After the release last week of the latest national hospital stats, SA’s Premier Mike Rann got busy on Twitter.
Doesn’t it say something about the absurd state of health debate when a politician is proud to skite about having more hospital beds than other places?
Wouldn’t it make more sense – in an ideal world – to be able to skite about needing fewer hospital beds than other places?
Presumably this might mean you have a healthier population for all sorts of reasons. It might also mean that you don’t need as many hospital beds because your public health programs, primary health and community-based care, and aged care services are doing so well?
It might also suggest that your hospitals are providing such good service that fewer patients are having to be re-admitted because of adverse events arising from their care.
Skiting about hospital bed numbers makes no sense, to me at least. Presumably this is just another example of the gulf we so often see between sensible health policy and effective health politics.
Update (May 3)
More on why we should stop the focus on hospital beds
Thanks to the Croakey reader who referred me to this paper, Hospital capacity planning: from measuring stocks to modelling flows, published in the Bulletin of the World Health Organization last year.
It notes that hospital capacity planning remains dominated by “bed numbers”, although there are several problems with this approach, including that bed numbers or bed occupancy do not provide a good measure of the services provided inside hospitals, and are also not suitable for predicting future demand. Nor are bed numbers a useful measure of hospital capacity given the trend towards growing numbers of day cases and shorter lengths of hospital stay.
“Thus, while bed numbers have the benefit of convenience, as they are one of the few indices of hospital capacity that are routinely collected, there is a growing recognition of the intrinsic limits of this measure,” state the authors, from England and the Netherlands.
Patient flows are a more useful measure, they say, citing the example of a childrens’ hospital in California that was able to admit 7% more children per year and improve patient satisfaction by use of improved patient flow systems.
An interesting extract from the article:
Traditionally, hospitals were designed around specialties and departments rather than around the needs of patients. Patients often spend most of their time in hospitals waiting for something to happen, with large areas provided for this inactivity. The situation is often exacerbated by the inefficient management of admission and discharge. In the United Kingdom of Great Britain and Northern Ireland, a patient admitted on a Friday night may have a length of stay that is 25% longer than a patient admitted on a Tuesday. To accommodate this phenomenon, beds and wards in effect become holding areas for “work in progress” and have, in the past, been planned accordingly. A consequence is that in many hospitals the flow of patients is inefficient, dislocated and disorganized….