Dr Tracey McDonald AM PhD FACN, Professor of Ageing, 2012
The National Hospital Performance Authority (NHPA) has released a report on 'avoidable hospitalisations' adding to a suite of reports on how our Australian health and community care system is working. I commend the NHPA website to you as a teaching and learning resource that I hope will be useful to you and your students.
NOTE: The original site has been closed down however current information can be accessed at: https://www.myhospitals.gov.au/our-reports
It is important for us to keep abreast of these types of reports because the Council of Australian Governments (COAG) uses 'relative length of stay' as an efficiency measure for hospitals and we are the people most directly involved with the efficient progress of the patient journey. Potentially avoidable hospitalisation is also regarded as an effectiveness measure for Medicare Locals in the primary health care context. The report ”Healthy Communities: Potentially avoidable hospitalisations in 2011–12”, (https://dspace2.flinders.edu.au/xmlui/handle/2328/26600 ) was compiled when Medicare Locals were still being set up and does not reflect on the performance of Medicare Locals. Even so, it can be used to assist them in targeting interventions in primary health care and may be used as a baseline for future assessments of effective community-based health services.
Length of stay variations occur between patients with similar health conditions because of variations in severity and complexity. Older adults are particularly affected by this aspect and because they do need more time to heal and recover, they are unfairly compared with younger adults and their failure to perform at a younger pace leads to being cruelly labelled as a 'bed blocker'. The measure of 'average length of stay at the hospital' evens out many individual differences, highlighting instead where there may be opportunities for improved approaches to care but it is up to us to ensure that individual circumstance remains a core value when judging the need for case-based resourcing.
The report finds that among patients admitted for two of sixteen selected conditions or procedures, average lengths of stay at some major metropolitan hospitals were three and four times longer respectively than at similar hospitals with the shortest stays. For a further seven conditions, average lengths of stay were between two and three times longer. The implications for the health professions lie in increased scrutiny of admission assessment and care process administrative factors that may be causing delays in treatment and compromising clinical nursing and medical outcomes.