Radio-Canada reported on July 27 that the number of patients who do not require care in hospitals has skyrocketed. According to the Ministry of Health and Social Services, 13% of hospitalized patients no longer need hospital care. And of this number, almost half are waiting for a place in accommodation.
Posted at 10:00 a.m.
What you need to know is that the medical staff has the obligation to follow the hospitalized patient until his state of health has stabilized. Many events can occur if precautions are not taken, which could lead to readmission.
A readmission, as the word implies, is a second admission to hospital, often within 30 days of discharge. Emergency readmissions to hospital are among the hazards faced by hospital staff, and they can have different causes, such as side effects related to taking medication, complications following procedures, infections or exacerbated diseases.
According to 2020 data from the Canadian Institute for Health Information (CIHI), 1 in 11 Canadians are readmitted to hospital one month after discharge. Among the provinces, Quebec is doing relatively well with 8.9% of patients readmitted on an emergency basis within 30 days of discharge. However, CIHI estimates that hospital readmissions cost more than $2.3 billion a year in Canada.
Consequently, reducing unnecessary readmissions has become a goal that many countries are trying to achieve since there is potential to improve quality and reduce costs.
However, the shortage of staff, the number of closed beds and the lack of accommodation space create a bottleneck blocking the flow of patients from the hospital center to care partners and the community.
Moreover, in a text of Health Affairs, the authors note that the availability of care after hospital discharge influences inpatient readmission rates, and that patients without access to outpatient medical follow-up are more likely to be readmitted to hospital. In the study, hospitals located in areas with greater availability of family physicians, long-term care beds, and access to palliative care had lower readmission rates.
In addition, researchers report in an article in the British Medical Journal that high-performing hospitals have proportionally fewer readmissions within 30 days after discharge, without there being any differences in terms of diagnoses and readmission periods. However, since 30% of readmissions are potentially avoidable, this suggests that comprehensive strategies could help reduce readmissions.
watch committee
Faced with the lack of health care and resources, many citizens have decided to form monitoring committees in their region. These committees bring together the living forces of the municipalities to promote local governance in health establishments.
Listening to citizens and taking the pulse of the community is not new.
Already in 1988, the Commission of Inquiry into Health and Social Services of Dr Jean Rochon indicated that decentralization to the regions is a necessity to ensure adaptation to local conditions, the integration of services and the involvement of the population and social forces in social development and the management of socio-health services.
In the wake of the Rochon report, the Ministry of Health and Social Services (MSSS) was to create Regional Boards, the ancestor of health agencies. The Regional Boards were to ensure community participation in planning, program evaluation and resource allocation, and to promote concerted action among professionals, institutions and community organizations.
With the abolition of regional structures that represent them and listen to them, the monitoring committees have decided to go to the front and defend and promote local care in their respective regions.
All for one !
To improve access to health care, hospitals must develop more links with local authorities. The goal is to work together to better meet the needs of patients, to set up more long-term care, more palliative care and to deploy home care teams more effectively.
In addition, attention should be paid to the first line. Statistics Canada revealed that 4.6 million Canadians, or 14.5% of people over the age of 12, do not have a family doctor. Without a family doctor, there are no regular checkups to assess health, and ailments may go undiagnosed.
With local governance and partnerships where the actors concerned are present, we can hope to set in motion interesting projects to unclog the network, treat patients well and thereby prevent readmissions.
The challenges and issues that concern each region are complex, and it is through consultation, exchanges and innovative initiatives that we can break down the organizational, professional and bureaucratic silos and barriers that too often block progress and change. .