More than 30,000 bed days were lost at one major Dublin hospital last year due to the delayed discharge of patients.
The bed days were lost at the Mater Hospital because of a lack of long-term, rehabilitation and hospice beds to discharge patients to.
The extent of the so-called "bed-blocking" crisis at the hospital is revealed in an internal report obtained by The Irish Times under the Freedom of Information Act. It states that the bed days lost in 2002 were the equivalent to having 82 beds closed for the full year.
"The potential for utilisation of these bed days and the impact on services if having them available for use is enormous," the report said. If the beds were freed up they could be used to reduce waiting lists and in the long run reduce emergency admissions.
"Throughout 2002, the hospital has been unable to admit medical elective patients. As a result, and due to increasing severity of illness, many waiting list patients present in the emergency department requiring acute admission.
"Other patients in similar situations repeatedly present in out-patient clinics eventually requiring admission. Medical out-patient admissions have accounted for 566 admissions up to the end of November 2002, an increase of 22 per cent on 2001."
Referring to how waiting lists could be reduced using the blocked beds, it said there were 4,772 patients on the hospital's waiting list. "The hospital, using the 30,158 bed days lost, would have been able to clear its waiting list (with bed days left over)," the report continued.
The most common reason for delayed discharges was a shortage of long-term care beds. Some 15,159 bed days were taken up in 2002 by persons over age 65 awaiting long-term care.
A further 7,440 bed days were lost as a result of patients waiting for rehabilitation. More than 1,000 bed days were taken up by patients awaiting hospice beds and 3,408 bed days were lost to patients awaiting adapted housing and equipment.
Furthermore, the report pointed to adverse effects on the patients themselves who were not being discharged. These included stroke patients and those with spinal injuries "being denied access to rehabilitation on time".
The hospital's chief executive Mr Martin Cowley told a meeting of the hospital board in February that bed-blocking, which also affects many other hospitals, was still causing serious problems at the Mater in 2003. "At present there are 101 long-stay patients occupying beds," he said.
The hospital, which is facing an €18 million deficit this year, announced last month it would have to close 115 beds to cut costs.