Emergency Bottleneck Solution: More Public Hospital Beds Equals Less Access Block, Australian Medical Association

Main Category: Public Health
Article Date: 12 Sep 2008 - 5:00 PDT

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The Australian Medical Association's Vice President, Dr Gary Speck, said that breaking access block was in the best interests of patients, staff, hospital administrators and even politicians. Access block is the prolonged wait for a public hospital inpatient bed after emergency department (ED) treatment, which can lead to poorer outcomes including death.

The AMA was today taking part in the Access Block Solutions Summit to look at how best to overcome access block within existing public hospital capacity.

"The bottom line is more hospital beds are needed to break access block," he said.

Dr Speck said working on strategies to keep people out of hospital is at best, a second-order issue and should only accompany the main game - more hospital beds.

"Research shows that co-located GP services and telephone advice services don't fix the ED access problem.

"Access block might well be the biggest issue affecting safety and patient care in Australian hospitals.

"Governments cannot keep pretending that trying to get everyone healthy will be the cure for access block. People will still get sick, will still need to go to hospital and public hospitals will still need more beds," he said.

The AMA has been advocating for a Federal Government cash injection of more than $3 billion to fund at least 3,750 extra beds and the associated staff and infrastructure so public hospitals can cope with demand and operate at internationally-accepted safe bed occupancy levels of 85 per cent or less.

A study commissioned by the Australian College of Emergency Medicines estimated that more than 1,500 patients die each year as a result of emergency department overcrowding. That is similar to the number of people who die on our roads each year.

The review prepared by Simpson Centre for Health Services Research, of UNSW for today's summit stated that there was clear evidence that the main cause of access block and ED overcrowding was a combination of major increases in emergency admissions and ED presentations with almost no increase in the capacity of hospitals to cope with the demand.

The review also said that the most vulnerable individuals affected by access block were those who required unplanned hospital admissions - such as the elderly, particularly those with chronic and complex conditions, those brought by ambulance and children.

Dr Speck said the situation had steadily worsened over the past five to 10 years because governments have reduced the number of public inpatient beds. Hospitaland administrators treathought the problem was insurmountable when, in reality, it's not.

"Getting hospital administration and the whole health system to admit there is a problem is half the solution to access block.

"Bureaucrats need to admit that running an emergency department at 150 per cent capacity is inherently dangerous and until they do admit that, we won't be able to turn things around.

"Having spare bed capacity in the hospital is vital for the safe and effective handling of emergency admissions," he said.

Australian Medical Association

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