Victoria has fewer stranded hospital patients – it’s not what you think
In 2023, Victoria delivered almost 2,000 hours of CHSP-funded community nursing for every 1,000 people aged 75 and over – substantially more than any other state.
Victoria consistently reports fewer older patients stranded in hospital waiting for aged care than other states.
While some credit its network of public sector aged care homes, new analysis suggests that explanation doesn’t stack up.
Tim Hicks, Executive General Manager Policy and External Relations at Australia’s largest Not For Profit aged care provider Bolton Clarke, points to community nursing as the key differentiator.
Data across jurisdictions shows a clear link between per-capita Commonwealth-funded home nursing under the Commonwealth Home Support Program (CHSP) and lower rates of older people stuck in hospital awaiting residential aged care – with Victoria standing apart from other states on both measures.
In 2023, Victoria delivered almost 2,000 hours of CHSP-funded community nursing for every 1,000 people aged 75 and over – substantially more than any other state. By comparison, New South Wales and Queensland delivered fewer than half that amount (see the interactive main chart).
Some have argued Victoria’s higher number of State-funded public sector residential aged care homes explains its lower hospital exit block.
But around 70% of those homes are in regional Victoria, while more than 70% of the over-65 population lives in major cities – so regional beds can’t be the cause of the metropolitan hospital flow.
Experienced nurses embedded in the health system
Tim says what is different about Victoria is its large, sophisticated community nursing system, which has operated since the 19th century and is tightly integrated with public hospitals.
Bolton Clarke alone has dedicated district liaison nurses embedded in discharge and emergency department teams at 17 major Melbourne hospitals to improve post-discharge health outcomes.
“It’s not just the number of nurses – it’s how the service is embedded in the health system,” Tim told The Weekly SOURCE. “These are highly experienced nurses who can manage complex clinical needs at home.
“It isn’t a silver bullet – fundamentally we need more aged care beds that are funded appropriately to deal with more complex cases – but there is clearly a lot that other states can learn from the Victorian model.”
The findings align with Australian and international evidence showing in-home nursing reduces emergency presentations, hospital admissions and length of stay.
They also land amid warnings from health economist Stephen Duckett, whose recent report shows 8-10% of public hospital bed days are now occupied by patients awaiting discharge.
