Finding an effective solution for our stretched hospitals
Australia’s hospitals are under unprecedented pressure. BDO economists Anders Magnusson and Dr Tania Dey explore a potential solution.
Australia’s hospitals are under unprecedented pressure. Emergency departments (EDs) are seeing record demand. The cost of avoidable admissions is spiralling. Clinicians are stretched. And communities, especially in regional and outer-metropolitan areas, are feeling the pinch of long waits and fragmented care.
We’ve long known that new models of care are needed. What’s becoming increasingly clear is that Advanced Allied Health Practitioner (AAHP)-led models could offer an effective solution.
What is an AAHP-Led Model of Care?
AAHPs are experienced allied health professionals, such as physiotherapists, occupational therapists, podiatrists, and dietitians, who’ve expanded their scope through advanced training and credentialing.
In AAHP-led models, these practitioners assume expanded roles, sometimes serving as first-contact clinicians. They can assess, diagnose, treat, and refer patients, streamlining care and reducing reliance on hospital pathways.
It’s not about replacing doctors. It’s about getting the right care, at the right time, from the right professional.
Why Now?
The increasing relevance of AAHP-led models is driven by three main factors: the overload of emergency departments, the need for expanded advanced practice roles to alleviate workforce strain, and the necessity for new models to prove both clinical effectiveness and economic value amid budget constraints.
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Developing a robust economic case is important for large-scale implementation.
BDO’s recent feasibility study is crucial, providing insights that benefit not just South Australia, but health systems nationwide.
The South Australian Case Study: Hospital Avoidance Clinics
BDO modelled the impact of hypothetical AAHP-led Hospital Avoidance Clinics across SA. These clinics would treat patients with conditions like minor injuries, mobility issues, and falls, diverting them from EDs to allied AAHP-led care.
Located in hospital precincts or community settings, the clinics would receive referrals from GPs, ambulances, and ED triage, ensuring timely, appropriate care.
The economic modelling suggests that statewide implementation could:
- Redirect 32,000 presentations annually from EDs to AAHP-led clinics.
- Achieve a benefit–cost ratio of 1.8. Meaning that, for every $1 invested, $1.80 in social and economic benefit is returned.
- Deliver $65 million in annual cost savings/total benefits from 26 advanced AHPs appointed in SA, i.e. generate around $2.5 million in benefits per AAHP full-time equivalent (FTE) per year.
Those numbers are hard to ignore.
Beyond the Balance Sheet: The Social Value
Economic modelling is about more than dollars saved, it’s about broad improvements.
Improving patient flow by reducing non-urgent cases in emergency departments leads to faster care for those in need.
The study also highlighted quality-of-life gains from early interventions by allied health practitioners, which help prevent functional decline and keep individuals active in their communities.
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Furthermore, advanced practice roles enhance workforce sustainability by improving career pathways and job satisfaction, helping to retain skilled professionals in the public system. While harder to quantify than bed-day savings, these benefits are essential for an efficient healthcare system.
Challenges on the Road to Adoption
The AAHP-led care model has a strong economic case, but rolling it out comes with a few key challenges.
First, data gaps exist because many models are still in pilot stages, resulting in limited long-term cost and outcome data.
Then there’s regulatory complexity: extended-scope roles require solid governance, legislation, and credentialing.
And finally, cultural change, getting patients and clinicians comfortable with allied health as a first point of contact, takes time and leadership.
These hurdles aren’t deal-breakers, but they do need thoughtful planning to ensure the model delivers on its full potential.
Why Public Health Should Pay Attention
AAHP-led models go beyond addressing workforce challenges; they focus on prevention and early intervention in healthcare.
By facilitating timely care for patients, these models can help reduce functional decline in older adults, prevent hospitalisations from falls or untreated chronic conditions, and support recovery and reintegration after illness or injury.
This approach serves as an effective upstream investment in public health, redirecting resources to interventions that lessen the demand for acute care.
A Smarter Path Forward
The pressures on our health system aren’t going away. If anything, demographic trends and the prevalence of chronic disease suggest they will intensify. AAHP-led models of care won’t solve every problem, but they can make a measurable difference.
By diverting the right patients from EDs, freeing up hospital capacity, improving patient outcomes, and delivering strong economic returns, these models hit the sweet spot where public health priorities and economic imperatives meet.
The South Australian feasibility study is more than a local exercise; it’s a signal to health leaders nationwide. With careful design, robust evaluation, and political will, Advanced Allied Health Practitioner-led care could move from a promising concept to mainstream practice.
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