New South Wales must think outside the box to stop the number of "stranded" aged care patients in hospitals from spiralling out of control, the state's productivity commissioner says.
According to recent data from NSW Health, the number of people who occupied hospital beds while awaiting placement in aged care facilities had jumped almost 40 per cent over the past year, from 761 to 1,063 patients.
A new report from the NSW Productivity and Equality Commission, released on Wednesday, estimated that figure could reach more than 7,000 in 10 years if aged care and community care services failed to keep pace with Australia's ageing population.
The report, which was commissioned by the state government, said an extra 2,600 aged care beds would be needed each year to meet future demand, but NSW was projected to deliver only 660.
It said the costs associated with patients stranded in NSW hospital beds were estimated to exceed $1 billion annually.
Patients waiting for aged care beds in hospitals has risen by 40 per cent in a year. (ABC News: Timothy Ailwood)
NSW Productivity and Equality Commissioner Peter Achterstraat told the ABC more funding was required for aged care support and health prevention, but other alternatives could be explored.
"We need to look outside the box. There may as well be a third alternative, such as intermediate care where people can go to facilities which are not an acute hospital but not quite an aged care facility,"
he said.
Peter Achterstraat emphasised the need for intermediate care. (ABC News: Liam Patrick)
Mr Achterstraat said previous research conducted by the commission found that keeping patients in hospital beds was costing $1,000 a night, compared with "just a few hundred dollars" at an aged care facility.
"If an elderly person is at home and they have an accident or something and they need to go to the hospital … normally they'd be ready after five days to go home," he said.
"But in many situations they can't go home because they need someone at home to change the bandages or to administer medicines.
"So they stay in hospital, they can't go home and there's no aged care facilities available for them because there's a shortage … there are over 1,100 people in New South Wales hospital beds today who shouldn't be there."
NSW government responds
Ryan Park says the state government will provide interim support services. (ABC)
NSW Health Minister Ryan Park said the state government would provide interim services, but argued aged care was traditionally the responsibility of the Commonwealth.
In early September, state and territory leaders called for the Commonwealth to expand its Support at Home package to help stranded patients return home sooner.
The productivity commission is also calling for the service to be expanded, estimating there were more than 100,000 Australians waiting to access funding for at-home support services in March 2026, with average waits of about 12 months.
Mr Park said the state government would introduce a $28 million pilot program, which could include funding for short-term services such as clinical care, wound care and symptom management, personal care, as well as domestic assistance.
"It is a significant reform because we're essentially stepping into a space [that is] traditionally the responsibility of the Commonwealth, but I can't see hospital beds continue to be taken offline each and every day," he said.
Funding not in line with building new aged care homes
The commission's report found Commonwealth government funding for new aged care homes had not kept up with rising construction and operating costs.
It said the federal government was not providing sufficient returns to recover the up-front costs of new homes; the biggest barrier to increasing supply.
"Meaningful and sustained reductions in stranded patients will require the Australian Government to ensure the capacity of aged care services keeps pace with population needs," the report said.
"The Australian Government should increase residential aged care funding to efficient levels that support development feasibility, long-term investment confidence and the supply response needed as the population ages."
Federal Aged Care and Seniors Minister Sam Rae's office has been contacted for comment.
Other recommendations include establishing a dashboard to track stranded patients in NSW hospitals, ensure aged care funding supports demand, expanding community based services, as well as setting up a cross-agency delivery team to coordinate action on aged care supply and stranded patients.