Patients waiting for space in nursing homes or rehab hospitals are impeding timely access to emergency care, scheduled operations and other services, according to a report released Tuesday.
In its sixth annual report card, the Wait Time Alliance (WTA), a consortium of national doctors' organizations, also said the provinces and territories deserve a B grade for their efforts to reduce wait times for certain types of medical care.
The group said Canadian hospitals have managed to reduce wait times in five priority areas: cancer care, heart procedures, diagnostic imaging, joint replacement and sight restoration.
However, one in six hospital beds are taken up by so-called "bed blockers," patients who would be better cared for in another facility. This leaves critically ill patients languishing in emergency rooms and others waiting months for elective or scheduled surgeries.
Dr. Lorne Bellan, chair of the WTA, which advocates for goals set out in the 10-year federal-provincial-territorial health accord signed in 2004, said the problem not only affects the patients needing immediate care, but also those who would be better served elsewhere but are left to languish in hospitals for extended periods.
"A myriad of factors lead to long waits for care, but the high number of hospital patients waiting for alternative levels of care such as rehabilitative or long-term care is likely the single-biggest cause of wait times," Bellan said.
"Even more important is the fact that these patients would receive more appropriate and cost-effective care outside of the hospital."
The 2004 Health Accord promised $5.5 billion in funding to reduce wait times in the five priority areas, and since then, both the provinces and the federal government have announced a number of wait-related initiatives.
Tuesday's report, which is based on data from the years 2007 through to 2011, awarded an "A" grade only to wait times for heart bypass surgery. In contrast, wait times for knee surgery received the lowest grade, a "C."
But the report cites the significant impact "alternate-levels-of-care" stays are having on wait times in emergency rooms and for scheduled or elective surgeries.
According to the report, an ALC patient is occupying an acute-care bed despite no longer being an acute-care patient. This leaves patients who are admitted to hospital via emergency or who are post-surgery waiting for a bed.
The report warns that ALC cases will become an ever-growing problem as the population ages. The median age of patients in hospitals who are waiting for a bed in an alternate facility is 80 years and their median hospital stay is 26 days.
"On average, one ALC patient in the (emergency department) denies access to four patients per hour to the emergency department," the report says. "The lack of a proper patient flow in the emergency department can also affect paramedic services and first-response wait times as paramedics must wait to transfer patients at the emergency department."
The report calls for a number of strategies to address the problem of ALC patients, including greater investments in home care and increased support for family caregivers, in addition to hospital services that better assist patients navigate the system.
