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Community care keeps more patients at home

Fewer patients are presenting at emergency departments across the Waikato as health organisations focus on working together to provide more integrated health care.

Both Tokoroa and Thames emergency departments recorded significantly less presentations for the 2014 calendar year.

Tokoroa had 667 fewer patients come through ED in 2014 which could correlate to the 766 more patients seen at Tokoroa Medical Centre in the same period.

John Macaskill-Smith

John Macaskill-Smith

Midlands Health Network chief executive John Macaskill-Smith said the organisation had been seeing more patients overall in primary care.

“Also in Tokoroa the PAs (physician assistants) have played a massive part, seeing over 6000 patients as drop-in-acute-casuals,” he said.

Macaskill-Smith also attributed the change to the how the organisation manages patients with long term conditions in the community.

At the end of 2013, Midlands Health Network opened a new onsite medical centre attached to the Tokoroa Hospital campus.

In Thames 525 less people required treatment at emer

gency department which again could be correlated to efforts in community and primary care health services.

Hugh Kininmonth

Hugh Kininmonth

Hauraki Primary Health Organisation chief executive Hugh Kininmonth said these changing patterns would raise many questions for the future of health services

“I absolutely agree that these (and other) initiatives are showing the fruits of collaborative efforts,” he said.

However he also suggested both community and health care work closely together to understand the changing trends.

“The marvellous developments at Tokoroa have taken 20 years to implement, [so] it is not premature to begin strategic development discussions now,” said Kininmonth.

Waikato District Health Board last month appointed Dr Damian Tomic as clinical director primary care; he said the statistics were encouraging but more work needed to be done to understand the decline.

Damian Tomic

Damian Tomic

“We need to monitor the trends over a longer term to truly understand why they have dropped and how we can maintain them,” he said.

“Improvements in community care is like a jigsaw… e-referrals, physician assistants, models of care, public health nurses, primary options, general practice services, school-based health services – they are all part of [it]….which leads to patients staying out of hospital.”

Tomic said the only major influence in reducing emergency department patients is by improving the care of patients in the community.

“The challenge is ensuring all those jigsaw pieces continue to fit together and provide patients with the most effective care.”


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