Halifax ER sees rise in patients who need community services, not acute medical care

Halifax's emergency department is reporting a rise in patients admitted solely because of social circumstances — and the number of these patients is expected to spike over the holidays, a physician and researcher said Tuesday.

Dr. Jasmine Mah, the Dalhousie University researcher leading a study aimed at learning how to care for so-called "social admissions," said they are often older than the average patient and do not have an acute medical issue but are unable to access home care or community services.

As well, these patients may be dealing with issues related to mental health, dementia or unstable housing, and often end up in hospital because their families are having trouble caring for them, Mah said.

"They deserve to be treated well by our system," she said. "They deserve to have their needs met.

"It just seems they haven't found a place, or service, that provides for those needs in a health system that's already so constrained."

The doctor said she's found that these types of patients are admitted around the holiday season more often than the rest of the year. During her research, she has heard stories of adult children who return home for the holidays to find that their parents' health has declined.

In cases where a family isn't able to find the long-term care, mental health care or home care needed, Mah says they may turn to the hospital when they feel like they have run out of options. "These are families that are trying their best and have nowhere else to turn."

Sometimes these patients are "older adults who don't have nearby family, so there's no one to advocate on their behalf," she said.

Last year, Halifax's QEII Health Sciences Centre emergency department recorded 109 cases of social admissions, Mah said, adding that the hospital is on track to see 120 cases in 2022 — up from 33 reported in 2019.

Longer stay than average patient

While these patients make up less than one per cent of admissions, Mah said her research found that they account for 3.6 per cent of hospital bed occupants. "They stay much longer than the average patient."

Mah said it's expected that if action isn't taken to support this patient group, more of them will be admitted next year.

While research is still in its early stages, Mah said she sees two approaches that could be taken to better care for social admissions: either increasing hospital resources or ramping up support services and access to primary care.

Adding more staff and hospital beds to care for these unique and complex patients would involve a "shift in perception" regarding the kind of patients ER doctors are prepared to care for, Mah said.

She added that if hospitals are not considered the best place for these types of patients, "then we have to support community-based intervention." That would include, she said, increasing patients' access to primary health care, occupational therapy and physiotherapy within their home or community.

This story was produced with the financial assistance of the Meta-Canadian Press News Fellowship, which is not involved in the editorial process.