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NSW taxpayers are spending an estimated $1.2 million a day on hospital patients awaiting discharge to aged and disability care, as long waitlists for nursing homes leave families in limbo, frail patients vulnerable to sickness, and emergency departments under strain.
Amid a fight between state and Commonwealth governments over who pays for surging hospital costs associated with an older and sicker population, NSW Health Minister Ryan Park warned the delay was exposing vulnerable patients to greater risk of falls and hospital-acquired infections, and leading to “bed block” across the state’s hospital network.
The number of patients in NSW hospitals awaiting discharge to aged and disability care has jumped more than 60 per cent in a year, the latest data shows. Credit: Aresna Villanueva
“It absolutely clogs the system up because we can’t get acute patients into beds if we’ve got aged care or NDIS patients stuck in those beds after they should have been discharged,” Park said. “It’s terrible for the patient and their family but also terrible for our staff because that person is utilising a bed that we so desperately need … Some of these people can stay in hospital for months.”
There were 1151 aged care and NDIS recipients in NSW public hospitals at the beginning of this month who had exceeded their expected date of discharge, NSW Health shows, an increase of more than 60 per cent in a year.
The number accounts for more than 5 per cent of the 21,937 overnight hospital beds across the state.
The issue is particularly acute in Park’s own electorate of Keira, where a recent analysis found up to 20 per cent of bed days in the Illawarra Shoalhaven Local Health District were occupied by aged care residents due to an estimated shortage of more than 1000 residential care places.
The taskforce tracked 1133 patients heading to aged care who ended up in hospital, finding the vast majority (94 per cent) first arrived at hospital through the emergency department.
They spent an average of 66 days in hospital. In one case a patient spent 410 days waiting for a place in aged care.
The study estimated the cost to the health district’s budget at about $86 million a year. NSW Health estimates an overnight stay in hospital costs the state $1075 per bed, translating to a statewide cost for all 1151 patients of more than $1.2 million a day.
University of NSW Adjunct Professor Kathy Eagar, a health services and aged care expert who helped lead the study, said extended hospital stays were bad both for elderly patients and the whole system.
“By the end of that process of lying around in a hospital bed, if [patients] weren’t already completely frail and deconditioned, they are by the time they get out,” Eagar said. “Those patients are sitting in medical beds, and then because the medical beds are full, the medical patients overflow into the surgical beds. When the surgical beds are full, elective surgery gets cancelled.
“It’s not the patients who are the problem. It’s a system failure.”
The most recent data shows 2534 patients were waiting longer than recommended for elective surgery at the end of June.
Park will on Wednesday announce a $30 million funding package towards establishing short-stay surgical centres to shorten wait times for common procedures such as tonsil removals, hernia repairs and cataract extractions, accounting for more than 80 per cent of all surgeries performed in NSW public hospitals.
Treasurer Daniel Mookhey and his state and territory counterparts have been threatening to stall a new health funding deal and major changes to the NDIS unless the Albanese government stumps up billions more to cover a 12 per cent growth in the cost of running hospitals.
Premier Chris Minns last week said it was unlikely a new funding arrangement would be struck by the end of the year, after he and other state premiers and chief ministers shot down the Commonwealth’s offer of an extra $20 billion over five years.
“The idea that we’re on the brink or the precipice of the deal is a long way off,” Minns said.
Two days later the board of state treasurers released a report showing up to 10 per cent of hospital bed days were occupied by people waiting to go into nursing homes or disability care, leading to significant growth in costs that were “legitimate, unavoidable, [and] almost certain to persist over the medium term”.
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Kellie Sloane, NSW opposition minister for health, said the Minns government needed to step in and investigate providing more aged care beds out of hospital to support the state’s most vulnerable.
“We cannot tolerate a situation where we have so many older people languishing in hospital beds,” Sloane said. “This merry-go-round of misery needs to stop, and someone needs to be accountable for what can only be described as a national disgrace.”
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