Occupied: Doctors blame blockages on the wards for a blow-out in emergency department wait times. Photo: Nicolas WalkerHundreds of elderly people are clogging hospital beds in NSW because they are waiting for beds in overstretched nursing homes, putting further strain on the public health system.
More than 550 people in acute hospital beds who are fit to be discharged are waiting for placement in a nursing home on any given day in NSW, at vast cost to the taxpayer and considerable risk to their health.
According to documents obtained under Freedom of Information laws, nearly half of them had been in hospital longer than 35 days and 22 people had been there for longer than 400 days at the most recent census.
With the population of people aged over 70 set to boom over the next decade, the Aged Care Financing Authority has forecast an extra 76,000 aged care beds will be required.
Doctors blame blockages on the wards for a blow-out in emergency department wait times, with many hospitals failing to meet their targets while ambulances line up outside.
The NSW chief executive of the peak industry body Leading Aged Services Australia Charles Wurf said industry uncertainty had resulted in NSW providers slowing or abandoning their building works, at a time that the ageing population was booming.
“It’s a substantial problem because it takes us four years to put beds on the ground,” Mr Wurf said.
“If we don’t get going again the crisis will certainly come.”
A census conducted for the Department of Health and Ageing in 2012-13 showed that, nationally, 1197 people aged over 65 had continued to occupy hospital beds after their treatment was complete, down from 1252 the previous year.
NSW and the ACT were the only states that recorded an increase in long stay older patients, by 34 per cent and 49 per cent respectively, which was attributed to a change in methodology in NSW and the redevelopment of several aged care homes in the ACT.
The occupancy rate is currently 93 per cent but Mr Wurf said it was only 70 per cent for low care beds, while high care was running at 95 to 98 per cent.
Council of the Ageing chief executive Ian Yates said occupancy rates varied enormously between aged care providers, with popular centres running at capacity while others had beds available.
But “bed blocking” was regularly an issue in Australia.
“At any point in time you’re going to have a certain number of people in hospital beds who are being moved to a less acute facility and that doesn’t always happen with a click of the fingers … so there’s always going to be certain number,” he said.
There needed to be more transitional care programs that gave people a half-way option between hospital and home that would remove the immediate need for an aged care place, he said.
“We’ve had a shove-and-forget policy in this country for a long time.”
It is about six times more expensive to look after a patient in hospital than in aged care, at $1200 per day for the average NSW bed, versus $200 for a high-needs aged care bed.
Nearly 55,000 hospital bed days were occupied by long-stay older patients in NSW at the 2012-13 census.
Leading Aged Services Australia, which is lobbying the NSW Government to restore tax exemptions to for-profit aged care centres, has funded research that found the bed day cost to the NSW hospital system on patients who could be in residential care was $21 million.
NSW Health said in a statement that more than 60 per cent of older people with an extended length of stay were waiting for residential aged care.
“The availability of appropriate nursing home beds is a Commonwealth responsibility but the impact of the lack of availability is felt by the NSW Health system,” the statement said.
Its range of specialist services for aged care patients included the Acute to Age-Related Care Services program operating at most major hospitals, which identified how older patients needed to be supported after discharge and eliminated or reduced the time they needed to wait, it said.
The Department of Social Services said the federal government had a plan to ensure the supply of aged care places matched the growth in the aged population, and would reach 125 aged care places for 1000 people aged 70 or older by 2021-22.
HammondCare chief executive Stephen Judd said the government would save money by funding rehabilitation programs in the community under Medicare, instead of putting them in aged care.
These could be done in a short-term stay environment or in people’s own homes.
“They’re cheap as chips,” Mr Judd said.
“And people have got a strong motivation to improve because they’re in their own homes and they probably want to stay there.”
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