Over 750 beds unavailable due to delayed discharge

SOME 756 beds in acute hospitals across the State are being inappropriately occupied by patients who have finished their treatment…

SOME 756 beds in acute hospitals across the State are being inappropriately occupied by patients who have finished their treatment and are awaiting a place to be discharged to, latest figures show.

This is the equivalent of having the largest hospital in the State full of patients who do not need acute hospital care. Dublin's St James's Hospital is the biggest hospital in the State with 753 inpatient beds, according to the Health Service Executive (HSE) website.

Even if all the delayed discharge patients were placed there it wouldn't have enough room for them.

The numbers would also put the equivalent of two hospitals the size of Limerick Regional Hospital out of commission for patients in need of acute care.

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The new figures collated by the HSE show the problem of delayed discharges, which began to abate after a number of initiatives, including home care packages, were announced by the Minister for Health, Mary Harney in late 2004, is now as bad as ever.

In the past week the problem has had a knock-on effect on the number of patients having to endure longer stays on trolleys in AE. Last week three ambulances were held up, one for four hours, at a Dublin hospital when all the trolleys in the hospital's emergency department were already occupied by patients waiting to be assessed or waiting for inpatient beds, many of which were inappropriately occupied.

The HSE confirmed 58 per cent of the 756 patients whose discharges had been delayed were occupying acute beds in the Dublin Academic Teaching Hospitals which include Beaumont, Tallaght, the Mater, St Vincent's and St James's.

It has also confirmed the processing of applications for nursing home subventions, home care packages and community supports was holding up the discharge of several patients.

But it said the biggest problem was many of these patients or their families had requested and were waiting to see if they could get a public long-stay bed, one for which the family did not have to pay. This is delaying the discharge of about 30 per cent of the patients.

The discharge of a further 33 per cent of the patients is being delayed because they require "a long-stay complex care bed because of their level of dependency", and these are beds which are not immediately available.

Another 10 per cent of the patients whose discharges have been delayed are awaiting transfer to rehabilitation beds or hospice care.

In a statement, the HSE said the numbers of delayed discharges "have increased for a number of reasons, including refurbishments taking place in a number of long-stay facilities throughout the country, which has led to the non-availability of 135 beds".

But it stressed it was important to put the figures into context. It said an average of 1,312 patients were discharged every day from hospitals with emergency departments.

It also said the number of people in receipt of home care packages rose from 8,035 at the end of 2007 to 8,837 at the end of September this year; a total of 9.24 million home help hours had been provided at the end of September, which was 2.88 per cent ahead of target; and an additional 295 public long-stay beds had been provided with a further 65 coming onstream before the end of the year.

It also claimed that while "the system generally is under pressure, the majority of hospitals across the country cope well on a consistent basis and the vast majority of hospitals have eliminated excessive waiting periods in AE".