CA: Ontario:One in five people visiting emergency departments could be served elsewhere, study finds
There's about a 20 per cent chance — not insignificant — you and others could be served elsewhere.
Almost one in five people visiting an emergency department could be treated for their conditions in other places that wouldn't tax limited hospital resources, according to a new report released Thursday by the Canadian Institute for Health Information.
The institute reports Canadians "are among the most frequent users of EDs (emergency departments) in the world," with 17 million visits in the latest period, 2013-14. Many of these people visit for "minor conditions not requiring hospitalization," as well as seniors living in long-term care residences.
Research and analysis vice-president Jeremy Veillard concluded providing these patients with more appropriate care alternatives "will benefit patients and their families and reduce the pressure on emergency departments."
Dr. Ian Digby, the emergency department care lead for the Waterloo Wellington Local Health Integration Network, said Thursday that while the emphasis is on diverting less ill patients, hospital emergency departments may still be the appropriate place for care.
"If somebody thinks they have an emergency, we want to see them. … They should come to emerg. We provide excellent care," Digby said of hospitals. "We are open 24-7 and we want to see them.
"That's what we're there for."
Hospital emergency personnel use a five-level triage system to assess patients, the highest requiring immediate resuscitation, followed by emergent and urgent levels. The last two are the least acute: less urgent and non-urgent care for incidents like minor scrapes.
Guelph General Hospital, the city's acute care facility, on Thursday reported experiencing 18,525 emergency department visits in the latest fiscal year in the last two categories, which it describes as visits in which people could have been treated in other medical settings, such as clinics.
That translates into 32.2 per cent of emergency department visits.
Digby said hospitals in the region are getting busier and often treating people with more complex care requirements, amplifying the need to divert those with minor ailments from potentially avoidable visits.
"There's been a lot of work done to increase the availability of family docs," he said.
Health Care Connect telephone and internet service identifies available doctors and nurse practitioners. Telehealth Ontario provides free confidential phone access (1-800-797-0000) to registered nurses. Health Links co-ordinates care from family physicians for people making high use of health services.
Where appropriate, the Local Health Integration Network, the regional funding and planning body, is guiding the evolution of alternatives to hospital visits for more minor ailments with the development of family health teams and after-hours clinics, which provide readily available services, Digby continued. The Guelph Family Health Team, for example, has 77 family physicians, nurse practitioners and other health professionals in several locations. Teams recognize patients want timely, accessible care.
"There's been a lot of recognition of this," said Digby. "I think we're moving forward."
"Family docs have been trying hard to figure out how to get people in more quickly when they need to be seen."
The institute found one in five visits in which patients were not admitted or were discharged home were for less acute ailments, which were treatable in doctor's offices or clinics. For example, about a third of visits (34 per cent) were for upper respiratory infections and sore throats, including getting the antibiotics they assumed they needed.
Further, one in three visits involved senior citizens from long-term care facilities. A quarter of these (24 per cent) were for potentially preventable conditions such as pneumonia and urinary tract infections. Another 10 per cent were for less-urgent or non-urgent events such as falls.
Drilling down, the institute reported children with minor medical conditions had the highest rates of emergency department visits. Complaints ranged from respiratory ailments to ear infections.
Often, the reason Canadians cited for going to emergency departments was the ease and timeliness for doing so, compared with making an appointment to see a family doctor.
As for seniors, the institute said they often have ready access to treatments in their long-term care facilities around-the-clock, so emergency department visits "may have been better addressed on site."
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Autor(en)/Author(s): Vik Kirsch
Quelle/Source: Guelph Mercury, 07.11.2014
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