Aged Care & Rehabilitation Clinical Services Plan 2007 – 2012

Aged Care & Rehabilitation Clinical Service Plan 2007 - 2012Table 6.4 quantifies the number of referrals made to ASET at each participating hospital in 2005/6.If incomplete RPAH data is excluded from analysis, it indicates that across the Area approximately13% of people aged 70-84 years and 21% of people aged 85+ years presenting to ED are referredto ASET. At present, not all referrals are able to be actioned due to the team circumstances at thetime, however it does provide an indication of demand.A review of 2005/6 ED presentations by over 70 year olds showed that they are consistent acrossweekdays and weekends. Approximately 60% of patients present between 8am - 5pm, 23% presentbetween 5pm - 10pm, and the remainder overnight.Of total ED presentations by over 70 year olds, 44% occurred during the core ASET hours of 8am -5pm weekdays. A further 17% occur between 5 - 10pm weekdays, and 15% occur during weekendbusiness hours.Table 6.4 ASET Activity 2005/06FacilityPeople Aged 70-84 People Aged 85+EDPresentationsASETReferrals%ReferredEDPresentationsASETReferrals%Referredto ASETto ASETBankstown 5,618 487 9% 1,907 325 17%Liverpool 5,865 691 12% 1,555 331 21%Fairfield 3,264 277 8% 885 123 14%Campbelltown 3,058 493 16% 1,083 233 22%RPAH 6,123 N/A N/A 1,691 N/A N/ACanterbury 3,618 504 14% 1,293 319 25%CRGH 6,002 1,128 19% 2,343 586 25%SSWAHS 33,548 N/A N/A 10,757 N/A N/ASSWAHS excl. 27,425 3,580 13% 9,066 1,917 21%Source: 2005/06 ASET Activity Reports; HIENote: Full year data is not available for RPAHCurrent and Emerging Issues• Population ageing – as the population continues to age rapidly and if current access trendscontinue, there will be an increase in demand from older people, particularly frail older people,on EDs;• Prevalence of dementia – the prevalence of dementia is expected to double by 2016.Particular expertise will be required to assist clients with dementia;• Service accessibility – ASET is not available at Bowral and Camden Hospitals. At present, theservice is generally only available during core business hours;• Emergency Department Roles/Ambulance flows – ED based aged care services will need tobe responsive to the facility’s role in emergency care, including ambulance flows. Changes maybe required over time in response to changing facility roles;• Local service model – there is considerable variability in ASET staffing across the Area. SomeASETs are single discipline, whilst others are multidisciplinary;• Evolving models of care in ED – new ED based models of care are being trialled across NSW.Results on service effectiveness are not yet available; and• Staffing – it is not possible to backfill ASET positions in many cases, resulting in reductions inservice activity.Projected Future ActivityIf the Emergency Department/Urgent Care Centre configuration remains the same, it could beexpected that the pattern of presentations for those aged 70-84 years and 85+ years will occur asreflected in Table 6.5. This calculation is based on 2005/6 activity and population estimates whichindicate that across SSW 41% of people aged 70-84 years and 70% of those aged 85+ yearspresent to ED annually.Page 38