The state government has proposed a $40 million “virutal ED” aka telehealth for residential aged care patients to reduce their attendance when not requiring admission to hospital. If this would work to reduce ramping and be safe for them, then great, but none of these things are likely to happen.
Some maths is useful:
– 30% of patients in ambulances ramped are over 70yrs of age
– but only 6% of people over 70 live in residential aged care (low huh? – a lot less than have aged care in the home) – so the program does not apply to 94%
– aged care residents make up about 3% of ED visits
– more than half of these need admission
– Feb 2023 saw 4000 hours of ambulance ramping
If the program were to prevent “unnecessary attendance” ie those who do not need admission, the maximum effect is therefore on less than half of 3% of ED attendances.
That would save 40 out of 4000 hours of monthly ramping. for $40 million.
It is supposed to be voluntary but
– if it truly is, then what aged care worker is going to spend time on the phone relaying symptoms for the likely answer to be “send them in”?
– it will need to be operationalised in procedure in nursing homes so while it may be “voluntary” for the administration there it will be part of what staff are told to do
– it is unlikely the patient will have the capacity or understanding or agency for it to be voluntary for them.
BUT that implies this works, and I describe below why a phone line for sick elderly people is both pointless and blatantly ageist – by definition. Fix ramping by resourcing beds properly not by putting up barriers to access for the most vulnerable people in the system.
My weekly thoughts in @westaustralian.