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Very low hospital capacity in Ontario

A key result of low hospital funding (discussed in the previous post) is that Ontario has fewer beds than the rest of Canada and far fewer beds than other developed countries. 

The rest of Canada has 27.4% more beds per capita than Ontario (i.e. a difference very similar to the funding difference with the rest of Canada). 

If Ontario had the same beds per capita as in the rest of Canada, we would have 39,385 beds.  That is an 8,489 extra beds.

In Windsor that would mean an additional 137 beds at Windsor Regional (500 beds reported x 27.4% = 137), 71 beds at Hotel Dieu, and 16 at Erie Shores for a total of 224 in Essex.

The 35 (mostly) rich nations in the OECD average 4.7 hospital beds per 1000 population.  If Ontario had that level of capacity that would mean 66,347 hospital beds in Ontario, more than double the current number.  For the three Essex hospitals, that would mean an additional 937 beds.[1]

What does this mean for Ontario?
Bed occupancy is very high in Ontario as a result of the lack of staffed and operating hospital beds. 

Bed occupancy in hospitals should not exceed 80-85%.  High levels of bed occupancy drive emergency room delays, superbug infections, cancelled surgeries, delays and backlogs.
In developed countries bed occupancy rates hover around 75%.
Under the OECD definition curative hospital beds excludes rehabilitative and LTC beds.  Eurostat, “Health care resource statistics – beds,” 2016, 

Ontario, however, often has hospitals with bed occupancy over 90% in all sorts of hospital beds — chronic care, rehabilitation, acute care, mental health care.  It is not especially unusual for larger urban centres to have occupancy over 100%, and sometimes far over 100%.

Windsor Regional, for example, reports medical and surgical beds at over 100% capacity in 2017/18.  In early 2017, the hospital cancelled surgeries to try to create capacity when 54 patients were without beds.

 Removing patients from hospitals:  Ontario hospitals have the lowest age-standardized length of stay of any province, 11.4% less than the Canada-wide average.  In fact, Ontario is significantly lower than any other province in terms of length of stay.   

Difficult to access inpatient services:  Despite this short length of stay, it is also harder to
be admitted to a hospital in Ontario than anywhere else in Canada – with Ontario having
7.7% fewer (age and sex standardized) hospital admissions than Canada as a whole.  Again,
no other province even comes close to the low number of hospitalizations as Ontario.  Both of these factors are of course in accord with the low number of beds in operation in Ontario. 
Not surprisingly, hospital re-admissions in Ontario have also crept up.
  
CIHI: Hospital 30 Day Readmissions



The increase over 4 years from 8.9 re-admissions per 100 patients to 9.2 is a 3.4% increase. 


[1] The rich country with the least number of hospital beds, Sweden, has 2.4 beds per thousand -- if even that was applied to Ontario that would mean an extra 3,000 beds Some advocates of hospital cuts have focused on Denmark, the only other developed country with fewer hospital beds than Canada.  But it has 2.5 beds per thousand – that would mean an additional 3,400 hospital beds in Ontario.  Ontario is truly an outlier.

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