Skip to main content

'Expert' thinking on hospital ranking

The Ontario government is considering a ranking system that would award Ontario hospitals stars for good performance, while identifying poor performers, the Ottawa Citizen claims. The “name-and-shame” scheme would be modeled after a short-lived British experiment. 


'Under the proposed system, hospitals would be given a rating of as many as three stars for their performance in areas such as treating patients safely and effectively, reducing surgical and emergency-room waits and improving cleanliness. Another system under consideration would simply rate hospitals “excellent,” “good,” “fair” or “weak,” according to documents released to the Citizen under provincial freedom-of-information laws.

'The merits and pitfalls of a star-rating system were discussed in 2009 by a panel of 13 experts advising Health Minister Deb Matthews on the future financing and accountability of hospitals. However, it’s not clear if the government has adopted the idea.'


The Citizen adds a ranking system "could also lay the groundwork for more sweeping changes to how hospitals are funded, with the goal of rewarding those that are more efficient and treat patients safely and effectively."


The Citizen says some British hospitals manipulated their data to look like they had improved standards when they actually hadn’t.  For example, to meet the target of a maximum four-hour wait for treatment in emergency departments, some hospitals made patients wait in ambulances outside the hospital until staff were confident they could be treated.


While details on the proposal are just emerging, this appears to be one more step towards a system based on competition and fragmentation rather than cooperation and integration.  The actual "choice" it will provide is limited for most, who will continue to rely on their doctors' advice and who, in any case, often live in cities with only one hospital.   


The influence of  British health care experiments on the thinking at the Ministry of Health and Long Term Care continues.  And that is a scary thought, given what the British Conservative-Liberal government is up to.  

Comments

Popular posts from this blog

Health care funding falls, again

Real provincial government health care funding per-person has fallen again this year in Ontario, the third year in a row.  Since 2009 real funding per-person has fallen 2.6% -- $63 per person. 

Across Canada real per person funding is in its fourth consecutive year of increase. Since 2009, real provincial funding across Canada is up $89 -- 3.6%.
In fact the funding gap between Ontario and Canada as a whole has gown consistently for years (as set out below in current dollars).

Ontario funds health care less than any other province -- indeed, the province that funds health care the second least (B.C.) provides $185 more per person per year, 4.7% more.  
Provincial health care spending in the rest of Canada (excluding Ontario) is now  $574 higher per person annually than in Ontario. 

 Ontario has not always provided lower than average health care funding increases-- but that has been the general pattern since 2005.
Private expenditures on health care have exceeded Ontario government increases …

Ontario long-term care staffing falls far short of other provinces

CUPE and others are campaigning for a legislated minimum average of four worked hours of nursing and personal care per resident per day in long-term care (LTC) facilities.  New research indicates that not only is LTC underfunded in Ontario, it is also understaffed compared to the other provinces. 
LTC staffing falls short:  The latest data published by the Canadian Institute for Health Information (and based on a mandatory survey undertaken by Statistics Canada) indicates that staffing at long-term care (LTC) facilities falls far short of other provinces. 
Part of this is driven by a low level of provincial funding for LTC.





Ontario has 0.575 health care full-time equivalent employees (FTEs) per bed staffed and in operation.[1]  The rest of Canada reports 0.665 health care FTEs.[2] The rest of Canada has 15.7% more health care staff per bed staffed and in operation than Ontario.[3] 


No other province reports fewer LTC health care staff per resident (or per bed) than Ontario.[4]

Occupancy r…

Six more problems with Public Private Partnerships (P3s)

The Auditor General (AG) has again identified issues in her annual reportwhich reflect problems with Ontario health care capacity and privatization.   First, here are six key problems with the maintenance of the 16 privatized P3 ("public private partnership") hospitals in Ontario:
There are long-term ongoing disputes with privatized P3 contractors over the P3 agreements, including about what is covered by the P3  (or “AFP” as the government likes to call them) contract.The hospitals are required to pay higher than reasonable rates tothe P3 contractor for  maintenance work the contractor has deemed to be outside of the P3 contract. Hospitals are almost forced to use P3 contractors to do maintenance work the contractors deem outside of the P3 contract or face the prospect of transferring the risk associated with maintaining the related hospital assets from the private-sector company back to the hospitalP3 companies with poor perf…