Defend Public Healthcare

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 mor

Recent Canadian Institute for Health Information (CIHI) data indicates that Ontario has a relatively high number of "nursing-sensitive adverse events" compared to other provinces.  An "adverse event" (or "medical error") occurs when something happens in the hospital that hurts rather than helps a patient. Over the last three reported years (ending 2011-12), nursing sensitive adverse events for surgical and medical patients averaged 5.1% higher in Ontario compared to the Canada-wide average.  (If Ontario could be removed from the Canada-wide average, the discrepancy would be higher still.) Ontario funds hospitals at just about the lowest level of any Canadian province. So the same CIHI data also indicates that nursing hours per patient (or, more specifically, "per weighted case") are 12.5% more across Canada than in Ontario.  That means an extra 5.32 hours of nursing care per patient Canada-wide compared to Ontario.   It sounds pret

Yesterday,  I wrote about the significant lack of nursing care in Ontario hospitals compared to the other provinces.  Even on a Canada-wide basis, there was 5.32 hours more nursing care per patient than in Ontario in 2010-11 (year end March 31).   That sounds kind of shocking. But it looks like it is getting worse.  Other data from CIHI indicates that over the course of 2011, Ontario hospitals lost thousands of nurses. Specifically, there was a sharp reduction in the number of Registered Nurses (RNs) working in Ontario hospitals in 2011, with a cut of 2,750 RNs to 58,699 according to new  CIHI data .  That is a loss of 4.5% of RNs.   Compounding the problem,  there was a decline in the number of Registered Practical Nurses (RPNs) working in hospitals in Ontario as well, with the numbers declining from 13,373 in 2010 to 13,126 in 2011.  That's a decline of 247 RPNs  -- or a loss of 1.8% of RPNs in one-year.  This is a significant change from the previous years: there

The “cost per weighted case” in Ontario hospitals in 2010-11 was $5,143, according to a new report from CIHI.   (This indicator measures the relative cost-efficiency of a hospital’s ability to provide acute inpatient care.)  The Ontario cost per weighted case compares with a Canada-wide average of $5,230.96. In other words, the Canada-wide average is 1.7% higher than Ontario.   Ontario has improved its position relative to the other provinces since 2009/10, when the  Canada-wide average was only 0.08% higher.   Ontario’s lower costs are especially significant as (presumably) Ontario hospital wages (like other wages) are higher than most other provinces.  Of all the other provinces, only Quebec has a lower cost per weighted case. As well, despite the lower costs per weighted case, clinical lab hours per weighted case, diagnostic services hours per weighted case, and pharmacy hours per weighted case were all higher in Ontario than the Canada-wide average.   Of the reporte

There was a sharp reduction in the number of Registered Nurses (RNs) working in Ontario hospitals in 2011, with a cut of 2,750 RNs to 58,699 according to new  CIHI data .  That's a 4.47% decrease in one year.  Community health numbers also took a very hard hit, while numbers were up very slightly in long-term care. For the first time in a long time the number of Registered Nurses (RNs) in Ontario has begun to decline.  In 2011, employed RNs declined from 95,185 to 94,723, a  decrease of  462, or just less than one-half of one percent. Registered Practical Nurses (RPN) continue to increase in numbers overall, up 1,023 from 2010, or 3.36%. Accordingly, the ratio between RNs and RPNs in Ontario has declined from 3.52 employed RN per employed RPN in 2004, to 3.01 RN per RPN.  While this relative decline mimics a country-wide trend, RN numbers across the country still continued to increase in 2011 (from 268,512 in 2010 to 270,724 in 2011). The overall numbers, however,

As noted yesterday, there has been very significant growth in the number of nurses. Moreover, Registered Practical Nurses (RPNs -- or 'LPNs' outside of Ontario) are growing three times more quickly than Registered Nurses, with 22.8% growth between 2006 and 2010 versus 7.4% growth for RNs. While over 60% of 'LPNs' work in just two areas ("Medicine/Surgery" or in "Geriatrics/Long Term Care"), those areas have actually seen slower than average growth (11% and 14.7% between 2006-2010). Really rapid growth was in other areas. The big areas of growth have been in "Operating Room/Recovery Room" (152.1% growth), "Emergency Care" (128.5%), "Community Health" (59%), "Maternity/Newborn" (35.2%), "Home Care" (49.1%), and "Paediatrics" (40.5%). Registered Nurses have grown in most categories -- the exceptions are "Geriatrics/Long Term Care", "Ambulatory care" and "Occupation