Patient transfers skyrocket on West Coast

Grey Base Hospital and Emergency entrance, Greymouth, West Coast. Photo / Ross Setford

The number of West Coast orthopaedic patients transferred elsewhere has skyrocketed since the West Coast District Health Board (WCDHB) began relying on collaboration with the Canterbury DHB.

In July 2012, WCDHB announced a comprehensive trans-alpine orthopaedic service. It said it was working more closely with Canterbury DHB to provide "comprehensive orthopaedic services to the West Coast community as part of a trans-alpine approach to providing sustainable services for the West Coast".

At the time, WCDHB's chief medical officer Dr Carol Atmore said the new arrangement should lead to "less than a dozen" extra orthopaedic transfers to Christchurch a year.

However, the figures show more Coasters are being shunted over the hill.

Just 20 orthopaedic patients were transferred from the Coast the year before the trans-alpine service started, according to information obtained under the Official Information Act.

Transfers quadrupled to 81 in 2012/13 - the first year of the service.

Transfers rose to 113 in 2013/14 and to 138 last year - seven times as many as before the trans-alpine arrangement.

The WCDHB said it didn't hold full data for transfers before 2013/14, so the figures shouldn't be compared to data after 2013/14.

However, the pre-2013/14 figures are similar to those cited in 2012 by Dr Atmore. The figures show 259 patients - in all specialties - were transferred from the Coast in 2010/11 compared to 474 patients last year. Most went to Christchurch Public Hospital.

The biggest increase was orthopaedic patient transfers.

Again, the DHB said data wasn't complete so the years before and after 2013/14 shouldn't be compared.

The cost of patient transfers rose $71,044 - from $1,149,449 in 2010/11 to $1,220,493 last year. The costs include internal patient transfers between West Coast hospitals, transfers between other DHB facilities around the country and air retrieval team costs.

ACC, not the DHB, pays for patient transfers that occur within the first 24 hours of care.

The data shows most of the patients transferred went by air ambulance.

In 2010/11 143 patients went by air ambulance and 103 by ambulance. In 2014/15 201 patients went by air ambulance and 188 by ambulance.

The number sent by motor vehicle has jumped from seven in 2010/11 to 51 last year.

However, the DHB again said data was incomplete.

The main reasons for patient transfer elsewhere included acute coronary conditions, abdominal pain, fractures, premature labours and trauma injuries.

The largest single treatment cost over the past five years was $325,492 for a child treated for heart problems at Auckland DHB in 2013/14. This was followed by a patient in specialist intensive care at Canterbury DHB in 2012/13, who cost the WCDHB $296,051, and a general surgical patient treated at Canterbury DHB in 2014/15 who cost $279,246.

The WCDHB was unable to provide total treatment costs for patients transferred off the West Coast.

The number of patients transferred, by specialty in 2010/11, with last year's figures in brackets was:

• Coronary care 53 (36);

• intensive care 20 (10);

• general medical 44 (53);

• obstetric 10 (43);

• general surgery 60 (62);

• orthopaedic 32 (138)

• paediatric medical/surgical transfers 9 (35);

• neonatal intensive-care 2 (10);

• other medical specialties (eg neurology, nephrology, palliative, oncology) 12 (15);

• other surgical specialities (eg urology, neurosurgery, gynaecology, ENT) 17 (44);

• mental health 0 (1).

- Westport News