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Showing posts from June, 2013

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 narrowi…

Hospital restructuring picks up (but very quietly)

Community pressures to preserve small hospitals:  Local opposition to hospital cuts has driven Prince Edward County residents to demand that their local hospital be allowed to break away from the multi-site Quinte Health corporation.

This is becoming a more common community demand as small hospitals trapped inside much larger multi-site hospital corporations are particularly vulnerable to cuts. At worst, their ongoing viability is threatened.

As expected, there is no appetite for such proposals at the mother house. Health Minister Deb Matthews has written back declaring that "de-amalgamation" is not under consideration (while, at least, also offering assurances that the government is committed to all sites in the Quinte Healthcare Corporation.)
Government pressures to merge: Indeed, the direction of the government is very much in the opposite direction. The Central East LHIN has just announced that two large hospitals, Rouge Valley and Scarborough, will proceed with stak…

Cut back and hope no one gets hurt?

In May, as the chemotherapy drug mixture scandal swirled, the Ontario Hospital Association tried to distance the contracting out of chemo mixtures from the cost cutting that is so widespread in hospitals at the moment: 

"Contrary to the assertions of some commentators and unions, the outsourcing of compounding by hospitals was not driven primarily, or even secondarily, by cost considerations in most cases."  
Hmm... OCHU's release on this issue did not suggest the contracting out was done to cut costs -- there was no evidence on this point at the time.  Instead, among many other points, OCHU noted examples of contracting out costing more.

The OHA claims hospitals were motivated by the health and safety of their employees (god bless 'em), patient safety, best practices, etc, etc., etc.  

But not money.  

Despite the OHA claims, however, hospitals are mixing their own drugs, without reports of duff chemo mixtures -- unlike the contracting out situation.
Cash Money: As it tur…

Ambulances and Public Health get cash (while other sectors starve)

From time to time there are rumors that EMS (ambulance services) and municipal public health services may move over to the tender mercies of the Local Health Integration Networks (LHINs), which fund hospitals, home care, long term care, and other health services.

Fortunately-- for these services -- that has not happened yet.  
The government is starving the LHINs.  According to the recently released Budget Estimates, the LHINs are going to get $300 million less than what they got two years ago.
In contrast, public health services (provided by municipalities but funded to a considerable extent by the province) are budgeted to get about a 6.4% increase from the provincial coffers this year.   Over the last two years the increase is 12.2%. 
Not too bad.
"Emergency Health Services" (aka EMS) are also largely provided by municipalities but funded almost 50% by the province.  And EMS has also done okay, with a 3.8% increase this year according to the Estimates. Over the last two years,…

Doctors get lion's share of Budget funding

Forget all the government Budget rhetoric about better home care.  The real winners are the docs.

The Ontario Budget Estimates are out and  the line item primarily covering the doctors ("Ontario Health Insurance") is going up 2.9 per cent to $13.3 billion.  The rest of the health care sector got an increase of  0.3 %, just over one-tenth as much.

In dollar terms, the Ontario Health Insurance line item got an increase of $374 million.  The total increase for all of health care (capital and operating expenses) is only $486 million, so this will eat up more than 3/4 of the total health care increase.

A relatively small group of people are getting most of the total increase in health care spending -- and  about 10% of the total $3.6 billion increase in all provincial spending.

Every $100 million split between 25,000 Ontario physicians means another $4,000 per physician, on average.

The pathetic LHINs (which are the main funders of hospitals, home and community care, and long term …