Misuse of acute beds contributing to trolley crisis and waiting lists, study finds


A new medical study has raised concerns about the ineffective and ineffective use of acute care beds in the Irish healthcare system, after a survey found nearly 40% of beds in a major Dublin hospital were occupied by patients classified as “delayed discharges”.

Research by medical staff at Connolly Hospital Blanchardstown in Dublin also found there was ‘a striking correlation’ between delayed discharges and the number of patients on hospital trolleys.

However, it found that the proportion of delayed discharge patients occupying acute care beds had been reduced to 9% over a three-month period in 2020 due to the availability of additional facilities.

The study said its findings, published by Ireland’s Royal Academy of Medicine, contradicted ‘conventional wisdom’ that more acute care hospital beds were needed.

“It is clear that expensive acute hospital beds are being used inefficiently and inefficiently, which consequently impacts both the trolley crisis and waiting lists,” he concluded. .

The study noted that the daily cost of an acute hospital bed was estimated by the HSE at €838 in 2017, while the daily cost of nursing home beds ranged between €96 and €189.

Doctors at Connolly Hospital conducted an audit of acute care hospital beds in the first quarter of 2020, which coincided with an increase in the supply of relief beds in nursing homes.

One of the study’s lead authors, Professor Conor Burke, said the findings showed that providing more flexible beds needed to become a high priority to ensure better care was delivered at lower cost.

“Current data shows that 39% of acute care beds are occupied by patients who do not need them and whose well-being is compromised by an unnecessary hospital stay,” said Professor Burke, consultant in respiratory medicine at Connolly Hospital.

He said these patients would much rather be at home with access to community care support services or alternative facilities.

“Regardless of the significant cost new hospitals, our data argue for better use of existing acute care facilities. Only then should the construction of higher pitched beds be considered,” he said.

The study noted the dramatic reduction in the number of delayed discharges occupying beds at the start of 2020 was due to the provision of additional care home places by the HSE.

“We are not aware of any other possible intervention that could have a significant impact on delayed discharge in such a short time while allowing for better patient care of both withdrawing patients and those awaiting discharge. bed,” Professor Burke said.

The study found that hospital staff often had no choice but to use inappropriate hospital beds, such as surgical beds, which meant that patients scheduled for procedures would have operations canceled. , further adding to waiting lists.

The researchers noted that there is no national database for information on delayed discharges as there is a time lag in the figures contained in a register maintained by the HSE.

They also claimed that some patients were only delayed for discharge for short periods, which meant that they were not on the official register and that the true figure of delayed discharges was therefore “grossly underestimated “.

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