This continued emphasis on the non-urgent use of the ER diverts attention from the real issue facing Ontario emergency departments.
ER crowding is a direct result of hospital crowding, which in turn is a result of an insufficent number of hospital beds to meet the needs of an aging populatioin with their burden of chronic, complex illness.
Since the mid-1990’s there has been an approximate thirty percent reduction in hospital bed capacity and of the remaining beds, a further twenty percent are occupied by patients who would be better served at home or nursing homes. With an aging population will this be adequate?
The Minister of Health believes that there is a wellness dividend just around the corner with a healthier population and better community supports. Neither proposition is true. Despite decades of health promotion, the old just don’t seem to be less in need of care or hospitalization and anybody who has ever interacted with home care soon realizes that it looks good on paper but cannot meaningfully support the elderly in their homes.
Studies have shown that ER crowding rarely exists when hospitals function at 85% bed occupancy rates because there is some flexibility in the system. ER crowding is a given at 95% occupancy rates. Most Ontario hospitals today function (barely) with greater than 100% bed occupancies.
Furthermore, there is absolutely no proof that non-urgent patients in the ER significantly contribute to crowding. They require little in the way of resources and little clinical time. Strategies aimed at diverting them elsewhere has no meaningful impact.
There is a grey tsunami approaching Ontario’s shores in the near future. Like it or not bed capacity will be needed.
Will this health minister adhere to her outdated and unmeritous rhetoric or will she lead us safely through the difficult challenges that lay ahead?
Based on her recent and ill-considered pronouncements, I think we need to start building an Ark.
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Letter to the Editor