A record number of patients with the most serious,life-threatening conditions were treated by paramedics and emergency departments in the last quarter of 2023,the latest data shows.
Patients with life-threatening conditions are overwhelming NSW emergency departments,while those requiring specialist care are spending longer in hospital than they were five years ago.Glenn Hunt
The figures,released by the Bureau of Health Information on Wednesday,also show patients requiring specialised or longer-term care in hospital were hospitalised for almost two days longer than five years ago.
While acute patients spent an average of 4.7 days in hospital,non-acute patients admitted to public hospitals from October to December 2023 averaged 16.7 days,up from 14.8 days in the same three months of 2018.
Patients were spending longer in hospital beds on average during 2021 and 2022 due to more patients being treated in hospital for COVID-19,and patients being discharged to aged care.
Bureau of Health Information chief executive Dr Diane Watson,however,said analysis of four common conditions showed the length of stay was increasing for some,regardless of the impacts of the pandemic.
“At a time when hospitals are so busy,looking at how long patients spend in hospital is really important,” Watson said. “Our focus was on finding opportunities to reduce length of stay that were unrelated to COVID-19.”
The average length of stay for patients admitted because of heart failure,for example,increased from 3.8 days in 2018 to four days in 2023,despite a decline in the number of cases.
Heart Foundation chief medical adviser Garry Jennings said that during the pandemic many people with chest pain delayed seeking treatment,while others were successfully treated at home when they previously would have required hospital admission.
“This likely means that those in hospital may be more severe and require more intensive management,leading to an increase in length of stay,” he said. “As the heart failure population tends to be older … discharge is often delayed because people have nowhere to go.”
Jennings said he would like to see more community programs to prevent and treat heart disease without needing to go to hospital,more action against tobacco and vaping products,and a sugar levy imposed on junk food manufacturers.
Hip replacement recipients are also spending slightly longer recovering in hospital than they did five years ago,despite medical advancements reducing recovery times overseas and decreasing length of stay for the other most common joint surgery of knee replacements.
Ian Harris,a professor of orthopaedic surgery at the University of NSW,said that Australian hospitals should be aiming for an average closer to three days.
Health Minister Ryan Park.Rhett Wyman
“Other countries are doing it,and clearly some hospitals in Australia are doing it,too,” he said.
A patient receiving a hip replacement can spend anywhere from three to six days in hospital depending on where in NSW they live,the report shows.
Patients at Goulburn and Grafton hospitals,for example,spend just over three days in hospital on average,while patients at Mt Druitt hospital spend over five.
Eight hospitals across NSW have signed up to trial same-day joint surgeries in a key strategy to come from the elective surgery taskforce unveiled by Health Minister Ryan Park shortly after Labor won the 2023 state election.
Park said similar efforts were being made to improve emergency department performance,with a separate ED taskforce “considering ways to safely embrace innovative strategies to treat patients more effectively”.
“We are throwing everything in our rucksack at improving access and reducing wait times in our hospitals,” he said.