(Quebec) The private geriatric mini-hospitals promised by the Legault government worry the Association of Geriatric Physicians of Quebec (AMGQ), which deplores the addition of a “new access route” which will “exacerbate the problems” and “vampirizing” network resources.
Geriatric doctors have reservations about the new model that Quebec wants to develop.
The Coalition Avenir Québec promised two private mini-hospitals during the election campaign to relieve congestion on the front line. It was revealed this spring that future facilities will instead take the “more nested” form of geriatric outpatient centers1. One will be located in Lévis and the other in eastern Montreal.
“Although we welcome your desire to invest significant sums in improving care for the elderly, we believe that this approach will accentuate the problems by allocating resources to the wrong place,” writes the AMGQ in a letter addressed to the health Minister.
The Quebec Geriatric Society, full professor at the School of Nursing at the University of Victoria Damien Contandriopoulos and Mylaine Breton, from the Canada Research Chair in the clinical governance of primary care services, co-sign the missive published this Monday in La Presse.
“Take for example the fall. It can be the consequence of a trivial accident, but can also hide a medical problem. How can we ensure that patients referred to these “mini-hospitals” will be sent safely? Will they have access to the technical platform and consultations in specialized medicine if necessary? What will happen to the patient who was initially misdirected or who presents with medical deterioration? Will we transfer him to the emergency room? », they write.
Furthermore, they point out that older people who present for minor emergencies “are more likely to require hospitalization.”
According to them, “directing this clientele to an outpatient clinic risks not meeting needs, and even potentially harming patients by extending delays and increasing the number of transfers.”
“Finally, let us note the apparent absence of conclusive data supporting this project and the risk of draining the already largely insufficient human resources of the public system,” add the signatories, who are asking to meet Minister Christian Dubé. “We want to be part of the solution,” they say.
During its electoral commitment, the Legault government said it wanted the private mini-hospital in Montreal to include an outpatient clinic in geriatrics and that in Quebec, in pediatrics. However, after consulting the community and interested promoters (there were two calls for interest), Quebec revised its concept.
“The issue is the increase in the volume of the population in emergency rooms,” an aging population, explained the Minister of Health during the study of budgetary appropriations in April. Christian Dubé then mentioned the “more niche” scenario of “mini-emergencies” which would be “much more oriented towards the needs of an aging clientele”.
It is also because geriatric services are well organized in the National Capital that the project was moved to Chaudière-Appalaches, said MP Youri Chassin, who is leading the file2, last Wednesday. The call for tenders was published last week. The one in Montreal should be there soon.
“What we currently have is not a well-defined project,” laments the president of the AMGQ, Dr. Jacques Morin, in an interview.
According to the association, which represents some 100 geriatric doctors, we would rather benefit from integrating new services into the public health network in the context of the aging population.
“Wouldn’t integrating this population into our services be more relevant […] rather than creating something in parallel? It will always remain that our elderly people will find themselves in the hospital, on the front line, in hospitalization,” illustrates the vice-president of the AMGQ, Dr. Julia Chabot.
The two mini-hospitals are expected to be operational in 2025. The estimated cost for each facility is 35 million, which will be privately financed. Services will be covered by health insurance.