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Vital figures missing from Your Hospitals report
17 July 2009.
The latest Your Hospitals report reveals nearly 200,000 Victorians missed out on clinically appropriate care last winter, AMA Victoria President Dr Harry Hemley said today. Yet the published figures only show part of the story.
On the published figures, more than 195,000 Victorians did not receive access to medical care within clinically appropriate timeframes between July and December 2008 — a slight improvement on the same period in 2007.
“Today’s Your Hospitals tells usthe number of Victorians missing out on clinically appropriate care is slightly better, but still alarming,” Dr Hemley said. “But most concerning is that the Victorian Government continues to hide vital information — the time patients wait for a hospital outpatient clinic appointment — despite the Auditor-General’s recommendation to publish these data.
“The figures that are published only show part of the story — and it looks grim. Lengthy waits can seriously increase risk of complications and even death. All public hospital patients should be seen within the clinically appropriate times.”
Dr Hemley noted that the time to treatment includes the time to see a doctor in a hospital (which is not published) not just the time from when that doctor determines a patient needs treatment (the figures published today).
“The Victorian government has made commitments to improve the integrity of its hospital performance data, but until a commitment is made to publish the outpatient clinic waiting times, we will only have part of the picture of Victoria’s waiting times for surgery,” Dr Hemley said. “Victorians deserve to know the full story.”
Dr Hemley explained that the government operated a system where clinical care standards for waiting times were set by doctors. For example, all people entering an emergency department with no heartbeat are seen immediately, while people with less severe injuries may need to wait.
“Treating two out of three, or four out of five, patients on time is just not good enough — particularly if you happen to be the fifth person. All patients should be treated in a clinically-appropriate timeframe.
“Victorian hospitals are still fairly efficient, but our productivity gains are slowing. Innovation and good patient care is being strangled by inefficiencies,” Dr Hemley said. “Many of these issues were covered in the Ministerial Review of Public Hospital Medical Staff, which the Minister received 18 months ago.”
“Victorians know that their hospital system is struggling. The Your Hospitals report shows that this struggle is affecting more and more Victorians every day. Yet the Victorian Government still refuses to tell us the whole story.”
Background:
AMA Victoria has analysed the latest Your Hospitals report released today, and notes that in the July to December 2008 reporting period:
- Approximately 195,000 Victorians missed on out on care in a clinically appropriate time period.
- 20 per cent of category two emergency patients were not seen within ten minutes — this represents 10,000 patients with symptoms such as very severe pain, stroke, appendicitis, severe breathing difficulties, or major fractures over the six month period.
- 30 per cent of category three emergency patients were not seen within 30 minutes — over 47,000 Victorians suffering symptoms such as moderately severe blood loss, broken wrists, persistent vomiting, and dehydration over the six month period.
- 34 per cent of emergency department patients did not get a hospital bed within eight hours — more than 44,000 Victorians over the six month period.
- 26 per cent of non-admitted patients were not discharged within four hours — representing more than 83,000 Victorians over the six month period.
- Almost one in three Victorians needing semi-urgent elective surgery were not operated on within 90 days — an increase of around 1500 on the same period the previous year. These waiting times are in addition to the unspecified time these patients were waiting to be seen in outpatients, prior to being put on the waiting list for surgery.
Data background:
| Jul-Dec08 | Jul-Dec08 | Jul-Dec08 | Jul-Dec08 | Jul-Dec08 | |
| * CAT= clinically appropriate timeframe | % of patients seen within CAT | Actual | KPI met? | No. treated withing CAT (est) | No. missed out on care withing CAT (est) |
| Emergency | |||||
| Ambulance bypass | 3.1 | no | |||
| Cat 1 immediate | 100 | 4242 | yes | 0 | |
| Cat 2 10 mins | 80 | 50147 | yes | 40118 | 10029 |
| Cat 3 30 mins | 70 | 156544 | no | 109000 | 47544 |
| Cat 4 one hr | 64 | 203282 | n/a | 130100 | 73182 |
| Cat 5 2 hrs | 87 | 40802 | n/a | 35498 | 5304 |
| Bed w/i 12 hrs | |||||
| Bed w/i 8 hrs | 66 | 129216 | no | 85283 | 43933 |
| Non-admit w/i 4 hrs | 74 | 319000 | no | 235558 | 83442 |
| Elective | |||||
| Cat 1 30 days | 100 | 21061 | yes | 0 | |
| Cat 2 90 days | 74 | 35174 | no | 26029 | 9145 |
| Cat 3 365 days | 92 | 20527 | yes | 18885 | 1642 |
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