hospital said that she hasn’t had an emergency, but if the hospital were to close down, it would affect her greatly because now she would have to travel.
Usually emergency patients will be stabilized in Cagli and then transported to Urbino, Ricci said.