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House of Assembly - Fifty-First Parliament, Third Session (51-3)
2009-03-03 Daily Xml
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ROYAL ADELAIDE HOSPITAL

Ms CHAPMAN (Bragg—Deputy Leader of the Opposition) (15:08): My question is again to the Minister for Health. What evidence does the government have that it will be able to reduce the average length of stay for multi-day patients at the rail yard hospital to 5.6 days, and will it provide the public with that evidence?

The then Marjorie Jackson-Nelson hospital model of care document, which was available on the website, before the website was removed when the Premier announced that the name would be dropped, stated, 'with an average length of patient stay for multi-day patients at 5.6 days'. The most recent figures made available to the public show the average length of stay for multi-day patients in South Australian hospitals as being 7.1 days. The length of stay for multi-day patients in Australian hospitals has been steadily decreasing, but slowed to a decrease of 0.1 day from 2005-06 to 2006-07, and the opposition is informed that the length of patient stay is likely to plateau.

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (15:09): The deputy leader's question is counterpointed with something that they have been told. By whom? The qualifications of the person who told them this are unspecified. So, you ask a serious question on the basis of an unspecified, unknown source, an authority that presumably has not made out—

Members interjecting:

The Hon. J.D. HILL: I beg your pardon?

Mr Williams interjecting:

The Hon. J.D. HILL: What authority do I give for my claim?

The SPEAKER: Order, the member for MacKillop!

The Hon. J.D. HILL: Well, let me say I am the Minister for Health, and I have a health department that gives me information. I share with this house, in my own words in the best language I possibly can, the advice that the department gives me. Let me talk to you about average length of—

Ms Chapman interjecting:

The SPEAKER: Order!

The Hon. J.D. HILL: I didn't hear what she said anyway, Mr Speaker; she just interrupts me. The average length of stay is a key indicator that health systems are used to determine how well and how efficient their hospitals are. We measure it across all of the hospitals in South Australia. Obviously, a range of factors has to be taken into account, but, generally, the average length of stay in hospitals declining. There is a whole range of reasons for this, and I will go through some examples.

Surgical procedures, for example, change. In days gone by, procedures, which are now done through keyhole surgery, were done by opening up the body. If you open up the body, of course, the recovery takes longer than if you do it through keyhole surgery. A number of procedures which are quite complex can now be done within a day, and the patient is in and out of hospital within a day. In years gone by, they might have been in there for weeks at a time. Surgical innovation has reduced, to a certain degree, the average length of stay.

The discharge policy of an individual hospital reduces the average length of stay. For example, in the past, patients were discharged when the doctor, who was doing his or her rounds, would get to that patient and say, 'Oh, you can be discharged', and that could be 2 or 3 o'clock in the afternoon, and they may have spent almost 24 hours in the hospital unnecessarily waiting for the doctor to attend to them to discharge them. We now try to work our hospitals so that there is early consideration of those discharge matters within a day, so that it can be vacated earlier in the day. If you get the doctors to walk around the wards at 9 o'clock and make a decision, patients can then be discharged earlier, and that reduces the average length of stay.

If a policy is in place which dramatically reduces the risk of cross infection—and single rooms is one very prominent way of doing that—then, of course, fewer patients will get sick from other things they catch in the hospital, and if fewer patients get sick the average length of stay is reduced. Therefore, there are myriad ways that can be employed to reduce the average length of stay.

We have made some good progress in our South Australian hospitals over the last few years to reduce the average length of stay, and I am very certain that it will continue to decline. Now, of course, there are countermanding reasons why average length of stay will increase as people get older and have more complex and more comorbidities (as health people say), and then, of course, they may need to spend more time in hospital.

One of the things that we are trying to do is to make sure that the hospital system is there for acute patients. Those who are in recovery or have some need other than a health need, who need to be cared for, can be cared for in their own home. We have a very advanced out-of-hospital care program. We are also looking for other places where patients can go after they have been in hospital. There is a range of things that can be done, and I am very confident that we will continue to decrease the average length of stay, as has happened, generally, in western parts of the world.

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