Hospital Wait Times vs Long Term Care

Last week the Vancouver Sun had an interesting article indicating why hospital wait times are so long. The study comes from the Wait Time Alliance, which puts out hospital report cards, and breaks down results by province. According to the article:

“The data show that the system is barely functioning as a system at all, as too often, patients are languishing in hospitals instead of receiving the appropriate level of care they need,” said alliance chair Dr. Lorne Bellan. “These patients would receive more appropriate and cost-effective care outside of the hospital.”

According to the report card, several provinces are also reporting wait times for home care and long-term facilities. The report indicates that:

According to the Ontario Hospital Association’s calculations for April, approximately 4,256 patients were in an acute care or other inpatient bed in Ontario every day, waiting for an alternate level of care to be provided. Alberta reported 660 patients awaiting continuing care placement for the third quarter of 2010–2011. (Page 10 of the WTA 2011 Report Card).

Alternate Level Care (ALC) beds refer to spaces for people with chronic problems, like Alzheimer’s. The study points out that dementia cases are increasing as the population ages, and these patients require more specialized long-term care than hospitals can offer. Chronic patients admitted under emergency situations cause a chain reaction of problems for other patients once their emergency is over. If no long-term or home care facilities are available, they sit in a long-term care units taking up a bed that an ICU or surgical suite patient should step down to. This other patient remains in their bed, with means an emergency or surgical patient waits for treatment, which finally backs up emergency room spaces and surgical wait times.

The report card also indicates that money spent on ALC suites for chronic patients costs less than treating them in hospital care. While I don’t think provincial Ministries of Health should drastically reduce funds for hospitals – the report indicates that “increased demand for services, insufficient operating room time or equipment availability, and shortages of physicians and other health professionals” are major problems as well – perhaps the biggest chunk of wait times could be taken care of by improving and adding more ALC facilities, or more by providing additional home care, community and emergency clinics.

Because of my design background I would love to know: what is the impact of step-down units on wait times? I would love to see more statistics based on the model of hospital in the study, especially since their designs vary drastically.

I would also love to know: what has your experience been with wait times for long-term or alternative care facilities? What are you looking for in a long-term care facility?

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