3/15/16

Ontario hospital length of stay in rapid decline, Canadian average now 21% longer

New hospital inpatient length of stay data published by the Canadian Institute for Health Information (CIHI) indicates [1] Ontario lengths of stay continue to decline, but the pace of decline has picked up, and [2] the gap between the Ontario and Canadian average length of stay is growing and has now hit startling levels.
  • Since 2007/8, Ontario inpatients have 0.6 fewer days in hospital. This is a decline in length of stay of 8.7%. The Canadian average declined only 0.1 day (1.3%). The Ontario decline corresponds with the real funding cuts for Ontario hospitals in recent years.
  • Much of this occurred in the last year -- Ontario inpatients had 0.3 fewer days in 2014-15, a decline of 4.6%.
  • The Canadian average is now 1.2 days longer – or, put another way, Canadian patients stay 19% longer. This corresponds with the extra funding Canadian hospitals get compared to Ontario hospitals. 

Canadian hosptial length of stay 21% longer  than in Ontario

The trend is even more apparent if we look at “age standardized average length of stays” (which standardizes the age of patients for all jurisdictions and time periods and so is probably a more accurate measure).
  • Since 2007/8 length of stay has declined 1 full day in Ontario – a 14.9% decline. 
  • In the last single year reported (2014/15) the age standardized lengths of stay declined half a day in Ontario – or by 8.1%.
  • The gap with the Canadian average has grown from 0.6 fewer days in Ontario in 2007/8 to 1.2 fewer days in Ontario. 

In other words, in 2007/8 the Canadian average stay for an age standardized patient was 8.9% longer, but in 2014/15 that had grown to 21% longer. Quite incredible.

Ontario age standardized length of inpatient stay declining -- and far shorter than Canadian LOS

The government has focused on removing less sick patients from hospitals and treating them at home.  So the decline in length of stay has occurred while the patients in the hospital are relatively sicker.

The more rapid decline in length of stay fits directly with the harsh funding restraint imposed on Ontario hospitals in the last few years and the increasing re-admission of patients to hospitals in Ontario.  This CIHI chart shows the number of patients per 100 patients who must be readmitted within 30 days, a major increase in a few short years.  This means that means about 9,000 more patients must now be re-admitted to Ontario hospitals every year.


Canadian hospital inpatient re-admissions increasing

In just four years between 2009/10 and 2013/14 Ontario saw a 13.6% decline in the age standardized length of stay and a 9.6% increase in re-admissions.

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