Budget funding for seniors pleases CMA

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OTTAWA – Canadian Medical Association (CMA) President Laurent Marcoux says his association is encouraged that the federal Liberals’ Budget 2018 addresses a number of areas where the government can act to improve seniors' care across the country.
As outlined in CMA's pre-budget submission to government, many of these initiatives will ensure social equity and increase productivity, both clear themes in the budget. The association represents 85,000 physicians on national health and medical matters.
“Given that recommendations about caring for Canada's aging population are expected shortly from the House of Commons Standing Committee on Human Resources, Skills and Social Development and the Status of Persons with Disabilities, the CMA and its members are encouraged to see funding allocated in areas of dementia, home and community care, and the impact of gender for an aging population,” Marcoux says.
“In addition, CMA welcomes several initiatives that address important public health issues – along with the social determinants of health – such as providing funds to help address the opioids crisis, awareness efforts regarding the potential health impact of cannabis, and the provision of clean and safe water on reserves that keep families healthy in their communities.”
In its submission the CMA said a major hindrance to social equity in health care delivery and a serious cause of wait times is the inappropriate placement of patients, particularly seniors, in hospitals.
The CMA said investments in residential care infrastructure and continuing care will improve care for seniors while significantly reducing surgical and emergency department wait times, benefiting all patients.
“Alternate level of care (ALC) beds are often used in acute care hospitals to accommodate patients — most of whom are medically stable seniors — waiting for appropriate levels of home care or access to a residential care home/facility. High rates of ALC patients in hospitals affect all patients — they contribute to hospital overcrowding, lengthy waits in emergency departments, cancelled elective surgeries, and sidelined ambulance services waiting to off-load new arrivals (often referred to as code gridlock).
“Addressing the ALC problem is an essential component of reducing wait times across the health care system in Canada,” the CMA stated in its brief.
“An investment in appropriate home or residential care, which can take many forms, will alleviate inappropriate hospital admissions and facilitate timely discharges. Moreover, unnecessarily long hospital stays can leave patients vulnerable to hospital-acquired illnesses and disability such as delirium, deconditioning and falls.
“ALC patients with complex care needs who do not have a strong support system are more likely to wait in acute care before being placed in home care. In April 2016, ALC patients occupied 14 per cent of hospital inpatient beds in Ontario but this percentage ranged widely among health regions, from seven per cent to 29 per cent. In New Brunswick, 33 per cent of the beds in two hospitals were occupied by ALC patients, of whom 63 per cent had been diagnosed with dementia.”
Equally troubling, the CMA stated, was the fact that the average length of hospital stay of all ALC patients was 380 days. Providing more cost-effective and appropriate solutions will optimize the use of health care resources — it has been estimated that it costs $842 per day for a hospital bed versus $126 per day for a long-term care bed and $42 per day for care at home.

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