Home visits may ease hospital bed shortage
Sweden has the least number of hospital beds per capita in the EU, and still hospitals face a budget squeeze. Can advanced home care, which has doctors visit seriously ill patients in their homes, help solve hospital overcrowding?
Hospital beds can be hard to come by in Sweden, to the point that care givers cannot always take in new patients. Instead, they are moved between clinics, to nursing homes, or even sent home despite their condition.
According to Eurostat, Sweden has the least number of hospital beds per 100,000 inhabitants in all of the European Union.
Mikaela Luthman, who has worked in advanced home care at a private nursing home in Stockholm for five years, believes there are several advantages to treating patients in their homes.
"When we explain to patients that the purpose is that it should not be necessary to visit the emergency ward, almost all respond positively."
"What we see is that many patients live longer and live better if they can stay at home rather than at a hospital," says Mikaela Luthman.
Treating patients at home is also a way to save money.
"The majority of the patients get this kind of treatment because a doctor asks for it. Home care is kind of a win-win situation. It's cheaper than being at a hospital and it's better for the majority of the patients."
"Of course, the reason for the politicians to bill care out is because it's cheaper. Hospital beds are more expensive," says Mikaela Luthman.
Even though advances in medicine and shorter recovery periods after surgery has brought down the number of nights patients need to stay, the strain is still felt, and shortages regularly occur. Home care can help, but it cannot magically erase the demand for hospital beds at large.
"Care can always be made more efficient, but there is also more care needed all the time, especially as the Swedish population grows older," says Marie Wedin, chairperson of the Swedish Medical Association.
She believes that home care for seriously ill patients who are willing to be treated out of hospitals can only form part of the solution.
"There could be a solution in increased advanced home care, but advanced home care is built on the possibility and the safe feeling that there is always a hospital bed, if needed."
"You can't reduce the number of hospital beds beneath that limit," says Marie Wedin.
For her, the long-term solution is found at a more fundamental level.
"I think that hospital care in Sweden needs more money," she says.
And money may be hard to come by.
In February 2012, Uppsala University Hospital announced a cost-cutting budget that will get rid of almost 50 beds – a near five percent reduction.
Critics of advanced home care also say focusing on it as a budget cutter may result in forcing patients to accept treatment at home. But Mikaela Luthman's patient, who is being treated for cancer, is glad to be receiving home care.
"It's very convenient, for me and maybe also for the hospital. You don't ahve to travel to and from the hospital, you have everything you need at home, and you always feel more comfortable at home than you do at the hospital," the patient says.
Sven Hultberg Carlsson