Better Use of Hospital Beds Recommended

A comprehensive assessment of acute care facilities shows that an average of one in four people in hospitals could be eligible for discharge.

In releasing the Health Facilities Review, Health Minister Jamie Muir said the report underlines the need for improved planning and better use of resources in health care delivery.

"The problem is not the number of hospital beds, it's how they're being used," said Mr. Muir. "This is not in the best interests of taxpayers, and it's certainly not in the best interests of patients."

The Department of Health worked with personnel from the four health care regions, hospitals and health centres in the province on a survey over two-week periods in November and December. The survey showed as many as 37.8 per cent of beds in one region of the province are being occupied by people who could be eligible for discharge.

"By identifying some of the barriers to community care, the Health Facilities Review will help us make creative changes in the system which will result in smoother transitions to more appropriate services," said John Malcom, CEO of the Cape Breton Health care Complex and a member of the province's clinical services team. "Evidence like this provides us with the opportunity to implement the right solutions -- not the quickest and the most expensive, but the best for patients and a sustainable future for our health care system."

The single, largest factor that keeps patients in hospital longer than necessary is access to nursing home beds. A second phase of the review, looking at the issues within the long-term care sector, found occupancy rates in nursing homes are often as high as 99 per cent. Other factors contributing to discharge delays are transfer problems, access to care at home and community- or family-related issues.

Although nursing home beds are an issue, the report stated: "It may not be the most efficient use of existing resources to embark at this time on a major expansion of nursing home bed capacity throughout the province." Rather, the report says the current move to a "single entry system" and a consistently applied eligibility policy for seniors requiring health services has "resulted in an actual reduction in need for nursing home beds" in other jurisdictions.

The minister said the fact that health care costs have grown by 40 per cent since 1996-97 shows more money has not fixed the problems.

"For too long, people have tried to treat the symptoms of the problems by pouring money into the system. It's now time to develop a plan -- a prescription if you will -- to cure the problems themselves."

Mr. Muir also said evidence-based decision making is important in strategic planning.

The findings from the review will be used by an ad hoc committee formed to suggest criteria for future investments and bed allocations in long-term care. The review will also assist in the development of a clinical services 'footprint,' which will assess what clinical services should be provided where. This information will provide the long-term direction for health care in the future. As these plans are being developed, hospitals are looking at other ways to provide more appropriate care at less costs. One option may be moving away from the traditional way of using beds to assist people whose needs aren't currently being met.

Mr. Muir thanked staff from the regional health boards and hospitals and health centres throughout the province, as well as home-care and long-term care providers.

"These people provided us with tremendous support, and I thank them for their co-operation in planning and conducting the review."