Needless stays give hospitals $1.1b bill

Nearly a third of hospital admissions could be avoided, saving the health system $1.15 billion a year, university researchers say.

This is about a tenth of the Government's health budget for the coming year.

The study, published in today's New Zealand Medical Journal, says avoidable admissions accounted for more than 94,000 days spent in Christchurch Hospital by patients in 2003.

This cost about $96.6 million - $1 of every $7 of income received by the Canterbury District Health Board.

Hospitals in the rest of New Zealand are thought to be affected to at least the same extent.

Health Minister Pete Hodgson said last night the study was a reminder of why the Government was investing heavily in primary health care.

It is spending an extra $2.2 billion over seven years, mainly to reduce the cost of going to the doctor, in a bid to make more people seek early medical and nursing help.

This, it believes, will reduce the need for costly hospital stays.

Many district health boards have primary care schemes aimed at keeping people out of hospital. One of the largest is the Care Plus scheme, in which 42,000 people pay reduced fees to have regular GP and practice-nurse check-ups for chronic diseases.

Avoidable hospital stays are those that can be prevented by national health measures such as promoting physical activity, or in primary health care by vaccines or early treatment.

Conditions leading to such admissions include lung disease, cervical and breast cancers, infectious diseases, heart disease and strokes, diabetes and melanoma.

The Otago University review of Christchurch Hospital admissions from 2000 to 2004 found the leading cause of avoidable admissions was cardiovascular disease.

Just over half the cost of avoidable admissions and more than a third of the patient bed days were for this condition.

Government statistics show the number of hospital admissions that could have been avoided by primary health care rose during the 1990s and plateaued in 2000, just before the big spending started on primary care.

But there has been some early evidence the spending is paying off.

Mr Hodgson said: "We're confident that if we can make it easier and more affordable to access primary care, we can significantly reduce the pressure on our public hospital system and significantly improve the health of our families."

The researchers said only 30 per cent of patients in one study of cardiovascular disease had met all the targets for disease prevention.

Some of the new primary care money should go into specific preventive programmes, they said.

But Mr Hodgson said this was happening. The $76 million, four-year investment in obesity prevention was the latest example.

Dr John Cameron, medical executive of the Auckland primary care organisation ProCare, which has 700,000 patients, said managing some acutely unwell patients intensively in the community kept many out of hospital.

Screening and intensive treatment could save huge sums of money - such as by avoiding kidney dialysis for diabetes sufferers - but the benefits would become apparent only in the long term.