A CATHOLIC research paper handed to the Federal Government proposes a radical shake-up in the way health care is delivered to Australians who could be treated at home rather than in hospital.
The Catholic Health Australia paper, entitled Out of Hospital Care in Australia – advancing health’s ‘missing sector’, argues that shifting to a hospital-in-the-home approach could provide better treatment for between five and 10 per cent of private patients – as many as 200,000 people a year.
Out-of-hospital (OOH)options could radically change end-of-life care, mental health services and a long list of other programs that could be better provided at home.
“There is enormous potential for OOH care to transform from the ‘missing’ sector into a flourishing and highly effective sector which is a major contributor to health outcomes across Australia as well as the financial sustainability of our health system,” the CHA paper said.
CHA’s health policy director James Kemp said “far too many people are going into hospital every year for care that could be delivered in the comfort of their own home”.
“High-quality care can be delivered safely and effectively at home,” he said.
The paper highlights significant gaps in access to community-based palliative care services including both specialist palliative care and palliative care provided by other health professionals.
For instance, more than half of Australians die in hospitals, about a third die in residential aged care and only a quarter in their own homes.
This occurs despite evidence that most people would prefer to die at home.
The paper said the Catholic Health sector is already leading by example providing a significant amount of OOH care services including palliative care, mental health, rehabilitation, chemotherapy, postnatal care, renal dialysis, aged care, intravenous antibiotics, infusions and wound management.
These services are being provided across both public and private hospitals.
St Vincent’s Private Hospital Brisbane is highlighted as a case example that already delivers a community palliative care service for both public and private patients that alleviates physical symptoms and provides psychosocial and spiritual support for people with a terminal illness and their families.
The service is operated by clinical nurses, doctors and counsellors, and includes 24-hour-a-day specialist palliative care advice and home visits, with access to an inpatient palliative care unit if needed.
After initial assessment and development of a patient’s care plan, follow-up consultations are used to monitor the patient’s progress and help them to remain at home.
Referrals to the community palliative care service are accepted for both privately insured and state-funded patients who live in Brisbane City Council geographic boundary.
The service provides the same standard of care to all patients and carers regardless of funding.
The report said changes to the Private Health Insurance Act 2007 were needed in order to shift more patients to out-of-hospital care, as laws required complex individual contacts between the insurer and the hospital.
Private health insurers were also prohibited from funding out-of-hospital services to non-admitted patients.
“Today, for medically stable patients, treatment at home can often be more efficient and effective than traditional in-patient care,” Mr Kemp said.
“Our report shows out-of-hospital care can lower hospital readmission rates and increase patient satisfaction.
“We therefore need to ensure money starts to flow beyond hospital walls and into the community.
“This could be a game changer for the frail and elderly who often struggle in the hospital system and experience both physical and mental decline.
“We just need the private health insurance industry and the government to work co-operatively on reform that will allow more people to enjoy the benefits.”
Mr Kemp cautioned that it was essential that OOH care did not turn into the poor cousin of in-hospital care.
“We need patients to be able to trust that the care they receive is the same as in-hospital care, and for this we need national standards on out-of-hospital care and to track the care provided,” he said.