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Ford government fails to respond to 72% increase in COVID inpatient days, deepening the capacity crisis

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data.  

This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization.  

Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion.  That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year.  

The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million.    

In total, there were 60,653 COVID hospitalizations in Ontario in 2022/3, up from 47,543 in 2021/2.  That is an increase of 13,110 inpatients, or 27.6%.

The average COVID length of stay in Ontario hospitals also increased from 12.9 days in 20221/2 to 17.4 days in 2022/3.  As a result, over 1 million hospital bed days were taken up by COVID infected patients in 2022/3.  The increase in COVID inpatients and their increased length of stay results in over 430,000 extra COVID inpatient days, a 72% increase in 2022/3. That increase alone requires 1,178 beds  -- occupied 365 days per year.

Despite the increase in length of stay, costs per inpatient actually went down from $21,021 in 2021/2 to $20,0352 in 2022/3.  

Likely, this is due to a large drop in the number of patients treated in intensive care beds, which run at more than twice the cost of ordinary medical beds.  In 2022/3 there were 9,065 COVID patients in ICU versus 10,977 in 2021/2, a 17% decrease.  

Even with this reduction in ICU usage, the costs per COVID inpatient is over three times the cost for non-COVID inpatients and the length of stay is well over two times more.

As is the case for all types of Ontario inpatients, Ontario COVID patients are discharged more quickly than the Canadian average: 17.4 days versus 19.8 days for all of Canada (excluding Quebec). That's 12% less.  Likewise, the cost of hospitalization is lower in Ontario: $20,135 versus $24,369 in all of Canada (excluding Quebec) --  17% less. 

This fits the general trend: Ontario pushes all inpatients out 5.6% quicker and 15% cheaper than the Canadian average. 

Finally while the number of Ontario COVID infected patients going to ERs fell from 133,233 to 118,130, the wait times for these patients increased dramatically.  The 90th percentile of the COVID ER patients waited 14.9 hours in 2021/2 but 24.1 hours in 2022/3. 

The COVID world requires extra hospital resources. So far there is little recognition of that from a PC government focused on bringing back austerity and budgeting a hospital funding increase of 0.5% this year.  This continues their indifference to hospital pressures arising from population growth, aging, inflation, and increased utilization.  

Ford (falsely) uses rapid population growth to justify his draconian greenbelt "housing" plans -- but ignores that and so many other factors requiring growth of hospital capacity. 

And so the capacity crisis continues -- the big increase in wait times for surgeries, the 107,000 people waiting longer for surgeries than the maximum clinical guideline, the long ER waits, the ambulance offload delays, the unprecedented closures, the lack of hospital beds, the new high in the number of patients being treated in hallways. 


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