On 14 February, AusHSI hosted an ideas forum at QUT bringing together almost 100 leading clinicians, academics, policy makers, managers and carers to discuss the opportunities and barriers to adoption of home therapies – from ‘hospital in the home’ to renal dialysis and parenteral nutrition.
To inform debate at the forum, AusHSI produced an Issues Paper “Taking healthcare home”, which pulled together existing research and case studies comparing hospital treatment with acute and chronic treatment services in the home.
Among its findings, the issues paper identified that treating acutely ill patients at home, rather than in hospital, could slash treatment costs by up to 50%, reduce mortality rates by 20%, make hospital stays shorter and cut hospital readmission by a quarter.
The paper also found that, in many cases, it was better for the patient and more cost effective to treat patients at home rather than in hospital. But cultural change in the health profession was needed to overcome uncertainty about quality and safety and funding mechanisms had to ensure that home care providers were appropriately compensated while avoiding cost shifting between state and national funding systems.
Following the event, AusHSI will prepare a Recommendations Paper, to be released in June of this year.
AusHSI Academic Director Professor Nick Graves said: “Healthcare in the home has the potential to be important for health services in the next decade because we can’t afford to look after everyone in hospital.
“It is a priority for the Queensland Government because of its potential to improve patient flow, meet national emergency access targets and increase capacity within the healthcare system.”
“Also, when you are in hospital there are more opportunities for complex, costly and often unnecessary investigations and treatments to happen.”
The forum brought together leading speakers including:
- Nick Gray, Director of Renal Medicine, Sunshine Coast Hospital and Health Service
- Melissa McCusker, Nurse Unit Manager, Acute Care @ Home, QEII Hospital
- Kate McCarthy, Clinical Director of Hospital In The Home and Outpatient Parenteral Antibiotic Therapy, Metro North Hospital Health Service
- Jane Partridge, Director, Health Economics and Purchasing Unit, Queensland Health
- Amanda Dines, Executive Director, Royal Brisbane and Women’s Hospital
- Martin Chambers, member of Health Consumers Queensland.
Melissa McCusker, Nurse Unit Manager responsible for the Acute Care @ Home services of QEII Hospital commented “Home treatment is not a new concept but it can be difficult for patients and staff to understand,” she said.
“Queensland has taken a little longer than other states to grow the hospital in the home services. There needs to be a good working relationship and trust among the whole healthcare team.
“Besides the cost savings, patients often prefer being at home and there can be other benefits like a reduced risk of hospital acquired/cross infection, medication errors and decreased patient depression and anxiety.”
Healthcare consumer advocate Martin Chambers looks after his wife Loraine, who has been on renal dialysis for the past 13 years. He explained “When patients choose to be a home care patient, they accept a greater responsibility for their health but it also means you can retain control of your lifestyle,” he said.
“There are many good outcomes. Loraine has never developed an infection whereas the hospital renal unit has experienced relatively frequent virus outbreaks. When she first began treatment the doctors said we could expect five years or so of dialysis and we’re now at 13.”