Skip to main content

Canada provides least hospital inpatient care

Ontario provides even less hospital care than Canada

Canada is an extreme outlier in terms of hospital services.  We provide hospital inpatient services to fewer patients than any other developed nation.  

 The 34 member "rich nations" club, the Organization for Economic Coordination and Development (OECD) has released its  2013 comparison of health statistics for its member states.  For 2011 (or the reported year closest to 2011) the OECD reports that the average number of hospital discharges per 100,000 people is 15,561.    

The Canadian rate reported is 8,249.  

In other words, we have just over half (53%) the number of discharges as other developed nations.  Only Mexico has a lower number -- although many would classify it as a developing nation rather than a rich one.  Otherwise, Chile, which has 15% more discharges, is our nearest comparator.  The rest range between 24%  higher (Spain) to 333% higher (Austria).  (You can download the complete 2013 OECD comparison by clicking here.)

Even this may understate the difference between Canada and the rest of the developed world.  For some reason, Canada reports data only until 2010. As every previous year in Canada since 1982 (when the data was first reported) saw a significant decline, that probably also occurred in Canada in 2011, increasing the difference more. 

Since 1982 we have experienced a reduction of 42% in Canada. Despite the fact that it is much harder to get into a hospital in Canada, the average length of stay is only slightly longer in Canada than in the other 34 OECD nations (7.7 days versus 7.5 days).  

Why Canada?  The particular focus on cutting hospital services may have to do with the particular nature of public health care in Canada.  Under the Canada Health Act, the government is obliged to provide medically necessary services when the care occurs in a hospital.  With the exception of medically necessary physician services, no such obligation exists for necessary health care services  delivered through other providers.  Accordingly, public coverage is much more spotty for drugs, home care, long term care, dental care, physiotherapists, psychotherapists, etc., etc.

So there's a secret incentive in Canada for governments to move services outside of hospital walls.  An incentive that exists regardless of the quality of care.  

Why Ontario? Ontario appears to have taken this furthest, with the lowest  acute inpatient  hospitalization rate of any province in Canada.  

We are on the edge of the edge, it seems.

Photo: Christiana Care


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…