Huge rise in number of 'delayed discharge' patients

THE NUMBER of patients who no longer require an acute hospital care and who are occupying a bed inappropriately due to a lack of step-down or other facilities has increased by more than 60 per cent in the past two years, new figures show.

A report drawn up for the board of the Health Service Executive (HSE) last week found that there were 909 “delayed discharge” patients in hospital beds around the State in August.

HSE management warned that there were preliminary indications that the situation could get worse in the months ahead.

“Delayed discharges have increased by 22 per cent compared to the same period last year and 63 per cent compared to same period in 2007,” the report stated.

It said the number of delayed discharge patients continued to be high in the month of August. The problem had increased significantly between January and May this year but had then subsequently stabilised.

However, the HSE warned that the situation could deteriorate again in the weeks ahead.

“In 2008 and 2009, August has marked the beginning of an increase in delayed discharges until November. There are preliminary signs of an upsurge in August 2009, which may mark the start of this pattern in 2009.

“The actual pattern will not be apparent until next month,” the report stated.

The HSE figures for delayed discharges are based on data from 37 hospitals around the State. This does not include maternity, paediatric or single speciality centres.

The average number of delayed discharges for the whole of 2009 so far is 843, according to the report given to the HSE board.

Last month The Irish Timesrevealed that the HSE was planning to tackle the issue as one of its priorities for next year and was considering radical options to deal with the problem.

Among these proposals are the effective conversion of wings of hospitals into nursing homes or the transfer of staff and resources from the acute sector to enable patients to be treated in the community.

Under the first option, all delayed discharge patients in a hospital would be moved into one particular wing or part of the building.

Sources said that once the patients were “cohorted” within the hospital, this particular unit could be run more like a nursing home.

This would involve the provision of less intensive levels of care.

However, sources said this option was not ideal from a clinical point of view and also had industrial relations implications.

Another option is the transfer of staff and resources from the acute sector to a community setting to enable a greater number of patients to be treated there.

However, sources said that this could give an impression that hospitals were being downgraded and also present some industrial relations problems.

Meanwhile, the HSE report also reveals that 934 hospital beds around the State were closed during August. It said that this figure comprised 884 inpatient beds and 50 day beds.