More Beds, Geriatric ERs Part of State's Plan to Prepare Israel's Hospitals for Winter

Health Ministry has granted approval to allot beds for elderly patients, patients who need complex nursing care and those who require geriatric rehabilitation, in public and private institutions.

Hospitals in Holon and Nahariya will open 15-bed wards to ease the overcrowding expected in the winter, the first time in a decade the Health Ministry has decided to open new internal medicine wards in government-owned hospitals.

Those wards, which will open in Wolfson Medical Center in Holon and Western Galilee Hospital in Nahariya, are part of a broader process that would see additional, larger wards opening in other hospitals as well.

Some of the hospitals that could be affected by the change include Barzilai Medical Center in Ashkelon, Haemek Hospital in Afula, Ichilov Hospital in Tel Aviv, Rambam Medical Center in Haifa and Sheba Medical Center in Tel Hashomer. Each could expand inpatient capacity by up to 30 beds.

There are currently 1,000 emergency-room beds in general hospitals across the country, and an additional 115 at psychiatric hospitals and chronic-disease clinics. On certain days last winter internal medicine wards were at an average 112-percent capacity across the country, with overcapacity as high as 150 percent in some cases.

The program to expand inpatient capacity includes budget hikes for infrastructure and for hiring doctors, nurses and other staff.

The goal, which was agreed by the health and finance ministries about six months ago, is to add a total of 960 hospital beds over the next six years. One-quarter of these will be in internal medicine wards, with the remaining beds divided evenly among intensive care, maternity and neonatal wards.

The Health Ministry is also considering the establishment of emergency rooms designated for the elderly. These ERs would be located in existing geriatric hospitals, such as Hartzfeld Geriatric Center in Gedera or Fliman Geriatric Rehabilitation Center in Haifa.

A 2008 Health Ministry study found that 30 percent of emergency-room visits by patients older than 75 were unnecessary, in that these patients could have received effective treatment at their regular Health Maintenance Organization clinic. A separate study found that 10 percent of elderly patients who went to the hospital unnecessarily were admitted for observation or for treatment.

"Specialized geriatric emergency rooms can make things easier for the elderly population, which will be directed toward a place that is more familiar with their needs while also easing overcrowding in general emergency rooms," said Arnon Afek, the director of the Health Ministry's medical administration.

Hospitals in the United States have also been building emergency rooms designed for the elderly.

As part of its preparations for this winter, the Health Ministry has granted approval to allot beds for elderly patients, patients who need complex nursing care and those who require geriatric rehabilitation, both in public and private institutions. The ministry had previously refused to grant private institutions in the north the right to use hospital beds for patients in need of geriatric rehabilitation, despite an assessment by the ministry's own geriatrics department stating that Israel is about 1,200 beds short of the number of beds needed for geriatric rehabilitation.

In January the nurses union went on strike to protest the overcrowding. In a deal signed in March, the nurses said they would continue to work in internal medicine units only if capacity was restricted to 120 percent.

As part of its effort to reduce hospital overcrowding, the Health Ministry is also urging the entire population to get flu shots ahead of flu season.