Montreal, January 29, 2020 – Last year, nearly 380,000 Quebecers—or over 1,000 patients a day—ended up leaving a hospital emergency room without having been attended to by a doctor, shows a publication launched today by the MEI.
“More than one in ten patients who goes to an ER gives up on receiving care,” points out Patrick Déry, Senior Associate Analyst at the MEI and author of the publication. “Yet one fifth of these patients had been classified as ‘very urgent’ (Priority 2) or ‘urgent’ (Priority 3) during triage, which indicates that their condition could put their life in danger.”
The release of these data, which are from the Department of Health, comes after another difficult holiday period in Quebec hospitals. Shortly after New Year’s, the occupation rate of many emergency rooms exceeded 150%. Some reached 200%, and one Montreal hospital even registered a rate of 250%.
“We have to change course. One in five Quebecers still doesn’t have a family doctor, and in Montreal it’s nearly one in three. Emergency rooms are the health care system entry point for many patients,” says Patrick Déry, who adds that over half (55%) of emergency room visits are for conditions that could be treated in a clinic.
Despite the considerable—and growing—sums of money the government injects into the health care system each year, wait times are stagnating or getting worse: The median length of stay for patients on stretchers is the same as it was fifteen years ago, while it has increased 50% for ambulatory patients
“If the government wants to see an improvement, it has no choice but to do everything it can to lower the barriers that prevent patients from accessing care, even at the cost of upsetting certain interest groups,” says Patrick Déry.
Expanding the scope of practice of health professionals, notably that of nurse practitioners and pharmacists, could make a difference in the short term. Despite some recent progress, their autonomy is still needlessly restricted.
Other measures that will have a longer term impact can nonetheless be started now. Along with the reform of fee-for-service payments for doctors, the government should among other things put an end to medical school admissions quotas. It must also take advantage of the upcoming introduction of activity-based financing in hospitals to entrust the administration of some of these to entrepreneurs, all while maintaining the universal character of our health care system. “The combination of entrepreneurial innovation and universal coverage has produced good results in European systems. There’s no reason to deprive ourselves of the same,” concludes Patrick Déry.
The Viewpoint entitled “Emergency Rooms: When Patients Leave Untreated” was prepared by Patrick Déry, Senior Associate Analyst at the MEI. This publication is available on our website.
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