Call for action as WA EDs see influx of older patients

The Australasian College for Emergency Medicine (ACEM) State of Emergency report showed a 17% increase in older patients attending WA EDs from 2018/19 to 2023/24, compared with just a 4% increase among younger people and 16 % nationally.

The report found Australia’s health system and its workforce were not equipped for dealing with Australia’s ageing population.

Older people, classified in the report as non-Indigenous people aged 65 years and over and Aboriginal and Torres Strait Islander people aged 50 years and over, accounted for a quarter of all presentations to EDs.

They were found to be significantly more likely than younger people to present in higher urgency triage categories, to arrive by ambulance and to be admitted into hospital.

ACEM President Dr Peter Allely said the data reflected what emergency doctors experience on the ED floor every day.

“Australia’s population is ageing rapidly, and the number of older Australians has been forecast to continue growing,” he said.

“By 2030, it is projected that nearly one in five Australians will be aged 65 and over. Australia’s health system and its health workforce are just not equipped for this demographic change.”

Dr Allely wrote that despite the scale and predictability of demographic trends, federal, state and territory governments had not done enough to prepare for the volume and complexity of acute care needs as the population ages.

He described the increasing attendances from older Australians as a significant driver of the growing pressure on acute health systems.

“Too often older people cannot confidently access timely and appropriate care outside of hospital," he said.

“EDs are absorbing the consequences of these failures across the health system, leading to ambulance ramping, ED overcrowding, corridor care and access block.

“Unless these serious issues are addressed as a matter of urgency, as outlined in our recommendations, emergency care will come too late for many Australians.”

AMA (WA) President Dr Kyle Hoath told Medical Forum the report highlighted the extraordinary pressure on public hospital emergency departments and the failure to adequately meet the care needs of older Australians.

"Many remain in hospital despite being medically ready for discharge because they are waiting for a residential aged care placement, support at home or other services,” he said.

"These delays are distressing for patients and families. They also leave hospital beds unavailable for people waiting in emergency departments, compounding pressure across the system.

"Governments must work together to address the gaps between hospitals, aged care and community services. The complexity of those arrangements cannot remain an excuse for inaction.”

In its report ACEM has called for federal, state and territory governments and hospitals to strengthen alternative pathways to acute medical care for older people to reduce pressure on EDS.

WA Health Minister Meredith Hammat said the report confirmed issues the state government had been talking about for some time.

In September the number of older patients waiting in hospital for aged care places reached record highs.

“Western Australia is leaning in to provide support in this area, although it is the responsibility of federal government” she said.

She said WA was the first state to fund low interest loans for aged care providers to provide additional aged care beds.

The state government had also funded additional Time to Think beds, providing older people leaving hospital short term care in aged care facilities.

Federal Health Minister Mark Butler’s office did not provide comment on the report's 21 recommendations.