Hospitals are often stereotyped as providers of acute care services. In fact, acute care accounts for a relatively small portion of total hospital services. As noted a few days ago, costs per acute care patient (or, more exactly, per “weighted case”) in Ontario are significantly below the national average, coming in at $5,174 in 2010-11 (and $5,184 in 2011-12). There was 1,484,046 weighted acute care (and newborn) cases in 2010-11 in Ontario. So the total acute inpatient cost is about $7,678,454,004. In 2010-11, the total hospital sector expense (funded from both government and other sources) was $20.6 billion according (Read more…)
. . . → Read More: Defending Public Healthcare: Are hospitals primarily providers of acute care?
The real costs for the average hospital acute care patient are declining. As noted yesterday this is true for both Ontario and Canada, based on data just released from the Canadian Institute for Health Information. But the CIHI data also revealed other interesting trends, likely related. Administrative Costs Decline: Administrative costs continue their long decline in Ontario hospitals, falling again from 6.21% of total expenses in 2009-10 to 6.15% in 2010-11 and then down to 5.91% in 2011-12. With a total hospital spend in the range of $21 billion in Ontario, this (Read more…) . . . → Read More: Defending Public Healthcare: Ontario: 6.1 fewer hours of care per hospital patient
Ontario has the lowest hospital cost per weighted case of all the provinces. And the cost difference between Ontario and the rest of the country is growing.
Hospital Cost Per Weighted Case ($)
2009-2010 2010-2011 2011-2012 Newfoundland 6,001 6,283 6,332 PEI DQ DQ 5,257 Nova Scotia 4,998 5,403 5,384 New Brunswick 5,104 5,380 5,390 Quebec 4,455 4,550 4,728 Ontario 5,164 5,174 5,184 Manitoba 5,403 5,438 5,396 Saskatchewan 5,722 5,883 6,174 Alberta 6,139 6,399 6,631 BC 5,456 5,571 5,232 North West Territories N/R N/R N/R Yukon DQ 7,709 7,394 Weighted Average 5,172 5,281 5,335
Source: Canadian Institute for Health Information (CIHI (Read more…)
. . . → Read More: Defending Public Healthcare: Costs of hospital treatment falling
A Great West Life Assurance executive recently claimed that private insurance for drug plans was becoming unsustainable — unless changes are made. Almost all private drug insurance plans are paid through employer paid insured benefit plans (often bargained with trade unions).
In fact, although there were significant increases during the 90s and the first decade of this century, drug costs for insured benefit plans have leveled off.
For 2010, 2011, and 2012 private drug insurance costs have risen just less than 3.1% per year on average, according to the Canadian Institute for Health Information (Table A). This is a (Read more…)
Contrary to the hysteria from conservatives, health care spending continues to decline as a percentage of the provincial budget. Last year, health care accounted for 38.5% of total expenditures, this year the government plans to bring it down to 38.3%. This continues the trend downwards since 2003/4 when health care accounted for 40% of total expenditures. Austerity Redux The provincial Budget reports that program spending is going up an impressive sounding 2.99% and health care spending is going up 2.3%. Although that sounds like a larger than expected increase in these days of austerity, (Read more…) . . . → Read More: Defending Public Healthcare: Health care spending continues decline
England has had a disproportionate impact on health care reform in Ontario over the last decade or so –under both Liberal and Progressive Conservative governments. After the election of a Conservative-Liberal Democrat government in Britain in 2010, English health policy took a decided turn towards bonzo-privatization. As elsewhere, the electorate were only informed after the election. So it was with a worried eye that I looked at the latest report on these reforms and what they might mean for Ontario from Ontario’s (very establishment-oriented) Change Foundation.
The good news is that the Change Foundation shows rather tepid interest
. . . → Read More: Defending Public Healthcare: English reforms lose their appeal in Ontario?
Yesterday, I wrote about the significant lack of nursing care in Ontario hospitals compared to the other provinces. Even on a Canada-wide basis, there was 5.32 hours more nursing care per patient than in Ontario in 2010-11 (year end March 31). That sounds kind of shocking. But it looks like it is getting worse. Other data from CIHI indicates that over the course of 2011, Ontario hospitals lost thousands of nurses. Specifically, there was a sharp reduction in the number of Registered Nurses (RNs) working in Ontario hospitals in 2011, with a cut of 2,750 RNs to 58,699 according . . . → Read More: Defending Public Healthcare: Nursing levels low and getting lower
The “cost per weighted case” in Ontario hospitals in 2010-11 was $5,143, according to a new report from CIHI. (This indicator measures the relative cost-efficiency of a hospital’s ability to provide acute inpatient care.) The Ontario cost per weighted case compares with a Canada-wide average of $5,230.96.
In other words, the Canada-wide average is 1.7% higher than Ontario. Ontario has improved its position relative to the other provinces since 2009/10, when the Canada-wide average was only 0.08% higher. Ontario’s lower costs are especially significant as (presumably) Ontario hospital wages (like other wages) are higher than most other . . . → Read More: Defending Public Healthcare: Hospital costs lower in Ontario
A new report from the Chief Medical Officer of Health in England reports that “rates of C. difficile have fallen consistently in all English regions in recent years. MRSA has fallen markedly and is now very low in many areas.”
As noted in November, there is no evidence of that in Ontario, as the incidence of both MRSA and C. Difficile is about the same as when public reporting started (i.e. over about the same period as when the rates of MRSA and C. Difficile were falling in England). While England has made good progress on MRSA and . . . → Read More: Defending Public Healthcare: MRSA and C. Difficile rates fall (but not here)
More hospital savings. Joanna Frketich reports Hamilton Health Sciences needs to find $20 million to $25 million in savings, while Hamilton St. Joseph’s is cutting $10 million to $12 million, and Burlington’s Joseph Brant must cut $4 million. In total, $34 to $41 million in cuts for Hamilton area hospitals. That is in the range of 1.7% to 2.7% of the hospitals’ budgets. This is on top of earlier cuts. Over the past year the three hospitals found $30 million in savings. The government would no doubt focus on the increase in home care funding of
. . . → Read More: Defending Public Healthcare: Hospital cuts in 1.7% to 2.7% range
Premier designate Kathleen Wynne has strongly suggested that hospital cutbacks will continue Of the cuts just announced at the Ottawa Hospital, Wynne says the government is “transforming the health-care system, so services that need to be delivered in a hospital setting are delivered in a hospital setting, but services that don’t are delivered elsewhere….It means there will be alterations in the health institutions in our cities and our towns.” One would hardly know she is referring to the cut of 290 jobs (and about $31 million) at the Ottawa Hospital. The Ottawa cuts
. . . → Read More: Defending Public Healthcare: It’s raining cuts
The Ontario government’s 26 page Action Plan for Seniors came out yesterday. There’s not much to it. About half of the report simply rehashes what is already in place. To the good, they at least formally recognize that the elderly population is expanding rapidly and that this is going to require an “overarching plan” that (absent their reforms) is going to cost a lot of cash. (For more information on the tsunami we are facing in long-term care, and how far short we are falling, click here, here, and here.) To the bad, their . . . → Read More: Defending Public Healthcare: A tiny response to growing elder needs
There was a sharp reduction in the number of Registered Nurses (RNs) working in Ontario hospitals in 2011, with a cut of 2,750 RNs to 58,699 according to new CIHI data. That’s a 4.47% decrease in one year. Community health numbers also took a very hard hit, while numbers were up very slightly in long-term care.
For the first time in a long time the number of Registered Nurses (RNs) in Ontario has begun to decline. In 2011, employed RNs declined from 95,185 to 94,723, a decrease of 462, or just less than one-half of one percent.
Registered Practical Nurses . . . → Read More: Defending Public Healthcare: Major decline in nursing in Ontario hospitals
There has been no progress stopping the spread of superbugs in Ontario hospitals according to government data. Reported C. difficile rates are about the same as they have been, starting this past year at 0.35 cases per thousand patient days… . . . → Read More: Defending Public Healthcare: No progress on hospital superbugs
Jane Meadus of the Advocacy Centre for the Elderly says that some seniors are being pushed out of hospital too soon under the province’s Home First policy, the Ottawa Citizen reports. “Patient safety is at high risk…While many patients will do well … . . . → Read More: Defending Public Healthcare: Elderly pushed out of hospitals: Elder Advocate
Private funding of health care is increasing faster than public funding. Now the Canadian Institute for Health Information reports that public funding is expected to fall to 69.7% of total funding in 2012.
Public funding has been much higher — in 1976 it provided 77% of all health care funding. After a slow, multi-year decline, it had stabilized by 1996. But it has now fallen three years in a row.
Canadian public sector health care spending is expected to increase 2.9% in 2012 while private funding is expected to increase 4.6% (more than half again as
. . . → Read More: Defending Public Healthcare: Public sector health care funding shrinks – again
Today, in the Ottawa Citizen, the Queensway Carleton Hospital in Ottawa reports a big decline in the number of ”ALC” patients (down from 50 patients a day to 20 or 25 — a 50% to 60% decline). The Citizen also reports a smaller decline in the number of people waiting for a LTC bed (down 12.4% since September 2011 from 2,672 to 2,341).
The story highlights the home first program (where seniors get intensive home care for up to two months) and a decision not to discuss LTC options with patients. But it sounds like . . . → Read More: Defending Public Healthcare: Finding appropriate care for ALC patients in hospital
Quinte Health Care is simply stopping elective surgeries for a week to deal with funding shortfalls from the provincial government.
The hospital’s CEO Mary Clare Egberts told The Intelligencer that the cuts weren’t in keeping with QHC’s new “patient-first” strategy but a lack of provincial funding leaves few options. The Intelligencer adds that QHC will also reduce physiotherapy for outpatients at all four of its hospital sites effective November 1 and is looking for other ways to cut costs (e.g. reducing sick pay, overtime, and supplies). The nearby Perth & Smith Falls District Hospital is planning to cut . . . → Read More: Defending Public Healthcare: Funding crisis forces hospital to cancel surgeries
Joseph Brant Memorial Hospital has agreed to settle a law-suit by approximately two-hundred victims of a C. difficile outbreak at the hospital for $9,000,000, the Hamilton Spectator reports. That is an average of about $45,000 per claimant. The law-suit alleged the Burlington hospital was not properly cleaned, maintained and disinfected. OCHU has long warned that hospitals would be subject to law-suits because of cuts to housekeeping services. Since the 1970s hospital support services have been cut back again and again. Ninety-one patients infected with C. difficile died.
The settlement must still be approved by the courts. The Spec adds “that
. . . → Read More: Defending Public Healthcare: $9 M hospital settlement for law-suit alleging poor cleaning
Since closing 30 beds designed for non-acute patients in March, the number of non-acute patients occupying acute care beds at Health Sciences North in Sudbury has more than doubled.
In February only 44 non-acute care patients were occupying acute care beds. But since the bed closures that number has increased: to 77 in April, 96 in May, and now 100 this week.
The result is cancelled surgeries (4 this week) and a backed up hospital.
It’s hard to believe sticking so many non-acute patients in acute care beds is effective health care (or that it is going to save money).
. . . → Read More: Defending Public Healthcare: Bad health care practices follow bed cuts
A Windsor hospital has been officially blocked from setting up hospital beds in a for-profit retirement home.
As noted in June, the Hotel Dieu Hospital was trying to create 18 “assess and restore” hospital beds in a for-profit retirement home in Amhertsburg. The hitch for the Ministry of Health and LTC wasn’t the for-profit nature of the home, it was that the home didn’t meet the building and fire code for hospital services. This despite $300,000 in renovations by the retirement home and nine months of planning. For the hospital project, the retirement home installed wheelchair-accessible bathrooms, . . . → Read More: Defending Public Healthcare: Hospital can’t turn beds over to retirement home