In light of ongoing bed shortages and ambulance delays, a leader in one of Australia's busiest emergency departments is advocating for dedicated hospitals for older patients. Dr. David Green, the director of emergency medicine at Gold Coast University Hospital, highlights the urgent need to address the mounting challenges faced by hospitals nationwide.

"It's very, very difficult when you've got patients sitting in beds in the emergency department, and you're trying to offload ambulances and you've got no bed space," Dr. Green states. With 40 years of experience in the medical field, he points to the rising number of elderly patients as a significant factor contributing to the current crisis.

Dr. Green notes that many patients who survived heart attacks and strokes two decades ago are now returning with conditions like dementia and multiple chronic illnesses. This demographic shift has led to an increase in hospital admissions among older adults, further straining resources. He believes that creating hospitals similar to children's hospitals—specifically designed for those over 65—could help alleviate some of the pressure on the system.

While Dr. Green's proposal has sparked interest, some healthcare professionals are sceptical about its effectiveness. Health educator Jennifer Kosiol from Griffith University warns that a geriatric hospital could also become bed-blocked.

"We have around about 44 percent of our admissions to hospital are older than 65, and they tend to take up a large portion of hospital day beds, which means they tend to stay for longer than younger people," she explains.

Kosiol emphasises that the main issue is not just the availability of beds but the time older patients spend in hospitals waiting to be transferred to aged care facilities.

“If we don't have people that have a next of kin, an enduring power of attorney and they're not cognitively able to make decisions for themselves, we then have to rely on getting them a guardian through QCAT (Queensland Civil and Administrative Tribunal) and that process can take six months,” she adds.

Recent data from Queensland Health reveals that, as of May, 546 long-stay patients older than 65 were in public hospitals for more than 35 days, reflecting a 35 percent increase from the previous year.

State Health Minister Shannon Fentiman has recognised the growing issue, stating that the number of long-stay patients was "getting worse" and announcing a $200 million investment over two years to address it. The Australian and New Zealand Society for Geriatric Medicine (ANZSGM) has also called attention to the complexities involved in geriatric care, emphasising the need for systemic change.

Geriatrician and society president Dr. Robert O'Sullivan asserts that the hospital system must "get better at looking after older people because they are core business for our hospitals." He adds that improving basic care can help reduce hospital-acquired complications that often prolong stays.

On the other hand, Bond University academic Dr. Kieran Le Plastrier describes ramping as a "complex" issue but expresses concerns about fragmenting care.

“We used to have specific psychiatric hospitals for persons with psychiatric illness and what we learned from that is that people going into those hospitals sometimes didn't get the level of care they needed for their physical health even though they may have gotten good care for their mental health,” he explains.

Dr. Le Plastrier urges policymakers to think beyond "brick-and-mortar buildings" and invest more in preventative care.

“If you focus on people being able to get timely access to preventative care before they'd get really unwell, you can actually prevent hospitalisations — so that's got to be a key part of how we reframe healthcare in Australia,” he concludes