DHB targets needless hospital admissions

DHB acting chief executive Tim Evans said 383 locals under 74 years old were admitted to hospital between last April and this March. Photo / Warren Buckland

Too many Hawke's Bay people are ending up in hospital for issues which could have been addressed through early intervention, but the District Health Board is taking steps to reduce those admissions.

Hawke's Bay DHB acting chief executive Tim Evans said 383 locals under 74 years old were admitted to hospital for cellulitis - bacterial skin infections - between last April and this March. Cellulitis was the most common cause of hospital admissions which could have been addressed in primary care.

Just over 300 went to hospital with gastroenteritis/dehydration and 294 with respiratory infections or pneumonia.

The most common addressable condition for those aged 0-4 who ended up in hospital was gastroenteritis/dehydration, followed by asthma, then upper respiratory and ear nose and throat infections.

In the 12 months to March, there were two potentially preventable admissions locally for vaccine preventable diseases, said Mr Evans.

Clinical director of Child, Youth and Family and paediatrician Dr Philip Moore said the DHB was working to ensure parents understood what was required to bring up healthy children.

A lot of respiratory illness was related to smoking so the DHB placed some emphasis on a smoking cessation programme where it could refer parents to help to quit.

Children who grew up with smoking parents had about three times the admission rate for bronchiolitis and asthma, he said.

The DHB could also refer families to a local Healthy Homes Initiative where a public health nurse would inspect their house and give recommendations to make it a more healthy environment.

Dr Moore said a programme to prevent rheumatic fever in schools meant children with sore throats received antibiotics quickly when needed. The DHB had a similar intervention programme for skin infections.

Dr Moore said there had been a huge reduction in gastroenteritis cases since a rotavirus vaccine had been added to the vaccination schedule.

The DHB had high immunisation rates and low numbers of admissions for vaccine preventable diseases, he said.

Ministry of Health group manager Andrew Inder said early intervention and self management of long-term conditions were important to keeping people well and preventing unnecessary admissions.

He said enrolment with a general practice to ensure continuity of care with a general practice team, helped New Zealanders receive efficient care in community settings.

There were initiatives in place to ensure New Zealanders could access the primary care they needed to stay well, said Mr Inder.

The Government had extended free GP visits to all children aged under 13 who were eligible for publicly-funded health services.

Currently 99 per cent of children were covered. They were also exempt from the $5 co-payment for prescriptions at pharmacies.

The Very Low Cost Access scheme provided additional funding to general practices with an enrolled population of 50 per cent or more high needs patients where the practice agreed to maintain patient fees at a low level.

High needs people were defined as Maori and Pacific people and people living in areas of high socio-economic deprivation.

Currently, 1.3 million New Zealanders accessed primary care via the scheme.

Mr Inder said many general practices also provided services in a whanau-centred approach as part of a Whanau Ora collective or provider.