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Ford government promise falls far short of solving hospital hallway medicine problem


Tens of thousands of new Long-Term Care (LTC) beds needed just to offset aging  

The new Progressive Conservative government in Ontario has promised 30,000 new long-term care beds over the next ten years, often connecting this to their promise to end hospital hallway medicine.  But how does this promise stack up with growing demand for these facilities?

Most people 85 and older live in collective dwellings (LTC facilities, seniors residences, multiple level of care facilities).  The setting with the largest number of elders 85 and older is LTC facilities, with about 35% of the population 85 to 89  years old and almost 40% of the population 90 to 94 years. Older people are even more likely to be in a LTC facility.

nursing home use by population age 85 and older
Source; Statistics Canada
The population 85 and older is the main driver of the need for long-term care beds.

An additional thirty thousand LTC beds by 2028 will only partially offset the rapid growth in the 85+ population.  The ministry of finance projects 42.5% growth in the most relevant population (85 and over) between 2018 and 2028. That growth would require an additional 33,300 LTC beds, just to maintain the status quo -- where tens of thousands are on wait lists for a long-term care bed.  

This may underestimate the number of beds required as in recent years the government has begun to move young people into LTC homes.  If this policy is deepened, the number of beds required would increase further.  

Another factor that will likely increase LTC demand further is that the oldest age group (90+) is growing at an even more rapid rate than the 85+ age group. The 90+ age group will be 48.2% bigger by 2028.  If that age group drives growth, 37,875 new beds would be required.

The Conference Board estimates 78% growth in the need for LTC beds in Canada between 2017 and 2035 – even while assuming a marked reduction in the percentage of elderly people in LTC and increased number of patients dealt with through home care. Applied to Ontario this would mean an additional 60,800 LTC beds.

In other words 30,000 new beds will not offset aging and would require either more patients to be treated in home care or in hospital.  So it will definitely not solve the hospital capacity problem.  

Indeed, it will not make up for the decline in LTC capacity over the last 14 years. Since 2004, long-term care beds have increased by less than 0.4% per year, i.e. by a very small fraction of the growth of the population aged 85 and older.

Despite these factors, the Ford government repeatedly turns to its promise of creating new LTC beds when questioned about how it will solve meet its promise to solve the problem of hospital hallway medicine.  

They need to come up with an awful lot more than this.
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