Rising hospital bed occupancy and rising superbugs
Mon, Feb 6 2012 09:30 AM
| superbugs, bed occupancy
| Permalink
Dr Charles Saunders, deputy chair of the British Medical Association Scotland, recognizes that Scotland has made progress fighting hospital acquired infections, but
flags the threat rising bed occupancy now poses:
"There is pretty good evidence that once you get high bed occupancy rates then it is very difficult to stop a lot of HAI. Part of that is because you don't have time to get things properly cleaned and partly it is because once you get to those high rates, you tend to move people around hospitals a lot. So they get admitted to one ward and maybe go through three or four different wards in the next few days. If they have anything when they come in, they have an opportunity to spread it quite widely and they also obviously increase the opportunity they have to pick up stuff by being in different wards."
Yet, Scotland has more than twice as many hospital beds per capita compared with Ontario. -- Ontario has one of the highest hospital bed occupancies in the developed world.
Dr. Saunders also warned financial constraints on health boards could have an impact on tackling the superbug problem in the coming years.
"Pressure on budgets is probably going to put more stress on hospital systems in terms of turnover and pushing more people through perhaps than can be done so safely. I think we are likely to maintain where we have got to, but it will make continuing improvements more difficult."
Austerity, however, is not just threatening Scottish hospitals -- it is also threatening Ontario's.
Doug Allan
Fewer layers of administration in Ontario health care?
Sun, Feb 5 2012 09:30 AM
| restructuring, CCACs, LHINs
| Permalink
One interesting line in the Ontario government's new "Action Plan":
"In addition to integrating family health care into LHINs, we will introduce further reforms to promote more seamless local integration, with fewer layers of administration, to ensure we have a system truly structured around the complex needs of an aging population."
What might "fewer layers of administration" mean? That is unknown, at least to this writer. But some have pointed to the oddity of the Ministry of Health and LTC funding the LHINs, the LHINs then funding the CCACs, and the CCACs then funding the contracted home care providers. Especially as the CCACs have been restructured so their boundaries coincide with the LHIN boundaries.
Other thoughts?
Doug Allan
60 hospital beds closing -- 62 layoff notices
Fri, Feb 3 2012 04:30 PM
| Sudbury, cutbacks
| Permalink
Health Sciences North in Sudbury has issued layoff notices to 62 staff as the hospital moves to shut down 30 beds March 31, 2012. Another 30 are scheduled to shut March 31, 2013. All 60 beds are at the hospital's Memorial site.
The Hospital defends the cuts, arguing that ambulatory clinics will replace the beds, the
Sudbury Star reports.
But Dr. Stephen Kosar, president of the Sudbury and District Medical Society is skeptical, adding that he is hoping for a stay of execution: "Maybe the governor will make a call before they walk down the green mile."
The beds to be closed are serving alternative level of care (ALC) patients. There were 43 ALC patients in acute-care beds at the main hospital and 61 at the Memorial site on Thursday. The
Star reports that the "hospital has fewer beds than planners wanted and they said it would only be large enough to serve the community -- and the region -- if it had no ALC patients."
Doug Allan
EMS costs up and ambulances delayed. More to come?
Thu, Feb 2 2012 08:44 PM
| Windsor, EMS
| Permalink
The overload on hospital beds is catching up with Windsor/Essex Emergency Medical Services (ambulance services).
The Windsor Star reports that the time spent by EMS paramedics waiting in hospital emergency rooms has increased 350% since 2009, increasing from 2,653 hours in '09 to 9,557 hours in 2011. EMS paramedics can't leave a patient at a hospital until the hospital takes over care, but sometimes hospitals are so backed up they have no room for new patients.
The dramatic increase in "off-load delays" has driven up EMS costs, the Star reports.
But, aside from driving a cost explosion, the off-load problems are also delaying EMS response time. "We have a limited amount of ambulances in the county," EMS Chief Randy Mellow told the Star. "There are times when we delay non-emergency calls sometimes up to an hour if we don't have an ambulance."
The off-load delays stem from a bed shortage in Windsor that spiked after a "public private partnership" (P3) long term care project failed, sparking a serious backlog in Windsor hospitals.
With hospital cuts planned by the provincial government, this may well get worse.
Doug Allan
Ontario Health Action Plan does not add up
Wed, Feb 1 2012 12:24 PM
| cutbacks, onpoli, home care
| Permalink
The Ontario government's Health Care Action Plan, announced yesterday, will mean
less public health care.
As has been the constant refrain for decades, the official plan is to move patients from hospitals to home care. The idea is that hospitals are expensive and home care is cheap.
But the plan does not add up. The home care hours promised - 3 million -- mean spending about an extra $75 million, based on government figures.
That's a tiny drop in the bucket of the government's $47,139,590,260 ($47 billion) health care spend: less than 2 tenths of one percent. It may make up for population growth this year. It may even make up for the aging population (this year). But is it going to also reduce the 10,000 person home care wait list, divert people from ending up in long term care facilities, or offset hospital cuts? No way -- it's a pathetically small increase by any standard, never mind by what the government says it is doing.
As in the past (with the Mike Harris government), the plan appears to be to pretend to increase home care, to justify the cuts in other health care services.
Doug Allan
Lowest rated P3 ever goes to market (& costs rise)
Fri, Jan 27 2012 11:15 AM
| privatization, p3
| Permalink
The largest public private partnership (P3) bond financing in Canada has raised $1.37 billion for a new Montreal hospital. It is for what must be one of the longest P3 deals as well -- a 38.8 year deal to build, finance, and maintain the Centre hospitalier de l'Université de Montréal (CHUM).
The
National Post reports that the four equity partners in the P3 deal are all European corporations. Canadian and Quebec partners were squeezed out once again, it seems.
The P3 financing deal is also the lowest-rated one ever to come to market. The
Post reports that the bonds came with a
6.721% coupon.
"Part of the difficulty attracting buyers was the credit profile of the investment. The issue was rated BBB (high) by DBRS, one notch higher than the Baa2 assigned by Moody's Investors Service Inc. Every single P3 that has been broadly marketed so far in Canada has enjoyed an A-level rating."
The
Post goes on to note:
"If the CHUM deal proved one thing, it's that issuers don't need A-category credit ratings to do bond transactions in the P3 world. It also showed that there's no natural limit on the size of such transactions. ... 'It's really just one more deal,' Mr. McCallum (of RBC Capital Markets, which underwrote the deal) said, modestly. 'There's a maturing of the sector. And this deal is another marker in the maturing of the sector.' "
Critics argue that the cost of financing P3s is too high, and that government financing is more affordable than private financing.
This deal raises the cost of P3s to even higher levels.
Doug Allan
$15 to $22 million in hospital cuts forecast
Thu, Jan 26 2012 01:06 PM
| cutbacks, Hamilton
| Permalink
Hamilton Health Sciences is warning that it will have to cut costs by $15 to $22 million, the Hamilton Spectator reports. The range in cost cutting is based on funding increases in 2012-13 of either 0% or 1%.
The hospital expects about 140 jobs will be affected, but says its goal is to accomplish the cuts through attrition rather than layoffs.
The hospital Executive Vice-President, Murray Glendining, told the Spectator that he is getting “a little nervous” the hospital won’t get the 1 per cent increase.
Doug Allan
Privatization works! More Americans lack health insurance
Tue, Jan 24 2012 11:32 AM
| privatization, USA
| Permalink
Gallup
reports that the percentage of American adults without any form of health care insurance has reached the highest level since they began tracking coverage in 2008.
In 2011, 17.1% of adult Americans had no health care insurance. That is up from 14.8% in 2008. The percentage insured has declined every year since the report started.
Gallup reports that it asks 1,000 American adults each day about their healthcare coverage and reports
monthly,
quarterly, and annual averages. In December 2011, the monthly percentage of uninsured adults increased to 17.7%, tying July 2011 for the highest on record.
The USA is leading example of health care privatization in the developed world.
Doug Allan