UBC Faculty Research and Publications

The British Columbia medical and hospital atlas : a companion to the British Columbia Rx atlas, 2nd edition Morgan, Steve; Cunningham, Colleen; Hanley, Gillian; Mooney, Dawn Sep 30, 2009

Your browser doesn't seem to have a PDF viewer, please download the PDF to view this item.

Item Metadata

Download

Media
52383-Morgan_S_Med_hospital_atlas.pdf [ 10.25MB ]
Metadata
JSON: 52383-1.0048539.json
JSON-LD: 52383-1.0048539-ld.json
RDF/XML (Pretty): 52383-1.0048539-rdf.xml
RDF/JSON: 52383-1.0048539-rdf.json
Turtle: 52383-1.0048539-turtle.txt
N-Triples: 52383-1.0048539-rdf-ntriples.txt
Original Record: 52383-1.0048539-source.json
Full Text
52383-1.0048539-fulltext.txt
Citation
52383-1.0048539.ris

Full Text

Steve Morgan, PhDColleen Cunningham, MAGillian Hanley, MADawn Mooney, BAThe British ColumbiaMedical and Hospital AtlasA companion to the British Columbia Rx Atlas, 2nd EditionSeptember 2009Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson16125-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%311113Logarithmic scaleIndicates one LHAThe British Columbia Medical and Hospital Atlas was produced by: Centre for Health Services and Policy Research University of British Columbia #201 – 2206 East Mall (LPC)  Vancouver, BC   V6T 1Z3  Phone: 604-822-4969  Email: enquire@chspr.ubc.caYou can download this publication from our website, at www.chspr.ubc.ca        This work is licensed under a Creative Commons Attribution-Noncommercial 2.5 Canada license.How to cite this report:  Morgan, S., C. Cunningham, G. Hanley, and D. Mooney. (2009). The British Columbia Medical and Hospital Atlas (A Companion to the British Columbia Rx Atlas, 2nd Edition). Vancouver, Centre for Health Services and Policy Research, University of British Columbia.Library and Archives Canada Cataloguing in Publication The British Columbia medical and hospital atlas : a companion to the British Columbia rx atlas, 2nd edition / Steve Morgan ... [et al.].ISBN 978-1-897085-20-21. Medical care--British Columbia.  2. Medical care, Cost of--British Columbia.  3. Hospital care--British Columbia.  4. Hospitals--British Columbia--Cost of operation.  I. Morgan, Steve  II. University of British Columbia. Centre for Health Services and Policy Research RA983.A4B7 2009                      362.109711                        C2009-905011-0U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1Contents 2 About CHSPR 3 Acknowledgments 4 Introduction 6 Methods 12 How to read the maps  Medical services  17 1 Medical services from all providers 29 2 Medical services from general practitioners 41 3 Medical services from diagnostic specialists 53 4 Medical services from surgical specialists 65 5 Medical services from medical specialists  Hospital services 77 6 Inpatient care and day procedures 89 7 Inpatient care 101 8 Day procedurest h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s2About CHSPRThe Centre for Health Services and Policy Research (CHSPR) is an independent research centre based at the University of British Columbia. Our mission is to stimulate scientific inquiry into ways in which health care services can best be organized, funded, and delivered to promote the health of populations.CHSPR aims to contribute to the health of populations by ensuring that our research is relevant to contemporary health policy concerns and by working closely with decision-makers to translate research findings into policy options. Our researchers are active participants in many policy-making forums and provide government and non-government organizations in British Columbia, Canada, and abroad with advice and assistance.CHSPR receives funding from the British Columbia Ministry of Health to support research with a direct role in informing policy. Our researchers are also funded by competitive external grants from provincial, national, and international funding agencies. For more information about CHSPR, please visit www.chspr.ubc.ca. U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h3AcknowledgmentsThe British Columbia Medical and Hospital Atlas is a companion to the British Columbia Rx Atlas, 2nd Edition. Its production was made possible through the financial support of the British Columbia Ministry of Health Services and the Canadian Institutes of Health Research (CIHR).De-identified data for this atlas were extracted from the Population Data BC databases with the permis-sion of the BC Ministry of Health Services. We greatly appreciate their dedication to making data avail-able for research of value to the public, professionals, and policy makers.Several colleagues contributed to the work presented in this atlas. Lixiang Yan provided invaluable assistance by converting tens of millions of claim-level data records into research variables needed by our project team. Daniel Martin spent tireless hours preparing most of the maps and illustrations found throughout the atlas. Several faculty of the UBC Centre for Health Services and Policy Research provided advice on the use of British Columbia medical and hospital data. Finally, editor Merrie-Ellen Wilcox helped make the atlas as clear and accessible as possible.We take sole responsibility for all results and conclusions in this atlas; no endorsement by supporting organizations and associates is intended or should be inferred.Steve Morgan, PhDColleen Cunningham, MAGillian Hanley, MADawn Mooney, BAt h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s4What you will find in The British Columbia Medical and Hospital AtlasA companion atlasThis British Columbia Medical and Hospital Atlas was produced as a companion to the 2nd edition of The British Columbia Rx Atlas. It provides medical and hospital services information comparable to that found for pharmaceuticals in The British Columbia Rx Atlas.Our goal for the companion atlas was not to conduct a comprehensive analysis of all causes and conse-quences of all types of care that might be received from physicians and within hospitals. Rather, we sought to provide comparable information about the relative magnitudes of regional variations in the three largest components of heath care: prescription drugs, medical care, and hospital-based services.Ultimately, The British Columbia Medical and Hospital Atlas places the findings of The British Columbia Rx Atlas in context and allows interested readers an opportunity to explore potential area-level interactions between spending on and use of pharmaceuticals and spending on and use of medical and hospital services.Measuring variationsThe pages that follow include original information about variations in the use and cost of medical and hospital services by residents across 79 Local Health Areas (LHAs) of British Columbia (BC). To make “fair comparisons” across regions, all analyses in this atlas take into account local differences in the age, sex, and health needs of area residents.This analysis is made possible by the availability of de-identified administrative datasets that describe the age, sex, health status, and medical and hospital services use of virtually all 4 million residents of BC. Together, these databases constitute one of the most comprehen-sive information resources of its kind in the world.We used advanced statistical techniques on the BC datasets, quantifying not only regional variations in spending on medical and hospital care, but also the regional variations in key factors that determine the extent of spending.Contents of the atlasThe atlas includes five chapters on medical services provision and three chapters on hospital services.Medical servicesEach chapter on medical services use presents an analysis of the use and cost of fee-for-service medical services provided by different types of specialists for BC residents during the calendar year 2006 (the same year as data used in The British Columbia Rx Atlas).There are four chapters describing the use and cost of services provided by different types of practitioner, and one chapter for all medical services combined. Specifically, the atlas contains information about the following types of medical services:all medical services combined• services provided by general practitioners• services provided by medical specialists• services provided by surgical specialists • services provided by diagnostic specialists• For each of these types of medical service, we computed regional variations in the following four measures:spending per capita on the service type• the number of users of the service type per 1,000 • residentsthe average number of contacts with the service • type made per user, and the average cost per contact with the service type.• IntroductionU B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h5In addition to providing detailed analyses of regional variations, we also provide information about the use of and spending on these medical services across age groups of the population.Hospital servicesEach chapter on hospital service use presents an analysis of the use and cost of a different type of hospital services used by BC residents during the fiscal year 2005/06 (the period closest to the 2006 calendar year for which hospital data were available to us at the time of analysis). There are two chapters for unique types of hospital service and one for all hospital services combined. Specifically, the atlas contains information about the following types of hospital service: inpatient hospital stays• day procedures, and• inpatient stays and day procedures, combined.• For each of these types of hospital service use, we computed regional variations in the following four measures:spending per capita on the hospital service type• the number of users of the hospital service type per • 1,000 residentsthe average number of days in hospital (or visits to • hospital) per user, and the average cost per day (or visit) of the service • type.Finally, in addition to presenting detailed analyses of regional variations, we provide information about the use of and spending on these hospital services across age groups of the population.Information resourcesWe do not draw conclusions about policy or practices in this atlas. Instead, we hope that this companion to the 2nd edition of The British Columbia Rx Atlas will serve as a valuable guide for the provincial and regional policy makers, health care professionals, and health services researchers who are best positioned to determine which areas are worthy of further investiga-tion or potential policy intervention.To facilitate access to and use of the information provided, the entire atlas is available for download at www.chspr.ubc.ca. There you will also find download-able versions of data tables and “slide-ready” versions of most of the illustrations found in the atlas.t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s6FrameworkWe used advanced statistical methods and population-based administrative health care datasets to quantify the extent of regional variations in medical and hospital service use and cost across Local Health Areas (LHAs) of British Columbia (BC). We compared what was actually observed in each LHA in 2006 (or the fiscal year 2005/06 for hospital data) with predictions for the LHA based on provincial averages for the age, sex, and health status of its residents.Consistent with the BC Rx Atlas, for which this atlas is a companion document, we quantified regional varia-tions in four measures of each medical and hospital service type:spending per capita•  —the total amount spent on relevant service per residentusers of the service  per 1,000 residents•  —the number of people who used the given type of service at least once per 1,000 residents units of service per user•  —the average number of units of the service type received by users cost per unit of service received•  —the average cost per unit of the service received by residents.These four measures are related, insofar as the three latter factors directly influence per capita spending: changes in the rate of service use, average amount of service, or average cost per unit of service will have direct impacts on per capita spending.Units of service We used common measures of service use to compare the level of intensity of service use across regions. These measures are independent of underlying condi-tions being treated with a given service type.Medical services: We used a unit of medical services based on the concept of a “doctor–patient contact,” which has previously been employed in literature on BC medical services use (e.g., Barer et al. 2004).A contact refers to any interactions between a patient and a physician on a given calendar date that are associated with one or more billable medical services. Although some patients may see a given doctor more than once on a given day, these events are accounted for as a single contact.The extent of service billing per “contact” of this type will reflect the intensity of service provision if the medical services fee schedule reflects relative values.Hospital services: We used a length of stay concept to measure units of hospital services. For inpatient stays, this measure reflected the number of days a patient was in the hospital, which was set equal to the number of nights spent in the hospital plus one. For surgical day care patients, we counted their length of stay as one day.The cost per “day” in hospital will reflect the intensity of service provision if provincial costing methodolo-gies (see “Spending and costing,” below) reflect relative values.Data sourcesWe used de-identified, linked administrative data from Population Data BC. This included demographic information, such as age, sex, and LHA of residence, and information on all hospital discharges and all fee-for-service physician visits and diagnostic procedures in 2006.To measure medical services spending and use, we use MSP billing records, which include details on all fee-for-service billings in the province, but do not include any billings for (or details on services provided through) non-fee-for-service programs such as the Alternative Payment Program. MethodsU B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h7CohortThe databases used in this atlas cover every resident of BC except select populations whose health care is under federal jurisdiction—that is, First Nations, veterans, and Royal Canadian Mounted Police (approximately 4% of the population).To ensure that our analyses described a full year of health care and pharmaceutical use, we excluded any resident who lived in BC for fewer than 275 days in 2006. After exclusions, we were left with compre-hensive data for 3.9 million (92%) of the 4.2 million individuals living in BC in 2006.RegionsLHAs are geographically contiguous regions used for the planning of health services delivery. We analyzed variations across 79 of the 89 LHAs in BC. We excluded four of the 89 LHAs because of small population size: Nisga’a, Telegraph Creek, Stikine, and Snow Country. We excluded six more LHAs because they had very high rates (>30%) of non-fee-for-service medical care provision: Fernie, Bella Coola, Central Coast, Vancou-ver Island West, Queen Charlotte, and Upper Skeena. This exclusion was necessary to ensure validity of our predictions and regional comparisons, and because our health status measures are based, in part, on administrative records of fee-for-service medical visits (see “Health status measures,” below).Medical specialty typesWe classified medical services received by BC residents based on administrative codes indicating the practi-tioners’ specialty at the time the service was provided. This is a categorization by type of medical service provider, not by type of medical service.Specialties were grouped as follows:general practitioners•  —all claims with the General Practitioner specialty codemedical specialists•  —all claims with specialty codes of Dermatology, Neurology, Psychiatry, Pediatrics, Internal Medicine, Pediatric Cardiology, Physical Medicine & Rehab, Public Health, Occupational Medicine, Geriatric Medicine, Cardiology, Emer-gency Medicine, Rheumatology, Clinical Immuni-zation and Allergy, Medical Genetics, Respirology, Endocrinology, Gastroenterology, Nephrology, Infectious Disease, Hematology, or Oncology surgical specialists•  — all claims with specialty codes of Obstetrics & Gynaecology, Ophthamology, Otolaryngology, General Surgery, Neurosurgery, Orthopaedic Surgery, Plastic Surgery, Cardio & Thoracic Surgery, Urology, Anaesthesia, Vascular Surgery, or Thoracic Surgerydiagnostic specialists•  —all claims with specialty codes of Radiology, Pathology, Medical Microbiol-ogy, or Nuclear Medicineother specialists•  —all others, including mainly of chiropractors, osteopaths, physician therapists, and other non-physicians. Separate analyses are presented for General Practice, Medical Specialties, Surgical Specialties, and Diagnos-tic Specialties; separate analysis is not presented for Other Specialties, although these data are included in the overall medical services results.Spending and costing The costing of medical services was based on fees paid as per the provincial fee schedule. This relatively straightforward approach will gauge relative intensity of care provided if the fee schedule itself reflects relative values of services.t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s8The costing of hospital services is more complex, given that BC’s hospitals are block funded. We used the BC Ministry of Health Services’ hospital-specific cost esti-mates for services of a given Resource Intensity Weight (RIW) or Day Resource Intensity Weight (DRIWs).RIWs and DRIWs are values computed by the Canadian Institute for Health Information to reflect the relative amount of resources required for treating patients of a given age and health status. Thus, the hospital costing estimates should reflect the relative intensity of treatment if hospital costs are proportional to the relative values of services.Health status measuresFor every individual in our research dataset, we con-structed measures of general and condition-specific health status using the Johns Hopkins University ACG Case-Mix System.The ACG system produces health status measures based on diagnostic information from administrative health care data. We ran the ACG software (version 7.0) on diagnoses drawn from every record of medical and hospital service use for each person in our database in 2006. Each hospital discharge record in our dataset contained up to 25 ICD-10 diagnosis codes; and each record of a fee-for-service medical visit contained a single ICD-9 code indicating the primary reason for the visit.We used the ACG system’s Expanded Diagnostic Clusters (EDCs) to indicate the presence of specific clinical conditions. EDCs are groupings of diagnosis codes that describe the same underlying condition (e.g., hypertension).To gauge general health status, we used the Aggregated Diagnostic Groups (ADGs) from the ACG system. ADGs comprise 32 broad groupings of diagnosis codes that are similar in terms of disease severity, likelihood of persistence and expected health services resource use. We measured overall health status using the total number of ADGs for which an individual had diagnoses. This count of ADGs ranged from 0 to 32, with higher numbers indicating lower overall health status.Statistical modelsFor each service type, we used a series of statistical models to describe variations in our four measures of medical or hospital service use and cost.Spending per capitaOur first statistical model was of total spending per capita in 2006. This analysis included every person in our database, regardless of whether they used any of the medical or hospital services in question.To assist in the normalization of the data, we ran this statistical model on the natural logarithm of spending on the services used by each individual (plus $1 to avoid taking the logarithm of zero). We also used Heckman’s two-stage estimation procedure to correct for selection bias.The Heckman procedure involves calculating a specific term (the inverse Mills ratio) from a selection model describing the likelihood of having positive spending, and then adding this term to an ordinary least squares model describing spending per capita for those with positive expenditures (Heckman 1979; Woodridge 2003). Our ordinary least squares model included the follow-ing variables: age, sex, and overall health status (count of ADGs). Our selection model used these variables plus indicators of specific health needs (using EDCs).Results from this log-transformed model were projected back to levels.Methods (continued)U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h9Users of servicesOur second statistical model was of the likelihood that an individual used any of the medical or hospital services in question in 2006. This analysis included every person in our database.We used logistic regression for this model, which included the following variables: age, sex, overall health status (count of ADGs), and indicators of specific health needs (using EDCs).Units of serviceOur third statistical model was of the units of the medical or hospital services in question received per user in 2006. This analysis included only those persons who used some of the medical or hospital services in question in 2006.We used ordinary least squares for this model, which included the following variables: age, sex, overall health status (count of ADGs), and indicators of specific health needs (using EDCs).Cost per unit of serviceOur fourth statistical model was of the total cost per unit of the medical or hospital services in question in 2006. This analysis included only those persons who used some of the medical or hospital services in question in 2006.We used ordinary least squares for this model, which included the following variables: age, sex, overall health status (count of ADGs), and indicators of specific health needs (using EDCs).In order to accurately compute the average cost per unit of services, we weighted each patient-level observation in this model by the number of units of the medical or hospital services in question that she or he received in 2006. If we had not done so, computed average costs per unit of service would be skewed by the fact that each patient’s average cost per unit of service would receive the same weight regardless of how many (or how few) units of service she or he received.Measures of variationFor every individual in our research dataset, the databases provided us with four measures of the use and cost of the medical or hospital services in question (e.g., spending, use, units, and cost per unit) as actually observed in 2006. Our province-wide statistical models (described above) provided four estimates of these values based (in effect) on the provincial averages for persons of the given age, sex, and health status.Our measures of regional variation are based on com-paring what was actually observed in 2006 for residents in a given LHA with what the province-wide statistical model predicts for the LHA residents. Throughout this atlas, we refer to this as a comparison of the actual value for the LHA and the levels predicted based on provincial averages for populations of the same age, sex, and health status.Testing significanceWe tested the statistical significance of differences between what was actually observed in an LHA and what was predicted by province-wide statistical models.To do this, we computed every statistical model described above 79 extra times. Each extra run included a different fixed-effect variable for testing the significance of differences between provincial averages and those of the specific LHA. This method compares each LHA to the provincial average (rather than to a “reference” LHA) while taking into account the age, sex, and health status of residents within the LHA.Throughout this atlas, we set measures of variation to zero when the statistical model indicated that dif-ferences between the actual value for the LHA and the levels predicted based on provincial averages for t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 0populations of the same age, sex, and health status were not statistically significant (at a 95% confidence level).As explained under Statistical Models, our province-wide statistical model for spending per capita is based on Heckman’s two-stage procedure to correct for selection bias. This method is unbiased but produces relatively large standard errors. As a result, some LHA-specific variations in spending per capita do not show up as statistically significant variations even though variations in the rate of use, days (or visits) per user, or cost per unit of service for the particular LHA do show up as statistically significant.Deviation scaleTo facilitate equivalent comparisons of LHAs with actual values of a given variable that are above levels predicted based on the provincial averages for popula-tions of the same age, sex, and health status to LHAs with actual values below predictions based on provin-cial averages, we report deviations using a logarithmic scale. Our scale is the logarithm of the ratio of the actual value for an LHA to the prediction for that LHA.A logarithmic scale is used because a basic ratio of 1.5 is not “as different” from 1.0 as a ratio of 0.5 is. The latter is a two-fold difference, and the former is not. Thus, our logarithm-based deviation scale reports these as –69% and +41%. This is better balanced in terms of drawing attention to relatively high versus relatively low values.Methods (continued)ReferencesBarer M.L., R. G. Evans, K. M. McGrail, B. Green, C. Hertzman, S. B. Sheps (2004). “Beneath the calm surface: The changing face of physician-service use in British Columbia, 1985/86 versus 1996/97.” Canadian Medical Association Journal 170(5): 803–807.Heckman, J.J. (1979). “Selection Bias as a Specification Error.” Econometrica 47(1): 153-161.Woodridge, J.M. (2003). Introductory Econometrics: A Modern Approach. 2nd Ed. Mason: Thomson South-Western.U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1 1t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 2ALBERTAALASKAY U K O NW A S H I N G T O N878194605957565154538892505280 552883 492725262930241819461035711121314152322207821317716177675424346697062 616364656667687147728584 4833343532921Part ofVancouverCoastalNorthernInteriorVancouver         IslandVancouverCoastalFraserHow to read the mapsBritish Columbia’s health regionsBritish Columbia (BC) is divided into 89 Local Health Areas (LHAs), each of which belongs to one of five health authorities that are responsible for regional figure a» Map of BC’s regional health authorities and their constituent local health areas (LHA)health service planning and management. In Figure A, the health authorities are indicated by colour and name and LHAs are indicated by number.U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1 3Using cartograms to depict population sizeA majority of BC’s population resides in the Vancouver and Victoria metropolitan areas, which are relatively small geographic areas in the southwest corner of the province. To ensure that areas with significant popula-tion can be “seen” in this report, we map patterns of prescription drug use onto a population cartogram of LHAs (Figure B).Instead of showing LHAs by land area and location, the cartogram shows them sized by their population. 51 Snow Country87 Stikine94 Telegraph Creek53 Upper Skeena56 Nechako57Prince George28 Quesnel   27Cariboo–Chilcotin25100 MileHouse20SalmonArm19 Revelstoke78 Enderby22Vernon18 Golden   9Castlegar11Trail12 Grand Forks13 Kettle Valley14 South Okanagan16 Keremeos33Chilliwack32Hope76 Agassiz–Harrison75Mission42MapleRidge38Richmond166 Vancouver South163VancouverNortheast162VancouverDowntown Eastside44NorthVancouver48HoweSound47PowellRiver85IslandNorth72CampbellRiver71Courtenay   69Qualicum  70Alberni68Nanaimo64GulfIslands63Saanich61GreaterVictoria65Cowichan62Sooke67 Ladysmith66 LakeCowichan84IslandWest46SunshineCoast 45 West   Van.–Bowen I.161VancouverCityCentre165VancouverMidtown164VancouverWestside37Delta201Surrey41Burnaby202       South Surrey–White Rock43Coquitlam40 NewWestminster34Abbotsford35Langley     15Penticton17 Princeton5 Creston2 Cranbrook1Fernie4 Windermere10ArrowLakes6KootenayLake23CentralOkanagan21Armstrong29Lillooet30SouthCariboo 31 Merritt77 Summerland24Kamloops26 NorthThompson81 Fort Nelson60 PeaceRiver North59 PeaceRiver South55 Burns Lake49 Bella Coola83 Central Coast54 Smithers   88Terrace80Kitimat50QueenCharlotte52PrinceRupert92 Nisga’a3 Kimberley7Nelsonfigure B» Population cartogram of BC’s local health areas (LHA)LHAs have been resized torepresent their population.1,000 peopleThe general shapes and locations of LHAs are retained, but regions with large population are much more prominent.Densely-populated urban and suburban health authorities—Vancouver Coastal (blue), Fraser (purple), and Vancouver Island (green)—stand out in the cartogram. More rural health authorities—Interior (yellow) and Northern (red)—are smaller in the cartogram, although their larger population centres remain prominent.t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 4How to read the maps (continued)t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s2Introductionfigure 1a» Spending per capita in BC, by age group, 2006U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h3figure 1B» Users per 1,000 population in BC, by age group, 20061 Medical services from all providersOverall spending and useTh e BC government spent approximately $1.94 billion, or $493 per capita, on fee-for-service medical services provided for BC residents during the calendar year 2006.Overall, approximately 84% of BC residents received some form of medical services.On average, BC residents who received medical services contacted a practitioner 11.2 times. Th e average cost per medical services contact was $52.20.Spending and use by ageAverage government spending per capita for medical services varied by more than 500% across age groups, from a low of $202 per resident aged 10–19 to a high of $1,134 per resident aged 80 and older.Average per capita spending on medical services increased gradually across age groups through to ages 40–49; spending then increased more substantially with each successive 10-year age group through to age 70–79.Th e age gradient in spending per capita on medical services is not refl ected in shares of each age group that received at least some medical care.Th e number of users of medical services per 1,000 residents in each age group varied by only 21%, from a low of 782 users per 1,000 residents aged 20–29 to a high of 945 users per 1,000 residents aged 70–79.Numberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population1000750500250$1200$900$600$300361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$1134.04860805 782811 820859916945902$330.70$419.57 $423.02$547.62$782.09$1104.15$201.52$223.58Numberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population1000750500250$1200$900$600$300361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$1134.04860805 782811 820859916945902$330.70$419.57 $423.02$547.62$782.09$1104.15$201.52$223.58Total spending in BC: $1.94-billionSpending per capita in BC: $492.83Users of services per 1,000 pop. in BC: 842Spending per user of services in BC: $585Contacts per user of services in BC: 11.2Average cost per contact in BC: $52.23Included in this analysisThis analysis includes all fee-for-service care received by BC residents during the calendar year 2006. It includes all services, regardless of practitioner specialty (e.g., General Practice, Medical Specialties, Surgical Specialties, Diagnostic Specialties, and Other Specialties).t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s2Introductionfigure 1a» Spending per capita in BC, by age group, 2006U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r s e a r C h3figure 1B» Users per 1, 00 opulatio  in BC, by age group, 20061 Medical services from all providersOverall spending and useThe BC government spent approximately $1.94 billion, or $493 per capita, on fee-for-service medical services provi ed for BC residents during the calendar year 2006.Overall, approximately 84% of BC residents r ceived some form of medical services.On average, BC residents who r ceived medical services contacted a practitioner 11.2 times. The average cost per medical services contact was $52.20.Spending and use by ageAverage government spending per capita for medical services varied by more than 500% across age groups, from a low of $ 02 per resident aged 10–19 to a high of $1,134 per resident aged 80 and older.Average per capita spending on medical services increased gradually across age groups through to ages 40–49; spending the  increased more substantially with each successive 10-ye r age group through to age 70–79.The age gradient in spending per capita on medical service is not r fl ected in shares of each age group that r ceived at lea t some medical care.The number of users of medical services per 1, 00 residents in each age group varied by only 21%, from a low of 782 users per 1, 00 residents aged 20–29 to a high of 945 users per 1, 00 residents aged 70–79.Numberof eopleAge group0-9Numberof eopleAge group 0-19 0-29 0-39 0-49 0-59 0-69 0-79 80+Spending per capita0-9 0-19 0-29 0-39 0-49 0-59 0-69 0-79 80+Users per 1,000 population1000750500250$1200$900$600$3003 1,726 489,845 501,726 30,509 657,119 594,595 376,291 25 ,621 172,9623 1,726 489,845 501,726 30,509 657,119 594,595 376,291 25 ,621 172,962$1134.04860805 782811 820859916945902$330.70$419.57 $423.02$547.62$782.09$1 04.15$201.52$223.58Numberof eopleAge group0-9Numberof eopleAge group 0-19 0-29 0-39 0-49 0-59 0-69 0-79 80+Spending per capita0-9 0-19 0-29 0-39 0-49 0-59 0-69 0-79 80+Users per 1,000 population1000750500250$1200$900$600$3003 1,726 489,845 501,726 30,509 657,119 594,595 376,291 25 ,621 172,9623 1,726 489,845 501,726 30,509 657,119 594,595 376,291 25 ,621 172,962$1134.04860805 782811 820859916945902$330.70$419.57 $423.02$547.62$782.09$1 04.15$201.52$223.58Total spending in BC: $1.94-b llionSpending per capita in BC: $492.83Users of services per 1, 00 op. in BC: 842Spending per user of services in BC: $ 85Contacts per user of services in BC: 11.2Average cost per contact in BC: $52.23Included in this analy isThis nalys s includes all fee-for-service care r ceived by BC residents during the calendar year 2006. It includes all services, regardless of practitioner specialty (e.g., G neral Pra tice, Medical Specialties, Surgical Specialties, Diagnostic Specialties, and Other Specialties).Results by type of medical or hospital serviceThe BC Medical and Hospital Atlas contains eight related 11-page chapters on variations in the use of and spending on different types of medical and hospital services. The following information is provided in each of these chapters:1.    Summary information about the type of medical or hospital service—Includes province-wide statistics on spending and use of the service in question.2.    Average age-specific spending on the type of medical or hospital service—Bars in this chart are proportional to the BC population in the age groups, giving a visual indication of the relative shares of total spending by age group. 3.    Age-specific use of the type of medical or hospital service—Bars in this chart are proportional to the BC population in the age groups, giving a visual indication of the relative shares of all users by age group.4.    Text summarizing key information about the use of and spending on the type of medical or hospital service.Regional variation mapsThe main component of each chapter is a series of two-page spreads relating to the four components of medical and hospital service use and spending studied in the atlas: total spending per capita, the number of users of the service per 1,000 residents, the average number of units of service received per user, and the average cost per unit of service. The following informa-tion is provided in each of the two-page spreads:5.    Text summarizing key information about variations in the relevant component of service use and cost. 6.    A table listing actual and predicted values for BC LHAs—For each LHA grouped by health authority, this table lists the actual value of the relevant measure (spending, service users, service units, or cost); what the province-wide statistical model predicts for each LHA given the age, sex, and health status of its popula-tion; and the extent to which those two measures differ. 1122336544U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1 5t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 2Note: Numbers have been rounded. Log deviations listed as 0% if LHA not statistically different from province (see Methods).Summary of measures of deviationtable 1e» Regional variation» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthSpendingpercapitaUsersper1,000Local health areaLocal health areaSpendingpercapitaContactsperuserCostpercontactUsersper1,000ContactsperuserCostpercontactU B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1 31 Medical services from all providersMeasures of deviationAft er diff erences in population age, sex, and health status have been accounted for, there was very little variation in the overall use and cost of medical services across BC’s LHAs in 2006.Medical service provider contacts per user varied more than the number of medical service users and costs per contact. Greater VictoriaCowichanCampbell RiverLadysmithSookeSaanichCourtenayLake CowichanAlberniNanaimoIsland NorthGulf IslandsQualicumTrailPentictonMerrittCentral OkanaganNelsonKamloopsVernonSouth OkanaganCastlegarPrinceton100 Mile HouseRevelstokeEnderbyLillooetArrow LakesKootenay LakeCariboo–ChilcotinSalmon ArmCranbrookSummerlandArmstrong GoldenNorth ThompsonCrestonKimberleySouth CaribooGrand ForksWindermereKeremeosKettle ValleyQuesnelSmithersKitimatTerracePrince RupertBurns LakePrince GeorgeNechakoPeace River NorthPeace River SouthFort NelsonAgassiz–HarrisonMaple RidgeSouth Surrey–White RockNew WestminsterMissionSurreyDeltaAbbotsfordHopeCoquitlamLangleyChilliwackBurnabyNorth VancouverWest Van.–Bowen IslandVan. Downtown EastsideVancouver WestsideVancouver City CentreHowe SoundPowell RiverSunshine CoastVancouver MidtownVancouver SouthVancouver North EastRichmond3%2%1%1%1%1%1%0%0%0%-1%-1%-1%2%2%1%0%0%0%0%0%-1%-1%-1%-2%-23%9%0%10%12%13%1%7%0%-1%-5%-4%2%0%-3%13%-12%-4%0%0%-8%-3%-1%-2%-6%8%-2%-1%0%-7%-5%0%-5%0%0%0%-1%-2%2%5%-1%9%7%0%0%7%2%-1%-3%1%-7%4%3%0%3%3%3%3%0%0%0%0%-3%2%1%-3%-3%-3%1%1%-1%-2%-2%-1%-5%2%1%1%0%0%0%0%0%0%0%0%0%-1%4%1%1%1%1%0%0%0%0%0%0%0%0%0%0%0%0%0%-1%-1%-1%-3%-3%-3%-4%-4%-4%-4%-4%-6%0%0%0%-1%-1%-2%-3%-4%-5%-5%-10%4%3%5%-5%0%1%3%0%-2%-1%-5%-7%-4%2%4%9%-1%-5%-5%5%0%0%-8%-9%-7%0%-11%-5%-29%-9%-6%-3%-6%-5%-14%-17%-15%-15%-19%-19%-25%-14%-23%-4%-3%6%0%-10%-9%-5%-24%-16%-12%-20%2%1%1%-1%3%3%1%0%0%-1%-2%-3%1%4%2%4%3%-3%1%2%1%0%0%0%-1%-2%-3%-4%-16%0%-1%0%1%1%0%-3%-5%-3%-3%-3%-5%-2%-8%0%0%2%0%0%-2%-3%-7%-6%-4%-4%0%0%4%1%2%0%-2%0%3%1%6%6%1%6%-2%-1%-1%0%4%-2%-2%3%10%7%3%5%4%0%11%6%5%-5%-2%0%-11%8%0%-5%5%3%-3%0%3%0%2%4%5%6%3%-2%7%-2%-5%-7%t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s4Spending per capitatable 1a» Variation in spending per capita by local health area, 2006Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActual valuefor LHAPredictedvalue forLHALog.devi-ationLocal health areaActual valuefor LHAPredictedvalue forLHALog.devi-ationNote: Numbers have been rounded. Log deviations listed as 0% if LHA not statistically different from province (see Methods).U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h5figure 1C» Regional variation in spending per capita» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 1d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliableSnow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson772-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Logarithmic scaleIndicates one LHA1 Medical services from all providersRegional variations in spending per capitaAft er diff erences in population age, sex, and health status have been accounted for, there was almost no variation in per capita government spending on medical services across BC’s LHAs in 2006.In 77 LHAs, spending per capita on general practi-tioner services was within 5% of (or not statistically signifi cantly diff erent from) levels predicted based on provincial averages for populations of the same age, sex, and health status.Greater VictoriaCowichanCampbell RiverLadysmithSookeSaanichCourtenayLake CowichanAlberniNanaimoIsland NorthGulf IslandsQualicumTrailPentictonMerrittCentral OkanaganNelsonKamloopsVernonSouth OkanaganCastlegarPrinceton100 Mile HouseRevelstokeEnderbyLillooetArrow LakesKootenay LakeCariboo–ChilcotinSalmon ArmCranbrookSummerlandArmstrong GoldenNorth ThompsonCrestonKimberleySouth CaribooGrand ForksWindermereKeremeosKettle ValleyQuesnelSmithersKitimatTerracePrince RupertBurns LakePrince GeorgeNechakoPeace River NorthPeace River SouthFort Nelson$566$537$538$540$498$594$525$539$527$520$451$573$599$590$593$561$526$464$494$547$600$520$588$520$448$544$463$495$391$459$530$458$528$488$353$432$473$435$483$460$356$525$429$454$436$527$495$451$448$413$360$326$370$277$553$534$535$539$490$580$521$549$525$521$456$562$603$569$587$557$523$461$494$548$602$515$591$520$448$546$470$511$396$459$533$461$535$494$362$445$488$451$501$478$371$548$454$457$429$529$502$457$458$425$376$342$391$3072%1%1%0%0%0%0%0%0%0%0%0%-1%4%1%1%1%1%0%0%0%0%0%0%0%0%0%0%0%0%0%-1%-1%-1%-3%-3%-3%-4%-4%-4%-4%-4%-6%0%0%0%-1%-1%-2%-3%-4%-5%-5%-10%Agassiz–HarrisonMaple RidgeSouth Surrey–White RockNew WestminsterMissionSurreyDeltaAbbotsfordHopeCoquitlamLangleyChilliwackBurnabyNorth VancouverWest Van.–Bowen IslandVan. Downtown EastsideVancouver WestsideVancouver City CentreHowe SoundPowell RiverSunshine CoastVancouver MidtownVancouver SouthVancouver North EastRichmond$436$510$568$548$488$489$492$490$554$449$451$474$476$505$567$548$465$502$425$551$546$459$470$454$433$424$502$563$543$485$486$489$486$554$451$454$478$483$495$557$541$464$502$425$544$542$462$475$460$4423%2%1%1%1%1%1%0%0%0%-1%-1%-1%2%2%1%0%0%0%0%0%-1%-1%-1%-2%Logarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita772Users per 1,0007441Contacts per user4381918Cost per contact14362t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s4Spending per capitatable 1a» Variatio  in spending per capita by local health area, 2006Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health reaActual valuefor LHAPredictedvalue forLHALog.devi-ationLocal health reaActual valuefor LHAPredictedvalue forLHALog.devi-ationNote: Numbers have been rounded. Log deviations listed as 0% if LHA not statistically different from provinc  (se  Methods).U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r s e a r C h5figure 1C» Regional variatio  in spending per capita» Dev ation of actual values for local health areas from pred ctions based on provinci l averages for opulations of the same age, sex, and health status, 2006figure 1d» Extent of regional variation» Number of local health areas with given dev ations of actual values from pred ctions based on provinci l averages for opulations of the same age, sex, and health status, 2006Relatively igh, given the ag , sex, and heal h status of LHA residentsRelatively low, given the ag , sex, and heal h status of LHA residentsLHAs have be n r sized torepresent their population.1,000 eopleD ta are unre iableSnow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQu snelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGr aterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSu shineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookF rnieWind mereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonP ace RiverNorthP ace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson772-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Logarithmic scaleIndicates one LHA1 Medical services from all providersRegional variations in spending per capitaAft er diff rences in opulation age, sex, and health status have been accounted for, th re w s almost no var atio  in per capita government spending on medical services across BC’s LHAs in 2006.In 77 LHA , spending per capita on g neral practi-tioner services was within 5% of (or no  sta stically signifi cantly diff rent from) l vels predicted based on provinci l averages for opulations of the same age, sex, and health status.Gr ater VictoriaCowichanCampbell RiverLadysmithSookeSaanichCourtenayLake CowichanAlberniNanaimoIsland NorthGulf IslandsQualicumTrailPentictonMerrittCentral OkanaganNelsonKamloopsVer onSouth OkanaganCastlegarPrinceton100 Mile HouseRevelstokeEnderbyLillooetArrow LakesKootenay LakeCariboo–ChilcotinSalmon ArmCranbrookSummerlandArmstrong GoldenNort  ThompsonCrestonKimberleySouth CaribooGrand ForksWindermereKer meosKettle ValleyQuesnelSmithersKitimatTerracePrince RupertBurns LakePrince GeorgeNechakoPeace River NorthPeace River SouthFort Nelson$566$537$538$540$498$594$ 25$539$527$520$451$573$599$590$593$561$526$ 64$ 94$547$600$520$588$520$448$544$463$495$391$459$530$458$528$488$ 53$432$473$435$483$460$356$ 25$429$ 54$436$527$495$451$448$413$360$326$370$277$553$534$ 35$539$490$580$521$549$ 25$521$456$562$603$569$587$557$523$461$ 94$548$602$ 15$591$520$448$546$470$511$396$459$533$461$ 35$ 94$362$445$488$451$501$478$371$548$ 54$457$429$529$502$457$458$425$376$342$391$3072%1%1%0%0%0%0%0%0%0%0%0%-1%4%1%1%1%1%0%0%0%0%0%0%0%0%0%0%0%0%0%-1%-1%-1%-3%-3%-3%-4%-4%-4%-4%-4%-6%0%0%0%-1%-1%-2%-3%-4%-5%-5%-10%Agassiz–HarrisonMaple RidgeSouth Surrey–White RockNew WestminsterMissionSurreyDeltaAbbotsfordHopeCoquitlamLangleyChilliwackBurnabyNorth VancouverWest Van.–Bowen IslandVan. Downtown EastsideVancouver WestsideVancouver City CentreHowe SoundPowell RiverSunshine CoastVancouver MidtownVancouver SouthVancouver North EastRichmond$436$510$568$548$488$489$492$490$554$449$451$ 74$476$ 05$567$548$465$502$425$551$546$459$470$ 54$433$ 24$502$563$543$485$486$489$486$554$451$ 54$478$483$495$557$541$ 64$502$425$544$542$462$475$460$4423%2%1%1%1%1%1%0%0%0%-1%-1%-1%2%2%1%0%0%0%0%0%-1%-1%-1%-2%Logarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per c pita772Users per 1,0007441Contacts per user4381918Cost per contact143627.    A mapping of regional variations using the carto-gram of BC LHAs—Scaled by population size, LHAs in this map are coloured based on the extent to which the relevant measures (spending, service users, service units, or cost) differ from levels predicted based on provincial averages for populations of the same age, sex, and health status. 8.    Histograms—These vertical bar graphs depict the distribution of regional variations in each of the four measures studied in the chapter for quick comparison across the measures.Summary of variations9.    For each LHA (grouped by health authority), we list the extent to which the four measures of use and cost differ from levels predicted based on provincial averages for populations of the same age, sex, and health status. Data presented in this way gives a visual indication of the extent to which variations in spending per capita on the type of medical or hospital service studied are driven by variations in rates of use, the amount of service received per user, or the cost per unit of service.68877599t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 6U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1 7Medical services1Medical services from all providerst h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 8Introductionfigure 1a» Spending per capita in BC, by age group, 20061 Medical services from all providersNumberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population1000750500250$1200$900$600$300361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$1134.04860805 782811 820859916945902$330.70$419.57 $423.02$547.62$782.09$1104.15$201.52$223.58Total spending in BC: $1.94-billionSpending per capita in BC: $492.83Users of services per 1,000 pop. in BC: 842Spending per user of services in BC: $585.03Contacts per user of services in BC: 11.2Average cost per contact in BC: $52.23Included in this analysisThis analysis includes all fee-for-service care received by BC residents during the calendar year 2006. It includes all services, regardless of practitioner specialty (e.g., General Practice, Medical Specialties, Surgical Specialties, Diagnostic Specialties, and Other Specialties).U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1 9figure 1B» Users per 1,000 population in BC, by age group, 2006Overall spending and useThe BC government spent approximately $1.94 billion, or $493 per capita, on fee-for-service medical services provided for BC residents during the calendar year 2006.Overall, approximately 84% of BC residents received some form of medical services.On average, BC residents who received medical services contacted a practitioner 11.2 times. The average cost per medical services contact was $52.20.Spending and use by ageAverage spending per capita for medical services varied by more than 500% across age groups, from a low of $202 per resident aged 10–19 to a high of $1,134 per resident aged 80 and older.Average per capita spending on medical services increased gradually across age groups from ages 10-19 through to ages 40–49; spending then increased more substantially with each successive 10-year age group through to age 70–79.The sharp age gradient in spending per capita on medical services is not reflected in shares of each age group that received at least some medical care.The number of users of medical services per 1,000 residents in each age group varied by only 21%, from a low of 782 users per 1,000 residents aged 20–29 to a high of 945 users per 1,000 residents aged 70–79.Numberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population1000750500250$1200$900$600$300361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$1134.04860805 782811 820859916945902$330.70$419.57 $423.02$547.62$782.09$1104.15$201.52$223.58t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s2 0Spending per capitatable 1a» Variation in spending per capita by local health area, 2006Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationNote: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).1 Medical services from all providersRegional variations in spending per capitaAfter we accounted for differences in population age, sex, and health status, there was almost no variation in per capita government spending on medical services across BC’s LHAs in 2006.In 77 LHAs, spending per capita on all medical services was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status.Greater VictoriaCowichanCampbell RiverLadysmithSookeSaanichCourtenayLake CowichanAlberniNanaimoIsland NorthGulf IslandsQualicumTrailPentictonMerrittCentral OkanaganNelsonKamloopsVernonSouth OkanaganCastlegarPrinceton100 Mile HouseRevelstokeEnderbyLillooetArrow LakesKootenay LakeCariboo–ChilcotinSalmon ArmCranbrookSummerlandArmstrong GoldenNorth ThompsonCrestonKimberleySouth CaribooGrand ForksWindermereKeremeosKettle ValleyQuesnelSmithersKitimatTerracePrince RupertBurns LakePrince GeorgeNechakoPeace River NorthPeace River SouthFort Nelson$566$537$538$540$498$594$525$539$527$520$451$573$599$590$593$561$526$464$494$547$600$520$588$520$448$544$463$495$391$459$530$458$528$488$353$432$473$435$483$460$356$525$429$454$436$527$495$451$448$413$360$326$370$277$553$534$535$539$490$580$521$549$525$521$456$562$603$569$587$557$523$461$494$548$602$515$591$520$448$546$470$511$396$459$533$461$535$494$362$445$488$451$501$478$371$548$454$457$429$529$502$457$458$425$376$342$391$3072%1%1%0%0%0%0%0%0%0%0%0%-1%4%1%1%1%1%0%0%0%0%0%0%0%0%0%0%0%0%0%-1%-1%-1%-3%-3%-3%-4%-4%-4%-4%-4%-6%0%0%0%-1%-1%-2%-3%-4%-5%-5%-10%Agassiz–HarrisonMaple RidgeSouth Surrey–White RockNew WestminsterMissionSurreyDeltaAbbotsfordHopeCoquitlamLangleyChilliwackBurnabyNorth VancouverWest Van.–Bowen IslandVan. Downtown EastsideVancouver WestsideVancouver City CentreHowe SoundPowell RiverSunshine CoastVancouver MidtownVancouver SouthVancouver North EastRichmond$436$510$568$548$488$489$492$490$554$449$451$474$476$505$567$548$465$502$425$551$546$459$470$454$433$424$502$563$543$485$486$489$486$554$451$454$478$483$495$557$541$464$502$425$544$542$462$475$460$4423%2%1%1%1%1%1%0%0%0%-1%-1%-1%2%2%1%0%0%0%0%0%-1%-1%-1%-2%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h2 1figure 1C» Regional variation in spending per capita» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 1d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliableSnow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson772-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita772Users per 1,0007441Contacts per user4381918Cost per contact14362t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s2 2Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Users per 1,000 populationtable 1B» Variation in users of services per 1,000 population by local health area, 2006Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvaluefor LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ation1 Medical services from all providersRegional variations in rate of useThere was almost no regional variation in the number of recipients of medical services per 1,000 residents of BC’s LHAs in 2006, after we accounted for differences in population age, sex, and health status.In all but five LHAs studied, the number of users of medical services per 1,000 residents was either within 5% of, or not statistically significantly different from, rates predicted based on provincial averages for populations of the same age, sex, and health status.SookeSaanichGreater VictoriaCourtenayCampbell RiverQualicumCowichanLake CowichanAlberniNanaimoLadysmithIsland NorthGulf IslandsMerrittTrailCentral OkanaganPentictonVernonSummerlandSouth OkanaganArmstrong KamloopsCastlegarPrinceton100 Mile HouseCariboo–ChilcotinCranbrookGoldenRevelstokeSalmon ArmEnderbyKeremeosNelsonLillooetKimberleyNorth ThompsonGrand ForksSouth CaribooArrow LakesWindermereCrestonKettle ValleyKootenay LakeKitimatQuesnelSmithersTerracePrince RupertBurns LakePrince GeorgePeace River SouthFort NelsonPeace River NorthNechako8668798648598548708528418468428498258368808788708728658658728558498408558508378478288288408348448198238278198268288168058207927288558378418378428248158047877817818408568468488438658488488478478568378618478488478548498568638488448458598538408458358398528518658428468518448558578538428588588528378418358408418428368378228308373%3%2%1%1%1%1%0%0%-1%-1%-2%-3%4%4%3%2%2%1%1%1%1%0%0%0%0%0%0%-1%-1%-2%-2%-3%-3%-3%-3%-3%-3%-4%-5%-5%-8%-16%2%0%0%0%0%-2%-3%-4%-4%-6%-7%Maple RidgeMissionSurreyAbbotsfordDeltaSouth Surrey–White RockCoquitlamNew WestminsterHopeLangleyChilliwackBurnabyAgassiz–HarrisonNorth VancouverHowe SoundPowell RiverWest Van.–Bowen IslandSunshine CoastVancouver North EastVancouver SouthVancouver MidtownVan. Downtown EastsideVancouver City CentreVancouver WestsideRichmond8758658628648648768388428538388468167938588378618608478308238198088088128048388378368408418548368418538408448408528428278528548548408418378368368418414%3%3%3%3%3%0%0%0%0%0%-3%-7%2%1%1%1%-1%-1%-2%-2%-3%-3%-3%-5%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h2 3Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 1d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 1e» Regional variation in users of services per 1,000 population» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson7441-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita772Users per 1,0007441Contacts per user4381918Cost per contact14362t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s2 4Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).table 1C» Variation in contacts per user of services by local health area, 2006Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationContacts per user1 Medical services from all providersRegional variations in contacts per userThe number of contacts with providers of medical services per user of medical services varied modestly across BC’s LHAs in 2006.The numbers of provider contacts per medical services user in Vancouver Downtown Eastside and several Fraser LHAs were above levels predicted based on provincial averages for populations of the same age, sex, and health status.Contacts per user in many Interior and Northern LHAs were below levels predicted based on provin-cial averages.Campbell RiverGreater VictoriaCowichanCourtenaySaanichSookeLake CowichanNanaimoAlberniQualicumIsland NorthLadysmithGulf IslandsMerrittVernonPentictonTrailCastlegarSouth OkanaganEnderbyCentral OkanaganCranbrookNelsonArrow LakesKamloopsArmstrong SummerlandSalmon ArmRevelstokePrincetonCariboo–Chilcotin100 Mile HouseLillooetGoldenKeremeosCrestonKimberleyNorth ThompsonSouth CaribooGrand ForksKettle ValleyWindermereKootenay LakeKitimatTerraceSmithersQuesnelPrince GeorgeBurns LakePrince RupertPeace River SouthPeace River NorthFort NelsonNechako5%4%3%3%1%0%0%-1%-2%-4%-5%-5%-7%9%5%4%2%0%0%0%-1%-3%-5%-5%-5%-5%-6%-6%-7%-8%-9%-9%-11%-14%-14%-15%-15%-17%-19%-19%-23%-25%-29%6%0%-3%-4%-5%-9%-10%-12%-16%-20%-24%SurreyMissionNew WestminsterMaple RidgeAbbotsfordBurnabyDeltaHopeSouth Surrey–White RockCoquitlamChilliwackLangleyAgassiz–HarrisonVan. Downtown EastsideNorth VancouverPowell RiverHowe SoundVancouver SouthVancouver North EastVancouver MidtownWest Van.–Bowen IslandVancouver City CentreRichmondSunshine CoastVancouver Westside13%12%10%9%7%2%1%0%0%-1%-4%-5%-23%13%0%0%0%-1%-2%-3%-3%-4%-6%-8%-12%11.612.512.011.912.810.812.011.611.412.79.911.812.112.312.313.112.011.313.211.811.610.910.811.410.710.911.811.310.111.69.910.810.39.211.510.710.49.310.310.29.88.79.111.310.89.810.49.910.19.79.38.47.58.311.111.911.711.612.610.811.711.711.713.210.412.513.011.311.712.611.711.513.212.011.711.211.312.011.311.512.612.110.912.610.811.811.410.513.212.512.211.012.512.412.411.212.210.610.610.210.910.411.110.810.59.99.210.511.611.812.411.511.511.410.912.412.410.410.810.39.613.011.012.210.011.110.810.611.911.110.311.310.010.210.411.310.510.811.110.812.012.410.411.210.912.111.511.112.010.011.111.010.912.311.611.012.211.3U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h2 5Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 1d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 1f» Regional variation in contacts per user of services» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%4381918Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita772Users per 1,0007441Contacts per user4381918Cost per contact14362t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s2 6Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Cost per contacttable 1d» Variation in cost per contact by local health area, 2006Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ation1 Medical services from all providersRegional variations in cost per contactAfter we accounted for differences in population age, sex, and health status, the average cost per contact with medical service provider varied only slightly across BC’s LHAs in 2006.In 62 LHAs, the average cost per medical service provider contact was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status.Costs per medical service provider contact in Vancou-ver Centre and Vancouver Westside were above levels predicted based on provincial averages.Gulf IslandsIsland NorthCampbell RiverAlberniSookeNanaimoLadysmithQualicumGreater VictoriaSaanichCowichanLake CowichanCourtenayKootenay LakePrincetonNorth Thompson100 Mile HouseCariboo–ChilcotinTrailSouth CaribooSalmon ArmEnderbyLillooetKamloopsKettle ValleyCastlegarRevelstokeGrand ForksCrestonNelsonKeremeosArmstrong Arrow LakesCentral OkanaganMerrittPentictonSouth OkanaganVernonSummerlandWindermereKimberleyCranbrookGoldenNechakoPrince RupertTerraceKitimatBurns LakeSmithersQuesnelPrince GeorgePeace River NorthPeace River SouthFort Nelson$57$55$54$54$53$53$54$54$52$53$52$53$51$59$59$57$57$55$56$56$56$56$55$54$55$54$53$55$54$53$54$52$53$52$52$52$52$51$52$51$50$50$46$56$55$55$55$54$53$52$51$50$49$47$53$52$52$53$52$53$53$54$52$53$53$53$53$53$54$52$53$52$53$54$53$53$53$52$53$53$52$53$53$52$54$53$53$52$52$53$53$53$53$52$53$52$52$52$52$52$52$52$52$52$52$51$52$506%6%4%3%2%1%1%1%0%0%0%0%-2%11%10%8%7%6%6%5%5%5%4%4%3%3%3%3%0%0%0%0%0%-1%-1%-2%-2%-2%-2%-3%-5%-5%-11%7%6%5%4%3%2%0%-2%-2%-5%-7%Agassiz–HarrisonLangleyDeltaNew WestminsterHopeCoquitlamChilliwackSouth Surrey–White RockBurnabyMaple RidgeAbbotsfordSurreyMissionVancouver WestsideSunshine CoastVancouver City CentreWest Van.–Bowen IslandNorth VancouverVancouver MidtownRichmondPowell RiverHowe SoundVan. Downtown EastsideVancouver SouthVancouver North East$57$52$52$52$52$52$52$52$51$51$49$49$48$57$57$56$56$53$53$52$53$51$52$52$50$53$52$52$52$53$52$52$53$52$52$52$52$52$52$53$52$53$52$52$52$53$51$52$52$528%0%0%0%0%0%-1%-1%-2%-2%-5%-5%-7%9%7%7%5%2%2%1%0%0%-1%-1%-3%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h2 7Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 1d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 1G» Regional variation in cost per contact» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%14362Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita772Users per 1,0007441Contacts per user4381918Cost per contact14362t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s2 8Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Summary of measures of deviationtable 1e» Regional variation» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthSpendingpercapitaUsersper1,000Local health areaLocal health areaSpendingpercapitaContactsperuserCostpercontactUsersper1,000ContactsperuserCostpercontact1 Medical services from all providersMeasures of deviationAfter we accounted for differences in population age, sex, and health status, there was very little variation in the overall use and cost of medical services across BC’s LHAs in 2006.Medical service provider contacts per user varied more than the number of medical service users and costs per contact. Greater VictoriaCowichanCampbell RiverLadysmithSookeSaanichCourtenayLake CowichanAlberniNanaimoIsland NorthGulf IslandsQualicumTrailPentictonMerrittCentral OkanaganNelsonKamloopsVernonSouth OkanaganCastlegarPrinceton100 Mile HouseRevelstokeEnderbyLillooetArrow LakesKootenay LakeCariboo–ChilcotinSalmon ArmCranbrookSummerlandArmstrong GoldenNorth ThompsonCrestonKimberleySouth CaribooGrand ForksWindermereKeremeosKettle ValleyQuesnelSmithersKitimatTerracePrince RupertBurns LakePrince GeorgeNechakoPeace River NorthPeace River SouthFort NelsonAgassiz–HarrisonMaple RidgeSouth Surrey–White RockNew WestminsterMissionSurreyDeltaAbbotsfordHopeCoquitlamLangleyChilliwackBurnabyNorth VancouverWest Van.–Bowen IslandVan. Downtown EastsideVancouver WestsideVancouver City CentreHowe SoundPowell RiverSunshine CoastVancouver MidtownVancouver SouthVancouver North EastRichmond3%2%1%1%1%1%1%0%0%0%-1%-1%-1%2%2%1%0%0%0%0%0%-1%-1%-1%-2%-23%9%0%10%12%13%1%7%0%-1%-5%-4%2%0%-3%13%-12%-4%0%0%-8%-3%-1%-2%-6%8%-2%-1%0%-7%-5%0%-5%0%0%0%-1%-2%2%5%-1%9%7%0%0%7%2%-1%-3%1%-7%4%3%0%3%3%3%3%0%0%0%0%-3%2%1%-3%-3%-3%1%1%-1%-2%-2%-1%-5%2%1%1%0%0%0%0%0%0%0%0%0%-1%4%1%1%1%1%0%0%0%0%0%0%0%0%0%0%0%0%0%-1%-1%-1%-3%-3%-3%-4%-4%-4%-4%-4%-6%0%0%0%-1%-1%-2%-3%-4%-5%-5%-10%4%3%5%-5%0%1%3%0%-2%-1%-5%-7%-4%2%4%9%-1%-5%-5%5%0%0%-8%-9%-7%0%-11%-5%-29%-9%-6%-3%-6%-5%-14%-17%-15%-15%-19%-19%-25%-14%-23%-4%-3%6%0%-10%-9%-5%-24%-16%-12%-20%2%1%1%-1%3%3%1%0%0%-1%-2%-3%1%4%2%4%3%-3%1%2%1%0%0%0%-1%-2%-3%-4%-16%0%-1%0%1%1%0%-3%-5%-3%-3%-3%-5%-2%-8%0%0%2%0%0%-2%-3%-7%-6%-4%-4%0%0%4%1%2%0%-2%0%3%1%6%6%1%6%-2%-1%-1%0%4%-2%-2%3%10%7%3%5%4%0%11%6%5%-5%-2%0%-11%8%0%-5%5%3%-3%0%3%0%2%4%5%6%3%-2%7%-2%-5%-7%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h2 92Medical services from general practitionersMedical servicest h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s3 0Introductionfigure 2a» Spending per capita in BC, by age group, 20062 Medical services from general practitionersNumberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population1000750500250$500$375$250$125361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$418.21811720755784 789829885921884$145.15$161.77$149.55$175.65$243.54$344.26$82.22$109.71Total spending in BC: $692-millionSpending per capita in BC: $175.77Users of services per 1,000 pop. in BC: 805Spending per user of services in BC: $218.29Contacts per user of services in BC: 6.3Average cost per contact in BC: $34.59Included in this analysisThis analysis includes all fee-for-service care provided for BC residents by practitioners with a General Practitioner specialty designation during the calendar year 2006.U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h3 1figure 2B» Users per 1,000 population in BC, by age group, 2006Overall spending and useThe BC government spent approximately $692 million, or $176 per capita, on fee-for-service care provided for BC residents by general practitioners.Overall, approximately 80% of BC residents received some form of care from a general practitioner.On average, BC residents who received general prac-titioner care contacted a general practitioner just over six times. The average cost per contact was $34.60.Spending and use by ageAverage government spending per capita for fee-for-service care from general practitioners varied by more than 500% across age groups, from a low of $82 per resident aged 10–19 to a high of $418 per resident aged 80 and older.Average per capita spending on general practitioner services was relatively stable among adults aged 20–29 through 50–59. Spending then grew with each succes-sive age group. The age gradient in spending per capita on general practitioner services is not reflected in shares of each age group that received at least some care of this type.The number of users of general practitioner services per 1,000 residents in each age group varied by only 28%, from a low of 720 users per 1,000 residents aged 10–19 to a high of 921 users per 1,000 residents aged 70–79.Numberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population1000750500250$500$375$250$125361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$418.21811720755784 789829885921884$145.15$161.77$149.55$175.65$243.54$344.26$82.22$109.71t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s3 2Spending per capitaVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationNote: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).table 2a» Variation in spending per capita by local health area, 20062 Medical services from general practitionersRegional variations in spending per capitaAfter we accounted for differences in population age, sex, and health status, there was very little varia-tion across BC’s LHAs in per capita government spending on services received from general practi-tioners in 2006.In 60 LHAs, spending per capita on general practi-tioner services was either within 5% of, or not statis-tically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status.Levels of spending per capita on general practitioner services in Northern LHAs tended to be slightly above predictions based on provincial averages.Island NorthAlberniLake CowichanCampbell RiverCourtenayCowichanSookeGreater VictoriaNanaimoSaanichQualicumLadysmithGulf IslandsWindermereCranbrookGoldenArrow LakesCastlegar100 Mile HouseRevelstokeMerrittTrailGrand ForksCrestonLillooetSalmon ArmSouth OkanaganKimberleyKettle ValleyNelsonArmstrongPrincetonSummerlandCariboo–ChilcotinVernonEnderbyPentictonSouth CaribooCentral OkanaganKamloopsKeremeosNorth ThompsonKootenay LakePeace River SouthSmithersNechakoPrince RupertKitimatQuesnelPeace River NorthBurns LakeFort NelsonTerracePrince George$180$198$213$213$196$197$177$193$173$196$197$185$180$161$193$183$197$193$221$184$255$221$189$193$191$198$228$163$173$176$187$196$202$178$216$203$215$174$200$169$188$162$107$176$196$165$215$222$207$164$205$153$193$153$170$188$205$206$190$192$172$190$171$194$195$187$185$151$181$172$185$182$209$174$242$210$179$183$182$189$218$156$165$168$179$188$194$172$208$196$207$168$194$166$182$156$111$165$183$154$202$209$195$155$193$145$185$1506%5%4%4%3%3%3%1%1%1%1%-1%-2%7%7%6%6%6%6%6%6%5%5%5%5%5%5%5%4%4%4%4%4%4%4%4%4%3%3%1%0%0%-3%7%7%6%6%6%6%6%6%5%4%0%HopeMissionChilliwackMaple RidgeAbbotsfordSurreyCoquitlamDeltaSouth Surrey–White RockNew WestminsterBurnabyLangleyAgassiz–HarrisonPowell RiverHowe SoundSunshine CoastNorth VancouverRichmondVancouver North EastVancouver SouthVancouver MidtownWest Van.–Bowen IslandVan. Downtown EastsideVancouver City CentreVancouver Westside$238$204$184$192$197$181$152$169$202$176$161$153$106$223$177$192$171$149$159$161$149$178$166$145$133$225$196$178$187$192$180$151$168$202$177$162$156$120$214$171$187$170$149$159$162$152$181$170$150$1396%4%3%3%3%1%1%0%0%0%-1%-2%-12%4%3%3%1%0%0%0%-2%-2%-3%-3%-4%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h3 3Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 2d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 2C» Regional variation in spending per capita» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%18160Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita18160Users per 1,0007 9Days per user23749Cost per day383533t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s3 4Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Users per 1,000 populationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvaluefor LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 2B» Variation in users of services per 1,000 population by local health area, 20062 Medical services from general practitionersRegional variations in rate of useAfter we accounted for differences in population age, sex, and health status, there was virtually no regional variation in the number of recipients of general practitioner services per 1,000 residents of BC’s LHAs in 2006.The number of users of general practitioner services per 1,000 residents did not differ in any LHAs by more than 5% from levels predicted based on provincial averages for populations of the same age, sex, and health status.Island NorthAlberniCowichanCourtenaySookeQualicumNanaimoSaanichLake CowichanCampbell RiverGreater VictoriaLadysmithGulf IslandsGoldenWindermereCranbrookCastlegarArrow LakesRevelstokeGrand ForksKeremeosSalmon ArmNorth Thompson100 Mile HouseTrailArmstrongSummerlandCariboo–ChilcotinSouth OkanaganKimberleyVernonCrestonPrincetonKettle ValleyPentictonLillooetSouth CaribooMerrittCentral OkanaganNelsonEnderbyKamloopsKootenay LakePeace River NorthPeace River SouthSmithersQuesnelBurns LakePrince RupertKitimatFort NelsonNechakoPrince GeorgeTerrace7968188248248378438108508178178307917407947768148107857947958158067808208468228377988437858427588217548457927918488447678047955777507767958057968198367666987698007868098178188318388068478148158307957647757618007977737837838047967708108368138287898347768347508137468377847848418387627987955967367627827967878108267576947667991%1%1%1%1%1%1%0%0%0%0%-1%-3%2%2%2%2%2%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%0%-3%2%2%2%1%1%1%1%1%0%0%0%HopeMissionChilliwackMaple RidgeAbbotsfordSouth Surrey–White RockCoquitlamDeltaNew WestminsterSurreyBurnabyLangleyAgassiz–HarrisonHowe SoundSunshine CoastPowell RiverNorth VancouverRichmondWest Van.–Bowen IslandVancouver SouthVancouver North EastVancouver City CentreVancouver MidtownVancouver WestsideVan. Downtown Eastside8298418158488358458068308098287817776428118098198297738267897937627717577368198328078418298438058308128337867866638038048158297748297937987737827727561%1%1%1%1%0%0%0%0%-1%-1%-1%-3%1%1%1%0%0%0%-1%-1%-1%-1%-2%-3%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h3 5Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 2d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 2e» Regional variation in users of services per 1,000 population» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%7 9Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita18160Users per 1,0007 9Days per user23749Cost per day383533t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s3 6Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationContacts per usertable 2C» Variation in contacts per user of services by local health area, 20062 Medical services from general practitionersRegional variations in contacts per userAfter we accounted for differences in population age, sex, and health status, the number of contacts with general practitioners per user of their services varied modestly across BC’s LHAs in 2006.In 50 LHAs, the average number of contacts with general practitioners per user was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status. The average number of contacts per user in Northern LHAs tended to be slightly above levels predicted based on provincial averages.Contacts per user in Vancouver City Centre, West Vancouver–Bowen Island, and Vancouver Westside were below predictions based on provincial averages.AlberniLake CowichanCampbell RiverCourtenayIsland NorthCowichanGreater VictoriaGulf IslandsNanaimoSookeSaanichLadysmithQualicumMerrittCranbrookGoldenArrow LakesGrand ForksCastlegarKettle ValleyLillooetTrailCentral OkanaganSalmon ArmPentictonSummerland100 Mile HouseNelsonWindermereCrestonSouth OkanaganVernonKootenay LakeKeremeosRevelstokeArmstrong KamloopsNorth ThompsonSouth CaribooEnderbyKimberleyPrincetonCariboo–ChilcotinBurns LakeKitimatQuesnelSmithersFort NelsonPeace River NorthPrince RupertNechakoPeace River SouthTerracePrince George8%8%6%5%5%5%3%3%1%0%0%0%-2%13%11%9%8%8%7%7%5%5%5%5%4%4%4%4%3%3%3%1%0%0%0%0%0%0%0%0%-3%-6%-6%11%11%9%9%9%8%8%6%6%-1%-2%HopeMissionAbbotsfordMaple RidgeSurreyChilliwackNew WestminsterCoquitlamDeltaSouth Surrey–White RockBurnabyLangleyAgassiz–HarrisonVan. Downtown EastsidePowell RiverHowe SoundSunshine CoastVancouver North EastVancouver MidtownNorth VancouverVancouver SouthRichmondVancouver City CentreWest Van.–Bowen IslandVancouver Westside9%8%3%3%2%1%0%-3%-3%-4%-5%-7%-13%11%7%0%-2%-2%-2%-3%-3%-3%-7%-8%-13%6.67.16.86.85.96.76.96.66.46.06.66.66.98.26.36.16.66.36.36.06.26.86.86.37.16.76.65.95.26.67.37.04.66.45.86.16.05.56.16.65.46.25.96.56.96.56.25.45.56.45.45.76.25.76.06.56.46.45.66.46.66.46.36.06.66.67.17.25.75.66.15.85.95.65.86.56.56.06.86.46.35.75.06.47.16.94.86.45.76.26.05.66.16.55.66.56.25.86.26.05.74.95.15.95.15.46.35.87.67.06.86.66.76.26.65.76.16.96.25.64.67.56.95.96.26.16.06.16.25.85.86.45.26.96.46.66.46.66.26.75.96.37.26.56.05.26.76.55.96.36.26.16.36.46.06.36.95.9U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h3 7Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 2d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 2f» Regional variation in contacts per user of services» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%23749Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita18160Users per 1,0007 9Days per user23749Cost per day383533t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s3 8Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Cost per contactVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 2d» Variation in cost per contact by local health area, 20062 Medical services from general practitionersRegional variations in cost per contactAfter we accounted for differences in population age, sex, and health status, the average cost per contact with general practitioners was notably varied across BC’s LHAs in 2006.In only 35 LHAs, average cost per contact with general practitioners was either within 5% of, or not statisti-cally significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status.Average costs per contact in rural LHAs were generally above levels predicted based on provincial averages. In contrast, average costs per contact in LHAs within the city of Vancouver were below levels predicted based on provincial averages.Campbell RiverIsland NorthGulf IslandsLake CowichanAlberniLadysmithCowichanSookeCourtenaySaanichGreater VictoriaNanaimoQualicum100 Mile HouseRevelstokeWindermereKootenay LakeLillooetCariboo–ChilcotinNelsonSalmon ArmTrailGoldenPrincetonCrestonEnderbyKettle ValleyCranbrookCastlegarGrand ForksKimberleyNorth ThompsonArrow LakesMerrittArmstrong South OkanaganVernonKamloopsKeremeosSouth CaribooSummerlandPentictonCentral OkanaganNechakoPrince RupertPeace River NorthSmithersPeace River SouthQuesnelBurns LakeTerraceKitimatFort NelsonPrince George$38$38$37$37$37$36$36$35$35$35$34$33$34$41$40$40$41$39$38$39$39$38$38$39$39$38$38$38$38$38$38$38$38$37$37$37$37$36$36$36$36$36$35$44$41$40$40$40$39$39$39$38$37$35$35$35$35$35$35$35$35$34$35$35$35$35$35$35$34$35$35$35$34$35$35$35$34$35$35$35$35$35$35$35$35$35$36$34$35$35$35$35$35$35$35$35$35$35$34$35$34$35$35$35$35$34$34$3510%10%6%6%6%2%2%2%0%-1%-3%-4%-5%16%15%15%14%12%12%10%10%10%10%9%9%9%8%8%8%8%7%7%7%7%7%5%5%3%3%2%2%2%0%22%18%15%14%14%13%13%12%11%10%1%HopeChilliwackAgassiz–HarrisonMissionLangleyAbbotsfordMaple RidgeSouth Surrey–White RockBurnabyCoquitlamDeltaSurreyNew WestminsterPowell RiverSunshine CoastHowe SoundNorth VancouverVancouver WestsideRichmondWest Van.–Bowen IslandVancouver SouthVancouver North EastVancouver MidtownVancouver City CentreVan. Downtown Eastside$38$36$36$35$35$35$34$35$34$33$33$33$33$39$38$37$34$34$33$34$33$33$32$33$30$35$35$35$34$35$34$34$35$35$34$34$34$35$35$35$34$34$35$34$35$34$35$34$35$348%4%3%2%1%0%0%-1%-3%-3%-3%-5%-5%11%9%7%-2%-3%-3%-3%-5%-5%-6%-6%-13%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h3 9Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 2d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 2G» Regional variation in cost per contact» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%383533Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita18160Users per 1,0007 9Days per user23749Cost per day383533t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s4 0Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Summary of measures of deviationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthSpendingpercapitaUsersper1,000Local health areaLocal health areaSpendingpercapitaContactsperuserCostpercontactUsersper1,000ContactsperuserCostpercontacttable 2e» Regional variation» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 20062 Medical services from general practitionersMeasures of deviationAfter we accounted for differences in population age, sex, and health status, variations across BC’s LHAs in spending per capita on services received from general practitioners tended to result from variations in the average number of contacts and cost per contact with general practitioners per user of these services.Island NorthAlberniLake CowichanCampbell RiverCourtenayCowichanSookeGreater VictoriaNanaimoSaanichQualicumLadysmithGulf IslandsWindermereCranbrookGoldenArrow LakesCastlegar100 Mile HouseRevelstokeMerrittTrailGrand ForksCrestonLillooetSalmon ArmSouth OkanaganKimberleyKettle ValleyNelsonArmstrongPrincetonSummerlandCariboo–ChilcotinVernonEnderbyPentictonSouth CaribooCentral OkanaganKamloopsNorth ThompsonKeremeosKootenay LakePeace River SouthSmithersNechakoPrince RupertKitimatQuesnelPeace River NorthBurns LakeFort NelsonTerracePrince GeorgeHopeMissionChilliwackMaple RidgeAbbotsfordSurreyCoquitlamDeltaSouth Surrey–White RockNew WestminsterBurnabyLangleyAgassiz–HarrisonPowell RiverHowe SoundSunshine CoastNorth VancouverRichmondVancouver North EastVancouver SouthVancouver MidtownWest Van.–Bowen IslandVan. Downtown EastsideVancouver City CentreVancouver Westside6%4%3%3%3%1%1%0%0%0%-1%-2%-12%4%3%3%1%0%0%0%-2%-2%-3%-3%-4%9%8%1%3%3%2%-3%-3%-4%0%-5%-7%-13%7%0%-2%-3%-3%-2%-3%-2%-8%11%-7%-13%8%2%4%0%0%-5%-3%-3%-1%-5%-3%1%3%11%7%9%-2%-3%-5%-5%-6%-3%-13%-6%-3%1%1%1%1%1%-1%0%0%0%0%-1%-1%-3%1%1%1%0%0%-1%-1%-1%0%-3%-1%-2%6%5%4%4%3%3%3%1%1%1%1%-1%-2%7%7%6%6%6%6%6%6%5%5%5%5%5%5%5%4%4%4%4%4%4%4%4%4%3%3%1%0%0%-3%7%7%6%6%6%6%6%6%5%4%0%5%8%8%6%5%5%0%3%1%0%-2%0%3%3%11%9%8%7%4%0%13%5%8%3%5%5%3%-3%7%4%0%-6%4%-6%1%0%4%0%5%0%0%0%0%6%9%6%8%11%9%8%11%9%-1%-2%1%1%0%0%1%1%1%0%1%0%1%-1%-3%2%2%2%2%2%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%1%0%1%1%-3%2%2%0%1%1%1%2%1%1%0%0%10%6%6%10%0%2%2%-3%-4%-1%-5%2%6%15%8%10%7%8%16%15%7%10%8%9%12%10%5%7%8%10%7%9%2%12%5%9%2%2%0%3%7%3%14%14%14%22%18%11%13%15%13%10%12%1%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h4 1Medical services3Medical services from diagnostic specialistst h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s4 2Introductionfigure 3a» Spending per capita in BC, by age group, 20063 Medical services from diagnostic specialistsNumberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population1,000750500250$300$225$150$75361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$248.07266331448505546648764834786$69.95$98.20$109.29$148.36$207.45$271.38$33.94$23.84Total spending in BC: $462-millionSpending per capita in BC: $117.30Users of services per 1,000 pop. in BC: 541Spending per user of services in BC: $216.96Contacts per user of services in BC: 3.9Average cost per contact in BC: $55.75Included in this analysisThis analysis includes all fee-for-service care provided for BC residents during the calendar year 2006 by practitioners with one of the following diagnostic specialty designations: Radiology, Pathology, Medical Microbiology, or Nuclear Medicine.U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h4 3figure 3B» Users per 1,000 population in BC, by age group, 2006Overall spending and useThe BC government spent approximately $462 million, or $117 per capita, on fee-for-service care provided for BC residents by practitioners with a diagnostic specialty designation.Overall, approximately 54% of BC residents received some form of care from a diagnostic specialist.On average, BC residents who received care from diagnostic specialists contacted a diagnostic specialist (or the services provided under their care) 3.9 times. The average cost per contact was $55.75.Spending and use by ageAverage government spending per capita for fee-for-service care from diagnostic specialists varied by approximately 1,100% across age groups, from a low of $24 per resident under the age of 10 to a high of $271 per resident aged 70–79.Average per capita spending on diagnostic special-ist services increased in stages across age groups. Spending was approximately $24 and $34 per child and teen, and then doubled to $70 among adults aged 20–29. Spending on diagnostic specialist services grew steadily through the adult years. This appears to be driven by a similarly steady increase in the number of users of diagnostic specialist services per 1,000 residents across the age groups. The number of users of diagnostic specialist services per 1,000 residents in each age group varied by just over 300%, from a low of 266 users per 1,000 residents under age 10 to a high of 834 users per 1,000 residents aged 70–79.Numberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population1,000750500250$300$225$150$75361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$248.07266331448505546648764834786$69.95$98.20$109.29$148.36$207.45$271.38$33.94$23.84t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s4 4Spending per capitaVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationNote: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).table 3a» Variation in spending per capita by local health area, 20063 Medical services from diagnostic specialistsRegional variations in spending per capitaAfter we accounted for differences in population age, sex, and health status, there were modest variations across BC’s LHAs in per capita govern-ment spending on services received from diagnostic specialists in 2006.In 58 LHAs, spending per capita on diagnostic specialist services was either within 5% of, or not statistically significantly different from, levels pre-dicted based on provincial averages for populations of the same age, sex, and health status.Levels of spending per capita on diagnostic special-ist services in Vancouver Island LHAs and LHAs among the Kootenay Rockies (southeast Interior) tended to be higher than levels predicted based on provincial averages.Gulf IslandsNanaimoSaanichSookeIsland NorthGreater VictoriaCowichanCampbell RiverQualicumLake CowichanAlberniLadysmithCourtenayKootenay LakeRevelstokeLillooetWindermerePrincetonNelsonCranbrookArrow LakesSalmon ArmCastlegarNorth ThompsonCrestonVernonKimberleyTrailSouth OkanaganPentictonKeremeosGoldenKamloopsSouth CaribooMerrittArmstrong EnderbySummerlandCentral Okanagan100 Mile HouseCariboo–ChilcotinKettle ValleyGrand ForksNechakoKitimatTerraceBurns LakePrince GeorgeQuesnelSmithersPeace River SouthPeace River NorthFort NelsonPrince Rupert$140$140$154$122$115$139$133$129$162$129$124$142$124$113$113$114$108$158$116$117$134$127$125$97$123$130$117$139$140$134$121$98$118$117$124$115$127$112$107$114$94$88$87$78$141$121$105$97$104$100$94$81$66$94$123$130$143$114$107$131$126$125$158$127$124$131$126$87$102$106$100$148$109$110$127$121$122$95$122$129$108$133$141$134$122$92$109$119$128$116$128$113$110$118$100$98$99$75$137$119$103$96$104$97$93$81$69$9813%7%7%7%7%6%5%3%3%2%0%0%-2%26%9%8%8%7%6%6%6%5%3%2%1%0%0%0%0%0%0%0%0%0%0%-1%-1%-1%-3%-3%-6%-11%-13%4%2%2%1%1%0%0%0%0%-3%-4%Agassiz–HarrisonNew WestminsterCoquitlamLangleyBurnabyDeltaSurreySouth Surrey–White RockHopeAbbotsfordChilliwackMaple RidgeMissionSunshine CoastVancouver City CentreVan. Downtown EastsideNorth VancouverWest Van.–Bowen IslandPowell RiverVancouver WestsideVancouver MidtownHowe SoundRichmondVancouver SouthVancouver North East$127$131$109$110$118$114$114$134$122$110$98$110$103$139$125$127$123$142$129$111$108$92$103$112$109$99$128$107$107$118$114$115$138$126$115$103$116$110$131$119$122$121$138$124$107$109$94$107$115$11226%2%2%0%0%-1%-1%-3%-3%-4%-5%-6%-7%6%4%4%0%0%0%0%-1%-2%-3%-3%-3%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h4 5Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 3d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 3C» Regional variation in spending per capita» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%582145Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita582145Users per 1,00063295Contacts per user2223361321Cost per contact1639213t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s4 6Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Users per 1,000 populationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvaluefor LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 3B» Variation in users of services per 1,000 population by local health area, 20063 Medical services from diagnostic specialistsRegional variations in rate of useAfter we accounted for differences in population age, sex, and health status, there were modest variations across BC’s LHAs in the numbers of recipients of services from diagnostic specialists per 1,000 residents in 2006.In 63 LHAs, the use of diagnostic specialist services was either within 5% of, or not statistically significantly different from, rates predicted based on provincial averages for populations of the same age, sex, and health status.Although moderate when differences in population age, sex, and health status are taken into account, variations in the rates of use of services from diagnos-tic specialists were greatest across Interior LHAs.Gulf IslandsLadysmithSaanichSookeNanaimoGreater VictoriaCowichanIsland NorthCampbell RiverQualicumLake CowichanAlberniCourtenayKootenay LakeLillooetRevelstokeKamloopsKimberleyGoldenNelsonCranbrookWindermereArrow LakesNorth ThompsonTrailSalmon ArmPrincetonCastlegarVernonKeremeosArmstrongSummerlandCentral OkanaganPentictonSouth OkanaganCreston100 Mile HouseEnderbySouth CaribooMerrittCariboo–ChilcotinGrand ForksKettle ValleyNechakoSmithersPrince GeorgeTerraceBurns LakeQuesnelPeace River SouthPeace River NorthKitimatPrince RupertFort Nelson60359363157457359357552455762355253455149456754156154852451554050555151258455258852657855654257056558359952054253153156349147446146150750653552952347843955251843453955459454054456955450554961455854456239852150652551549449351948953549856853857752357856654657256958861053156154955358752452451444049549853352152747844556153244811%7%6%6%5%4%4%4%1%1%0%-2%-2%22%8%7%7%6%6%4%4%3%3%3%3%3%2%0%0%0%0%0%-1%-1%-2%-2%-3%-3%-4%-4%-7%-10%-11%5%2%2%0%0%0%0%-1%-2%-3%-3%Agassiz–HarrisonLangleyCoquitlamNew WestminsterDeltaBurnabySurreySouth Surrey–White RockHopeChilliwackAbbotsfordMaple RidgeMissionSunshine CoastPowell RiverVancouver City CentreVancouver WestsideWest Van.–Bowen IslandVan. Downtown EastsideNorth VancouverHowe SoundVancouver MidtownRichmondVancouver SouthVancouver North East55252152755654852654058256250552252351157157454052559552855951250449951650744751252355455153655259858352954855554655256152851458352155551851652154053321%2%1%0%-1%-2%-2%-3%-4%-5%-5%-6%-7%3%2%2%2%2%1%1%-1%-2%-4%-5%-5%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h4 7Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 3d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 3e» Regional variation in users of services per 1,000 population» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%63295Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita582145Users per 1,00063295Contacts per user2223361321Cost per contact1639213t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s4 8Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationContacts per usertable 3C» Variation in contacts per user of services by local health area, 20063 Medical services from diagnostic specialistsRegional variations in contacts per userAfter differences in population age, sex, and health status have been taken into account, there were moderate variations across BC’s LHAs in the number of contacts with diagnostic specialists per user of these services in 2006.In 39 LHAs, the number of contacts with a diagnostic specialist per user was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status.Except for Powell River and Vancouver Downtown Eastside, diagnostic specialist contacts per user in Vancouver Coastal LHAs were below levels predicted based on provincial averages.Gulf IslandsIsland NorthSaanichCampbell RiverNanaimoLadysmithAlberniGreater VictoriaCourtenaySookeCowichanLake CowichanQualicumKimberleyKootenay LakeNelsonCranbrookArrow LakesPrincetonPentictonCastlegarSouth OkanaganWindermereRevelstokeLillooetSalmon ArmKamloopsTrailKeremeosGoldenArmstrongVernonNorth ThompsonSummerlandEnderbyCrestonCentral OkanaganSouth CaribooMerritt100 Mile HouseGrand ForksKettle ValleyCariboo–ChilcotinPeace River SouthKitimatPrince GeorgeBurns LakeNechakoPeace River NorthFort NelsonTerraceQuesnelSmithersPrince Rupert18%11%10%8%6%3%3%2%1%0%0%0%-3%28%27%17%15%15%14%14%13%11%10%10%9%8%6%0%0%0%0%0%0%0%-4%-7%-7%-8%-10%-12%-17%-18%-28%12%8%6%0%0%0%0%0%-3%-4%-13%Agassiz–HarrisonLangleyMissionNew WestminsterCoquitlamHopeChilliwackAbbotsfordBurnabyMaple RidgeSurreySouth Surrey–White RockDeltaPowell RiverVan. Downtown EastsideSunshine CoastVancouver City CentreHowe SoundNorth VancouverVancouver MidtownVancouver North EastVancouver WestsideWest Van.–Bowen IslandRichmondVancouver South32%9%7%6%2%0%0%0%0%0%-1%-4%-6%11%4%0%0%-2%-3%-7%-7%-8%-9%-11%-12%4.54.04.54.24.14.24.04.14.23.64.03.94.34.84.14.54.34.74.74.94.45.03.84.13.94.33.94.24.33.43.94.33.64.04.24.13.73.83.63.63.63.53.43.94.13.93.73.33.32.83.93.63.53.23.83.64.13.83.94.13.94.04.13.64.04.04.53.63.13.83.74.14.14.33.94.53.43.83.64.03.64.24.23.44.04.33.64.14.34.44.04.14.04.04.34.24.53.43.83.73.73.33.32.83.93.73.63.64.54.14.34.33.74.33.94.04.03.93.84.23.64.64.04.23.83.53.73.53.63.53.93.43.53.33.74.04.03.64.33.94.04.03.93.84.43.94.13.94.13.83.53.83.73.93.84.23.84.0U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h4 9Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 3d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 3f» Regional variation in contacts per user of services» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%2223361321Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita582145Users per 1,00063295Contacts per user2223361321Cost per contact1639213t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s5 0Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Cost per contactVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 3d» Variation in cost per contact by local health area, 20063 Medical services from diagnostic specialistsRegional variations in cost per contactAfter we accounted for differences in population age, sex, and health status, the average cost per contact with diagnostic specialists varied moderately across BC’s LHAs in 2006.In 39 LHAs, the average cost per contact with diagnos-tic specialists was either within 5% of, or not statisti-cally significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status. The costs per diagnostic specialist contact in several Vancouver Coastal LHAs were above levels predicted based on provincial averages.Average costs per diagnostic specialist contact in Fraser LHAs tended to be below levels predicted based on provincial averages.QualicumNanaimoLake CowichanCowichanGreater VictoriaLadysmithSookeAlberniCampbell RiverSaanichCourtenayIsland NorthGulf IslandsMerrittCreston100 Mile HouseCariboo–ChilcotinEnderbySouth CaribooTrailWindermereKootenay LakePrincetonGoldenKettle ValleyArmstrong KamloopsSalmon ArmCastlegarVernonNorth ThompsonGrand ForksLillooetCentral OkanaganRevelstokeKeremeosArrow LakesNelsonCranbrookSummerlandSouth OkanaganPentictonKimberleyKitimatTerracePrince RupertSmithersPeace River NorthFort NelsonQuesnelBurns LakeNechakoPeace River SouthPrince George$60$59$60$58$57$57$58$58$56$54$54$55$51$61$58$59$57$57$58$57$56$55$57$55$55$54$55$54$54$53$53$51$51$51$50$51$52$51$51$49$47$47$44$62$58$57$57$56$55$55$54$51$50$49$54$55$56$55$55$54$56$56$56$54$55$57$54$57$55$56$54$56$56$55$55$56$56$55$55$55$56$55$56$55$56$54$55$55$54$55$56$56$57$55$54$55$57$57$56$56$56$56$56$57$56$56$56$5711%7%7%5%4%4%4%4%0%-1%-3%-3%-6%7%6%6%6%3%3%3%2%0%0%0%0%-2%-2%-2%-4%-4%-5%-6%-7%-8%-8%-8%-9%-9%-11%-12%-15%-16%-25%8%4%2%2%0%0%-3%-4%-10%-11%-14%DeltaBurnabySouth Surrey–White RockSurreyCoquitlamNew WestminsterAbbotsfordMaple RidgeAgassiz–HarrisonLangleyHopeChilliwackMissionWest Van.–Bowen IslandVancouver WestsideVancouver SouthVancouver City CentreVancouver MidtownRichmondNorth VancouverSunshine CoastVancouver North EastVan. Downtown EastsideHowe SoundPowell River$57$56$54$56$56$55$52$53$51$51$51$50$47$61$60$61$61$61$61$59$58$59$60$52$49$56$56$54$56$57$56$55$57$55$56$56$55$55$55$56$56$56$57$56$56$55$57$57$57$552%0%0%-1%-2%-3%-5%-6%-8%-8%-10%-11%-17%11%8%8%8%8%7%6%6%5%5%-9%-12%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h5 1Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 3d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 3G» Regional variation in cost per contact» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%1639213Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita582145Users per 1,00063295Contacts per user2223361321Cost per contact1639213t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s5 2Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Summary of measures of deviationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthSpendingpercapitaUsersper1,000Local health areaLocal health areaSpendingpercapitaContactsperuserCostpercontactUsersper1,000ContactsperuserCostpercontacttable 3e» Regional variation» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 20063 Medical services from diagnostic specialistsMeasures of deviationAfter we accounted for differences in population age, sex, and health status, variations across BC’s LHAs in spending per capita on services received from diagnostic specialists tended to result from variations in the average number of contacts with diagnostic specialists per user.The effects of regional variations in contacts with diagnostic specialists interacted with frequently opposite variations in the cost per contact.Gulf IslandsNanaimoSaanichSookeIsland NorthGreater VictoriaCowichanCampbell RiverQualicumLake CowichanAlberniLadysmithCourtenayKootenay LakeRevelstokeLillooetWindermerePrincetonNelsonCranbrookArrow LakesSalmon ArmCastlegarNorth ThompsonCrestonVernonMerrittSouth CaribooTrailGoldenKamloopsKeremeosSouth OkanaganPentictonKimberleyArmstrongEnderbySummerlandCentral Okanagan100 Mile HouseCariboo–ChilcotinKettle ValleyGrand ForksNechakoKitimatTerraceBurns LakePrince GeorgeQuesnelSmithersPeace River NorthPeace River SouthFort NelsonPrince RupertAgassiz–HarrisonNew WestminsterCoquitlamLangleyBurnabyDeltaSurreySouth Surrey–White RockHopeAbbotsfordChilliwackMaple RidgeMissionSunshine CoastVancouver City CentreVan. Downtown EastsideWest Van.–Bowen IslandVancouver WestsideNorth VancouverPowell RiverVancouver MidtownHowe SoundRichmondVancouver SouthVancouver North East26%2%2%0%0%-1%-1%-3%-3%-4%-5%-6%-7%6%4%4%0%0%0%0%-1%-2%-3%-3%-3%32%6%2%9%0%-6%-1%-4%0%0%0%0%7%0%0%4%-9%-8%-3%11%-7%-2%-11%-12%-7%-8%-3%-2%-8%0%2%-1%0%-10%-5%-11%-6%-17%6%8%5%11%8%6%-12%8%-9%7%8%5%21%0%1%2%-2%-1%-2%-3%-4%-5%-5%-6%-7%3%2%1%2%2%1%2%-2%-1%-4%-5%-5%13%7%7%7%7%6%5%3%3%2%0%0%-2%26%9%8%8%7%6%6%6%5%3%2%1%0%0%0%0%0%0%0%0%0%0%-1%-1%-1%-3%-3%-6%-11%-13%4%2%2%1%1%0%0%0%0%-3%-4%18%6%10%0%11%2%0%8%-3%0%3%3%1%27%10%9%10%14%17%15%15%8%13%0%-7%0%-10%-8%0%0%6%0%11%14%28%0%-4%0%-7%-12%-28%-18%-17%0%8%0%0%6%-3%-4%0%12%0%-13%11%5%6%6%4%4%4%1%1%0%-2%7%-2%22%7%8%3%2%4%4%3%3%0%3%-2%0%-4%-4%3%6%7%0%-2%-1%6%0%-3%0%-1%-3%-7%-11%-10%5%-2%0%0%2%0%2%-1%0%-3%-3%-6%7%-1%4%-3%4%5%0%11%7%4%4%-3%0%-8%-7%2%0%-9%-11%-9%-2%-4%-5%6%-4%7%3%3%0%-2%-8%-15%-16%-25%-2%3%-12%-8%6%6%0%-6%-10%8%4%-4%-14%-3%2%0%-11%0%2%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h5 3Medical services4Medical services from surgical specialistst h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s5 4Introductionfigure 4a» Spending per capita in BC, by age group, 20064 Medical services from surgical specialistsNumberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population500375250125$300$225$150$75361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$265.15126105155211 220282396519502$55.02$80.21 $75.14$105.94$177.63$278.62$27.05$27.94Total spending in BC: $389-millionSpending per capita in BC: $98.74Users of services per 1,000 pop. in BC: 245Spending per user of services in BC: $402.69Contacts per user of services in BC: 3.1Average cost per contact in BC: $129.49Included in this analysisThis analysis includes all fee-for-service care provided for BC residents during the calendar year 2006 by practitioners with one of the following surgical specialty designations: Obstetrics & Gynaecology, Ophthamology, Otolaryngology, General surgery, Neurosurgery, Orthopaedic Surgery, Plastic Surgery, Cardio & Thoracic Surgery, Urology, Anaesthesia, Vascular Surgery, or Thoracic Surgery.U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h5 5figure 4B» Users per 1,000 population in BC, by age group, 2006Overall spending and useThe BC government spent approximately $389 million, or $99 per capita, on fee-for-service care provided for BC residents by practitioners with a surgical specialty designation.Overall, approximately 25% of BC residents received some form of care from a surgical specialist.On average, BC residents who received surgical specialist care contacted a surgical specialist just over three times. The average cost per contact was $129.50.Spending and use by ageAverage government spending per capita for fee-for-service care from surgical specialists varied by more than 1,000% across age groups, from a low of $27 per resident aged 10–19 to a high of $279 per resident aged 70–79.Average per capita spending on surgical specialist services grew steadily from childhood to working age, levelled off, and then grew relatively steadily through retirement age. The age gradient in the rate of use of surgical spe-cialist services was not as steep as the gradient for spending on these services. The number of users of surgical specialist services per 1,000 residents in each age group varied by almost 500%, from a low of 105 users per 1,000 residents aged 10–19 to a high of 519 users per 1,000 residents aged 70–79.Numberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population500375250125$300$225$150$75361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$265.15126105155211 220282396519502$55.02$80.21 $75.14$105.94$177.63$278.62$27.05$27.94t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s5 6Spending per capitaVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationNote: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).table 4a» Variation in spending per capita by local health area, 20064 Medical services from surgical specialistsRegional variations in spending per capitaAfter we accounted for differences in population age, sex, and health status, there were moderate variations across BC’s LHAs in per capita government spending on surgical specialist services in 2006.In 40 LHAs, spending per capita on surgical specialist services was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status.After we accounted for differences in population age, sex, and health status, levels of spending per capita on surgical specialist services varied significantly across Northern and Interior LHAs.AlberniGulf IslandsLake CowichanCowichanCourtenaySaanichSookeLadysmithNanaimoQualicumCampbell RiverIsland NorthGreater VictoriaKootenay LakeCranbrookKimberleyCariboo–ChilcotinKamloopsPrincetonSalmon ArmEnderbyTrailPentictonCastlegarArmstrong KeremeosNorth ThompsonGrand ForksSummerlandSouth OkanaganNelsonVernonCentral OkanaganRevelstokeArrow LakesKettle ValleySouth Cariboo100 Mile HouseCrestonLillooetMerrittWindermereGoldenTerraceKitimatPrince RupertPrince GeorgeQuesnelPeace River SouthSmithersNechakoBurns LakePeace River NorthFort Nelson$122$114$108$109$116$121$99$121$117$143$106$90$105$86$93$98$105$112$128$117$128$126$128$103$102$123$105$110$118$129$80$111$105$80$95$93$109$104$85$94$103$57$32$116$112$97$87$81$54$75$68$86$44$32$110$103$98$100$113$118$97$106$102$134$94$83$110$69$82$88$95$102$117$109$120$119$123$99$101$123$106$111$120$133$84$119$113$87$104$103$122$116$99$110$121$68$84$85$97$84$88$88$59$83$76$96$57$4610%10%10%9%3%3%1%0%0%0%0%0%-5%21%12%10%10%10%9%7%6%5%5%4%1%0%0%-1%-1%-3%-5%-7%-7%-8%-10%-10%-11%-12%-15%-15%-16%-18%-96%31%14%14%-1%-7%-9%-10%-10%-12%-27%-35%Agassiz–HarrisonLangleyChilliwackSurreyBurnabyDeltaNew WestminsterCoquitlamSouth Surrey–White RockMaple RidgeHopeMissionAbbotsfordVancouver WestsideVancouver City CentreWest Van.–Bowen IslandNorth VancouverPowell RiverVancouver MidtownVan. Downtown EastsideVancouver North EastVancouver SouthSunshine CoastRichmondHowe Sound$114$100$111$93$92$105$118$92$125$102$113$92$94$92$92$120$99$105$84$90$83$88$110$82$81$83$91$105$91$90$100$106$88$126$104$118$97$100$88$90$119$99$104$84$91$86$92$114$88$8933%9%5%3%2%0%0%0%-1%-2%-5%-5%-7%5%3%0%0%0%0%-1%-4%-4%-4%-6%-9%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h5 7Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 4d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 4C» Regional variation in spending per capita» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%4 014121723Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita4 014121723Users per 1,0003114122353Contacts per user7402084Cost per contact20184298t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s5 8Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Users per 1,000 populationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvaluefor LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 4B» Variation in users of services per 1,000 population by local health area, 20064 Medical services from surgical specialistsRegional variations in rate of useAfter we accounted for differences in population age, sex, and health status, there were moderate variations across BC’s LHAs in number of recipients of surgical specialist services per 1,000 residents in 2006.In 31 LHAs, the number of recipients of surgical spe-cialist services per 1,000 residents was either within 5% of, or not statistically significantly different from, rates predicted based on provincial averages for populations of the same age, sex, and health status.After we accounted for differences in population age, sex, and health status, the numbers of recipients of surgical specialist services per 1,000 residents varied significantly across LHAs in all health authorities except Vancouver Coastal.NanaimoLadysmithCampbell RiverLake CowichanGulf IslandsCowichanAlberniIsland NorthQualicumSaanichCourtenaySookeGreater VictoriaKootenay LakeCranbrookKamloopsKimberleyPrincetonCariboo–ChilcotinSalmon ArmEnderbyTrailPentictonCastlegarArmstrongNorth ThompsonKeremeosGrand ForksSummerlandSouth OkanaganNelsonVernonCentral OkanaganRevelstokeArrow LakesSouth Cariboo100 Mile HouseKettle ValleyLillooetMerrittCrestonWindermereGoldenTerraceKitimatPrince RupertPrince GeorgeQuesnelPeace River SouthSmithersBurns LakeNechakoPeace River NorthFort Nelson2873002812842852902662303222982772402501992392452322732362582612722772382342142462232442682042472351952152242231942042181941588031427624621921116619421116214111125426725125625926624921630629227424026717022123022126222725025726927624024122626123826128822127125921924625926022824326323719721722924622422723318922124418718916312%11%11%10%10%9%7%6%5%2%0%0%-7%16%8%6%5%4%4%3%0%0%0%0%0%-5%-6%-6%-7%-7%-8%-9%-10%-12%-13%-15%-15%-16%-17%-19%-20%-22%-99%32%11%9%-3%-10%-13%-13%-14%-15%-29%-39%Agassiz–HarrisonNew WestminsterLangleySurreyDeltaCoquitlamBurnabyChilliwackSouth Surrey–White RockMaple RidgeMissionHopeAbbotsfordVancouver WestsideVancouver City CentreWest Van.–Bowen IslandNorth VancouverPowell RiverVancouver MidtownVan. Downtown EastsideVancouver North EastVancouver SouthSunshine CoastRichmondHowe Sound25727924425325923324824729924122825322724924629725626422423522723324821920919625422824224722624124330225024427124723623829525726522523423424126323323327%9%7%5%4%3%3%2%-1%-4%-7%-7%-8%5%3%0%0%0%0%0%-3%-3%-6%-6%-11%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h5 9Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 4d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 4e» Regional variation in users of services per 1,000 population» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%3114122353Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita4 014121723Users per 1,0003114122353Contacts per user7402084Cost per contact20184298t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s6 0Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationContacts per usertable 4C» Variation in contacts per user of services by local health area, 20064 Medical services from surgical specialistsRegional variations in contacts per userAfter we accounted for differences in population age, sex, and health status, the number of contacts with surgical specialists per user of surgical specialist services varied moderately across BC’s LHAs in 2006.In 40 LHAs, the average number of contacts with surgical specialists per user was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status. The average numbers of contacts per user in most Northern and Interior LHAs were below levels predicted based on provincial averages.AlberniSookeNanaimoGreater VictoriaSaanichCowichanLake CowichanLadysmithQualicumCourtenayCampbell RiverGulf IslandsIsland NorthKamloopsCranbrookCentral OkanaganKimberleyKeremeosArmstrong VernonNorth ThompsonSouth CaribooEnderbySummerlandSalmon ArmPentictonTrailPrincetonSouth OkanaganKettle ValleyMerrittKootenay LakeLillooetCastlegarGrand ForksNelsonCreston100 Mile HouseCariboo–ChilcotinRevelstokeWindermereArrow LakesGoldenTerraceKitimatPrince RupertPrince GeorgeNechakoQuesnelPeace River SouthBurns LakeSmithersPeace River NorthFort Nelson10%7%4%3%0%0%0%0%-2%-3%-3%-3%-14%7%4%2%0%0%0%0%0%0%0%-4%-5%-6%-6%-8%-8%-9%-9%-10%-10%-12%-13%-14%-15%-16%-16%-17%-17%-17%-41%8%0%-6%-7%-9%-15%-21%-23%-26%-31%-36%Agassiz–HarrisonNew WestminsterLangleySurreyChilliwackCoquitlamAbbotsfordDeltaMaple RidgeBurnabyMissionSouth Surrey–White RockHopeVancouver MidtownVancouver SouthVancouver North EastRichmondVancouver WestsideVancouver City CentreNorth VancouverVan. Downtown EastsideWest Van.–Bowen IslandHowe SoundSunshine CoastPowell River15%10%6%4%3%3%3%3%2%0%-3%-3%-11%3%1%0%-1%-2%-2%-2%-2%-5%-14%-14%-18%3.43.23.23.33.23.13.03.23.23.12.93.02.63.23.13.23.03.03.13.32.83.03.33.03.03.03.02.83.02.82.92.42.82.82.72.62.72.72.62.52.42.72.23.23.12.72.92.72.72.42.52.42.11.93.13.03.13.23.23.23.13.23.33.23.03.13.03.02.93.22.93.13.13.33.03.13.23.23.13.23.23.13.23.03.22.73.13.13.13.03.23.23.03.02.93.23.22.93.02.93.12.93.12.93.13.12.92.73.23.53.23.13.23.13.23.23.23.13.03.32.93.13.23.13.13.13.13.13.03.22.72.92.72.83.13.03.03.13.03.13.13.13.13.13.43.23.03.13.13.13.13.13.23.13.43.23.33.2U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h6 1Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 4d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 4f» Regional variation in contacts per user of services» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%7402084Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita4 014121723Users per 1,0003114122353Contacts per user7402084Cost per contact20184298t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s6 2Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Cost per contactVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 4d» Variation in cost per contact by local health area, 20064 Medical services from surgical specialistsRegional variations in cost per contactAfter we accounted for differences in population age, sex, and health status, the average cost per contact with surgical specialists varied notably across BC’s LHAs in 2006.In only 29 LHAs, the average cost per contact with surgical specialists was either within 5% of, or not statistically significantly different from, levels pre-dicted based on provincial averages for populations of the same age, sex, and health status.The costs per contact with surgical specialists in rural LHAs were generally well above levels predicted based on provincial averages for populations. In contrast, the costs per surgical specialist contact in several LHAs within the city of Vancouver were below levels predicted based on provincial averages.Island NorthAlberniQualicumGulf IslandsCourtenayLake CowichanSookeNanaimoCampbell RiverGreater VictoriaSaanichLadysmithCowichanGoldenGrand ForksNorth ThompsonKootenay LakeCariboo–Chilcotin100 Mile HouseLillooetKettle ValleyRevelstokeKeremeosMerrittPrincetonSouth OkanaganSouth CaribooSummerlandCrestonArrow LakesCastlegarWindermerePentictonTrailSalmon ArmNelsonEnderbyKamloopsKimberleyArmstrong Central OkanaganVernonCranbrookBurns LakeSmithersFort NelsonNechakoPrince RupertPeace River NorthQuesnelPeace River SouthPrince GeorgeKitimatTerrace$151$136$137$134$133$125$128$128$131$127$127$126$119$185$181$173$176$173$171$167$172$162$168$161$165$162$162$159$161$161$156$149$154$155$152$148$151$144$140$141$139$135$127$164$160$153$157$144$143$145$138$138$132$116$130$129$132$130$131$128$128$128$129$130$130$130$129$135$133$133$136$134$133$131$135$129$135$131$134$132$134$132$136$137$134$129$133$135$134$133$137$132$131$134$132$135$130$131$131$125$132$125$127$129$128$130$126$13115%6%4%3%2%0%0%0%0%-2%-2%-3%-8%32%31%26%26%25%25%24%24%23%22%21%21%21%19%19%17%16%15%15%15%14%13%11%10%9%7%5%5%0%-3%23%20%20%18%14%12%12%7%6%5%-13%HopeChilliwackAgassiz–HarrisonMissionDeltaCoquitlamMaple RidgeAbbotsfordSouth Surrey–White RockLangleyNew WestminsterSurreyBurnabySunshine CoastPowell RiverHowe SoundVan. Downtown EastsideNorth VancouverRichmondWest Van.–Bowen IslandVancouver City CentreVancouver MidtownVancouver WestsideVancouver North EastVancouver South$153$140$138$134$128$128$132$128$127$126$123$118$119$155$149$142$128$125$123$126$122$119$121$118$119$130$128$131$129$130$128$131$127$133$132$130$127$129$137$134$132$130$129$127$131$128$126$129$126$12716%9%5%4%0%0%0%0%-4%-4%-5%-7%-8%12%11%8%-1%-3%-3%-4%-5%-6%-6%-7%-7%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h6 3Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 4d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 4G» Regional variation in cost per contact» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%20184298Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita4 014121723Users per 1,0003114122353Contacts per user7402084Cost per contact20184298t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s6 4Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Summary of measures of deviationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthSpendingpercapitaUsersper1,000Local health areaLocal health areaSpendingpercapitaContactsperuserCostpercontactUsersper1,000ContactsperuserCostpercontacttable 4e» Regional variation» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 20064 Medical services from surgical specialistsMeasures of deviationAfter accounting for differences in population age, sex, and health status, variations across BC’s LHAs in spending per capita on surgical specialist services tended to result from a combination of factors.After we accounted for differences in population age, sex, and health status, the number of users of surgical specialist services per 1,000 residents and the average number of contacts per user were positively correlated across BC’s LHAs.The effects of regional variations in the use of and contact with surgical specialists interacted with gener-ally opposite variations in the cost per contact with surgical specialists. Overall, areas with the lowest rate of use of surgical specialist services had higher costs per unit of those services.AlberniGulf IslandsLake CowichanCowichanCourtenaySaanichSookeIsland NorthQualicumNanaimoCampbell RiverLadysmithGreater VictoriaKootenay LakeCranbrookKimberleyCariboo–ChilcotinKamloopsPrincetonSalmon ArmEnderbyTrailPentictonCastlegarArmstrongKeremeosNorth ThompsonGrand ForksSummerlandSouth OkanaganNelsonVernonCentral OkanaganRevelstokeArrow LakesKettle ValleySouth Cariboo100 Mile HouseCrestonLillooetMerrittWindermereGoldenTerraceKitimatPrince RupertPrince GeorgeQuesnelPeace River SouthSmithersNechakoBurns LakePeace River NorthFort NelsonAgassiz–HarrisonLangleyChilliwackSurreyBurnabyCoquitlamDeltaNew WestminsterSouth Surrey–White RockMaple RidgeHopeMissionAbbotsfordVancouver WestsideVancouver City CentreWest Van.–Bowen IslandNorth VancouverPowell RiverVancouver MidtownVan. Downtown EastsideVancouver North EastVancouver SouthSunshine CoastRichmondHowe Sound33%9%5%3%2%0%0%0%-1%-2%-5%-5%-7%5%3%0%0%0%0%-1%-4%-4%-4%-6%-9%15%6%3%4%0%3%3%10%-3%2%-11%-3%3%-2%-2%-5%-2%-18%3%-2%0%1%-14%-1%-14%5%-4%9%-7%-8%0%0%-5%-4%0%16%4%0%-6%-5%-4%-3%11%-6%-1%-7%-7%12%-3%8%27%7%2%5%3%3%4%9%-1%-4%-7%-7%-8%5%3%0%0%0%0%0%-3%-3%-6%-6%-11%10%10%10%9%3%3%1%0%0%0%0%0%-5%21%12%10%10%10%9%7%6%5%5%4%1%0%0%-1%-1%-3%-5%-7%-7%-8%-10%-10%-11%-12%-15%-15%-16%-18%-96%31%14%14%-1%-7%-9%-10%-10%-12%-27%-35%10%-3%0%0%-3%0%7%-14%-2%4%-3%0%3%-10%4%0%-16%7%-8%-5%0%-6%-6%-12%0%0%0%-13%-4%-8%-14%0%2%-17%-17%-9%0%-16%-15%-10%-9%-17%-41%8%0%-6%-7%-15%-21%-26%-9%-23%-31%-36%7%10%10%9%0%2%0%6%5%12%11%11%-7%16%8%5%4%6%4%3%0%0%0%0%0%-6%-5%-6%-7%-7%-8%-9%-10%-12%-13%-16%-15%-15%-20%-17%-19%-22%-99%32%11%9%-3%-10%-13%-13%-15%-14%-29%-39%6%3%0%-8%2%-2%0%15%4%0%0%-3%-2%26%-3%7%25%9%21%13%10%14%15%15%5%22%26%31%19%21%11%0%5%23%16%24%19%25%17%24%21%15%32%-13%5%14%6%12%7%20%18%23%12%20%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h6 5Medical services5Medical services from medical specialistst h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s6 6Introductionfigure 5a» Spending per capita in BC, by age group, 20065 Medical services from medical specialistsNumberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population500375250125$200$150$100$50361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$171.59202142 149182218295384467455$39.03$53.38$68.50$96.51 $130.20$179.89$38.15$52.17Total spending in BC: $312-millionSpending per capita in BC: $79.21Users of services per 1,000 pop. in BC: 247Spending per user of services in BC: $320.30Contacts per user of services in BC: 3.7Average cost per contact in BC: $87.29Included in this analysisThis analysis includes all fee-for-service care provided for BC residents during the calendar year 2006 by practitioners with one of the following medical specialty designations: Dermatology, Neurology, Psychiatry, Pediatrics, Internal Medicine, Pediatric Cardiology , Physical Medicine & Rehab, Public Health, Occupational Medicine, Geriatric Medicine, Cardiology, Emergency Medicine, Rheumatology, Clinical Immunization and Allergy, Medical Genetics, Respirology, Endocrinology, Gastroenterology, Nephrology, Infectious Disease, Hematology, or Oncology.U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h6 7figure 5B» Users per 1,000 population in BC, by age group, 2006Overall spending and useThe BC government spent approximately $312 million, or $79 per capita, on fee-for-service care provided for BC residents by practitioners with a medical specialty designation.Overall, approximately 25% of BC residents received some form of care from a medical specialist.On average, BC residents who received medical spe-cialist care contacted a medical specialist 3.7 times. The average cost per contact was $87.30.Spending and use by ageAverage government spending per capita for fee-for-service care from medical specialists varied by just under 500% across age groups, from a low of $38 per resident aged 10–19 to a high of $180 per resident aged 70–79.Average per capita spending on medical specialist services was higher among young children than among teens and young adults. Spending on medical specialist services grew steadily through the adult years. This appears to be driven by a similarly steady increase in the number of users of medical specialist services per 1,000 residents across the age groups. The number of users of medical specialist services per 1,000 residents in each age group varied by just over 300%, from a low of 142 users per 1,000 residents aged 10–19 to a high of 467 users per 1,000 residents aged 70–79.Numberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population500375250125$200$150$100$50361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$171.59202142 149182218295384467455$39.03$53.38$68.50$96.51 $130.20$179.89$38.15$52.17t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s6 8Spending per capitaVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationNote: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).table 5a» Variation in spending per capita by local health area, 20065 Medical services from medical specialistsRegional variations in spending per capitaAfter we accounted for differences in population age, sex, and health status, there were very significant varia-tions in per capita government spending on medical specialist services across BC’s LHAs in 2006.In only 20 LHAs, spending per capita on medical spe-cialist services was either within 5% of, or not statisti-cally significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status.Levels of spending per capita on medical specialist services in LHAs within and around Vancouver and in the Greater Victoria LHA were significantly higher than predicted based on provincial averages.Gulf IslandsSaanichGreater VictoriaSookeNanaimoCowichanLadysmithLake CowichanIsland NorthQualicumAlberniCampbell RiverCourtenayKootenay LakeKamloopsGrand ForksRevelstokeArmstrongMerrittSummerlandEnderbyPrincetonCentral OkanaganPentictonSalmon ArmNelsonCastlegarKeremeosSouth CaribooTrailNorth ThompsonArrow LakesSouth Okanagan100 Mile HouseVernonLillooetKettle ValleyCariboo–ChilcotinCrestonKimberleyGoldenCranbrookWindermerePeace River SouthPrince GeorgeSmithersKitimatNechakoTerraceQuesnelPeace River NorthBurns LakeFort NelsonPrince Rupert$111$102$102$77$68$73$68$69$49$73$60$59$58$55$73$54$54$57$56$70$60$86$91$89$68$60$72$70$65$80$51$53$75$55$67$49$53$54$37$29$20$27$14$32$56$42$45$35$50$41$22$37$18$31$98$92$93$79$70$77$73$77$56$83$69$72$74$45$66$71$62$70$79$80$68$87$92$92$71$64$79$78$74$91$61$64$93$69$86$63$72$76$57$47$38$54$33$52$69$52$57$54$81$70$39$67$34$6212%10%9%-3%-3%-6%-7%-10%-13%-13%-14%-20%-25%20%9%0%0%0%0%0%0%-1%-1%-3%-5%-7%-9%-11%-13%-14%-17%-18%-21%-23%-25%-25%-30%-34%-43%-49%-66%-71%-85%0%-21%-23%-24%-43%-49%-54%-57%-59%-61%-69%New WestminsterBurnabySurreyLangleyDeltaCoquitlamHopeMissionAgassiz–HarrisonSouth Surrey–White RockMaple RidgeAbbotsfordChilliwackVancouver City CentreVancouver WestsideWest Van.–Bowen IslandVan. Downtown EastsideNorth VancouverVancouver MidtownVancouver North EastVancouver SouthRichmondPowell RiverSunshine CoastHowe Sound$102$85$78$69$84$74$66$67$68$87$80$67$62$123$111$113$143$92$96$81$89$80$73$79$50$86$73$72$64$78$69$81$77$53$89$85$77$73$95$87$89$119$80$84$75$83$76$70$87$6217%16%8%7%7%7%0%0%0%-2%-5%-14%-16%25%24%24%18%14%13%8%7%5%5%-9%-22%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h6 9Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 5d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 5C» Regional variation in spending per capita» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%20127131314Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita20127131314Users per 1,0008136141820Contacts per user74111121925Cost per contact201033673t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s7 0Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Users per 1,000 populationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvaluefor LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 5B» Variation in users of services per 1,000 population by local health area, 20065 Medical services from medical specialistsRegional variations in rate of useThere were significant variations in the number of recipients of medical specialist services per 1,000 residents across BC’s LHAs in 2006.In only eight LHAs, the number of recipients of medical specialist services per 1,000 residents was either within 5% of, or not statistically significantly different from, rates predicted based on provincial averages for popula-tions of the same age, sex, and health status.The numbers of recipients of medical specialist services per 1,000 residents in LHAs within and around Vancouver and in the Greater Victoria LHA were significantly higher than predicted based on provincial averages. Medical specialist service use in most Northern and Interior LHAs was well below rates predicted based on provincial averages.SaanichGreater VictoriaGulf IslandsNanaimoCowichanLadysmithLake CowichanSookeQualicumIsland NorthAlberniCampbell RiverCourtenayKootenay LakeKamloopsCentral OkanaganPentictonNelsonPrincetonSalmon ArmRevelstokeSummerlandEnderbyCastlegarKeremeos100 Mile HouseSouth CaribooArmstrongArrow LakesTrailNorth ThompsonVernonGrand ForksSouth OkanaganCariboo–ChilcotinMerrittLillooetKettle ValleyCrestonKimberleyGoldenCranbrookWindermereKitimatSmithersPrince GeorgeTerracePeace River SouthPeace River NorthNechakoQuesnelFort NelsonBurns LakePrince Rupert30429125724225024424422927519020418920819224125125019723621119623321919520920218820120122016521917420518619615715816714211713499208180169164127109106137901061042822712402492592542582463012142392382661692262732732202642362262712572362542482312492492732092812342782572732202242522192082422062432152202492011811792351562122177%7%7%-3%-3%-4%-6%-7%-9%-12%-16%-23%-25%12%7%-8%-9%-11%-11%-11%-14%-15%-16%-19%-20%-21%-21%-21%-21%-22%-24%-25%-29%-31%-32%-33%-34%-35%-41%-44%-57%-59%-74%-16%-18%-26%-42%-46%-51%-52%-54%-55%-69%-74%Agassiz–HarrisonBurnabyNew WestminsterSurreyLangleyDeltaCoquitlamSouth Surrey–White RockMaple RidgeAbbotsfordMissionChilliwackHopeWest Van.–Bowen IslandVancouver City CentreVancouver WestsideVan. Downtown EastsideNorth VancouverVancouver MidtownVancouver North EastVancouver SouthPowell RiverRichmondSunshine CoastHowe Sound24228530528226127024628624922421620122636228228127728225025625728023823317619624326125423625523329026225625123928028723523524725222823524326623026222521%16%16%10%10%6%5%-2%-5%-13%-15%-17%-22%23%18%18%12%11%9%9%6%5%4%-12%-25%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h7 1Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 5d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 5e» Regional variation in users of services per 1,000 population» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%8136141820Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita20127131314Users per 1,0008136141820Contacts per user74111121925Cost per contact201033673t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s7 2Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationContacts per usertable 5C» Variation in contacts per user of services by local health area, 20065 Medical services from medical specialistsRegional variations in contacts per userAfter we accounted for differences in population age, sex, and health status, the average number of contacts with medical specialists per user of these services varied widely across BC’s LHAs in 2006.Average number of contacts with medical specialists per user within only 11 LHAs was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status.Medical specialist contacts per user in Greater Victoria and in most LHAs within and around the city of Vancouver were significantly higher than predicted based on provincial averages.Medical specialist contacts per user in Northern and Interior LHAs were well below levels predicted.Gulf IslandsSaanichGreater VictoriaSookeAlberniCowichanNanaimoLake CowichanLadysmithCampbell RiverCourtenayQualicumIsland NorthKootenay LakeCastlegarPentictonKamloopsTrailCentral OkanaganSummerlandSouth OkanaganSalmon ArmNelsonVernonArmstrongPrincetonSouth CaribooKeremeosNorth ThompsonMerrittRevelstokeGrand ForksEnderby100 Mile HouseLillooetKettle ValleyCariboo–ChilcotinArrow LakesCrestonCranbrookGoldenKimberleyWindermerePrince GeorgeNechakoQuesnelPeace River SouthBurns LakeKitimatSmithersTerraceFort NelsonPeace River NorthPrince Rupert16%11%7%0%-12%-14%-17%-17%-18%-18%-24%-24%-28%0%0%-6%-7%-8%-9%-10%-18%-18%-19%-19%-20%-22%-23%-24%-26%-28%-30%-31%-31%-31%-33%-35%-41%-45%-49%-52%-54%-57%-70%-5%-18%-20%-23%-30%-33%-35%-38%-41%-43%-50%New WestminsterBurnabySurreyDeltaCoquitlamAgassiz–HarrisonMaple RidgeChilliwackLangleyAbbotsfordMissionSouth Surrey–White RockHopeVan. Downtown EastsideVancouver City CentreVancouver MidtownVancouver WestsideVancouver North EastVancouver SouthRichmondNorth VancouverWest Van.–Bowen IslandSunshine CoastHowe SoundPowell River9%5%3%0%0%0%-3%-6%-8%-8%-10%-13%-19%34%23%20%18%14%12%10%7%3%-18%-26%-31%4.34.04.03.63.43.33.23.13.23.23.13.22.73.13.63.83.23.83.53.53.53.23.13.53.23.23.03.02.82.82.92.93.02.82.72.93.02.62.52.52.22.21.83.93.23.33.03.02.52.62.92.22.32.43.63.53.73.63.83.83.83.73.83.94.04.13.63.23.94.13.44.23.93.94.13.83.74.33.94.03.83.83.63.73.94.04.03.83.84.04.54.14.04.33.73.93.74.13.94.03.84.13.43.74.23.43.64.04.03.73.63.63.53.53.73.73.23.63.63.53.35.94.74.44.24.04.13.83.73.63.32.83.03.73.53.43.63.53.43.83.93.53.93.94.04.04.23.73.63.53.53.63.43.53.54.03.64.1U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h7 3Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 5d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 5f» Regional variation in contacts per user of services» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%74111121925Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita20127131314Users per 1,0008136141820Contacts per user74111121925Cost per contact201033673t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s7 4Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Cost per contactVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 5d» Variation in cost per contact by local health area, 20065 Medical services from medical specialistsRegional variations in cost per contactAfter we accounted for differences in population age, sex, and health status, the average cost per contact with medical specialists varied moder-ately across BC’s LHAs in 2006.In 36 LHAs, the average cost per contact with medical specialists was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for popu-lations of the same age, sex, and health status. The costs per contact in rural LHAs were generally well above levels predicted based on provincial averages.Gulf IslandsCampbell RiverIsland NorthSookeLake CowichanCourtenayGreater VictoriaSaanichNanaimoCowichanLadysmithAlberniQualicumKettle ValleyLillooetSouth CaribooNorth ThompsonKeremeosPrincetonGrand ForksSouth OkanaganArrow LakesMerrittCastlegarCentral OkanaganSalmon Arm100 Mile HouseNelsonCariboo–ChilcotinRevelstokeTrailKamloopsKootenay LakeEnderbyPentictonArmstrong CrestonKimberleyVernonSummerlandWindermereCranbrookGoldenPrince RupertBurns LakeTerraceNechakoQuesnelSmithersKitimatPeace River NorthFort NelsonPrince GeorgePeace River South$101$98$94$93$91$89$87$84$87$87$87$87$84$117$115$114$112$111$112$107$107$103$103$101$103$101$98$99$99$96$94$94$92$92$92$89$90$91$87$85$77$79$78$125$115$104$103$91$89$88$86$91$85$84$88$88$87$87$87$87$87$85$87$88$86$88$87$89$89$89$87$88$89$88$88$87$87$88$90$89$88$89$90$89$88$88$86$87$89$89$89$90$90$89$90$92$92$88$87$89$90$88$90$89$87$91$88$8714%11%9%7%5%2%1%0%0%0%0%0%-3%28%25%25%25%24%23%19%19%17%16%14%13%13%11%11%9%7%7%7%6%6%4%0%0%0%-3%-4%-16%-16%-16%36%28%16%13%4%0%0%0%0%-3%-4%CoquitlamHopeSouth Surrey–White RockDeltaMaple RidgeMissionNew WestminsterAbbotsfordAgassiz–HarrisonBurnabyChilliwackLangleySurreyHowe SoundSunshine CoastVancouver WestsideVancouver City CentreNorth VancouverRichmondWest Van.–Bowen IslandVancouver MidtownVan. Downtown EastsideVancouver SouthPowell RiverVancouver North East$87$87$87$85$87$86$83$83$80$81$83$81$78$102$102$94$93$89$88$87$88$88$85$86$79$87$89$87$87$89$88$87$89$86$87$90$88$86$88$89$87$88$87$86$86$87$89$86$90$850%0%0%-2%-2%-3%-5%-7%-7%-7%-8%-8%-10%15%13%8%6%2%2%0%0%-1%-1%-5%-7%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h7 5Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 5d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 5G» Regional variation in cost per contact» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%201033673Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita20127131314Users per 1,0008136141820Contacts per user74111121925Cost per contact201033673t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s7 6Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Summary of measures of deviationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthSpendingpercapitaUsersper1,000Local health areaLocal health areaSpendingpercapitaContactsperuserCostpercontactUsersper1,000ContactsperuserCostpercontacttable 5e» Regional variation» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 20065 Medical services from medical specialistsMeasures of deviationAfter we accounted for differences in population age, sex, and health status, variations across BC’s LHAs in spending per capita on medical specialist services tended to result from a combination of the number of users of medical specialist services per 1,000 residents and the average number of contacts with medical specialists per user.The effects of regional variations in the use of and contact with medical specialists interacted with frequently opposite variations in the cost per contact with medical specialists.Gulf IslandsSaanichGreater VictoriaSookeNanaimoCowichanLadysmithLake CowichanIsland NorthQualicumAlberniCampbell RiverCourtenayKootenay LakeKamloopsGrand ForksMerrittRevelstokeEnderbyArmstrongSummerlandPrincetonCentral OkanaganPentictonSalmon ArmNelsonCastlegarKeremeosSouth CaribooTrailNorth ThompsonArrow LakesSouth Okanagan100 Mile HouseVernonLillooetKettle ValleyCariboo–ChilcotinCrestonKimberleyGoldenCranbrookWindermerePeace River SouthPrince GeorgeSmithersKitimatNechakoTerraceQuesnelPeace River NorthBurns LakeFort NelsonPrince RupertNew WestminsterBurnabySurreyLangleyDeltaCoquitlamHopeMissionAgassiz–HarrisonSouth Surrey–White RockMaple RidgeAbbotsfordChilliwackVancouver City CentreVancouver WestsideWest Van.–Bowen IslandVan. Downtown EastsideNorth VancouverVancouver MidtownVancouver North EastVancouver SouthRichmondPowell RiverSunshine CoastHowe Sound17%16%8%7%7%7%0%0%0%-2%-5%-14%-16%25%24%24%18%14%13%8%7%5%5%-9%-22%9%5%3%-8%0%0%-19%-10%0%-13%-3%-8%-6%23%18%3%34%7%20%14%12%10%-31%-18%-26%-5%-7%-10%-8%-2%0%0%-3%-7%0%-2%-7%-8%6%8%0%-1%2%0%-7%-1%2%-5%13%15%16%16%10%10%6%5%-22%-15%21%-2%-5%-13%-17%18%18%23%12%11%9%9%6%4%5%-12%-25%12%10%9%-3%-3%-6%-7%-10%-13%-13%-14%-20%-25%20%9%0%0%0%0%0%0%-1%-1%-3%-5%-7%-9%-11%-13%-14%-17%-18%-21%-23%-25%-25%-30%-34%-43%-49%-66%-71%-85%0%-21%-23%-24%-43%-49%-54%-57%-59%-61%-69%16%11%7%0%-17%-14%-18%-17%-28%-24%-12%-18%-24%0%-7%-31%-28%-30%-31%-20%-10%-22%-9%-6%-18%-19%0%-24%-23%-8%-26%-45%-18%-31%-19%-33%-35%-41%-49%-57%-54%-52%-70%-23%-5%-35%-33%-18%-38%-20%-43%-30%-41%-50%7%7%7%-7%-3%-3%-4%-6%-12%-9%-16%-23%-25%12%7%-29%-33%-14%-16%-21%-15%-11%-8%-9%-11%-11%-19%-20%-21%-22%-24%-21%-31%-21%-25%-34%-35%-32%-41%-44%-57%-59%-74%-46%-26%-18%-16%-52%-42%-54%-51%-69%-55%-74%14%0%1%7%0%0%0%5%9%-3%0%11%2%6%7%19%16%7%6%0%-4%23%13%4%13%11%14%24%25%7%25%17%19%11%-3%25%28%9%0%0%-16%-16%-16%-4%-3%0%0%13%16%4%0%28%0%36%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h7 7Hospital servicesInpatient care and day procedures6t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s7 8Introductionfigure 6a» Spending per capita in BC, by age group, 20066 Hospital services: inpatient care and day proceduresNumberof peopleAge group0-9Numberof peopleAge group361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,96210-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population30022515075$2,500$1,875$1,250$625$2,440.5713132719985111166239271$325.13$411.35 $374.38$532.93$913.85$1,664.86$159.52$398.27Total spending in BC: $2.35-billionSpending per capita in BC: $597.34Users of services per 1,000 pop. in BC: 112Spending per user of services in BC: $5,311.59Days per user of services in BC: 5.8Average cost per day in BC: $912.85Included in this analysisThis analysis includes all inpatient care and day procedures received by BC residents in BC hospitals during the fiscal year 2005/06. This does not include emergency care that did not result in admission to the hospital or the cost of long-term care.U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h7 9figure 6B» Users per 1,000 population in BC, by age group, 2006Overall spending and useThe BC government spent approximately $2.35 billion, or $597 per capita, on all inpatient care and day proce-dures received by BC residents in BC hospitals.Overall, approximately 11% of BC residents received some form of hospital-based care.On average, BC residents who received hospital-based care were in hospital for an average of 5.8 days. The average cost per day of care was $913.Spending and use by ageAverage levels of government spending per capita for inpatient care and hospital day procedures varied by approximately 1,500% across age groups. The cost of hospital-based care ranged from a low of $160 per resident aged 10–19 to a high of $2,441 per resident aged 80 and older.Average per capita government spending on hospital-based care was varied but comparable across adult age groups up to 50–59 years of age. Spending per resident then increased by 40–80% across each successive 10-year age group. The age gradient in the rate of use of inpatient care and day procedures was is not as steep as the gradient for spending on this type of care.The number of users of hospital-based care per 1,000 residents in each age group varied by approximately 800%, from a low of 32 users per 1,000 residents aged 10–19 to a high of 271 users per 1,000 residents aged 80 and older.Numberof peopleAge group0-9Numberof peopleAge group361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,96210-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population30022515075$2,500$1,875$1,250$625$2,440.5713132719985111166239271$325.13$411.35 $374.38$532.93$913.85$1,664.86$159.52$398.27t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s8 0Spending per capitaVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationNote: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).table 6a» Variation in spending per capita by local health area, 20066 Hospital services: inpatient care and day proceduresRegional variations in spending per capitaThere were significant variations across BC’s LHAs in per capita government spending on all inpatient care and day procedures received during the 2005/06 fiscal year, even after we accounted for differences in popula-tion age, sex, and health status.In 31 LHAs, spending per capita on hospital-based care was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status.The levels of spending per capita on hospital-based care among LHAs around the city of Vancouver were well below levels predicted based on provincial averages.Campbell RiverAlberniNanaimoSookeLadysmithCowichanCourtenaySaanichGulf IslandsLake CowichanIsland NorthGreater VictoriaQualicumTrailCrestonCariboo–Chilcotin100 Mile HouseCastlegarCranbrookWindermereKamloopsKimberleyRevelstokeGrand ForksSalmon ArmNelsonPentictonSouth OkanaganSummerlandSouth CaribooGoldenCentral OkanaganArmstrongKootenay LakeArrow LakesKettle ValleyKeremeosPrincetonNorth ThompsonLillooetMerrittEnderbyVernonNechakoPrince RupertKitimatQuesnelBurns LakePeace River SouthSmithersTerracePeace River NorthPrince GeorgeFort Nelson$665$711$709$551$810$628$584$648$626$643$743$736$769$771$780$583$693$623$635$527$661$748$545$606$666$595$754$783$658$586$574$620$606$688$730$701$687$833$825$669$600$582$668$681$720$790$756$747$625$637$746$468$650$487$565$620$650$516$771$604$570$646$582$573$583$748$795$564$591$443$528$489$504$420$528$598$443$497$547$490$644$699$593$529$536$582$595$471$634$588$588$649$630$595$537$569$731$452$510$563$542$549$475$486$571$383$568$38216%14%9%6%5%4%2%0%0%0%0%-2%-3%31%28%28%27%24%23%23%22%22%21%20%20%19%16%11%10%10%7%6%2%0%0%0%0%0%0%0%0%0%-9%41%35%34%33%31%27%27%27%20%0%0%Agassiz–HarrisonChilliwackMissionHopeLangleyAbbotsfordMaple RidgeNew WestminsterSurreyDeltaCoquitlamSouth Surrey–White RockBurnabyPowell RiverHowe SoundSunshine CoastVan. Downtown EastsideNorth VancouverVancouver MidtownVancouver WestsideWest Van.–Bowen IslandVancouver City CentreVancouver SouthRichmondVancouver North East$529$558$577$596$551$515$574$680$516$499$498$646$490$821$540$747$1,116$546$635$560$580$667$527$441$514$370$494$518$552$525$491$555$692$540$502$516$689$594$706$511$717$1,142$597$721$649$684$789$658$550$64236%12%11%8%5%5%3%0%0%-1%-4%-6%-19%15%5%0%-2%-9%-13%-15%-16%-17%-22%-22%-22%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h8 1Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 6d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 6C» Regional variation in spending per capita» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%1213125631Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHADays per user55461733Cost per day-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%11542192Spending per capita1213125631Users per 1,0001713206518t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s8 2Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Users per 1,000 populationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvaluefor LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 6B» Variation in users of services per 1,000 population by local health area, 20066 Hospital services: inpatient care and day proceduresRegional variations in rate of useAfter we accounted for differences in population age, sex, and health status, there were significant variations across BC’s LHAs in the number of users of hospital-based care per 1,000 residents in the 2005/06 fiscal year.The rate of hospital services in only 18 LHAs use was either within 5% of, or not statistically significantly different from, rates predicted based on provincial averages for populations of the same age, sex, and health status.Hospital service use in many Vancouver Coastal LHAs was well below rates predicted based on provincial averages. After we accounted for differences in popula-tion age, sex, and health status, use of hospital services was most common among residents of Northern LHAs.Island NorthCampbell RiverAlberniLake CowichanNanaimoGulf IslandsSookeCourtenayCowichanLadysmithSaanichGreater VictoriaQualicumKootenay LakeTrailCariboo–ChilcotinCreston100 Mile HouseCastlegarNorth ThompsonPrincetonCranbrookKamloopsKimberleyWindermereGrand ForksSalmon ArmRevelstokeNelsonPentictonKettle ValleyKeremeosSouth OkanaganArrow LakesSouth CaribooMerrittSummerlandLillooetCentral OkanaganGoldenArmstrongEnderbyVernonNechakoQuesnelKitimatPrince RupertBurns LakeTerraceSmithersPeace River SouthFort NelsonPeace River NorthPrince George1241311261251241271141261231261291181321251661451571531381281501321331301161361401241251481231421481281281311321191271031091191091361451451401421431341199911011710011211211311611910812111912312712213889120107118115108101119105106105941111141021041261051221321141151171191081191001101171239110410510110610910292819110422%15%12%10%6%6%5%4%3%0%0%-3%-4%34%33%31%29%29%24%23%23%23%23%22%21%20%20%20%19%16%16%15%12%11%11%11%10%10%6%0%0%0%-12%39%33%32%32%29%27%27%25%21%19%12%Agassiz–HarrisonChilliwackMissionHopeAbbotsfordLangleyMaple RidgeNew WestminsterDeltaCoquitlamSouth Surrey–White RockSurreyBurnabyPowell RiverSunshine CoastHowe SoundVan. Downtown EastsideNorth VancouverVancouver MidtownVancouver WestsideWest Van.–Bowen IslandVancouver City CentreRichmondVancouver SouthVancouver North East140129126136124115118117113100131106921441251071051039192110928287859711311112411510811311911110313611011212312010311311410610813011210411010937%14%13%10%7%6%5%0%0%-3%-4%-5%-19%15%4%4%-8%-10%-16%-16%-16%-19%-24%-24%-24%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h8 3Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 6d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 6e» Regional variation in users of services per 1,000 population» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%1713206518Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHADays per user55461733Cost per day-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%11542192Spending per capita1213125631Users per 1,0001713206518t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s8 4Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 6C» Variation in days per user of services by local health area, 2006Days per user6 Hospital services: inpatient care and day proceduresRegional variations in days of hospital careAfter we accounted for differences in population age, sex, and health status, the average number of days in hospital per user of inpatient care or hospital day procedures varied moderately across BC’s LHAs in the 2005/06 fiscal year.In 46 LHAs, the average number of days of hospital-based care per user of these services was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status. Average lengths of stay in hospital for patients from the cities of Vancouver and Victoria were notably higher than predicted based on provincial averages.Island NorthGreater VictoriaSookeSaanichGulf IslandsLake CowichanLadysmithAlberniCampbell RiverCowichanNanaimoCourtenayQualicumNorth ThompsonCranbrookKimberleyWindermereCrestonKootenay LakeNelsonCastlegarArrow LakesGrand ForksKettle ValleySouth OkanaganKeremeosPrincetonGoldenRevelstokeArmstrongVernonKamloops100 Mile HouseLillooetSouth CaribooMerrittEnderbyCentral OkanaganSalmon ArmPentictonTrailSummerlandCariboo–ChilcotinFort NelsonBurns LakeNechakoPeace River SouthPrince GeorgeQuesnelPrince RupertSmithersPeace River NorthKitimatTerrace34%14%0%0%0%0%0%0%0%-7%-9%-10%-14%21%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%-5%-11%-12%-14%-15%-17%38%21%20%16%10%0%0%0%0%0%0%New WestminsterSurreyHopeLangleyBurnabyMaple RidgeCoquitlamChilliwackMissionAbbotsfordDeltaSouth Surrey–White RockAgassiz–HarrisonVan. Downtown EastsideVancouver MidtownVancouver North EastVancouver City CentreVancouver WestsideVancouver SouthRichmondNorth VancouverSunshine CoastPowell RiverHowe SoundWest Van.–Bowen Island11%3%0%0%0%0%0%-9%-10%-12%-13%-14%-22%40%17%13%13%0%0%-5%-8%-9%-9%-12%-22%7.57.65.55.95.75.06.66.25.35.65.65.45.46.65.76.55.35.75.95.65.25.65.16.35.95.25.75.94.75.66.35.35.15.74.95.05.15.75.25.85.25.54.46.36.56.16.26.15.45.24.95.35.15.35.36.65.46.16.25.66.25.85.46.06.15.96.25.35.56.25.16.05.85.85.66.25.65.56.35.96.05.35.35.86.45.55.55.45.55.65.75.95.86.56.06.45.24.35.35.05.25.55.14.95.04.94.75.36.85.55.75.76.25.85.35.25.15.14.85.84.410.87.06.57.45.96.25.35.36.16.04.45.16.15.36.35.76.05.65.35.75.65.75.56.75.57.35.95.76.56.16.05.65.76.66.65.06.4U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h8 5Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 6d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 6f» Regional variation in days per user of services» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson5546173-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%3Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHADays per user55461733Cost per day-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%11542192Spending per capita1213125631Users per 1,0001713206518t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s8 6Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 6d» Variation in cost per day by local health area, 2006Cost per day6 Hospital services: inpatient care and day proceduresRegional variations in cost per dayAfter we accounted for differences in population age, sex, and health status, the average cost per day of hospital-based care varied moderately across BC’s LHAs in the 2005/06 fiscal year.In 42 LHAs, the average cost per day of hospital-based care was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status.Average costs per day of hospital care in LHAs around the city of Vancouver were above levels predicted based on provincial averages.QualicumNanaimoLadysmithCampbell RiverAlberniCowichanLake CowichanSookeSaanichCourtenayGulf IslandsGreater VictoriaIsland NorthVernonKamloopsKimberleyRevelstokeSalmon ArmSouth OkanaganSummerlandSouth CaribooGoldenArmstrongKootenay LakeArrow LakesKeremeosPrincetonNorth ThompsonLillooetMerrittEnderbyCariboo–ChilcotinTrailPentictonCastlegarCentral Okanagan100 Mile HouseCranbrookKettle ValleyGrand ForksCrestonNelsonWindermereKitimatTerracePrince RupertQuesnelSmithersPrince GeorgePeace River SouthNechakoBurns LakePeace River NorthFort Nelson$1,076$1,019$965$952$914$920$1,028$883$858$869$872$825$801$973$931$880$928$913$899$904$938$948$990$928$1,018$935$966$979$994$919$954$922$894$879$871$864$882$847$904$877$869$845$855$1,080$990$989$963$960$914$852$822$808$805$783$951$918$904$938$919$927$973$906$886$912$916$871$927$928$925$911$935$935$925$902$944$949$957$980$979$939$914$958$911$941$953$954$936$926$934$928$950$921$983$955$947$924$971$978$921$923$977$939$921$939$914$930$932$94012%10%7%0%0%0%0%-3%-3%-5%-5%-5%-15%5%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%-3%-5%-5%-7%-7%-7%-8%-8%-9%-9%-9%-13%10%7%7%0%0%0%-10%-11%-14%-15%-18%MissionDeltaCoquitlamSurreyNew WestminsterBurnabySouth Surrey–White RockLangleyChilliwackMaple RidgeAbbotsfordAgassiz–HarrisonHopeHowe SoundVancouver WestsideWest Van.–Bowen IslandVancouver MidtownRichmondVan. Downtown EastsideVancouver City CentreVancouver SouthNorth VancouverSunshine CoastPowell RiverVancouver North East$901$920$938$893$852$855$849$850$829$833$824$859$762$1,132$1,026$1,025$997$1,022$985$973$981$1,003$989$958$923$926$925$928$919$885$893$897$910$914$921$912$960$932$951$879$904$893$918$894$889$897$919$915$921$8930%0%0%-3%-4%-4%-5%-7%-10%-10%-10%-11%-20%17%15%13%11%11%10%9%9%9%8%4%3%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h8 7Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 6d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 6G» Regional variation in cost per day» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson11542192-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHADays per user55461733Cost per day-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%11542192Spending per capita1213125631Users per 1,0001713206518t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s8 8Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Summary of measures of deviationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthSpendingpercapitaUsersper1,000Local health areaLocal health areaSpendingpercapitaUsersper1,000table 6e» Regional variation» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006CostperdayDaysperuserCostperdayDaysperuser6 Hospital services: inpatient care and day proceduresMeasures of deviationAfter we accounted for differences in population age, sex, and health status, variations across BC’s LHAs in spending per capita on hospital-based care was driven almost entirely by variation in the number of residents who received inpatient care or hospital day procedures per 1,000 residents.Variations in likelihood of use of hospital-based care interacted with average costs per day of care received, variations that were often in opposite directions.Campbell RiverAlberniNanaimoSookeLadysmithCowichanCourtenaySaanichLake CowichanGulf IslandsIsland NorthGreater VictoriaQualicumTrailCrestonCariboo–Chilcotin100 Mile HouseCastlegarCranbrookWindermereKamloopsKimberleyRevelstokeGrand ForksSalmon ArmNelsonPentictonSouth OkanaganSummerlandSouth CaribooGoldenCentral OkanaganArmstrongNorth ThompsonKootenay LakePrincetonKeremeosArrow LakesMerrittLillooetEnderbyKettle ValleyVernonNechakoPrince RupertKitimatQuesnelBurns LakePeace River SouthSmithersTerracePeace River NorthPrince GeorgeFort NelsonAgassiz–HarrisonChilliwackMissionHopeLangleyAbbotsfordMaple RidgeSurreyNew WestminsterDeltaCoquitlamSouth Surrey–White RockBurnabyPowell RiverHowe SoundSunshine CoastVan. Downtown EastsideNorth VancouverVancouver MidtownVancouver WestsideWest Van.–Bowen IslandVancouver City CentreVancouver SouthRichmondVancouver North East36%12%11%8%5%5%3%0%0%-1%-4%-6%-19%15%5%0%-2%-9%-13%-15%-16%-17%-22%-22%-22%-22%-9%-10%0%0%-12%0%3%11%-13%0%-14%0%-9%-12%-9%40%-8%17%0%-22%13%0%-5%13%-11%-10%0%-20%-7%-10%-10%-3%-4%0%0%-5%-4%4%17%8%10%9%11%15%13%9%9%11%3%37%14%13%10%6%7%5%-5%0%0%-3%-4%-19%15%4%4%-8%-10%-16%-16%-16%-19%-24%-24%-24%16%14%9%6%5%4%2%0%0%0%0%-2%-3%31%28%28%27%24%23%23%22%22%21%20%20%19%16%11%10%10%7%6%2%0%0%0%0%0%0%0%0%0%-9%41%35%34%33%31%27%27%27%20%0%0%0%0%-9%0%0%-7%-10%0%0%0%34%14%-14%-14%0%-17%0%0%0%0%0%0%0%0%-11%0%-12%0%-15%0%0%-5%0%21%0%0%0%0%0%0%0%0%0%20%0%0%0%21%16%0%0%0%10%38%15%12%6%5%0%3%4%0%10%6%22%-3%-4%33%29%31%29%24%23%21%23%22%20%20%20%19%16%12%10%11%0%6%0%23%34%23%15%11%11%10%0%16%-12%39%32%32%33%29%25%27%27%19%12%21%0%0%10%-3%7%0%-5%-3%0%-5%-15%-5%12%-5%-9%-3%-7%-7%-8%-13%0%0%0%-9%0%-9%-5%0%0%0%0%-7%0%0%0%0%0%0%0%0%0%-8%5%-11%7%10%0%-14%-10%0%7%-15%0%-18%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h8 97Inpatient careHospital servicest h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s9 0Introductionfigure 7a» Spending per capita in BC, by age group, 20067 Hospital services: inpatient careNumberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population20015010050$2,500$1,875$1,250$625361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$2,183.66105184764364368114170$288.43$359.47 $301.35$420.13$727.53$1,383.36$135.73$353.41Total spending in BC: $1.98-billionSpending per capita in BC: $502.26Users of services per 1,000 pop. in BC: 60Spending per user of services in BC: $8,335.37Days per user of services in BC: 9.6Average cost per day in BC: $867.71Included in this analysisThis analysis includes all inpatient care received by BC residents in BC hospitals during the fiscal year 2005/06. This does not include emergency care that did not result in admission to the hospital or the cost of long-term care.U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h9 1figure 7B» Users per 1,000 population in BC, by age group, 2006Overall spending and useThe BC government spent approximately $1.98 billion, or $502 per capita, on inpatient care received by BC residents in BC hospitals.Overall, approximately 6% of BC residents received some form of inpatient care.BC residents who received inpatient care were in hospital for an average of 9.6 days. The average cost per day of care was $868.Spending and use by ageAverage levels of government spending per capita for inpatient care varied by approximately 1,600% across age groups. The cost of inpatient care ranged from a low of $136 per resident aged 10–19 to a high of $2,184 per resident aged 80 and older.Average per capita government spending on inpatient care was varied but comparable across adult age groups up to 50–59. Spending per resident then increased by 60–90% across each successive 10-year age group.Differences in the rate of use of inpatient care across age groups up to 50–59 years of age were greater than differences in spending per capita in these age groups; however, the age gradient for rates of use of inpatient care across subsequent age groups was not as steep as the gradient for spending on this type of care across those age groups.The number of users of inpatient care per 1,000 resi-dents in each age group varied by nearly 1,000%, from a low of 18 users per 1,000 residents aged 10–19 to a high of 170 users per 1,000 residents aged 80 and older.Numberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population20015010050$2,500$1,875$1,250$625361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$2,183.66105184764364368114170$288.43$359.47 $301.35$420.13$727.53$1,383.36$135.73$353.41t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s9 2Spending per capitaVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationNote: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).table 7a» Variation in spending per capita by local health area, 20067 Hospital services: inpatient careRegional variations in spending per capitaAfter we accounted for differences in population age, sex, and health status, there were significant variations across BC’s LHAs in government spending per capita on inpatient care during the 2005/06 fiscal year.Variations in spending per capita on inpatient care distinguished southwestern urban and suburban areas from the rest of the province.With the exceptions of Vancouver Downtown Eastside and Sunshine Coast, spending per capita on inpatient care among Vancouver Coastal LHAs was below levels predicted based on provincial averages for populations of the same age, sex, and health status. In contrast, spending in many Northern and Interior LHAs was above levels predicted based on provincial averages.Island NorthLake CowichanGulf IslandsNanaimoSookeCowichanGreater VictoriaCourtenayLadysmithAlberniCampbell RiverSaanichQualicumKootenay LakeWindermereGoldenKettle ValleyCrestonPrincetonKimberleyCranbrook100 Mile HouseArrow LakesGrand ForksTrailRevelstokeCastlegarSalmon ArmNelsonMerrittCariboo–ChilcotinPentictonCentral OkanaganLillooetKeremeosArmstrongEnderbySouth OkanaganVernonKamloopsNorth ThompsonSouth CaribooSummerlandFort NelsonNechakoKitimatBurns LakeQuesnelPeace River NorthSmithersPrince GeorgeTerracePrince RupertPeace River South$659$544$529$600$469$535$647$483$697$620$546$543$641$586$469$529$603$675$694$663$549$573$622$502$636$445$506$531$495$501$479$589$535$565$510$488$467$607$560$550$732$480$500$446$589$666$636$637$406$537$560$621$588$547$456$430$424$518$407$473$620$477$625$489$486$544$655$362$311$362$423$477$494$497$414$432$470$380$481$346$411$440$410$426$409$519$472$499$459$440$426$572$549$467$491$429$492$278$368$440$430$476$307$418$477$549$428$39137%24%22%15%14%12%4%1%0%0%0%0%-2%48%41%38%35%35%34%29%28%28%28%28%28%25%21%19%19%16%16%13%12%12%11%10%9%6%2%0%0%0%0%47%47%41%39%29%28%25%16%12%0%0%Agassiz–HarrisonHopeChilliwackMissionAbbotsfordLangleyCoquitlamBurnabyMaple RidgeNew WestminsterSurreyDeltaSouth Surrey–White RockVan. Downtown EastsideSunshine CoastPowell RiverHowe SoundVancouver MidtownNorth VancouverVancouver North EastVancouver City CentreVancouver SouthRichmondVancouver WestsideWest Van.–Bowen Island$400$477$449$477$420$453$413$414$475$585$430$398$524$1,035$627$681$442$556$444$438$580$447$364$465$461$291$439$419$460$414$450$450$495$485$602$460$434$604$933$585$641$447$602$507$528$700$544$446$583$60932%8%7%4%1%1%0%0%-2%-3%-7%-9%-14%10%7%0%-1%-8%-13%-19%-19%-19%-20%-23%-28%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h9 3Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 7d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 7C» Regional variation in spending per capita» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%10201555123Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita10201555123Users per 1,00010232065213Days per user194017912Cost per day11543182t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s9 4Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Users per 1,000 populationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvaluefor LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 7B» Variation in users of services per 1,000 population by local health area, 20067 Hospital services: inpatient careRegional variations in rate of useAfter we accounted for differences in population age, sex, and health status, there were significant variations across BC’s LHAs in the number of users of inpatient care per 1,000 residents in the 2005/06 fiscal year.The pattern of use of inpatient care distinguished southwestern urban and suburban areas from the rest of the province.The numbers of recipients of inpatient care per 1,000 residents among most LHAs within the city of Vancouver were below rates predicted based on provincial averages for populations of the same age, sex, and health status. In contrast, rates of use in many Northern and Interior LHAs were well above predic-tions based on provincial averages.Island NorthLake CowichanGulf IslandsAlberniSookeNanaimoCowichanCampbell RiverLadysmithGreater VictoriaCourtenaySaanichQualicumKootenay LakeWindermereGoldenCrestonKettle ValleyNorth ThompsonPrincetonGrand Forks100 Mile HouseTrailKimberleyCranbrookArrow LakesRevelstokeCastlegarSalmon ArmNelsonMerrittCariboo–ChilcotinKamloopsPentictonCentral OkanaganKeremeosSouth CaribooEnderbyArmstrongSouth OkanaganVernonLillooetSummerlandNechakoFort NelsonKitimatBurns LakePeace River SouthPrince RupertPeace River NorthQuesnelSmithersPrince GeorgeTerrace75737572667070646968646467727378907475827577857273777070716672686576736763696473686062777277776870687170646452575957576162586266626469454853625253585557635455585457585561575666646055615867665561494652535052515455565836%24%23%22%14%14%13%10%10%3%3%0%0%46%41%37%37%37%36%34%30%29%29%28%28%28%25%21%20%18%17%17%15%14%13%12%12%12%11%8%3%0%0%46%45%40%37%31%29%28%28%24%14%11%Agassiz–HarrisonHopeChilliwackMissionAbbotsfordLangleyMaple RidgeNew WestminsterSurreyDeltaCoquitlamSouth Surrey–White RockBurnabySunshine CoastVan. Downtown EastsidePowell RiverHowe SoundVancouver MidtownNorth VancouverVancouver North EastVancouver SouthVancouver City CentreRichmondVancouver WestsideWest Van.–Bowen Island687166646760606357555064516666685653524848504345504963616164596165625955726161626458596059606254586733%12%8%5%3%0%0%-3%-7%-8%-9%-12%-17%7%6%6%0%-10%-15%-20%-21%-22%-22%-26%-29%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h9 5Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 7d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 7e» Regional variation in users of services per 1,000 population» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%10232065213Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita10201555123Users per 1,00010232065213Days per user194017912Cost per day11543182t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s9 6Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 7C» Variation in days per user of services by local health area, 2006Days per user7 Hospital services: inpatient careRegional variations in days of hospital careAfter we accounted for differences in population age, sex, and health status, the average number of days within hospital per user of inpatient care varied moder-ately across BC’s LHAs in the 2005/06 fiscal year.In 40 LHAs, the average number of days of inpatient care per user of these services was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status. Lengths of stay in hospital for patients from LHAs within the cities of Vancouver and Victoria were notably higher than predicted based on provincial averages.Island NorthGreater VictoriaSookeSaanichLadysmithAlberniCampbell RiverCourtenayQualicumCowichanNanaimoLake CowichanGulf IslandsLillooetCranbrookKimberleyKootenay LakeNelsonCastlegarKettle ValleySouth OkanaganKeremeosPrincetonGoldenArmstrongKamloopsNorth ThompsonSouth CaribooSummerlandVernonCentral OkanaganCariboo–Chilcotin100 Mile HousePentictonCrestonSalmon ArmWindermereTrailMerrittRevelstokeGrand ForksEnderbyArrow LakesPeace River SouthPrince GeorgeQuesnelPrince RupertSmithersBurns LakeNechakoPeace River NorthKitimatFort NelsonTerrace26%11%0%0%0%0%0%-10%-14%-15%-15%-22%-23%1%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%-10%-11%-12%-12%-12%-12%-14%-15%-17%-17%-18%-19%-21%-26%11%9%0%0%0%0%0%0%0%0%0%New WestminsterMaple RidgeSurreyCoquitlamBurnabyHopeLangleyMissionChilliwackDeltaAbbotsfordSouth Surrey–White RockAgassiz–HarrisonVan. Downtown EastsideVancouver MidtownVancouver City CentreVancouver North EastVancouver WestsideVancouver SouthPowell RiverHowe SoundRichmondNorth VancouverSunshine CoastWest Van.–Bowen Island14%9%7%6%5%0%0%0%-7%-8%-10%-10%-24%31%16%15%13%4%4%0%0%-5%-5%-12%-16%11.412.18.510.410.99.89.49.19.28.68.87.68.69.99.010.69.29.48.89.410.39.19.27.38.59.510.28.510.19.28.87.88.89.88.88.87.68.77.97.38.07.78.29.89.99.59.08.310.89.67.78.38.210.18.910.88.710.510.510.09.510.010.610.010.29.410.89.89.410.810.09.99.89.010.910.210.68.49.39.49.29.411.210.19.88.89.911.110.010.08.810.39.48.79.79.510.78.89.18.98.98.49.78.47.88.66.89.311.310.08.89.210.09.69.48.68.88.48.110.37.416.311.012.610.410.610.011.17.38.79.110.19.79.99.28.28.69.510.99.39.19.59.18.911.49.411.99.310.99.110.29.611.38.09.29.611.411.4U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h9 7Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 1d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 7f» Regional variation in days per user of services» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson19401791-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%2Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita10201555123Users per 1,00010232065213Days per user194017912Cost per day11543182t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s9 8Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 7d» Variation in cost per day by local health area, 2006Cost per day7 Hospital services: inpatient careRegional variations in cost per dayAfter we accounted for differences in population age, sex, and health status, the average cost per day of inpatient care varied moderately across BC’s LHAs in the 2005/06 fiscal year.In 43 LHAs, the average cost per day of inpatient care was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status.The costs per day of inpatient care in most Vancouver Coastal LHAs were above levels predicted based on provincial averages.QualicumNanaimoLadysmithSookeSaanichGulf IslandsCowichanLake CowichanAlberniCampbell RiverCourtenayGreater VictoriaIsland NorthKimberleyKootenay LakeArrow LakesTrailGrand ForksKettle ValleyKeremeosPrincetonGoldenRevelstokeArmstrongVernonKamloopsNorth ThompsonCariboo–ChilcotinLillooetSouth CaribooMerrittSummerlandEnderbySalmon ArmCranbrookCentral Okanagan100 Mile HouseCrestonCastlegarSouth OkanaganWindermereNelsonPentictonKitimatTerracePrince RupertQuesnelSmithersPrince GeorgePeace River SouthNechakoBurns LakePeace River NorthFort Nelson$1,032$977$926$840$816$826$880$987$883$901$826$788$769$868$891$982$861$844$866$829$913$927$875$893$896$895$957$906$955$901$875$801$873$848$828$836$854$850$824$808$848$799$789$1,051$956$934$935$930$880$821$793$765$772$757$902$877$858$864$838$870$883$926$879$891$865$832$884$869$935$941$890$906$936$887$864$909$885$907$884$877$911$895$866$894$899$854$907$886$874$884$904$900$885$878$924$875$880$930$872$874$935$895$882$897$874$882$891$89813%11%8%0%0%0%0%0%0%0%-5%-5%-14%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%-4%-5%-5%-6%-6%-7%-8%-9%-9%-11%12%9%7%0%0%0%-9%-10%-14%-14%-17%CoquitlamDeltaMissionSurreyNew WestminsterBurnabySouth Surrey–White RockLangleyMaple RidgeAbbotsfordChilliwackAgassiz–HarrisonHopeHowe SoundVancouver WestsideWest Van.–Bowen IslandVancouver MidtownVan. Downtown EastsideRichmondVancouver City CentreVancouver SouthSunshine CoastNorth VancouverVancouver North EastPowell River$901$869$871$847$814$809$798$801$785$775$776$792$698$1,080$967$956$953$961$964$928$927$938$939$870$908$879$874$880$873$840$847$845$861$874$865$866$911$886$909$832$851$854$864$870$850$853$872$873$849$8702%0%0%-3%-3%-5%-6%-7%-11%-11%-11%-14%-24%17%15%12%11%11%10%9%8%7%7%2%0%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h9 9Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 7d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 7G» Regional variation in cost per day» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson11543182-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita10201555123Users per 1,00010232065213Days per user194017912Cost per day11543182t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 0 0Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Summary of measures of deviationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthSpendingpercapitaUsersper1,000Local health areaLocal health areaSpendingpercapitaUsersper1,000table 7e» Regional variation» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006CostperdayDaysperuserCostperdayDaysperuser7 Hospital services: inpatient careMeasures of deviationAfter we accounted for differences in population age, sex, and health status, variation across BC’s LHAs in spending per capita on inpatient care was driven almost entirely by variation in the number of residents who received inpatient care per 1,000 residents.Variations in likelihood of use of inpatient care interacted with average costs per day of care received, variations that were often in opposite directions.Island NorthLake CowichanGulf IslandsNanaimoSookeCowichanGreater VictoriaCourtenayLadysmithAlberniCampbell RiverSaanichQualicumKootenay LakeWindermereGoldenKettle ValleyCrestonPrincetonKimberleyCranbrook100 Mile HouseArrow LakesGrand ForksTrailRevelstokeCastlegarSalmon ArmNelsonMerrittCariboo–ChilcotinPentictonCentral OkanaganLillooetKeremeosArmstrongEnderbySouth OkanaganVernonNorth ThompsonKamloopsSouth CaribooSummerlandFort NelsonNechakoKitimatBurns LakeQuesnelPeace River NorthSmithersPrince GeorgeTerracePrince RupertPeace River SouthAgassiz–HarrisonHopeChilliwackMissionAbbotsfordLangleyCoquitlamBurnabyMaple RidgeNew WestminsterSurreyDeltaSouth Surrey–White RockVan. Downtown EastsideSunshine CoastPowell RiverHowe SoundVancouver MidtownNorth VancouverVancouver North EastVancouver City CentreVancouver SouthRichmondVancouver WestsideWest Van.–Bowen Island32%8%7%4%1%1%0%0%-2%-3%-7%-9%-14%10%7%0%-1%-8%-13%-19%-19%-19%-20%-23%-28%-24%0%-7%0%-10%0%6%5%9%14%7%-8%-10%31%-12%0%0%16%-5%13%15%4%-5%4%-16%-14%-24%-11%0%-11%-7%2%-5%-11%-3%-3%0%-6%11%7%0%17%11%7%2%9%8%10%15%12%33%12%8%5%3%0%-9%-17%0%-3%-7%-8%-12%6%7%6%0%-10%-15%-20%-22%-21%-22%-26%-29%37%24%22%15%14%12%4%1%0%0%0%0%-2%48%41%38%35%35%34%29%28%28%28%28%28%25%21%19%19%16%16%13%12%12%11%10%9%6%2%0%0%0%0%47%47%41%39%29%28%25%16%12%0%0%26%-22%-23%-15%0%-15%11%-10%0%0%0%0%-14%0%-15%0%0%-12%0%0%0%-12%-26%-19%-17%-18%0%-14%0%-17%-12%-12%-11%1%0%0%-21%0%-10%0%0%0%0%0%0%0%0%0%0%0%9%0%0%11%36%24%23%14%14%13%3%3%10%22%10%0%0%46%41%37%37%37%34%28%28%29%28%30%29%25%21%20%18%17%17%14%13%0%12%11%12%8%3%36%15%12%0%45%46%40%37%28%28%24%14%11%29%31%-14%0%0%11%0%0%-5%-5%8%0%0%0%13%0%-9%0%0%-6%0%0%-5%-6%0%0%0%0%-7%-4%-9%0%0%-11%-5%0%0%0%0%-8%0%0%0%0%0%-17%-10%12%-14%0%-14%0%0%9%7%-9%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1 0 18Day proceduresHospital servicest h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 0 2Introductionfigure 8a» Spending per capita in BC, by age group, 20068 Hospital services: day proceduresNumberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population20015010050$300$225$150$75361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$256.90281627405580118160138$36.70$51.88$73.03$112.80$186.32$281.50$23.79$44.86Total spending in BC: $374-millionSpending per capita in BC: $95.08Users of services per 1,000 pop. in BC: 62Spending per user of services in BC: $1,525.16Day-visits per user of services in BC: 1.2Average cost per day-visit in BC: $1,258.75Included in this analysisThis analysis includes all day procedures received by BC residents in BC hospitals during the fiscal year 2005/06. This does not include emergency care that did not result in admission to the hospital.U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1 0 3figure 8B» Users per 1,000 population in BC, by age group, 2006Overall spending and useThe BC government spent approximately $374 million, or $95 per capita, on hospital day procedures received by BC residents in BC hospitals.Overall, approximately 6% of BC residents received a hospital day procedure.BC residents who received hospital day procedures visited hospitals for these procedures an average of 1.2 times in the year. The average cost per day procedure was $1,259.Spending and use by ageAverage levels of government spending per capita for hospital day procedures varied by nearly 1,200% across age groups. The cost of hospital day procedures ranged from a low of $24 per resident aged 10–19 to a high of $282 per resident aged 70–79.Average per capita government spending on hospital day procedures grew steadily (about 40–65% per age group) across each successive 10-year age group from ages 10–19 to 70–79. Day procedure spending was slightly lower per resident aged 80 and older than per resident aged 70–79.Differences in the rate of use of hospital day proce-dures across age groups closely resembled differences in spending across age groups.The number of users of hospital day procedures per 1,000 residents in each age group varied by nearly 1,000%, from a low of 16 users per 1,000 residents aged 10–19 to a high of 160 users per 1,000 residents aged 70–79.Numberof peopleAge group0-9Numberof peopleAge group 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Spending per capita0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Users per 1,000 population20015010050$300$225$150$75361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962361,726 489,845 501,726 530,509 657,119 594,595 376,291 251,621 172,962$256.90281627405580118160138$36.70$51.88$73.03$112.80$186.32$281.50$23.79$44.86t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 0 4Spending per capitaVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationLocal health areaActual value for LHAPredictedvalue forLHALog.devi-ationNote: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).table 8a» Variation in spending per capita by local health area, 20068 Hospital services: day proceduresRegional variations in spending per capitaAfter we accounted for differences in population age, sex, and health status, there were significant variations across BC’s LHAs in government spending per capita on hospital day procedures during the 2005/06 fiscal year.After we accounted for differences in population age, sex, and health status, spending per capita on hospital day procedures was most varied across Fraser and Interior LHAs.Spending per capita on hospital day procedures among most Vancouver Costal LHAs was below levels pre-dicted based on provincial averages for populations of the same age, sex, and health status. The opposite was true for most Northern and Interior LHAs.Campbell RiverCourtenayNanaimoIsland NorthLake CowichanAlberniGulf IslandsSaanichLadysmithSookeQualicumCowichanGreater VictoriaCariboo–ChilcotinTrail100 Mile HouseKamloopsKeremeosPentictonSummerlandSouth OkanaganCrestonCranbrookGrand ForksKimberleyArrow LakesPrincetonKootenay LakeSalmon ArmRevelstokeNorth ThompsonKettle ValleyLillooetSouth CaribooMerrittNelsonCastlegarCentral OkanaganWindermereEnderbyArmstrongVernonGoldenQuesnelPrince RupertSmithersPeace River SouthPrince GeorgePeace River NorthTerraceKitimatBurns LakeFort NelsonNechako$119$100$109$83$98$91$97$105$113$82$128$93$89$104$135$120$111$178$165$158$176$105$85$104$85$108$139$101$135$100$92$98$105$106$100$100$117$85$58$115$118$108$46$119$132$101$78$89$62$126$124$111$42$91$96$98$107$76$101$91$107$106$118$86$136$100$99$71$93$89$83$139$132$128$143$88$73$89$73$106$117$77$107$83$78$98$96$101$98$81$88$87$60$121$129$138$82$79$89$75$65$82$57$86$91$86$51$6622%2%1%0%0%0%0%-1%-4%-5%-6%-7%-11%39%37%30%30%24%22%21%21%19%16%15%15%2%0%0%0%0%0%0%0%0%0%0%0%-2%-3%-6%-9%-24%-58%40%39%29%19%9%9%0%0%0%0%0%Agassiz–HarrisonChilliwackMissionAbbotsfordMaple RidgeLangleyDeltaHopeCoquitlamSouth Surrey–White RockSurreyNew WestminsterBurnabyHowe SoundSunshine CoastPowell RiverNorth VancouverVancouver WestsideWest Van.–Bowen IslandVancouver City CentreVancouver MidtownRichmondVan. Downtown EastsideVancouver SouthVancouver North East$128$109$99$95$99$98$100$118$84$121$86$96$76$97$120$140$101$96$119$87$79$77$81$80$76$82$89$82$85$88$88$92$110$83$119$87$98$94$85$117$112$107$105$131$104$98$98$106$106$10145%20%20%11%11%11%8%7%2%2%0%-2%-22%13%2%0%-5%-9%-9%-17%-21%-24%-27%-28%-29%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1 0 5Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 8d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 8C» Regional variation in spending per capita» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%1081075435Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita1081075435Users per 1,00019139104618Days per user79Cost per day3213622420t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 0 6Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Users per 1,000 populationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvaluefor LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 8B» Variation in users of services per 1,000 population by local health area, 20068 Hospital services: day proceduresRegional variations in rate of useAfter we accounted for differences in population age, sex, and health status, there were significant variations across BC’s LHAs in the number of users of hospital day procedures per 1,000 residents in the 2005/06 fiscal year.The pattern of use of hospital day procedures divided BC along urban versus rural lines. Rates of use of day procedures in LHAs in the cities of Vancouver and Victoria were below rates predicted based on provincial averages for populations of the same age, sex, and health status. In contrast, use of hospital day procedures in many Northern and Interior LHAs was higher than predicted based on provincial averages.Campbell RiverIsland NorthCourtenayNanaimoLake CowichanAlberniSaanichSookeLadysmithQualicumCowichanGulf IslandsGreater VictoriaCariboo–ChilcotinTrail100 Mile HouseKamloopsCastlegarKootenay LakeSalmon ArmKeremeosCrestonPentictonNelsonSouth OkanaganSummerlandRevelstokeNorth ThompsonCranbrookPrincetonKimberleyGrand ForksArrow LakesKettle ValleyLillooetSouth CaribooMerrittCentral OkanaganWindermereEnderbyArmstrongVernonGoldenQuesnelTerracePrince RupertNechakoKitimatSmithersBurns LakePeace River SouthPeace River NorthPrince GeorgeFort Nelson796173656465765669796465599010095808266849284897195856769718571776864687569665362555230899082698575816050633164567066666576597385697267596869596252677368725878695658607160666864637167665368636955596257506356625045583920%8%3%0%0%0%0%-6%-6%-7%-8%-10%-12%42%38%32%30%28%24%23%22%21%21%21%20%20%19%18%17%17%17%16%0%0%0%0%0%0%0%0%-14%-29%-60%41%38%37%31%30%30%26%19%10%8%-23%Agassiz–HarrisonMissionChilliwackAbbotsfordMaple RidgeLangleyDeltaHopeSouth Surrey–White RockCoquitlamSurreyNew WestminsterBurnabyPowell RiverHowe SoundSunshine CoastNorth VancouverVancouver WestsideWest Van.–Bowen IslandVancouver City CentreVancouver MidtownRichmondVan. Downtown EastsideVancouver SouthVancouver North East887476696966688081585764509059736054704944454645435659626061596273795758656172537264607760565961615945%22%21%13%13%11%10%9%3%3%0%0%-21%23%11%0%-7%-11%-11%-19%-24%-26%-29%-29%-30%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1 0 7Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 8d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 8e» Regional variation in users of services per 1,000 population» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%19139104618Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita1081075435Users per 1,00019139104618Days per user79Cost per day3213622420t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 0 8Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 8C» Variation in day procedures per user of services by local health area, 2006Day procedures per user8 Hospital services: day proceduresRegional variations in day proceduresAfter we accounted for differences in population age, sex, and health status, the average number of day procedures received per user of these services did not vary at all across BC’s LHAs in the 2005/06 fiscal year.Campbell RiverIsland NorthCourtenayNanaimoLake CowichanAlberniSookeLadysmithGulf IslandsGreater VictoriaCowichanSaanichQualicumCariboo–ChilcotinTrail100 Mile HouseKamloopsCastlegarKootenay LakeSalmon ArmKeremeosCrestonPentictonNelsonSouth OkanaganSummerlandRevelstokeNorth ThompsonCranbrookPrincetonKimberleyGrand ForksArrow LakesKettle ValleyLillooetSouth CaribooMerrittWindermereEnderbyArmstrongVernonGoldenCentral OkanaganNechakoQuesnelTerracePrince RupertKitimatSmithersBurns LakePeace River SouthPeace River NorthPrince GeorgeFort Nelson0%0%0%0%0%0%0%0%0%-2%-4%-4%-5%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%-3%5%0%0%0%0%0%0%0%0%0%0%MissionLangleySurreyCoquitlamNew WestminsterChilliwackAgassiz–HarrisonAbbotsfordMaple RidgeDeltaHopeSouth Surrey–White RockBurnabyPowell RiverHowe SoundNorth VancouverVancouver WestsideVancouver City CentreVancouver MidtownVan. Downtown EastsideVancouver SouthVancouver North EastRichmondWest Van.–Bowen IslandSunshine Coast3%3%3%3%2%2%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%-2%-3%-4%1.171.151.191.241.151.171.181.261.181.201.171.181.181.151.241.201.191.241.261.231.311.231.251.201.261.231.181.131.221.201.231.241.221.251.201.231.181.201.201.191.191.181.181.231.181.161.191.161.161.151.121.111.191.081.191.181.221.231.191.201.191.221.231.221.211.231.241.181.211.201.191.211.201.211.251.221.241.201.251.231.201.191.201.231.211.221.221.221.201.211.201.181.191.201.211.201.221.171.191.181.171.191.171.191.161.151.201.101.251.251.231.231.261.241.251.211.211.221.221.271.241.191.141.191.221.241.221.241.221.231.191.211.191.201.211.201.201.231.211.211.221.211.211.241.261.231.231.171.211.221.221.211.221.221.221.211.241.24U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1 0 9Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 8d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 8f» Regional variation in day procedures per user of services» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%79Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita1081075435Users per 1,00019139104618Days per user79Cost per day3213622420t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 1 0Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Vancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationLocal health areaActualvalue for LHAPredictedvalue forLHALog.devi-ationtable 8d» Variation in cost per day procedure by local health area, 2006Cost per day procedure8 Hospital services: day proceduresRegional variations in cost per procedure After we accounted for differences in population age, sex, and health status, the average cost per hospital day procedure varied moderately across BC’s LHAs in the 2005/06 fiscal year.In 32 LHAs, the average cost per day procedure was either within 5% of, or not statistically significantly different from, levels predicted based on provincial averages for populations of the same age, sex, and health status.The costs per day procedure in Vancouver Coastal LHAs were above levels predicted based on provin-cial averages. NanaimoQualicumCampbell RiverIsland NorthLake CowichanAlberniSookeLadysmithGulf IslandsGreater VictoriaCowichanSaanichCourtenayArmstrongVernonSummerlandSouth OkanaganPentictonEnderbyKeremeosPrincetonKootenay LakeSalmon ArmRevelstokeNorth ThompsonArrow LakesKettle ValleyLillooetSouth CaribooMerrittGoldenKamloopsNelsonCastlegarCentral OkanaganTrailGrand Forks100 Mile HouseKimberleyCranbrookCrestonCariboo–ChilcotinWindermerePrince RupertTerraceKitimatSmithersBurns LakePeace River SouthPrince GeorgeFort NelsonQuesnelPeace River NorthNechako$1,342$1,376$1,288$1,193$1,338$1,208$1,247$1,307$1,259$1,249$1,244$1,175$1,161$1,802$1,744$1,522$1,470$1,487$1,526$1,480$1,360$1,223$1,306$1,268$1,194$1,293$1,237$1,276$1,152$1,231$1,288$1,166$1,177$1,158$1,085$1,089$1,083$1,049$978$992$1,016$1,004$922$1,342$1,203$1,267$1,157$1,192$1,164$1,204$1,238$1,140$1,120$1,079$1,231$1,307$1,246$1,252$1,284$1,229$1,253$1,264$1,272$1,255$1,267$1,256$1,270$1,308$1,313$1,257$1,243$1,260$1,300$1,269$1,231$1,257$1,264$1,276$1,254$1,287$1,289$1,223$1,236$1,231$1,236$1,246$1,262$1,248$1,250$1,260$1,262$1,248$1,233$1,252$1,293$1,316$1,248$1,229$1,226$1,211$1,216$1,199$1,226$1,198$1,254$1,213$1,226$1,1919%5%0%0%0%0%0%0%0%0%0%-7%-9%32%28%19%17%17%16%15%10%0%0%0%0%0%0%0%0%0%0%-7%-7%-8%-14%-15%-15%-17%-23%-23%-24%-27%-30%9%0%0%0%0%0%0%0%-6%-9%-10%HopeBurnabySurreyNew WestminsterDeltaMaple RidgeCoquitlamSouth Surrey–White RockChilliwackLangleyAgassiz–HarrisonAbbotsfordMissionHowe SoundVancouver MidtownVancouver City CentreVancouver WestsideVancouver SouthVan. Downtown EastsideNorth VancouverVancouver North EastRichmondWest Van.–Bowen IslandSunshine CoastPowell River$1,212$1,236$1,225$1,199$1,199$1,173$1,173$1,176$1,157$1,187$1,165$1,136$1,080$1,446$1,470$1,430$1,462$1,452$1,428$1,429$1,420$1,425$1,417$1,380$1,307$1,255$1,277$1,274$1,266$1,273$1,252$1,263$1,276$1,259$1,296$1,278$1,261$1,234$1,235$1,256$1,233$1,268$1,264$1,245$1,251$1,256$1,266$1,276$1,275$1,2770%-3%-4%-5%-6%-7%-7%-8%-8%-9%-9%-10%-13%16%16%15%14%14%14%13%12%12%10%8%0%U B C  C e n t r e  f o r  h e a lt h  s e r v i C e s  a n d  p o l i C y  r e s e a r C h1 1 1Relatively high, given the age, sex, and health status of LHA residentsRelatively low, given the age, sex, and health status of LHA residentsLHAs have been resized torepresent their population.1,000 peopleData are unreliablefigure 8d» Extent of regional variation» Number of local health areas with given deviations of actual values from predictions based on provincial averages for populations of the same age, sex, and health status, 2006figure 8G» Regional variation in cost per day procedure» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006Snow CountryStikineTelegraph CreekUpper SkeenaNechakoPrince GeorgeQuesnelCariboo–Chilcotin100 MileHouse   SalmonArmRevelstokeEnderbyVernonGoldenCastlegarTrailGrand ForksKettle ValleySouth OkanaganKeremeosChilliwackHopeAgassiz–HarrisonMissionMapleRidgeRichmondVancouver SouthVancouverNortheastVancouverDowntown EastsideNorthVancouverHoweSoundPowellRiverIslandNorthCampbellRiverCourtenayQualicumAlberniNanaimoGulfIslandsSaanichGreaterVictoriaCowichanSookeLadysmithLakeCowichanIslandWestSunshineCoast West   Van.–Bowen I.VancouverCityCentreVancouverMidtownVancouverWestsideDeltaSurreyBurnabySouth Surrey–White RockCoquitlamNewWestminsterAbbotsfordLangleyPentictonPrincetonCrestonCranbrookFernieWindermereArrowLakesKootenayLakeCentralOkanaganArmstrongLillooetSouthCariboo MerrittSummerlandKamloopsNorthThompsonFort NelsonPeace RiverNorthPeace RiverSouthBurns LakeBella CoolaCentral CoastSmithersTerraceKitimatQueenCharlottePrinceRupertNisga’aKimberleyNelson-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%3213622420Logarithmic scaleIndicates one LHALogarithmic scaleIndicates one LHA-5 to +5%+6 to +15%+16 to +25%> +25%-15 to -6%< -25%-25 to -16%Spending per capita1081075435Users per 1,00019139104618Days per user79Cost per day3213622420t h e  B C  M e d i C a l  a n d  h o s p i t a l  a t l a s1 1 2Note: Log deviation reported as zero when not statistically significant (see “Testing significance” on page 9).Summary of measures of deviationVancouver Island HealthInterior HealthNorthern HealthFraser HealthVancouver Coastal HealthSpendingpercapitaUsersper1,000Local health areaLocal health areaSpendingpercapitaUsersper1,000table 8e» Regional variation» Deviation of actual values for local health areas from predictions based on provincial averages for populations of the same age, sex, and health status, 2006CostperdayDaysperuserCostperdayDaysperuser8 Hospital services: day proceduresMeasures of deviationAfter we accounted for differences in popula-tion age, sex, and health status, variations across BC’s LHAs in spending per capita on hospital day procedures were driven almost entirely by variations in the number of recipients of hospital day procedures per 1,000 residents.Variations in likelihood of use of hospital day procedures interacted with average costs per day of care received, variations that were often in opposite directions.Campbell RiverCourtenayNanaimoIsland NorthLake CowichanAlberniGulf IslandsSaanichLadysmithSookeQualicumCowichanGreater VictoriaCariboo–ChilcotinTrail100 Mile HouseKamloopsKeremeosPentictonSummerlandSouth OkanaganCrestonCranbrookGrand ForksKimberleyArrow LakesPrincetonKootenay LakeSalmon ArmRevelstokeNorth ThompsonKettle ValleyLillooetSouth CaribooMerrittNelsonCastlegarCentral OkanaganWindermereEnderbyArmstrongVernonGoldenQuesnelPrince RupertSmithersPeace River SouthPrince GeorgePeace River NorthTerraceKitimatBurns LakeFort NelsonNechakoAgassiz–HarrisonChilliwackMissionAbbotsfordMaple RidgeLangleyDeltaHopeCoquitlamSouth Surrey–White RockSurreyNew WestminsterBurnabyHowe SoundSunshine CoastPowell RiverNorth VancouverVancouver WestsideWest Van.–Bowen IslandVancouver City CentreVancouver MidtownRichmondVan. Downtown EastsideVancouver SouthVancouver North East45%20%20%11%11%11%8%7%2%2%0%-2%-22%13%2%0%-5%-9%-9%-17%-21%-24%-27%-28%-29%0%2%3%0%0%3%0%0%3%0%3%2%0%0%-4%0%0%0%-3%0%0%-2%0%0%0%-9%-8%-13%-10%-7%-9%-6%0%-7%-8%-4%-5%-3%16%8%0%13%14%10%15%16%12%14%14%12%45%21%22%13%13%11%10%9%3%3%0%0%-21%11%0%23%-7%-11%-11%-19%-24%-26%-29%-29%-30%22%2%1%0%0%0%0%-1%-4%-5%-6%-7%-11%39%37%30%30%24%22%21%21%19%16%15%15%2%0%0%0%0%0%0%0%0%0%0%0%-2%-3%-6%-9%-24%-58%40%39%29%19%9%9%0%0%0%0%0%0%0%0%0%0%0%0%-4%0%0%-5%-4%-2%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%-3%0%0%0%0%0%0%0%0%0%0%0%0%0%0%0%5%20%3%0%8%0%0%-10%0%-6%-6%-7%-8%-12%42%38%32%30%22%21%20%20%21%17%16%17%0%17%24%23%19%18%0%0%0%0%21%28%0%0%0%-14%-29%-60%41%37%30%19%8%10%38%30%26%-23%31%0%-9%9%0%0%0%0%-7%0%0%5%0%0%-27%-15%-17%-7%15%17%19%17%-24%-23%-15%-23%0%10%0%0%0%0%0%0%0%0%-7%-8%-14%-30%16%32%28%0%-6%9%0%0%0%-9%0%0%0%0%-10%UBC Centre for Health Services and Policy Researchthe University of British Columbia201-2206 east Mallvancouver, B.C. Canada  v6t 1Z3tel:  604.822.4969fax:  604.822.5690email: enquire@chspr.ubc.cawww.chspr.ubc.caAdvancing world-class health services and policy research, training and data resources on issues that matter to Canadians

Cite

Citation Scheme:

        

Citations by CSL (citeproc-js)

Usage Statistics

Share

Embed

Customize your widget with the following options, then copy and paste the code below into the HTML of your page to embed this item in your website.
                        
                            <div id="ubcOpenCollectionsWidgetDisplay">
                            <script id="ubcOpenCollectionsWidget"
                            src="{[{embed.src}]}"
                            data-item="{[{embed.item}]}"
                            data-collection="{[{embed.collection}]}"
                            data-metadata="{[{embed.showMetadata}]}"
                            data-width="{[{embed.width}]}"
                            async >
                            </script>
                            </div>
                        
                    
IIIF logo Our image viewer uses the IIIF 2.0 standard. To load this item in other compatible viewers, use this url:
http://iiif.library.ubc.ca/presentation/dsp.52383.1-0048539/manifest

Comment

Related Items