Surging hospital demand prompts calls for new strategies
Australia needs innovative solutions and new public health promotion measures to cope with the increasing demand for hospital care caused by an ageing population and an increase in chronic diseases.
Australia is likely reaching the limit of how the length of stay in hospital can be safely reduced, according to new research.
The research, published today in The Medical Journal of Australia, shows that containing hospital costs by limiting bed availability and reducing length of stay may no longer be a viable strategy.
Dr Natasha Reid, a research fellow and clinical epidemiologist at the Centre for Health Services Research at the University of Queensland, and her colleagues Thakeru Gamage, Dr Stephen Duckett, and Professor Leonard Gray, reviewed hospitalisation data from the Australian Institute of Health and Welfare (AIHW).
“We are likely reaching the limit of how much we can safely reduce length of stay in hospital using current health care models,” Dr Reid said in an interview with InSight+.
The burden of an ageing population and chronic diseases
The burden of Australia’s ageing population will continue to put demand on hospital systems, the research found.
“For the first time in history, there are more people aged 65 years and over than there are aged under 5 years,” Dr Reid said.
“The data are starting to indicate that we may not be able to further reduce length of stay using existing methods, and that hospital administrators need to start thinking about and educating themselves on what other solutions could be implemented.”
What needs to happen
Australia needs to start identifying other strategies that will help ease pressure on the acute care sector, Dr Reid said.
“Integrating technology (such as mobile health or remote monitoring) and investing in health promotion are just two potential avenues,” Dr Reid said.
Health systems need to be seriously considering how to adapt their operations to managing both an ageing population and chronic diseases, she said.
“Ageing and chronic disease management are core business in health care, and innovative solutions are needed to improve outcomes,” Dr Reid said.
Professor of Geriatric Medicine Leonard Gray, who co-authored the piece, said that one potential solution is increasing hospital capacity.
“One other solution to burgeoning demand related to population ageing is simply to build greater hospital capacity,” Professor Gray told InSight+.
“That is, more beds and significantly greater expenditure on hospital care.
“Until now, demand for beds has been controlled by reductions in length of stay for older people, with associated reductions in age specific bed utilisation.
“Logically, this cannot continue indefinitely, as the length-of-stay declines towards that of younger patients (which seems immovable, based on our observations).
Learning from overseas
Australia needs to look at what is being done internationally to help manage hospital admissions, Dr Reid said.
“Health services [overseas] have implemented solutions like expanding hospital at home programs, having dedicated emergency department processes and specialised wards for those who are frail,” she said.
For example, in the UK, many hospitals have implemented a Frailty at the Front Door service, aiming to improve the experience and outcomes of people with frailty who present at emergency.
Dr Reid said she and her colleagues were driven by the wish to positively impact the health of Australians.
“For as long as I can remember, I have wanted to positively impact the health and wellbeing of populations through evidence-based programs and health service design,” she said.
“The acute care/tertiary hospital sector is an area of huge potential because it is a necessary service, hugely expensive for government, and where we can create beneficial health, social, and financial impact.”
Read the research in The Medical Journal of Australia.
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