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Opinion: Fixing hospital overcrowding means forcing gov’t to take it seriously

Dr. Peter Zalan says meeting the approaching demographic wave of elderly patients means fixing the home-care system
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I read in a local newspaper recently about an 80-year-old woman who spent two days in the emergency department on a stretcher, only to be moved to a patient lounge with three other patients, no bathroom and no sink. 

One night, it was so loud in the patient lounge a nurse working at the hospital felt sorry for the woman and moved her to a shower room so she could sleep.

This story is not surprising. It is a common reality for patients, doctors and nurses at many hospitals in Ontario.

This undesirable outcome is partly due to our Alternate Level of Care (ALC) patients. This is a type of patient that I never met in medical school, nor read about in any textbook. They are individuals who have recovered from their acute illness, but cannot leave hospital because they lack the strength to manage at home independently and the services they need in the community are not available immediately. 

I remember when a group of physicians addressed city council on this very topic in November 2008. We also met with Rick Bartolucci, our MPP at the time, asking for help. The hospital did receive help and things got better. For a while. 

What to do? 

Some hospitals are considering extreme measures to persuade patients to leave. In May, I read a story in the Globe and Mail about an 88-year-old man who spent a month in a southern Ontario hospital. A doctor decided he had recovered sufficiently to be discharged, but the man’s son disagreed, insisting his father still needed care that he and his wife weren’t equipped to provide.

When the son refused to take his father home, hospital officials leveled a series of threats that included the warning, “If you won’t take your father home, an ambulance will drop him off at a homeless shelter.” While the threat was not carried out, consider the pressure the hospital was under even to consider using such tactics. 

Demand for admission to in-patient services has also been increasing. The recently released 2016 Canada census anticipates a growing number of seniors for many years to come. 

To give you an idea of the size of this growth, the over-85 group, a big user of hospital services, has increased by 19 per cent in the last five years. It is true the Ministry of Health and Long Term Care, the North East Local Health Integration Network (LHIN) and Health Sciences North have been working diligently and collaboratively on solutions. 

But progress has been slow. Health Sciences North is operating near 110-per-cent occupancy.

In 1871, four years after Confederation, 3.6 per cent of the population was 65 years of age and older. The life expectancy of Canadians at the time was 40 years and only one in three people reached the age of 65. Today, life expectancy is over 82 years, and nine in 10 people can expect to reach 65 years of age. Sudbury’s seniors compromise 18.3 per cent of our population and increasing. 

This state of affairs has many downsides. Ambulance crews are obliged to stay with their patients until they are seen by hospital staff. As a result, fewer ambulances are available to provide assistance on emergency calls. Some hospitals have had to reschedule elective surgeries when beds were lacking for post-operative care.

Then there is the budget. The 2016/2017 financial year ended at HSN with a $7 million deficit due to the $7 million cost of caring for ALC patients. How to balance the budget next year?

Health care is a provincial responsibility. Next year, we will have a provincial election. Think about what to ask our potential MPPs and political leaders. 

Dr. Peter Zalan is Past President of the medical staff at Health Sciences North. His monthly column tackles issues in health care from a local perspective. If you have a question for Dr. Zalan, email it to editor@sudbury.com.



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