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Acute and Chronic vying for a hospital bed in Canary

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The president of the Canarian Government, Paulino Rivero, warned yesterday that 400 hospitalized patients " are able to go home and their families do not collect, which is a blockage of beds needed for other patients." Probably unwittingly Rivero put a spotlight on one of the main shortcomings of health care in Spain: the lack of proper care (and in some cases, abandonment) suffering many of the patients who need to stay no longer admitted to a acute hospital but is also unable to return home.

The lack of adequate resources to fill this void, either because there are not enough beds for medium and long stay or jam dependency system, causing it to end up occupying general hospital beds by patients who should be treated in other centers.

President Rivero defined this as " a cultural thing " in his interview yesterday Cadena SER. Fonts of your apartment hours later clarified that the problem is that these are patients with multiple pathologies with families who can not look after or "do not want to pick them up." The debate probably has far more to do with the shortcomings of the health system and the Spanish social care network.

Hospital care is primarily aimed at addressing acute processes, ie to stabilize the person who has suffered a stroke or operate a broken hip. After completing this process, the hospital discharged the patient. But it may happen that the patient is unable to go home. Maybe he takes on a complex process of rehabilitation (speech therapy in the case of stroke, the patient physiotherapy hip) or a delicate convalescence that needs constant cures. The ideal destination for such people would be a medium or long hospital stay. But in many cases there is a sufficient number of public places, so it is not uncommon for sick relatives reject high.

PricewaterhouseCoopers highlighted this issue in the recent report Ten hot for health issues in Spain 2013. Under the heading An unmet need in our country: hospitals, intermediate care, the consultant addresses the shortage of beds for long stay in Spain, placing the country at the tail of the OECD.

The neighboring countries include many institutions that provide long-term " resources so that hospital beds, more cost to the system are released." This means that in Spain, " largely centers act as intermediate acute hospitals " by blocking beds for patients who do not need the assistance to be provided by a general hospital, such as the Canary Islands.

What is the total volume of the problem? The firm cites a report from the Age & Life Foundation (promoted, among others for health insurance companies and nursing homes) that sets in about 5,300 beds occupied by patients " who could benefit from an alternative care geriatric character." Other sources put 50% of beds occupied by chronic patients. According to data from the Ministry of Health, there are 102,700 beds in public general hospitals and nearly 20,000 private.

If these people leave these hospitals and transferred to intermediate care facilities estimated savings could mean about 1,500 million per year for the National Health System, according to the report.

José Antonio LÃ_pez Trigo, president of the Spanish Society of Geriatrics and Gerontology (SEGG) states that the reluctance of families or the patients themselves to go home " will be more." "That happens when there is inadequate support in the transition " from hospital to home, he says. "Maybe people are needing an intermediate care." The cause of this increased demand is that " the curves of population and resources are not growing at the same pace." " Now there is much over-aging, people over eighty years with many pathologies. When you enter is a serious episode, but everything suffers. It's like dominoes. Are people in a precarious situation and what they are trying to give them high without any intermediate devices. Technological demands with fewer resources as a nursing home, in exchange, please provide rehabilitation. "

This scenario adds the dependency system is not able to fill the role that was assigned to reinforce attention - from the standpoint of social - service these patients that require health monitoring of low or medium intensity. Seriously affected by the succession of cuts undertaken by the Government, the recognition process to aid goes through a severe blockage. The waiting list of people who have been granted the right to benefits but not yet the property amounts to 190,503 people, according to the latest data released late last year by the Ministry of Health, Social Services and Equality.

This means that, for example, that older person who suffers a hip fracture and take months or years waiting for aid may not leave the hospital for continued regardless, for example, by a family caregiver or residence that he should be granted. In the Canary Islands the two circumstances combine. Not only is among the autonomies with worse numbers in the dependency system development, according to reports by social services professionals and officials. In addition, the 7,663 hospital beds that comprise the archipelago spread over 12 public schools and 11 private, only 200 seats are care medium and long stay.

The lack of continuity between healthcare and social is nothing new. In his first appearance in the House of Representatives, the Health Minister Ana Mato, presented as a priority coordination between health and social fields, and move towards the so-called socio space able to provide comprehensive patient care. Sources for this department indicated to this newspaper yesterday that they are working on it and you are defining a catalog of services, shared information systems or the profile of the person with socio needs, among others.

With information from Emilio de Benito

 Tags: Acute, bed, Canary, chronic, hospital, vying

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