More beds, doctors, cost $52m

The largest sums were spent on hiring more doctors - particularly specialists in EDs - and nurses, and providing more beds. Photo / Thinkstock

DHB spending helps to cut delays in emergency departments

Reducing potentially harmful delays for patients in emergency departments cost district health boards more than $52 million, according to the first research to quantify the spending.

From mid-2009 the Government has required that 95 per cent of ED patients be admitted, discharged or transferred within six hours of arrival. Results against this target are published quarterly.

Auckland University researchers asked district health boards how much they spent on trying to reach the target in the 4 years from July 2008, because some DHBs started early on the task.

The largest sums were spent on hiring more doctors - particularly specialists in EDs - and nurses, and providing more beds.

In a paper published in an Australasian medical journal the researchers, Dr Peter Jones and colleagues, say their surveys found a positive correlation between DHB spending per capita in EDs and improved performance on the target. But they did not find such a link to spending in other parts of hospitals.

"Although total expenditure on the public health system increased during the study period, no additional funding was allocated to DHBs by the Ministry of Health for [the target]. Hence, most of these additional funds must have been reallocated from other areas, but few DHBs acknowledged this within their existing budgets.

" ... respondents [DHB officials] were largely unaware where the extra money for the ED had come from. Therefore, it is not possible to assess whether the implied disinvestment was appropriate, or whether the benefits of shifting funds to meet the ED target outweigh the benefits associated with the previous use of the resources."

The target was introduced after emergency specialists in 2008 estimated overcrowded hospitals and the associated blockages in EDs could be killing 400 patients a year.

In July to September this year, seven DHBs were at or above the required 95 per cent, 10 were on 90 to 93 per cent and three - both Wellington DHBs and Hawkes Bay - were slightly below 90 per cent.

Target study
• Emergency departments required to admit, discharge or transfer 95% of patients within six hours.
• District health boards spent more than $52 million to comply.
• 61% was spent in EDs, 39% in other parts of hospitals.
• 135 extra doctors and nurses in EDs, and 43 more in other parts of hospitals.
• 54 extra beds in EDs, and 56 elsewhere in hospitals.
Source: Auckland University study