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
DEVELOPING Slovakia's populist prime minister shot multiple times in attempted assassination
Slovakia's populist Prime Minister Robert Fico is in life-threatening condition after being wounded in a shooting after a political event Wednesday afternoon, according to his Facebook profile.
Transport Canada's UFO 'lead' planned to meet with U.S. intel officials, called info requests a 'wild goose chase'
Canada's transportation department had a UFO 'lead' who tried to 'quell' media interest and planned to meet with U.S. intelligence officials.
'Very expensive lunch': Sask. driver handed a cell phone ticket for using points app in McDonald's drive-thru
A warning from a Saskatoon driver about using your fast-food app while in the drive-thru line — a trip to get some free lunch cost him a lot more than he bargained for.
'The Fly' has become notorious in France after a brazen escape. What's his criminal history?
A prisoner nicknamed “The Fly” has become notorious in France overnight after a daring and bloody escape from a prison convoy in Normandy that left two guards dead.
BREAKING Ontario's 'crypto king' Aiden Pleterski arrested
Aiden Pleterski, the self-proclaimed 'crypto king' from Whitby, Ont., has been arrested in Durham Region after allegedly running a Ponzi scheme worth more than $40 million.
BREAKING Barge hits a bridge in Texas, damaging the structure and causing an oil spill
A barge hit a bridge in Galveston, Texas, on Wednesday, spilling oil into surrounding waters and closing the only road to a small island, officials said.
Person responsible for 1996 drugging of 'Titanic' crew likely not a local: Halifax police
Halifax Regional Police believe a non-resident could be responsible for the infamous drugging of numerous crew members of the 'Titanic' movie with a hallucinogenic in 1996.
Latest updates on the biggest wildfires burning in Canada
Thousands of people in Western Canada remain displaced from their homes as wildfires threaten their communities, triggering evacuation orders and alerts.
OPINION Your attention span is shrinking, studies say. Here's how to stay focused: Sandee LaMotte
Regaining your focus requires you to be mindful of how you are using technology -- a daunting task if you consider the average American spends at least 10 hours a day on screens.