Skip to main content

Why are fewer hospital patients waiting for LTC?

Ontario hospitals report a significant decline in the number of patients in hospital beds who are waiting for a long term care bed.  This has been the main category of the so-called "hospital bed blocker" -- the Alternative Level of Care (ALC) hospital patient -- so it is a significant change.  From November 2009 to March 2013, the number of patients waiting for LTC was reduced by 1,282 patients, an astonishing decline of 41%.

This sounds like a victory for better management, but the real story appears to be more complex.

This has not happened because a decline in the relevant population. As noted earlier, the 85 and older population is growing very quickly.

Instead, this coincides with a decline in the number of people (at home and in the hospitals) on long-term care waiting lists of 5,000.  As of 2012, we are down to only 32,000 people in total waiting for a long-term care bed, according to the Auditor General.

Both of these reductions in wait lists coincide with a narrowing in the definition  in 2010 by the government of who is even allowed to join the wait-lists for long-term care.

So, it is, perhaps, not so surprising that the number of hospital patients waiting for LTC has declined.  Indeed, the Auditor General declared in his recent review of LTC placement that the decline in people waiting for LTC in 2011 was primarily due to the tightened restrictions (see page 191 of his review).  Since 2011, the decline in  community and hospital patients waiting for LTC has been modest.

While the decrease in the LTC wait list in both the hospitals and the community was significant (overall a 15% reduction), it was much more marked for patients waiting in hospitals for LTC  (which saw the eye-popping 41% reduction noted above).

Judging by results, the main goal was to get patients waiting for LTC out of hospital beds.

A little after these changes to long-term care, there was a sharp increase in the number of patients in hospital waiting for home care and assisted living, starting quite abruptly in July 2011 -- presumably as a result of changes in government policy, the narrowing of long-term care wait-lists included.

As a result of the increase in patients waiting for home care, or assisted living, the decline in ALC patients is not nearly so marked as you might expect given the decline in patients waiting for LTC.

From a little over 400 patients waiting for home care or assisted living in June 2011, that wait list increased to 900 hospital patients by March 2013.

Acute Care ALC patients: With the decline in the number of patients in hospital waiting for long-term care, there are now more patients in acute care hospital beds waiting for other forms of hospital services. Seven-hundred and sixty patients in these beds are waiting to move into long-term care facilities, while 798 are waiting for other, non-acute hospital services. 

Despite this, hospitals are often described as "not the best place" for Alternate Level of Care (ALC) patients. In fact, hospital ALC patients are often simply receiving the wrong sort of hospital service, or are in the wrong sort of hospital bed.

Most of the acute care patients in this ALC category are waiting for complex continuing care and rehabilitation -- hospital services, which as noted in the last post, are being cut.

Fewer acute care patients are waiting for home care or assisted living services.  Only 567 acute care patients are waiting for home care or assisted living, considerably less than the number waiting for other hospital services or LTC services.

Photo by Sal Falko


Popular posts from this blog

Public sector employment in Ontario is far below the rest of Canada

The suggestion that Ontario has a deficit because its public sector is too large does not bear scrutiny. Consider the following. 

Public sector employment has fallen in the last three quarters in Ontario.  Since 2011, public sector employment has been pretty flat, with employment up less than 4 tenths of one percent in the first half of 2015 compared with the first half of 2011.

This contrasts with public sector employment outside of Ontario which has gone up pretty consistently and is now 4.7% higher than it was in the first half of 2011.

Private sector employment has also gone up consistently over that period. In Ontario, it has increased 4.3% since the first half of 2011, while in Canada as a whole it has increased 4.9%.

As a result, public sector employment in Ontario is now shrinking as a percentage of the private sector workforce.  In contrast, in the rest of Canada, it is increasing. Moreover, public sector employment is muchhigher in the rest of Canada than in Ontario.  Indeed as…

The long series of failures of private clinics in Ontario

For many years, OCHU/CUPE has been concerned the Ontario government would transfer public hospital surgeries, procedures and diagnostic tests to private clinics. CUPE began campaigning in earnest against this possibility in the spring of 2007 with a tour of the province by former British Health Secretary, Frank Dobson, who talked about the disastrous British experience with private surgical clinics.

The door opened years ago with the introduction of fee-for-service hospital funding (sometimes called Quality Based Funding). Then in the fall of 2013 the government announced regulatory changes to facilitate this privatization. The government announced Request for Proposals for the summer of 2014 to expand the role of "Independent Health Facilities" (IHFs). 

With mass campaigns to stop the private clinic expansion by the Ontario Health Coalition the process slowed.  

But it seems the provincial Liberal government continues to push the idea.  Following a recent second OCHU tour wi…

Hospital worker sick leave: too much or too little?

Ontario hospital workers are muchless absent due to illness or disability than hospital workers Canada-wide.  In 2014, Ontario hospital workers were absent 10.2 days due to illness or disability, 2.9 days less than the Canada wide average – i.e. 22% less.  In fact, Ontario hospital workers have had consistently fewer sick days for years.

This is also true if absences due to family or personal responsibilities are included.
Statistics Canada data for the last fifteen years for Canada and Ontario are reported in the chart below, showing Ontario hospital workers are consistently off work less.
Assuming, Ontario accounts for about 38% of the Canada-wide hospital workforce, these figures suggest that the days lost due to illness of injury in Canada excluding Ontario are about 13.6 days per year ([13.6 x 0.68] + [10.2 x 0.38] = 13.1).

In other words, hospital workers in the rest of Canada are absent from work due to illness or disability 1/3 more than Ontario hospital workers. 

In fact, Canad…