So far this year, Melhus municipality has paid 4.3 million kroner in fines because they have not received patients ready for discharge from hospital. – We see a “corona effect” on sick elderly and relatives, says municipal manager.
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41 patients were treated on Wednesday night at St. Olav’s hospital in Trondheim. They are ready for discharge and are waiting for the home municipality to have the capacity to receive them and provide them with further health care. This creates major capacity problems for the hospital.
– The consequence is that the treated patients occupy the beds of acutely ill patients who come to the hospital. The completed patients remain in the wards where they have been treated, and there are therefore no available beds to send the emergency patients to. Then it piles up with patients in the emergency room, says Deputy CEO Tom Christian Martinsen at St. Olavs Hospital in Trondheim.
He says that the situation threatens patient safety. Tuesday raised St. Olav’s hospital emergency services, which means, among other things, that they postpone planned operations that can wait so that they can free up beds.
–“Coronaeffekt”
Fragile elderly people living at home have deteriorated during the corona period. Melhus municipality believes that a main reason is canceled rehabilitation and activity offers. The municipality is now struggling to accept elderly patients who have been treated at St. Olav’s hospital in Trondheim.
– We see a “corona effect” on sick elderly and relatives. Many activities have been temporarily closed. This applies, among other things, to the offers of day rehabilitation. This has led to an increased burden on relatives who are now tired. This has also led to frail elderly people who could have lived at home with good relief needing to stay in the short-term wards in the municipality. We have too few such places, says Albert Verhagen in Melhus municipality.
In 2018, the municipality south of Trondheim paid almost 1.2 million kroner in daily fines to St. Olav’s hospital in Trondheim because they did not accept patients ready for discharge. This was shown by VG’s survey of the situation in the municipalities after the co-operation reform.
–These were fines for patients who remained in hospital for extra days, after they had finished their treatment. The fines for not accepting patients were introduced with the collaboration reform in 2012.
This year, it costs the municipality NOK 5,167 a day to leave a patient treated in hospital.
– At the end of September this year, we had paid NOK 4.3 million in daily fines to the hospital, says Verhagen.
He says that the health management clearly sees that delayed rehabilitation leads to the development of illness.
– We need more places for patients who are ready to be discharged from the hospital. Last week, the municipal council decided to spend NOK 3.5 million on a temporary department. For the coming year, we have put an extra 16 million on the budget, says municipal manager Verhagen.
He says that the health management sees a clear connection between loneliness, reduced municipal services and physical fitness during the pandemic.
– Basically, Melhus municipality has good health services for our citizens. We have a fairly large group of elderly residents, among other things, many pensioners move here from the city. During the corona period, social distance has created more loneliness. The lack of offers has put a greater burden on relatives. With fewer municipal day care services and delayed rehabilitation, health deteriorates. We see that effect clearly now, says Verhagen.
Also read: Alarms at the emergency room at Ahus: – We are standing with our backs to the wall now
Removed preventive measures
Trondheim municipality also has a large proportion of the patients ready for discharge who remain in hospital after they have finished treatment.
– We have to a small extent maintained offers through the pandemic. We have reallocated personnel and increased capacity for round-the-clock care, at the same time we have reduced capacity for day care and relief. These are the offers that are important preventive measures and that allow people to stay at home longer. We have wondered the same as Melhus municipality, if that change is the reason why we have more in hospitals, says health and welfare director Wenche Dehli.
The infection control measures have also led to lower mortality in the population.
– It will not take much before it also affects the capacity in the health and care sector in the municipalities, says Dehli.
– Very demanding situation
Trondheim municipality has set up a working group to look at why more patients ready for discharge are hospitalized.
The director of health and welfare says that the municipality receives as many patients ready for discharge from the hospital as they usually do. The problem is that more people are hospitalized.
– The infection situation is very demanding. It entails isolation requirements and sick leave in our services. Now our big focus is to keep sound services up for those who live in nursing homes or have offers in the home care service, says Dehli.
–The municipality will try to increase capacity so that they can receive more patients who have been treated at the hospital.
– We benefit from the hospital having the most normal operation possible and we want patients who have been treated to not have to stay in hospital and wait. Hospitals can take up and down planned activities. The municipal health service does not have such room for maneuver. We have activity at a fixed level. Patients who are ready for discharge must receive an offer from us as soon as possible. We are looking at all possibilities to increase capacity, says the director of health and welfare.
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