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Out of the ER (Emergency Room): Finding the 'Right' Setting for Elderly Patients
By Judith Maxwell, Globe and Mail
March 24, 2008
Canada
Emergency departments are health care's "canary in the coal mine." Today, the canary is telling us that the health care system is already reeling from the growing needs of older Canadians with chronic diseases like congestive heart disease, asthma and diabetes.
In Ontario, emergency visits by people under the age of 55 have not changed much over the past decade, averaging about three million a year. But people 55 and over are another story. Their visits have increased to 1.4 million per year in 2004-05 from 800,000 in the mid-90s.
The needs of older patients are more complex, so they require more staff time. They are also more likely to require a hospital bed. When beds are not available, they occupy space in emergency and still need staff attention. The crowding therefore affects waiting times for all patients.
For years now, the provinces have made health care their spending priority with negative repercussions for the quality of infrastructure and public services such as education. At the same time, demographers and health planners have been warning that the health care system has to get ready for an influx of elderly patients. Now the pressure on emergency departments has provided the wakeup call - greatly intensifying the need to strengthen community management of chronic disease.
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