OUT-OF-HOSPITAL PATIENT CARE
The Hon. IAN WEST:
My question is addressed to the Minister for Health. Will he outline to the House the benefits of out-of-hospital patient care?
The Hon. JOHN DELLA BOSCA:
I thank the Hon. Ian West for his very important question about out-of-hospital care for all citizens because it highlights an important change in the way we go about providing health care. Today the New South Wales Audit Office reported on its investigation into four out-of-hospital care programs coordinated by New South Wales Health. I am pleased to report to the House that this area of healthcare delivery is being recognised by an independent body as part of the way forward for developing quality health care for residents of New South Wales. The Auditor-General found:
International evidence shows that these programs provide good outcomes for patients, reducing the number of times they need to go to hospital and the number of days they need to stay there.
Further, the Auditor-General went on to say:
These programs help reduce the need for patients to attend emergency departments or occupy hospital beds. Treating suitable patients at home can thus save beds for seriously ill patients who can only be treated in hospital.
The Audit Office confirmed that treating patients in their home could deliver significant benefits for patients in the community. While recognising that these programs are clearly beneficial, the Audit Office has identified areas for improvement. One of the four programs still at a pilot stage is not achieving its planned objectives.
The audit also recommended that New South Wales Health needs to demonstrate that out-of-hospital care is an effective way to respond to growing demand and that it represents better value for money. Page 2 of the Auditor-General's report provides some indication of the cost effectiveness of the programs. The audit found that the pilot programs operate at about half the cost of providing care in hospital, thereby saving taxpayers $55 million a year, and delivers outcomes as good as does in-hospital care. As the Auditor-General recognised, the programs currently represent only about 3 per cent of inpatient admissions.
New South Wales Health has indicated already its intention to increase its capacity in this area, but that will be done carefully, with the patient's needs and interests being the primary factor taken into consideration. The Auditor-General found that New South Wales is on the right track in developing a broader range of services that will allow people to receive high-quality care in their own home. Area health services are to be congratulated for developing out-of-hospital programs that provide excellent clinical outcomes—and at a lower cost.
The benefit I have outlined is just one of the ways the Government is responding to the increase in demand identified by the Auditor-General. The programs are an extension of treatments we have come to accept as deliverable in the home, such as dialysis, chemotherapy and palliative care. Compared with conventional treatment, this approach can reduce the number of times that patients will have to attend hospital and will reduce the time they would otherwise spend in hospital. Out-of-hospital care also reduces the need for patients to attend emergency departments, thereby freeing departments and expert staff to respond to urgent cases.
Today's Audit Office report states that nearly 45,000 patients a year are currently being treated out of hospital in the four New South Wales programs that were investigated: Community Acute/Post Acute Care, ComPacks, Rehabilitation for Chronic Disease, and Healthy At Home. The Audit Office made four key recommendations: that New South Wales Health establish a team to monitor and implement the expansion of out-of-hospital programs; that the community be informed of what a shift to out-of-hospital services will mean; development of systems to monitor the numbers of patients; and the continuation of the Healthy At Home pilot programs until they can clearly demonstrate that the program is achieving its objectives. [Time expired.