Australasian health service problems
Steve Hayes
this. We are not alone in the problems we have with service delivery.
http://www.nzherald.co.nz/section/1/story.cfm?c_id=1&objectid=10531020
'Hundreds' die because of hospital crowding
Monday September 08, 2008
By Martin Johnston
A shortage of hospital beds is killing as many as the national road
toll - about 400 a year - say emergency doctors.
They are calling for a 15 per cent increase in the number of beds
after research that indicates hundreds die every year.
Their Australasian college is holding a conference in Melbourne on
Friday to combat the crisis of overcrowding in hospital emergency
departments, caused mainly by having too few inpatient beds.
An international review of studies on EDs, done for the college, finds
overcrowding and blocked access increases the risk of death 10 days
later by 34 per cent.
The review by the University of New South Wales calculates the excess
death toll in Australia is similar to the annual road toll of around
1500.
Dr Tim Parke, clinical director of Auckland City Hospital's adults'
emergency department, said yesterday that the number of deaths in New
Zealand probably matched its road toll too.
Typically more than 400 people die on New Zealand roads each year.
A spokeswoman for Health Minister David Cunliffe said last night that
his ministry would look into the college's concerns and advise him.
" ... this Government has undertaken the largest hospital building
[including seven new hospitals] campaign in the country's history and
made primary healthcare more accessible."
The ideal occupancy of inpatient wards is 85 per cent but many New
Zealand hospitals run at more than 90 per cent, especially in winter.
Waikato Hospital reached 109 per cent last Monday. The college says
the core problem is lack of beds and a 15 per cent increase is needed
in Australia and New Zealand.
In the Auckland region, a 15 per cent increase would add 315 beds to
the present stock of around 2100.
New Zealand's public hospital beds have declined from 2.48 per 1000
people in 1988 to 1.56 in 2006 - largely through reduced lengths of
stay and increased efficiencies like day surgery.
When Auckland City Hospital opened in 2003, amalgamating four
hospitals, doctors criticised the 7 per cent reduction in beds. At
around 1000 , it is still slightly below the 1062 before amalgamation.
The Waitemata District Health Board will have added 68 beds by the end
of this month and plans 300 more by 2013.
Overcrowded emergency departments lead to worse outcomes because of
factors like delays in starting antibiotics for pneumonia, delayed
heart-attack care and patients simply being overlooked because they
are on a trolley in a corridor. Auckland City Hospital no longer
permits patients to wait in ED corridors because of this risk.
--
"It's not that I'm afraid to die. I just don't want to be there when it
happens." - Woody Allen
--
Steve Hayes from Tshwane, South Africa
Web: http://hayesfam.bravehost.com/stevesig.htm
Blog: http://methodius.blogspot.com
E-mail - see web page, or parse: shayes at dunelm full stop org full stop uk
Gary
> Perhaps those South Africans thinking of packing for Perth should consider
> this. We are not alone in the problems we have with service delivery.
>
> http://www.nzherald.co.nz/section/1/story.cfm?c_id=1&objectid=10531020
>
> 'Hundreds' die because of hospital crowding
>
> Monday September 08, 2008
>
> By Martin Johnston
>
> A shortage of hospital beds is killing as many as the national road
> toll - about 400 a year - say emergency doctors.
>
If I recall rightly there are about 27 000 severe road accidents in
SA, and about the same number of people die in SA's road accidents as
are murdered - about 18 000. So your figure of 400 deaths on the road
- WOW!
Lance
Gary
> this. We are not alone in the problems we have with service delivery.
>
> http://www.nzherald.co.nz/section/1/story.cfm?c_id=1&objectid=10531020
>
> 'Hundreds' die because of hospital crowding
>
> Monday September 08, 2008
>
> By Martin Johnston
>
> A shortage of hospital beds is killing as many as the national road
> toll - about 400 a year - say emergency doctors.
>
According to
there were 12 454 fatal road crashes in SA in 2006. I am not sure
whether this figure includes pedestrian deaths. I think it puts the
above figure of 400 deaths on the road in perspective.
Lance
Gary
> this. We are not alone in the problems we have with service delivery.
>
> http://www.nzherald.co.nz/section/1/story.cfm?c_id=1&objectid=10531020
>
> 'Hundreds' die because of hospital crowding
>
> Monday September 08, 2008
>
> By Martin Johnston
>
> A shortage of hospital beds is killing as many as the national road
> toll - about 400 a year - say emergency doctors.
>
I am not sure what happened to my post. At any rate the Arrive Alive
PDF document (see http://www.arrivealive.co.za/) gives the following
statistics for 2006:
Fatal road crashes: 12 454
Total num,ber of fatalities in road crashes: 15 393
I think this puts SA in perspective when compared with 400 in a year!
I did think the number of road fatalities was the about the same as
the number of murders (+/- 18 000 per year) but it seems South african
drivers are less ferocious than deliberate South African murderers.
Lance
Peter H.M. Brooks
> On Sep 8, 5:30 am, Steve Hayes <hayesm...@hotmail.com> wrote:
>
> > Perhaps those South Africans thinking of packing for Perth should consider
> > this. We are not alone in the problems we have with service delivery.
>
> >http://www.nzherald.co.nz/section/1/story.cfm?c_id=1&objectid=10531020
>
> > 'Hundreds' die because of hospital crowding
>
> > Monday September 08, 2008
>
> > By Martin Johnston
>
> > A shortage of hospital beds is killing as many as the national road
> > toll - about 400 a year - say emergency doctors.
>
> I am not sure what happened to my post. At any rate the Arrive Alive
> statistics for 2006:
>
> Fatal road crashes: 12 454
>
> Total num,ber of fatalities in road crashes: 15 393
>
> I think this puts SA in perspective when compared with 400 in a year!
>
> I did think the number of road fatalities was the about the same as
> the number of murders (+/- 18 000 per year) but it seems South african
> drivers are less ferocious than deliberate South African murderers.
>
country, that isn't clear from the context. It also depends on whether
a road accident is listed as the cause of death if somebody dies in
hospital a day or so later.
Car crashes can be suicides - or murders - as well.
On the bright side, though, car crashes do exert something of an
evolutionary force on reaction speed, which is a proxy for
intelligence - it might be that one of the reasons that our accident
rate is so bad is related to the extraordinarily high levels of foetal
alcohol syndrome. Our murder rate may well be partially a result of
the same thing.
Roger Conroy
"Gary" <Lanc...@gmail.com> wrote in message
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Lance
_______________________________________________________________
The entire population of NZ could be absorbed into one of our metro cities
and you'd hardly notice the difference. I'd like to see the stats converted
into km/person/year and km/vehicle/year to be able to make a true
comparison. Of course NZ doesn't have taxis like we do!!!
Gary
wrote:
> "Gary" <LanceG...@gmail.com> wrote in message
Hmm. New Zealand has 4,115,771 (July 2007 est.) people. I doubt that
any of South Africa's cities is that large.
You can find a comparison in graphical form for 1980 in the following
pdf:
http://www.transport-links.org/transport_links/filearea/publications/1_603_PA1164_1986.pdf
In the correction to the post you quote (which I retracted) I chose to
give actual numbers because the original article cited actual numbers.
The source in the corrected version does give rates per 100 000
people. Frankly relative numbers are deeply misleading when talking
about such things as emergency services. 400 fatalities is small fry
compared with 15 000 even if South africa has a larger population.
Notice that South Africa has relatively poorer infrastructure, numbers
of medical practitioners, etc. even though its accident toll may seem
reduced when reported per 100 000 people. But the fact remains that
our poor infrastructure still has to handle enormous numbers of
injured people as a result of accidents.
Lance
Gary
>
> In the correction to the post you quote (which I retracted) I chose to
> give actual numbers because the original article cited actual numbers.
> The source in the corrected version does give rates per 100 000
> people. Frankly relative numbers are deeply misleading when talking
> about such things as emergency services. 400 fatalities is small fry
> compared with 15 000 even if South africa has a larger population.
> Notice that South Africa has relatively poorer infrastructure, numbers
> of medical practitioners, etc. even though its accident toll may seem
> reduced when reported per 100 000 people. But the fact remains that
> our poor infrastructure still has to handle enormous numbers of
> injured people as a result of accidents.
>
>
> - Show quoted text -
Smeed's Law might be of interest. See:
http://www.nationmaster.com/encyclopedia/Smeed's-law
http://en.wikipedia.org/wiki/Smeed's_Law.
Lance
Peter H.M. Brooks
things and it makes some sense that they should. We know, though, that
there are a number of confounding influences - seat belts, for
example, reduce the severity of the injuries, but, giving the driver a
greater feeling of safety, can increase the overall number of
accidents, and much the same applies to other safety technology.
Australia is notable for the ruthlessness with which it applies its
traffic laws - license endorsements, huge fines and prison sentences
for what, in the West, would be considered less serious. They also
have very low speed limits relative to other countries - the German
experience shows that speed is not directly related to traffic
accidents, but the draconian enforcement seems to produce a compliant
and timerous driving population.
What has surprised me over the years is that governments enjoy
producing punitive laws - usually in reaction to some highly
publicised fatalities or specific statistics that may not be very
representative of the real situation. The on thing that isn't applied
is a requirement for speed governors. If there is a national speed
limit, then, apart from the danger to revenue from speeding tickets,
what is the issue with requiring govenors on all vehicles that prevent
them exceeding it more than about 5%?
Even more sensible, what is to prevent all cars being govened to
maximum speeds depending on their braking ability? Massive Chelsea
tractors are probably much more dangerous than smaller cars because of
their relative momentum, even at lowish speeds.
It also has to be the case that good road design has an influence on
accident rates, as does the distance driven by particular drivers.
I've been impressed by the poor road design of many SA roads - traffic
merging with poor visibility, bends that are too tight for the likely
speed, no separation between on- and off- ramps and poorly maintained
signage. Road design in the Middle East appears not really to exist,
and their accident rates are, I think, higher than SA ones, even if
their fatalities are lower.
ProfQ
Bobby
and building new ones, complete with beds, and bedding, and toilet seats,
and toilet paper!!!!! Absolutely amazing, hey? WOW a REAL Hospital!
"Peter H.M. Brooks" <Peter.H....@gmail.com> wrote in message
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