Defend Public Healthcare

The Sault Ste. Marie Hospital hopes to save $1 million by cutting 73 jobs.  The hospital announced these  cuts with an updated "Hospital Improvement Plan". (Geez, I hope we don't see too many more "improvements".) As usual, the hospital plans to reduce the number of "alternative level of care patients" (i.e. convalescing patients past the acute stage). The trend however has been for an increase in these convalescing patients at hospitals -- Sudbury Regional Hospital recently released a report noting that ALC days at the hospital had doubled between 2004/05 and 2009/10. And that occurred largely before the current squeeze on home care and slow down in the creation of new LTC beds.  dallan@cupe.ca

The Sault Area Hospital has yet another outbreak of hospital acquired infections (HAIs), the Sault Star reports . In fact the MRSA outbreak was declared September 7, and 22 patients have now tested positive. Hospital president Ron Gagnon pointed to overcrowding as a contributing factor. "It's showing over-capacity is an issue," he added. As per government policy, the hospital is trying to reduce bed occupancy by developing new programs to move patients back to home.  And the hospital has achieved some modest success.  As of last week, 99 "ALC patients" (typically patients in medical or surgical beds who no longer require a medical or surgical bed), down from an average 103 in September. However, the majority of these patients  -- 73 -- are awaiting placement in long-term care and cannot benefit from these programs. As elsewhere, long-term care spaces are scarce in the community. And as elsewhere, the problem of high bed occupancy and the high number

Patients who no longer need medical or surgical beds (ALC patients) now occupy about half of the medical and surgical beds at the Lake of the Woods Hospital in Kenora, according to the Miner and News . Despite a rapidly aging population, the provincial government is slowing the development of new nursing home beds across the province. Some new transitional beds are being established in nursing homes, retirement homes, hospitals, and other facilities around the province, but not in sufficient numbers to stop the back up of patients in hospitals.  As a result, high bed occupancy constantly threatens the ability of the hospitals to treat new patients and provide adequate care.  "We've been fortunate that there hasn't been as much (admittance) as we had last fall and winter," said Mark Balcaen, the hospital CEO. "We're coping but at any moment, things could change. All you need is a four or five person surge to be admitted tonight and we're back to the

Yesterday, the Institute for  Clinical Evaluative Sciences (ICES -- funded by the Ontario Ministry of Health and LTC) released a detailed study on seniors health care entitled  Aging in Ontario .  The study reports a number of interesting results: The number of Ontario seniors aged 85 and older increased by 36% over six years (2002-3 through 2008-9), This is more than any other age group in the adult population.  There was also a 13.7% increase in seniors 65 and over. The number of acute care hospital beds per 100,000 Ontario seniors decreased (Quite significantly: from close to 1,000 beds to, perhaps, 850 beds -- D.A.). The number of "ALC patients" (i.e. patients in acute care beds who no longer need acute care services) waiting for a bed at an LTC home (i.e. a nursing home)  almost doubled between 2005/06 and 2008/09. Patients in hospitals waited 55 days in the last quarter of 2008/09 for admittance to an LTC home. Those admitted from the community waited 153 days, w

Ontario's for profit long term care homes see gold in them thar hills! Not satisfied with their LTC gig, now the OLTCA wants "to take those hospital acute-care patients who may do better in a “more home-like” environment." And it get's better: "Over time and with the right per-diem funding, (OLTCA president) Cormack suggests, long-term care could also serve well people with chronic conditions who are now in hospitals’ complex continuing care units." What's next? Emergency Rooms? ICUs? As predicted, the government's attempt to shrink public hospitals (and public health care) is a growth opportunity for the profit takers. dallan@cupe.ca Long-term care can be a restorative, transitional service provider -- June 30, 2010 -- OLTCA Morning Report

The tripling of waits for Ontario LTC beds has driven up the number of alternate level of care (ALC) patients in hospitals.  The Ontario Health Quality Council notes that every 3.3 day increase in the average hospital patient wait for an LTC bed is associated with a 1% increase in the number of hospital beds that are ALC. Now we are at 16% of acute beds that are filled with ALC patients. This despite a dramatic reduction in in the number of hospital admissions for ambulatory care sensitive conditions.  In 2007-8 there were (according to the Quality Council) 296 hospital admissions  per 100,000 population for all ambulatory care sensitive conditions. This is down from about 400 in 2002-3. That's about a 25% reduction in just five years.   So, for example, there has been a huge reduction in hospitalizations for angina  (the admission rate has decreased more than half over the last six years) and there has been a major decline in hospitalizations for asthma in the last four years

Some interesting observations from the Ontario Health Quality Council in its recent report: • Despite a major increase in LTC beds several years ago, wait times for an LTC bed have tripled since the spring of 2005 and are now at 105 days (over three months). For those waiting in the community, the wait is 173 days; for those waiting in hospital, it is 53 days. The latter contributes to the growth of ALC beds in hospitals. Only 40% of those needing LTC care got their first choice of home when placed for the first time. • One in four people placed in LTC could potentially be cared for in alternative settings. • There has been no major improvement in injury rates for health care employees in the past six years.  Although hospitals have lower injury rates than other sectors, such as LTC, overall healthcare has higher injury rates than other industries, such as construction and mining. The increase in LTC wait times should be no big surprise: as reported earlier, the government has s

The Champlain LHIN boss, Dr. Robert Cushman, has practically ridiculed the Cornwall Community Hospital for proposing to place 30 convalescent beds in the hospital to help deal with the growth of alternate level of care (ALC) patients. According to Cushman, the proposal is a 'knee jerk reaction'. How on earth does this fit with the Health Minister's new plan to create more short term 'restorative' beds? This response is also disappointing as the North East LHIN recently added 136 convalescent beds to the Memorial site of Sudbury Regional Hospital (for at least a year) to deal with their growth of ALC patients. It also seems the Central East LHIN will postpone the proposed cut of convalescent beds at Northumberland Hills Hospital for a year. Dr. Peter Zallan, of the Sudbury ALC Committee, notes that the creation of new convalescent beds at the Memorial site of Sudbury Regional was important: "Without the Memorial site, this place wouldn't be functioning

The Waterloo Record has run a fascinating story today on waits for long term care in Ontario.  Some highlights: From 2007 to 2009, the average wait time for a nursing-home bed in Ontario more than doubled, from 49 to 109 days. The province wide tally of people waiting is now more than 25,000 and rising, doubled from 12,000 in 2005. The supply of new beds is static, with annual growth of less than one per cent. Only 900 more beds are expected to be available in nursing homes over the next 24 months. The average wait for a long-term care bed through the Local Health Integration Network of Waterloo Wellington is 204 days. Only 33.9 per cent get their first choice of home. For hard-to-place seniors with a need for a higher level of care, waits can be two or more times the provincial average. In rural areas and northern Ontario, families may be separated by hundreds of kilometres, if there are beds at all. On average, less than 40 per cent of applicants get their first-choice home.