The acute-aged care interface: exploring the dynamics of 'bed blocking'.
OBJECTIVE
To understand the dynamics underlying 'bed-blocking' in Australian public hospitals that is frequently blamed on older patients.


METHODS
Analysis of primary and secondary data of utilisation patterns of hospital and aged care services by older Australians.


RESULTS
A model of the dynamics at the acute-aged care interface was developed, in which the pathway into permanent high-care Residential Aged Care (RAC) is conceptualised as competing queues for available places by applicants from the hospital, the community and from within RAC facilities. The hospital effectively becomes a safety net to accommodate people with high-care needs who cannot be admitted into RAC in a timely manner.


CONCLUSIONS
The model provides a useful tool to explore some of the issues that give rise to access-block within the public hospital system. Access-block cannot be understood by viewing the hospital system in isolation from other sectors that support the health and well-being of older Australians.
Travers
Catherine M
CM
Academic Unit in Geriatric Medicine, Princess Alexandra Hospital, Wooloongabba, Queensland, Australia. c.travers1@uq.edu.au
McDonnell
Geoff D
GD
Broe
Gerald A
GA
Anderson
Phil
P
Karmel
Rosemary
R
Duckett
Stephen J
SJ
Gray
Len C
LC
D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001509:Bed Occupancy / Q000706:statistics & numerical data*; D003422:Critical Care / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005069:Evaluation Studies as Topic; D005260:Female; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D018570:Risk Assessment; D012737:Sex Factors