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Private Hospital access fears confirmed
AMA Victoria President, Mukesh Haikerwal, today released the results of a survey of doctors, which confirm fears that certain patients have difficulty gaining access to private hospitals when they need to."Of the 520 doctors who responded to our fax-back survey, 124 reported knock-backs when trying to get patients into private hospital beds in the preceding four weeks," Dr Haikerwal said.
"We asked doctors to detail the circumstances of each bed refusal, looking at the age of the patients, diagnosis, hospitals involved and total delay in admission. The vast majority of the 242 patients who were refused admission (62%) were what we would term medical patients. That is, patients who require non-surgical treatments for conditions such as pneumonia, heart failure, and kidney failure.
"Age is confirmed as a barrier, with three out of five patients refused admission over the age of 65. If we use 55 as the cut-off age then it jumps to nearly three-quarters of those refused admission.
"To get a sense of the size of the problem we looked at data on private hospital admissions for 1999/2000, and compared it to our figures on admission refusals. From this comparison we identified a problem in the two age groups:75–84 years and 85 years plus.
"The 75–84 year age group make up 15% of private hospitals admission, but accounted for 28% of our refusals data. Likewise, the 85-year-plus group account for less than 5% of hospital admissions, but 16% of our refusals. Overall, 44% of patients refused admission were aged over 75, but this age group only makes up 20% of private hospital admissions.
"Obviously, it is these older people who are finding it particularly difficult to gain admission to a private hospital. If the refusal of admission only related to the reasons given by the hospital, ie, lack of beds or staff shortages, then our graph should show an even rate of refusals compared to admissions across the age groups, but instead it shows dramatic increases in the older age groups.
"The survey also showed admission refusals were not confined to particular hospitals, with knock-backs reported from private hospitals across the state.
Medical: patients who usually require non-surgical treatment such as intravenous medications, examples include pneumonia, heart failure, kidney infections.
Surgical no operation: patients with conditions who are usually under the care of a surgeon, but who in this instance would most likely be treated by non-surgical therapies, examples include pancreatitis, lumbar disc prolapse, secondary cancers and renal colic.
Surgical operation: patients, including children, with conditions which would normally require a surgical intervention, examples include appendicitis, initial cancer diagnoses or fractures.
Obstetrics: patients with conditions that occurred in the antenatal or perinatal period, examples include incomplete spontaneous abortion.
Paediatrics: children with non-surgical conditions, examples include gastroenteritis, bronchiolitis and asthma.
Psychiatry: patients with psychiatric conditions, for example depression.
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