1 out of 14 isle hospital patients await care home

About 7 percent of the patients in Hawaii hospitals at any given time do not need to be there but are waiting for space to open up in a long-term care facility, according to data being released Thursday by the Hawaii Health Information Corp.

Between 6.9 and 7.8 percent of hospital patients statewide were waitlisted, or remained in the hospital after the need for acute care ends, from 2006 to 2011.

Acute-care hospitals generally cost patients and insurers more money than long-term care facilities, so the lack of space at long-term care facilities tends to drive up health care costs.

On Maui, the rate ranged between 12 percent and 16 percent, and it varied between 8 percent and 10.5 percent on Kauai, HHIC data show.

Hawaii island’s rate was similar to Oahu’s, at between 6 percent and 7 percent, with the exception of 2007 and 2009 when rates were 7.7 percent and 9.2 percent, respectively.

However, despite more waitlisted patients statewide in 2011 compared with 2006, hospital stays were shorter, with the average length of stay for waitlisted patients dropping 25 percent, to 16.5 days from 21.7, across all counties except Maui, which increased 12 percent, to 18.8 days from 16.8.

Neighbor island hospitals saw higher costs and volume for waitlisted patients than Oahu with chronic diseases such as chronic obstructive pulmonary disease, degenerative nervous system disorders and diabetes.

Despite an 11 percent increase in the number of long-term care beds statewide, a major part of the waitlisting problem stems from insufficient staffing with higher skills in nursing homes to match the health needs of patients with complex conditions, the HHIC said.

"Our analyses make clear that the waitlist problem exists statewide but that has very special dimensions on each island," Peter Sybinsky, HHIC president and CEO, said in a news release. "Efforts by health plans, hospitals and other providers and community agencies need to take into account this variation as they work together to solve this vexing problem."

Other barriers to the placement of waitlisted patients include a lack of specialty equipment to provide appropriate care, multiple or high-cost antibiotics, and lack of community-based resources for patients with underlying mental illness, HHIC said.