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3. 3 Nightmare Access block Exit block Bed blockers

4. Are old people taking over our hospitals?

5. National Symposium on Aged Care Research Professor Len Gray Practitioner, Industrialist or Community Representative? September 2003

6. 6 Ambulance bypass episodes

8. 8 1000 Aged 65+ 500 The regional schematic Low 950 High 1050 Residential care Hospital Subacute 40 Total pop’n 270,000 Aged 70+ 24,000

9. 9 Transfers to residential care Total permanent admissions 621 High care admissions395 Low care admissions226 Transfers from hospitals ~280 Average wait? 3 weeks Beds occupied16 % of hospital beds occupied1.6% Ratio / 1000 70+0.67

10. 10 The regional schematic Low 950 High 1050 Residential care Hospital Subacute 40 Aged 65+ 500 Total pop’n 270,000 Aged 70+ 24,000 No man’s land Interim care 16

11. Source: DHA 11 Residential care beds Operational June 2001 by region

12. 12 The regional schematic 30 high care beds / 1000 Low 950 High 720 Residential care Hospital Subacute 40 Aged 65+ 500 No man’s land Interim care 16

13. Source: Gray L et al (unpublished) 13 Prevalence of ADL independence Acute wards PA hospital 2003 (Pilot study 1:4 patients 65+)

14. 14 What can be prevented? Delirium Pressure ulcers Weakness & immobility Incontinence Loss of self care capacity Depression & poor motivation Carer abandonment / placement Need for formal restorative care ?

15. Inouye S et al (1999) NEJM 340 9 669-76

16. 16 What might industry want? Ready-made solutions to unexpected issues –evidence based, feasible for implementation, rapid effect, cheap. Forecasting of emerging issues & advice around appropriate responses Robust advice based on international standard evidence that is locally applicable & preferably validated Resources to conduct appropriate investigations / research

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18. Are old people taking over our hospitals?

19. Source: AIHW National Hospital Morbidity Data Cubes 19 Total hospital bed days by age group 1993 - 2001

20. Source: National Hospital Morbidity Data Cubes 20 Total bed day use by age group 1993 – 2001 (rate per 1000 population)

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