Dr. Alexandra Rendely (physical medicine and rehabilitation specialist at University Health Network’s Toronto Rehabilitation Institute) and Dr. Anjali Bhayana (family physician and hospitalist in geriatric rehabilitation at University Health Network’s Toronto Rehabilitation Institute) advocate that more needs to be done to protect vulnerable and elderly persons from returning to inpatient care after discharge.

In an op-ed recently published in Healthy Debate, Dr. Rendely and Dr. Bhayana suggest that to make such healthcare policy reform would not only result in a decrease in hospital overcrowding, but would better protect elderly, racialized, disabled, and other vulnerable and marginalized populations from decompensating upon discharge and returning to hospital to be at risk of acquiring COVID-19 or other hospital-acquired infections.

To achieve this outcome, Dr. Rendely and Dr. Bhayana suggest that this critical healthcare reform needs to start with the provincial government providing more funding to the Ministry of Health and Long-Term Care (MOHLTC) to then fund Local Health Integration Networks (LHIN) throughout the province. They acknowledge that so doing would require an upfront cost but that it would be economically beneficial in the long term.

“As we discharge this enormous number of hospitalized, elderly COVID-recovered patients, including those disproportionately affected in racialized and low-income groups, the gaps in services expose stark inequities. It is imperative that home supports and outpatient rehabilitation resources be scaled up to meet this demand in all regions.

The Ford government has publicized a temporary wage boost for public sector PSWs but this is a band-aid solution to this ongoing shortage.

We are advocating for better wages, benefits and paid sick days for home-sector PSWs in agencies affiliated with LHINs; improved safety protocols and PPE provision to care for isolated COVID-19 positive patients at home, if necessary; immediate hiring of additional PSWs; and decreased cost barriers to training.

[…]

Implementing increased homecare resources would require upfront costs but would be beneficial in the long term. Housing a patient in a non-ICU bed costs $1,000-$1500 per day. Each day that patients are not in their homes, the system is financially stretched. LHINs receive only four per cent to five per cent of all provincial health spending, which is not enough. Prioritizing homecare needs to be the number one agenda item for the province in 2021. With an estimated 38,000 people on waitlists for long-term care beds, the emphasis should be on keeping these patients in their own homes safely with the supports they need.”

You can read the full article here:

https://healthydebate.ca/opinions/ontarios-inadequate-homecare

Dr. Rendely has published other articles during the COVID-19 pandemic about a host of critically needed public healthcare reforms in the Globe and Mail (https://www.theglobeandmail.com/opinion/article-canada-cant-afford-to-shut-down-operating-rooms-again/) and with the CBC (https://www.cbc.ca/news/opinion/opinion-hospital-patients-visitation-policies-1.5815267).

*This article was written by Matthew Rendely, Dr. Alexandra Rendely’s proud (and definitely not biased) twin brother.

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This paper is intended for the purposes of providing information only and is to be used only for the purposes of guidance. This paper is not intended to be relied upon as the giving of legal advice and does not purport to be exhaustive.