B.C. study details increasing complexity of hospital patients' needs
A British Columbia study showing that hospitalized patients' medical issues have become increasingly complex also highlights the need to address the growing pressures of an aging population on overworked health professionals, the lead researcher says.
Dr. Hiten Naik, an internal medicine physician and research fellow at the University of British Columbia, said policymakers need to invest more in hospital care teams that include pharmacists and physiotherapists.
“Oftentimes there will be less support on weekends, for example, and there's a gap at different times during the week,” said Naik, adding that one pharmacist could be staffing an entire ward.
“It should prompt a discussion on being more proactive because the health-care system can be a bit reactive.”
The number of hospitalized elderly patients with multiple conditions will only increase as people live longer due to medical innovation and treatment with various drugs, he said.
The study, published Monday in JAMA Internal Medicine, involved an analysis of health data covering 3.4 million non-elective hospitalizations in B.C. between 2002 and 2017. It found that by the end of that period, patients were nearly three times more likely to arrive in hospital through the emergency room, twice as likely to have multiple health issues and nearly twice as likely to be taking at least 10 medications.
Patients were also more likely to be 75 years or older, and they were more likely to be readmitted within 30 days after being discharged. During the first year of the study, the average patient was a 64-year-old male with three prescription medications.
However, the findings also show decreases in the likelihood of patients staying in the intensive care unit or dying in hospital, reflecting advancements in medical care that dramatically improved outcomes for those living with heart failure, HIV infection and lymphoma.
Naik said the COVID-19 pandemic revealed health-care staff burnout as a “real issue” but that more complex patients had already contributed to some of that burnout.
“Essentially, that's making our jobs more difficult because if someone has more medical issues, those are medical issues that need to be addressed.”
Naik said the study also showed that a proportion of hospitalizations increased due to substance use, including alcohol intoxication and withdrawal from opioids.
While the data lack information on factors that contribute to patient complexity, including homelessness and lack of social supports, it includes all hospitalized patients aged 18 and older during a 15-year period and goes beyond a single centre, disease or measure of complexity, compared with other research evaluating such trends in the Netherlands, China and Switzerland.
Dr. Samir Sinha, director of geriatrics at Sinai Health and University Health Network in Toronto, said the pandemic exacerbated conditions for seniors who were less likely to attend appointments with a primary care provider, missed cancer screenings and had their surgeries delayed, landing some of them in hospital.
“Then we were left dealing with significant consequences that in many ways could have been prevented,” he said.
Sinha said the key is to ensure more people have a family doctor and access to community care servicesto prevent or better manage chronic diseases sopatients don't languish on hospital wards.
“If we had a lot more of that we'd have a lot less pressure on our hospital system and our available staff would be better able to meet the demands on the acute-care system.”
Jane Meadus, a staff lawyer with the Advocacy Centre for the Elderly in Ontario, said providing enough home-care support would also reduce time spent in hospital and reduce burnout among seniors' family caregivers.
“That's a huge problem,” she said.
“This is the time of year when I start to hear from people who are trying to get out of hospital but told 'you can't have any home care because we've run out of our budget,”' she said of agencies that may have government funding renewed in April.
This report by The Canadian Press was first published Jan. 8, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
CTVNews.ca Top Stories
Canadians are eyeing moves to these cities for more affordable housing
Faced with elevated housing prices, half of Canadians in the country's largest cities are considering moving to places with more affordable housing.
Poilievre says Canadians 'fleeing' to Nicaragua, Liberals say it shows he 'doesn't have a clue'
Liberal parliamentarians are criticizing Conservative Leader Pierre Poilievre over a new video in which he promotes the idea that some Canadians are 'fleeing' Canada to live in Nicaragua because they can't afford a house in this country.
With DNA break, police ID victim in decades-old Newfoundland case
A skull was found along a backroad near St. John's more than 20 years ago. Now, police have finally identified the victim of the homicide.
'Do not drive': Nissan warns Canadian drivers of explosion risk impacting 48,000 vehicles
Car manufacturer Nissan has issued a do-not-drive warning for some older vehicles equipped with Takata airbag inflators, due to the risk of explosion during a crash.
Infant dies in ATV crash, N.S. RCMP says alcohol may be a factor
An infant has died and three others, including another child, were taken to hospital following an ATV crash in Forties, N.S., on Monday.
Tessa Virtue reveals she's expecting her first child. Here's what Canadians had to say
Canadian figure-skating icon Tessa Virtue is expecting her first child, she revealed via social media Tuesday.
Conservative Leader Pierre Poilievre's housing plan defeated in House of Commons
Conservative Leader Pierre Poilievre's housing bill has been defeated in the House of Commons with the Liberals, New Democrats and Bloc Quebecois voting against the legislation.
B.C. man to be extradited to U.S. on charges of sexually assaulting stepdaughter
A British Columbia man will be extradited to the United States, where he faces a possible life sentence if convicted of charges that he repeatedly sexually assaulted his stepdaughter, after losing his appeal of the extradition order Tuesday.
Trudeau must more publicly support ICC decisions amid Israel-Hamas war: ex-ministers
A group of prominent former politicians and current academics is asking Prime Minister Justin Trudeau to change his tone on the possibility of arrest warrants for senior Israeli leaders.