Ontario: 6.1 fewer hours of care per hospital patient

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.  

Photo: Belfast hospital by Slinky2000