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More hospital alternatives needed for frail seniors
03 October 2010.
AMA Victoria and Aged & Community Care Victoria (ACCV) today called on the next Victorian Government to minimise the time older Victorians spend in hospital by increasing options for care in alternative settings. The call comes at the beginning of Seniors Week, which runs until 10 October.
The next Victorian Government must develop a plan to care for Victoria's growing older population outside of the State's already overburdened public hospital system," said AMA Victoria President Dr Harry Hemley.
"We're eight weeks away from the state election I'm yet to see a plan from the government or opposition on how their government would care for the growing number of older Victorians," Dr Hemley said.
According to ACCV CEO Mr Gerard Mansour, older Victorians could avoid unnecessary admissions to residential aged care with increased support in the community.
"The time has come to give older patients more choice about where they recover after hospital admissions," he said.
AMA Victoria has put a proposal to the government and opposition to trial an alternative to hospital care for older Victorians who are not sick enough to be in hospital but are not ready to return home.
"A share-house style model would provide cheaper, more appropriate care to older Victorians who need a low level of care but want to regain or retain their independence," Dr Hemley said.
Under the share-house model proposal, up to eight patients would live in a supported share-house or unit. Each patient would have their own private room and access to a shared kitchen, common area, laundry and gymnasium. Patients would be expected to cook and clean form themselves, with support available as necessary.
ACCV's proposal's to keep older patients out of hospital recommends the use of aged care facilities to provide short stays for patients who are not sick enough to be in hospital but aren’t ready to go home.
"Our aged care industry is ideally placed to work with GPs and hospitals to provide the support needed to assist in their return home," said Mr Mansour. "We need to provide a platform for various lengths of stay would be a good use of existing aged care infrastructure.
"This is already a feature of many small rural services and is easily adaptable across Victoria," he said.
"Instead of having older patients lay in hospital beds or aged care facilities, we need to give them opportunities for rehabilitation in these two models of step down care," Mr Mansour said.
"It's about giving older Victorians the opportunity to keep their independence and return home if they can," Dr Hemley said. "Or, alternatively, improving their acceptance of the need to move to residential care."
BACKGROUND:
Objectives of the step out care program would include:
- Ensure patients have another care option other than straight to home or permanent entry to residential aged care,
- Providing practical and intensive allied health support to ensure the best possible chance of the patient returning home,
- Provide access to various social engagement and lifestyle programs which are a feature of residential aged care facilities,
- Freeing up acute hospital beds (up to 15,300 bed days per annum), and
- Allow older people an opportunity to see if they were ready to go back home, or improve acceptance of the need to move to permanent residential care.
Success Criteria
The trial should be deemed a success if
- fewer patients end up in unnecessary permanent entry to residential aged care, and
- fewer readmissions to hospital, and if acute beds are released for other patients. The trial should be rigorously evaluated over a three year period.
Together AMA Victoria and ACCV share a vision to help Victoria lead in the delivery of the right care in the right place and add value to new health reform initiatives.
Costing Summary for Model 1 (AMA Victoria) and Model 2 (ACCV)
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COMMUNITY STEP DOWN HOME - 8 BED/ROOM CONSTRUCTION |
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Category
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Year 1
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Year 2
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Year 3
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Total for 3 Years
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Capital costs
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$3,000,000
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$500,000
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$500,000
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$4,000,000
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Capital Cost per Unit p.a. (32 beds)
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$93,750
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$15,625
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$15,625
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Running costs
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$4,500,000
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$4,500,000
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$4,500,000
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$13,500,000
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Running cost per unit p.a.(32 beds)
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$140,625
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$140,625
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$140,625
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Evaluation & Project Mgmt
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$600,000
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$300,000
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$900,000
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$1,800,000
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Total for Community Step Down
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$8,100,000
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$5,300,000
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$5,900,000
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19,300,000
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(TOTAL 3 year Project Cost Per Unit, 32 Persons -$603,125) |
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AGED CARE FACILITY STEP DOWN – TYPICAL 10 BED/ROOM CONSTRUCTION |
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Category
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Year 1
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Year 2
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Year 3
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Total for 3 Years
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Capital costs
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$2,500,000
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$50,000
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$50,000
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$2,600,000
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Capital Cost per Unit p.a.(10 beds)
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$25,000
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$5,000
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$5,000
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Running costs
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$1,800,000
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$1,800,000
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$1,800,000
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$5,400,000
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Running Cost per Unit p.a. (10 beds)
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$180,000
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$180,000
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$180,000
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Evaluation & Project Mgmt
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$600,000
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$300,000
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$900,000
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$1,800,000
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Total for Aged Care Step Down
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$4,900,000
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$2,150,000
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$2,750,000
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* 9,800,000
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(TOTAL 3 Year Project Cost Per Bed, 10 Persons - $980,000) |
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Costing notes: There has been no allowance made for savings from acute care services or home support services foregone.
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