Continued reductions in access to seniors care lead to hospital overcrowding, longer wait times: study

(Vancouver) BC seniors face continued reductions in access to key home and community care services, with serious consequences for hospital overcrowding and wait times. That’s the central finding of a study released today that includes new data, obtained from the Ministry of Health, on changes in access to seniors care in recent years.

The study finds that while cuts to residential care and home support were especially steep between 2001 and 2006, a downward trend in access continued through 2009/10.

• Between 2001/02 and 2009/10, access to home support for seniors 75 and older dropped by 30%.
• Access to residential care dropped by 21%. The provincial government did create new assisted living services (a less intensive type of long-term care that does not include medical supervision) during this period, but even combined, residential care and assisted living show a 9% drop in access.
• Reductions in access to home nursing of 3 per cent were more moderate, and in community rehabilitation there has actually been an increase of 14 per cent.
• When all services are considered together, access to home and community care declined by 14 per cent.

The study also reveals the extent of the link between seniors care and hospital overcrowding and wait times.

• Between 2005/06 and 2010/11, there was a 35.5% increase in “Alternate Level of Care” (ALC) patients in BC hospitals. ALC patients are primarily elderly patients who no longer need acute care but continue to occupy a hospital bed because they cannot access appropriate home and community care services.
• The study estimates hospital occupancy rates in BC at 97% overall, with many hospitals operating well above 100% capacity. The optimal occupancy rate for patient safety and management of surgical and emergency room wait times is 85% or lower.

“Given BC’s aging population, now is the time to increase access to home and community care,” says study author Marcy Cohen. “These services can help seniors live healthy, independent lives in their own homes and communities, which reduces the need for expensive emergency visits and hospital stays. Home and community care also helps seniors get out of hospital quickly once they no longer need acute care.”

“BC's seniors and people with disabilities deserve high-quality and accessible public health care,” says Rachel Tutte, co-chair of the BC Health Coalition, which co-published the report. “Unfortunately, BC’s home and community care services have suffered during ten years of restructuring, including massive closures to residential care beds and continuing reduction in access for home support clients."

“Emergency room overcrowding and wait times for surgeries affect all British Columbians,” says Cohen. "The most cost-effective solution would be to improve access to home and community care services, and ensure they are better integrated within the broader health system. That will require strong provincial role — the Health Authorities can’t be expected to fix years of underfunding and restructuring in the absence of provincial coordination and leadership.”

Cohen notes that a recent landmark investigation by BC’s Ombudsperson included 176 comprehensive recommendations for improving access and accountability in seniors care. “The government’s response to the Ombudsperson to date has been inadequate and disappointing. We know what the solutions are, it’s time for action.”

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For more information or interviews, contact Sarah Leavitt at 604-801-5121 x233, or sarah@policyalternatives.ca. Download Caring for BC’s Aging Population: Improving Health Care for All British Columbians at www.policyalternatives.ca/hcc-for-seniors.