Help plan reduces hospital admissions

By SIMON COLLINS

South Aucklanders are staying out of hospital in record numbers as campaigns to insulate houses and help general practitioners do more treatments in the community appear to be keeping people healthier.

The Counties Manukau District Health Board says the growth rate in admissions to Middlemore and KidzFirst acute medical units dropped dramatically from 9 per cent a year through the 1990s to 2 per cent in the first half of this year.

That means about 2000 people who would have had to be sent to hospital this year if the previous growth rate had continued have been able to stay at home.

The 2 per cent growth rate is in line with the district's population growth and has been achieved despite a continuing epidemic of meningococcal disease.

The manager of the board's acute demand management project, Dr Phil Shackell, said: "We are all a little tentative in terms of, is it sustainable?"

"Personally I think it is. We are really excited about it."

The Ministry of Health's principal medical adviser, Dr Rob Buist, said: "It's very impressive. I suspect it's unmatched, but I don't have that in front of me.

"I would certainly suggest other district health boards look at what Counties Manukau are doing."

Dr Shackell said factors in the improvement included:

* Paying GPs up to $300 to buy services that will keep a patient out of hospital. Examples include home visits, x-rays, antibiotics or a night in a resthome.

This was started as a trial last year and extended to all GPs this winter. It is now helping about 250 patients a month.

* Four free GP visits and six hours of free nursing time a year for about 1000 patients with chronic illnesses such as diabetes, heart disease and emphysema, with agreed "care plans" for each patient. This started with about a dozen GP practices and is being extended gradually.

* Free home insulation for selected low-income people with respiratory and other problems.

* A public campaign to encourage people to see their GPs at the first sign of illness.

Women's health advocate Linda Williams said she had not heard of any patients who had been denied hospital treatment as a result of the initiatives.

The manager of the Manurewa People's Centre, Rangi McLean, said the policy meant people no longer went to hospital unnecessarily.

Herald feature: Feature: Our sick hospitals