Skip to main content

Ontario: 6.1 fewer hours of care per hospital patient


operating room in a hospital


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 (CIHI).   

But the CIHI data also revealed other interesting trends, likely related.  

Administrative Costs Decline: Administrative costs fell 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 0.3% reduction frees up about $63 million annually.

The decline in administrative costs across Canada has also been marked, declining by a similar amount as in Ontario to fall to 4.7% of total  hospital expenditures.  

Long-Term Efficiencies Achieved in Support and Administrative  Services: This decline in administrative costs is part of a longer term trend.  A 2005 report from CIHI indicated  administrative expenses took up significantly more of total expenditures than current levels (e.g. 8% of Canadian hospital expenditures as recently as 2001/2).     

An even sharper decline is seen in the share of total expenditures spent on hospital support services (which saw a decline from 21.8% to 16.4% over the decade 1992/3 to 2002/3).  

No other hospital functions have come even close to achieving such reductions.  

Nursing:  Hours worked in Ontario by all personnel in nursing services units per weighted case remain well below the Canada-wide average.   But  there was a slight uptick in Ontario in the most recent year reported.  

In total, we saw an increase from 42.81 hours in 2010-11 to 42.88 hours in 2011-12 -- an extra 4 minutes and 12 seconds for a typical patient (or, more exactly, per "weighted case").  

But hold the celebration.  

Ontario still provides 2.1 hours less care by personnel in nursing  units per weighted case than it did in 2007-8.  

Moreover, Ontario has a full 6.1 hours less care by personnel in nursing units than the Canada-wide average (including Ontario). And the gap between Ontario and the rest of Canada is growing. 

Nursing Inpatient Services Total Worked Hours per Weighted Case
2007-2008
2008-2009
2009-2010
2010-2011
2011-2012
NFLD
52.2
53.26
54.48
55.9
52.9
PEI
83.48
N/R
62.19
62.46
61.66
N. S.
56.79
57.34
U
U
54.95
N.B.
54.98
55.46
56.26
57.29
58.13
Quebec
49.73
50.06
50.82
50.73
52.47
Ontario
44.98
44.76
43.71
42.81
42.88
Manitoba
54.41
54.27
53.87
53.06
53.97
Saskatchewan
49.37
51.42
51.28
52.95
54.18
Alberta
54.12
54.65
54.52
54.24
54.36
B.C.
44.24
45.27
45.03
45.87
46.27
NWT
U
83.05
88.51
69.48
N/R
Yukon
48.84
48.97
50.25
56.31
54.51
Weighted Average
48.59
48.8
48.36
48.2
48.98
Source: CIHI

In 2007-8, the difference was 3.61 hours.  By 2010-11, it had increased to 5.39 hours.  In 2011-12 it was 6.1 hours.  That's a 69% increase in the differential in just four years.  

As Ontario is a big part of the Canada-wide weighted average, the difference between Ontario and the other provinces must be much more marked than this data reveals.

But even this data shows that on a Canada-wide basis patients get  14.2% more nursing care than patients just in Ontario.  Moreover, in a short period of time, Ontario has fallen far behind Canada in the amount of hospital care by nursing personnel.

As Ontario is currently applying austerity to hospitals more sharply than other provinces, this differential may well increase further when more recent data is released.  

For a summary of the CIHI data by province, click here.  

Comments

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…