Evelyn Ring, Irish Examiner Reporter, examines how home care may be able to help.

Delayed discharges are costing the health service over €500,000 a night. The cost is based on an analysis of a report on delayed discharges published this month by the HSE.  The report shows that 685 patients were occupying hospital beds across the country at midnight on Aug 13. Such patients no longer need acute care and are medically fit to be discharged. However, almost 90% of these are elderly people awaiting alternative care.

Home and Community Care Ireland, the representative body for private home care organisations, said it would cost at least €540,000 each night the 685 patients remained in hospital.  It said the cost — the equivalent of over 25,700 hours of home care — was based on the HSE’s own estimate of the cost of a hospital stay per night of between €800 and €900.  Of the 685 patients, 525 were awaiting long-term nursing care, while the remainder were waiting for home help, a home care package, access to a rehabilitation facility or special equipment from the HSE.

Dublin’s Beaumont Hospital tops the list for having the highest number of delayed discharges, at 113, followed by two other Dublin hospitals, St James’s, at 89, and St Vincent’s with 81. HCCI chair Michael Harty said the figures showed once again the cost of the Government’s refusal to provide a sustainable, joined-up approach to elder care.

“Despite continued calls for action by HCCI, practices such as the ring-fencing of one type of care over another and premature admissions into nursing homes persist,” he said.  He said the inefficient system cost the State millions of euro each year and directly contradicted Government policy of helping people to remain in their homes for as long as possible.

“Increasing home care funding could save millions annually by enabling faster discharge, thereby freeing up valuable resources for frontline services,” said Mr Harty. “At the same time, it would allow elderly dependent people to live at home for longer as well as prevent unnecessary admission in the first place.”

The HCCI produced a report earlier this year showing how the Government could save up to €48m in the next year alone, in addition to increasing transparency and patient choice.

The report contained evidence-based research to support the case for a phased outsourcing of home care services to 2021 in line with calls made by the minister for health and HSE for increased efficiencies and innovative models of care.

It also questioned the wisdom of ring-fencing budgets for one type of care over another, rather than having the money follow the patient in line with Government policy.

The report found up to €2bn could be saved in the next nine years if outsourcing and competitive tendering were brought in as Government policy.

Mr Harty said the Government had not, as yet, been moved by their calls.

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