Over the last number of weeks we have been debunking the myth that hospital cuts somehow represent service transfers to the community.
The data for 2012/13 is not yet available, but if we look at the volume of home care services delivered in 2011/12 we can see that for most clinical services, fewer visits –- not more — were delivered than in preceding years.
If hospital cuts truly represented a transfer to community-based services, shouldn’t these CCAC visits be rising, not declining?
The most obvious is physiotherapy. While Ontario hospitals are making significant cuts to outpatient physiotherapy, the actual number of physiotherapy visits delivered in the community by Community Care Access Centres (CCACs) and their agencies has dropped dramatically.
According to the Ontario Home Care Association, in 2005/06 there were 541,101 community physiotherapy visits. By 2011/12 that number had dropped by almost 100,000 visits to 444,054.
Cuts to outpatient rehab services are short sighted says Dr. Mark Bayley, author of a report on stroke services released this week by the Institute for Clinical Evaluative Sciences and theOntarioand Canadian Stroke Networks.
The lack of outpatient and CCAC rehab services mean many patients who would normally be able to go home end up in more expensive long term care facilities Bayley recently told the Toronto Star.
According to the 2011 Ontario Stroke Evaluation Report, patients are receiving far less visits than recommended from physiotherapists, occupational therapists and speech language pathologists.
Best practices suggest two visits per week from each of these professions. Instead over a two month period patients are averaging between three and four visits in total from each.
The report also notices considerable differences between the LHINs, calling for a more standardized approach for access to, and outcomes for, the rehabilitation sector.
InOntario only one in three stroke victims arrive at hospital in time to be considered for therapy that would dramatically improve outcomes.
While there was a reduction in overall wait times to stroke services, the report says there was also a reduction in access to inpatient rehabilitation among severly disable stroke patients.
The report also recommends the Ministry of Health Promotion continue to fund the warning signs of stroke television campaign.
The report did note that those taken to specialized stroke centers were more likely to receive care based on stroke best practices.
Between 2003/04 and 2009/10 there was also a reduced rate of emergency department visits and hospital stays for stroke or transient ischemic attack (TIA). TIAs are usually involve short term stroke-like symptoms and are considered to be a warning sign of a stroke.