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Nursing workforce study, volume 1 : demographic context and health system structure for nursing services… Kazanjian, Arminée, 1947-; Rahim-Jamal, Sherin, 1963-; Wood, Laura Christine, 1955-; MacDonald, Allyson Apr 30, 2000

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NURSING WORKFORCE STUDYVolume IDemographic Context and Health System Structurefor Nursing Services in CanadaHHRUOO:3 April 2000NURSING WORKFORCE STUDYVolume IDemographic Context and Health System Structurefor Nursing Services in CanadaArminee KazanjianSherin Rahim-JamalLaura WoodAllyson MacDonaldHHRU 00:3Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaVancouver, British Columbia V6T lZ3April 2000Canadian Cataloguing in Publication DataMain entry under title:Nursing workforce study(HHRU 00:3-00:7)Contents: Vol. I, Demographic context and health system structure fornursing services in Canada; v. 2, The supply of nursing personnel inCanada; v. 3, An inventory of nursing program enrolments and graduates inCanada by province/territory, 1998; v. 4, Nursing workforce deployment: asurvey of employers; v. 5, Changes in the nursing workforce and policyimplications.ISBN 1-894066-90-1 (v. I) - ISBN 1-894066-89-8 (v. 2) -ISBN1-894066-88-X (v. 3) - ISBN 1-894066-87-1 (v. 4) - ISBN 1-894066-86-3 (v. 5)I. Nursing-Canada. 2. Nurses-Supply and demand-Canada. 3.Nurses-Employment-Canada. 4. Nursing-Study and teaching-Canada. 5.Health services administration-Canada. I. Kazanjian, Arminee, 1947- II.University of British Columbia. Health Human Resources Unit. III. Series:Research reports (University of British Columbia. Health Human ResourcesUnit) ; HHRU 00:3-00:7.RT86.75.C3N882000 331.11'9161073'0971 COO-910438-0iiHEALTH HUMAN RESOURCES UNITThe Health Human Resources Unit (HHRU) was established as a demonstration project by the BritishColumbia Ministry of Health in 1973. Since that time, the Unit has continued to be funded on an ongoingbasis (subject to annual review) as part of the Centre for Health Services and Policy Research. The Unitundertakes a series of research studies that are relevant to health human resources management and to publicpolicy decisions.The HHRU's research agenda is determined through extensive discussions of key current issues and availableresources with the senior staff of the Ministry of Health. Various health care provider groups participateindirectly, through on-going formal and informal communications with Ministry of Health officials and withHHRU researchers. Research is undertaken by seven professional staff, including secretarial and analystsupport; Arminee Kazanjian is the Associate Director and Principal Investigator for the Unit.Three types of research are included in the Unit's research agenda. In conjunction with professional licensingbodies or associations, the HHRU maintains the Cooperative Health Human Resources Database. The Unituses these data to produce regular status reports that provide a basis for in-depth studies and for health humanresources planning. The Unit undertakes more detailed analyses bearing on particular health human resourcespolicy issues and assesses the impact of specific policy measures, using secondary analyses of data from theCooperative Database, data from the administrative databases maintained under the HIDU, or primary datacollected through surveys. The HHRU also conducts specific projects pertaining to the management of healthhuman resources at local, regional and provincial levels,Copies of studies and reports produced by the HHRU are available at no charge.Health Human Resources UnitCentre for Health Services and Policy Research#429-2194 Health Sciences MallVancouver, BeV6T IZ3Ph: (604) 822-48IOFax: (604) 822-5690email: hhru Ochspr.ubc.caURL: www.chspr.ubc.caIIINursing Workforce StudyThis study was commissioned by the Federal/ProvinciaIrrerritorial Advisory Committee on HealthHuman Resources (ACHHR) to develop baseline data on the supply and education of Registered Nurses(RNs), Registered Psychiatric Nurses (RPNs), and Licensed Practical Nurses (LPNs), and on employerpractices pertaining to the deployment of all patient care providers. The study results are published infive separate volumes:volume I of the study "Demographic Context and Health System Structure for Nursing Services inCanada", provides a general overview of demographic and system changes; it describes the currentdemographic context for nursing practice and the structure of provincial/territorial health caredelivery systems. The demographic analyses are based on 1996 Census data. Provinciallterritorialhealth care delivery information for the most part are obtained from "Health System Reform inCanada, 1997," by Health Canada.Volume II of the study, "The Supply of Nursing Personnel in Canada" examines data on the supplyof nursing personnel in the provinces and territories to provide basic information about employmentstatus, deployment (place of employment, area of responsibility, type of position, hours worked),age, and type and place of education/training. The analysis is based on data collected by therespective regulatory bodies in their registration and renewal processes. Two separate years ofsecondary data are utilized in the analysis (1990 and 1997), presenting a detailed national andregional picture on the supply of nurses in Canada.Volume III of the study "An Inventory of Nursing Program Enrolments and Graduates in Canada byProvince/Territory, 1998" describes the production of nursing personnel in Canada. A surveyquestionnaire was sent to provincial/territorial representatives (usually the education representative)of the ACHHR who were asked to complete the survey for all nursing education programs in theirjurisdictions. The questionnaire requested information as to the type of credential offered, the lengthof the program, the number enrolled in each year of the program, the number of students enrolledfull-time, part-time, or in distance education, and the number of graduates in 1997 and 1998. Theanalysis includes the impact of BN-only basic education for RNs.Volume IV of the study, "Nursing Workforce Deployment: A Survey of Employers" examinesemployer practices and policies for nursing workforce deployment in each province/territory. Asample survey regarding deployment was undertaken using a questionnaire pertaining to all threeregulated nursing groups: LPNs, also known as Registered Nurse Assistants (RNAs), RPNs, andRNs. Information on other professionals and unregulated patient care providers e.g. Aides was alsocollected by the questionnaire. The questionnaire was designed to capture the following information:hiring practices (amount of experience required, deployment, credentials, etc.), kinds of servicesprovided and the skills perceived to be needed to provide those services, numbers and mix of nursingpersonnel used to provide services, use of unregulated health care workers in relation to nursingservices provision, and anticipated changes in deployment practices related to changes in theorganization of the health care delivery system.Volume Vof the study, "Changes in the Nursing Workforce and Policy Implications" the final partof the study, synthesizes the findings from each of the above sections and attempts to delineate thesalient policy issues.Copies of other Volumes in this study may be obtained by contacting the Health Human ResourcesUnit.ivTable of ContentsStudy Synopsis ivList of Tables viList of Figures viiI. Introduction................................... 1II. Health Reform Initiatives in Canada 31. Structural Reform 32. Home Care 83. Health Human Resources 144. Long Term Care 19III. Demographic Analyses 20IV. Bed to Population Ratios 27V. Discussion 30References 35Appendiees 371. Population Estimates by Province/Territory by Census Division by Age and Sex 392. Proportion of Males and Females in each Province/Territory by Age Group and Percentof Males and Females in each Province/Territory by Age Group 553. Population Pyramids by Province/Territory 654. Acute Care - Number of Facilities and Number of Beds by Province/Territory 79Reports of the Health Human Resources Unit 83vTable ITable 2Table 3Table 4Table 5Table 6Table 7Table 8Table 9Table 10Table IITable 12Table 13Table 14Table 15List of TablesNurses Wages IHealth Reform Initiatives in Canada by Province/Territory, 1997 - StructuralReform 5Health Reform Initiatives in Canada by Province/Territory, 1997 - Home Care 9Public Home Care Expenditures by Province/Territory, Canada, 1988-89 to1997-98 13Health Reform Initiatives in Canada by Province/Territory, 1997 - Health HumanResources 15Health Reform Initiatives in Canada by Province/Territory, 1997 - Long TermCare 19Population Estimates in Canada by Province/Territory by Age and Sex, 1996 21Acute Care Beds per 1,000 Population by Province/Territory 28Acute Care Beds per 1,000 Population Aged 65 and Older by Province/Territory 28Long Term Care Beds per 1,000 Population by Province/Territory 29Long Term Care Beds per 1,000 Population Aged 65 and Older byProvince/Territory 29Total Health Expenditure by Use of Funds, by Province/Territory, 1997 andRegistered Nurse, Physician and Acute Care Bed Supply by Province/Territory,1997 31Number of Beds, Patient-days, Physician and Nurse Personnel in Canada, 1980-1994 32Nurses, Physicians and Acute Care Beds per 1,000 Population, byProvince/Territory, 1997 32Registered Nurses per 1,000 Population, by Province/Territory, 1998 33VIFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6List of FiguresProportion of Males and Females in Canada by Age Gronp, 1996 22Percent of Males and Females in Canada by Age Group, 1996 22Male and Female Population in Canada by Age Group, 1996 23Relative Proportion of 0-19 Year Olds in each Province/Territory 25Relative Proportion of 20-29 Year Olds in each Province/Territory 25Relative Proportion of 65-79 Year Olds in each Province/Territory 26viiviiiNURSING WORKFORCE STUDYVolume I: Demographic Context and Health System Structurefor Nursing Services in CanadaI. INTRODUCTIONNursing resources and nurse workforce issues have been getting a lot of attention during the past decade inCanada, as elsewhere. Nurse workforce issues are being debated in almost every province, mostly because ofjob action or impending job action by nurses as their contracts expire. Table I shows the expiry dates ofRegistered Nurses' (RNs) contracts across Canada.Table 1Nurses WagesHourly rate Contractmin / max expiresNlld. $15.10/$19.18 Jan. 19951'101 $17.69/$21.55 Apr. 1999N.S. $19.16/$22.48 Nov. 2000N.B. $17.58/$21.40 Jly.2000Que. $16.04/$23.30 Jly. 1998Ont. $18.30/ $27.04 Apr. 1998Man. $18.37/$21.65 Apr. 1999Sask. $18.52/$22.12 Apr. 1999Alta. $19.66/$24.11 Apr. 1999B.C. $20.98/$25.98 Apr. 2001Source: The Globe and Mail, April 3, 1999.Several issues related to the nursing workforce require analysis and monitoring, especially given the recentlyexpressed concern that the nursing workforce will be insufficient to meet the needs of the future health caredelivery system (Canadian Nurses Association, 1997). Our five part project, Nursing Workforce Study, hasbeen designed to collect primary and secondary data that can be used to identify and analyze the policyimplications of the current supply and deployment of nursing personnel and that may help to anticipate theeffects of changes in the nursing workforce on the provision of health care services in the future.As the demand for health services increases, the demand for health human resources may also increase in orderto provide increased service. The common rhetoric is that as the demographics of the Canadian populationchange, so will the demand for and utilization of health services and thus health human resources (Ryten et ai,1998). However, this is not entirely correct. As Barer et al. (1994), have discussed and illustrated, "thequantitative impact of population aging only accounts for a small fraction of the increases in per capita userates,' and that in fact, the increase in per capita lise rates in the elderly population has been "driven bychanges in patterns of health care practice, not in the numbers and ages of elderly people in the population."Thus, population demographics alone will not have a major impact on the demand for health services andhence for health human resonrces.However, demographic and other factors, such as government regulation and fiscal policy, system structure,changes in service delivery (especially physician practice patterns), and patient demand have majorimplications for health human resources in general and for nurse resources and the nursing workforce inparticular. Thus, this study (Volume I), has focused on describing the current demographic context fornursing practice and the structure of provincial/territorial health care delivery systems.In order to facilitate discussion, Part II, "Health Reform Initiatives in Canada," has been organized into fourmajor sections: Structural Reform, Home Care, Health Human Resources, and Long Term Care. It isimportant to note that the period covered is somewhat variable, depending on the data source. Provincialinformation and the information regarding the Northwest Territories were obtained from "Health SystemReform in Canada, 1997," (an official document based on a review conducted by Health Canada of healthsystem reform across Canada), and contains information up to November 30, 1997, except for BritishColumbia (up to February, 1998). With respect to the Yukon, the information in the tables was obtaineddirectly from the Yukon; the date of record is December, 1998.The section on "Demographic Analyses" is based on analyses using 1996 Census data prepared by StatisticsCanada.Our definition of 'nursing personnel' includes three groups of regulated professionals, Registered Nurses(RNs), Registered Psychiatric Nurses (RPNs), and Licensed Practical Nurses or Registered NursingAssistants (LPNs in this report). RPNs are not regulated east of Manitoba. The term 'nurses' will be usedthroughout this report to refer to all three groups of licensed personnel; when a specific group is underdiscussion, the appropriate abbreviation will be used.We have strived to use the most recent, publicly available, official sources of data throughout the report.2II. HEALTH REFORM INITIATIVES IN CANADA1. Structural ReformWith the exception of Ontario and the Yukon, all provinces in Canada have regionalized their health servicesto some degree (Table 2 illustrates the degree of regionalization in eaeh province). Although Ontario has 16District Health Councils and 34 Local Boards of Health, these councils and boards do not have the legalauthority to deliver health serviees in their jurisdictions.The situation in the Yukon is different from Ontario. The Yukon has not had the same experience of healthreform that other provinces have known. In the 1990's, the Yukon was negotiating and implementing thetransfer of health programs from federal to territorial administration. The Yukon Department of Health andSocial Services and the Yukon Hospital Corporation are the two territorial bodies administering health servicesnow. There are no regional or local bodies in the Yukon.In provinces that have undergone regionalization, regional health authorities have been established and areresponsible for the delivery of health services to their populations. In most of the regionalized provinces(Alberta, British Columbia, Manitoba, Newfoundland, Nova Scotia, Prince Edward Island, Quebec,Saskatchewan), and the Northwest Territories, the ministries of health have moved away from a focus onoperations and direct delivery of health services to a more global emphasis which includes setting broad healthcare strategies, policies, legislation, standards, priorities and accountabilities, as well as allocating resources tothe health authorities. The Department of Health and Community Services in New Brunswick, however, seemsto have retained a little more operational control over its health and community services in comparison with theother regionalized provinces. However, while the ministries of health in regionalized provinces have generallymoved away from direct operational control of most health services, there continue to be some importantservices which are administered at the provincial level (e.g. emergency services, physician services etc.).In provinces which have regionalized, the regional and local health authorities are generally responsible for thedelivery of both institutional and community-based health care services, including hospitals, long-termcarelcontinuing care facilities, community health services, public health, home care services, mental healthservices, and alcohol and substance abuse programs. There are two exceptions: Manitoba and Newfoundland.In Manitoba, not all health services facilities have transferred control to the regional authorities since this wasnot mandatory. The Manitoba legislation (The Regional Health Authorities Act, S.M. 1996,1'.53 - cap. R34)permitted an "opt-out" elause that stipulated that faeilities could either transfer control to regional authoritiesor maintain their autonomy by entering into eontracts with the regional authorities. However, "opting-out"meant that facilities would be responsible for their own fiscal deficits.In Newfoundland, reorganization of health services did not include the integration of institutional andcommunity health services under a single board structure (as is seen in the other provinces), except in NorthernNewfoundland and Labrador where community health services are integrated with acute and long-term careservices under the jurisdiction of two distinct regional integrated health boards. In the remaining regions ofNewfoundland, institutional and community health services are separate and fall under the jurisdiction ofInstitutional Health Boards and Community Health Boards, respectively (see Table 2).It is interesting to note that in Prince Edward Island, Quebec, and the Northwest Territories, the departmentsof health and social services are amalgamated in such a way that the resulting single structure in thesejurisdictions is responsible for both health and social services.3Along with the responsibility to deliver health services, the regional health authorities also receive funding toprovide services. The formulas used to determine health authority budgets vary from province to province andrange from blockfunding to population-based to population and needs-based funding formulas. Blockfunding is based on case mix and the service population. Population-based formulas take account of thenumber of people in a particular region, their age and gender, as well as the socio-economic health risk of thatpopulation. Needs-based or population needs-based funding is determined by looking at the relative healthneeds of regions for curative, restorative and rehabilitation services as well as for preventive and promotivehealth services. This funding formula reflects regional differences in need due to population size, agecomposition and health status and even includes adjustments for regional service cost differences.It is important to note that the funds allocated to the health authorities for the delivery of health services are theprimary source of nurses' salaries in the regions. Thus, with regionalization of health services, the nurseworkforce has also been regionalized to the degree that their remuneration comes from regional funds.However, while nurses are paid from regional budgets, most nursing unions negotiate at a provincial level,pointing to the need to have some degree of provincial coordination pertaining to the management of nursingresources at the provincial level.All regional authorities have some accountability for the services they provide. Accountability is enforced byvarious means, i.e. through performance indicators, audits, and legislation outlining the responsibilities of thehealth authorities. In addition, two provinces (Alberta and Newfoundland), have instituted provincial healthcouncils or provincial advisory committees which provide independent monitoring of the health system in thoseprovinces (sec Table 2).4Table 2 Healtb Reform Initiatives in Canada by Province/Territory, 1997 - Structural ReformProvince! Structural Reform Insured Programs PharmacareTerritory Provincial Health Insurance Premium PremiumProvincial Reaional Local Fundlna Allocation Model Accountability Yes No Yes NoNfid. MoH 6 RIBs 4CHBs Multi-year flat line budgeting. Public Service Reform No No, prg2 RIHBs Initiative which only for1 Nursing includes Business selectedHome Plans. groups.Board Provincial AdvisoryCommittee.PEl DHSS 5RA None Block funding (based PEL System No Noon historical budgets). Evaluation Project.PEL Health IndicatorsResource.Accountability Doc.Nova MoH 4RHB 38CHB Population-based, (under Business Plans. No YesScotia PAC development). Regular Reports. (senior'sPLC Use of performance program).4NDQ indicators.New MoH 8RHC None Block funding based on case Use of strategic plans. No PrgBrunswick mix and service population. Hospital Act requires consists ofthat RHC meet prov severalstandards in terms of individualquality & efficiency. drug plansdesignedto meetneeds ofdiff grps.Quebec MSSS 17 RB Board of Overall budget for institutions. Submission of annual ** YesI CRSSS Directors report.17RMC of public Annual publicinstitutions. information sessions.1 Ontario MoH 16DHC 34BQH Funding for service delivery Performance No No, onlyHSRC agencies is negotiated based on indicators, outcome certainprograms delivered. measures & pop grps arehealth indicators are covered.developed sector bysector, program byprogram.. .. contmuedPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaTable 2 (continued) Health Reform Initiatives in Canada by Province/Territory, 1997 . Structnral ReformProvince! Structural Reform Insured Programs PharmacareTerritory Provincial Health Insurance Premium PremiumProvincial Reeional Local Fundlna Allocation Model Accountabilitv Yes No Yes NoManitoba MoH 13 RHAs None Population-based. Legislation outlining No No, justDHACs responsibilities of deductible.Health Authorities.Sask.2 SH 32DHB None Population needs-based Audits of SH & No No, butSAHO IHA funding. DHBs. deductableHSAC Annual Reports from and co-HPEC DHBs to Minister of paymentsHealth. system.SH Annual Reports.Alberta MoH 17 RHAs Population-based. Prov Health Council Yes Yes2PHAs provides independentmonitoring of health.B.C. MoH II RHBs 34CHCs Needs-based. MoH. Yes No, just7 CHSSs Legislation deductibleoutlining responsibility then 70%of Health Authorities. coverage.Yukon3.4 DHSS None None Based on program needs Minister of Health. No No, justYHC established through negotiation Yukon Hospital Corp. deductiblewith DHSS. Board. for thosewith drugscoveredunderchronicdisease!disabilityprogramswho arcless than65 years.•.. continuedPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaTable 2 (continued) Health Reform Initiatives in Canada by Province/Territory, 1997· Structural ReformProvince! Structural Reform Insured Programs PharmacareTerritory Provincial Health Insurance Premium PremiumProvincial Regional Local Fundins Allocation Model Accountabilitv Yes No Yes NoNWT DHSS 8 HSSB 4 HSSB Population needs-based Partnership No NoNWTHCA approach (under development). Agreement.ContributionAgreement.AccountabilityFramework.Source: Health System Reform in Canada, 1997 (Review conducted by Health Canada).** Indicates no information was provided or that the information provided was unclear.1 Ontario is the only province in Canada that has not undergone regionalization. The regional and local boards do not have the authority to deliver health services.~ Information received directly from Policy and Planning, Saskatchewan Health.3 Information received directly from the Yukon Territory.4 The Yukon has not had the same experience of health reform that other provinces have known: In the 1990's, the Yukon was negotiating and implementing the transferof health programs from federal to territorial administration. The Yukon Department of Health and Social Services and the Yukon Hospital Corporation are the two territorialbodies administering health services now, There are no regional or local bodies.Glossary of AeronymsBaHCHBCHCCHSSCRSSSDHBDHCDHACDHSSHPECHAHSACHSRCHSSBMoHMSSSLocal Board of HealthCommunity Health BoardCommunity Health CouncilCommunity Health Services SocietyRegional Health & Socia! Services CouncilDistrict Health BoardDistrict Health CouncilDistrict Health Advisory CouncilDepartment of Health & Social ServicesHealth Provider Education CommitteeHealth AuthorityHealth Services Advisory CommitteeHealth Services Restructuring CommissionHealth & Social Services BoardMinistry of HealthDepartment of Health & Social Services (Quebec)NDONWTHCAPACPHAPLCRARBRHARHBRHCRIBRIBBRMCSAHOSHYHCNon-Designated OrganizationNorthwest Territories Healthcare AssociationProvincial Advisory CouncilProvincial Health AuthorityProvincial Leadership CommitteeRegional AuthorityRegional BoardRegional Health AuthorityRegional Health BoardRegion Hospital CorporationRegional Institutional BoardRegional Integrated Health BoardRegional Medical CommissionSaskatchewan Association of Health OrganizationsSaskatchewan Health/Department of HealthYukon Hospital CorporationPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia2. Home CareThe majority of the information in this section was obtained from the most recent work conducted by theFederal-Provincial-Territorial (FPT) Advisory Committee on Health Services Working Group on ContinuingCare. The comprehensive report on Home Care (Health Canada, 1999), released by the Advisory Committeein June, 1999, enabled us to not only expand on the rather limited information obtained from our initial source(Health Canada, 1997), but also to provide the most current information.In Canada, the provinces and territories have the jurisdictional responsibility to provide home care services.Publicly funded home care programs exist in every province and territory. However, the range of servicesprovided varies across the country, since each program has undergone its own unique development in responseto community needs (Health Canada, 1999).All provinces offer a similar range of basic services: client assessment; case coordination; case management;nursing services; and home support, including personal care, homemaking, Meals-an-Wheels, and respiteservices. Other services, such as rehabilitation (occupational therapy and physical therapy), respiratoryservices, specialized nursing care, social work services, and dietitian services vary by province and territory(Health Canada, 1999).In most provinces, the delivery of home care services has been integrated with long-term care and continuingcare (see Table 3). In the Yukon, although home care has not been formally integrated with long-term careand continuing care, the coordination of services does occur between those sectors in practice.New Brunswick, Nova Scotia, PEl, Quebec, and Saskatchewan have developed some form of acute or activetreatment home care program. These programs provide acute care services in people's homes as an alternativeto hospital in-patient care where appropriate, and provide follow-up services for those who have beendischarged early from hospital (see Table 3).Most provinces utilize a combination of public employees (including employees of regional health authoritiesor publicly funded agencies) and contracted agencies to deliver home care services (see Table 3). Four modelsappear to represent provincial and territorial home care programs (Health Canada, 1999):a) Single-entry functions (i.e. assessment, case management, discharge planning) are delivered by publicemployees or staff of publicly funded community agencies, while professional services (e.g. nursing,occupational therapy) and home support are contracted out (e.g. Ontario).b) Single-entry functions plus some professional services (e.g. nursing, occupational therapy, physicaltherapy) are delivered by public employees. However, some nursing services and home support servicesare contracted out either province-wide or in certain regions (e.g. Nova Scotia); therapy services arecontracted for the most part throughout Manitoba, and in Winnipeg, most nursing services and a smallportion of home support services are contracted to an agency.c) Single-entry functions plus all professional services are delivered by public employees (e.g. NewBrunswick, Newfoundland, British Columbia, Alberta). Home support services are contracted out byagency or client in most instances.d) Single-entry functions, professional and home support services are mainly delivered by public employees(e.g. Saskatchewan, Quebec, Prince Edward Island, Yukon, Northwest Territories).8Table 3 Healtb Reform Initiatives in Canada by Province/Territory, 1997 . Home CareProvince! 1 Pri vatc Clinics Home CareTerritory Integrated with LTC Types of Home Care Professional Personal Services Service Delivery Coverage and&CC v Services Public Contracted Co-paymentVo> No Ves No Emnlovees" Out ChargesNfid. ~* Yo> Seniors' home support program, Nursing, 'Home management, Assessment, Home support No charge forsupport for persons with social work, "personalcare, case mgm., services. professional services.developmental and physical respiratory services, respite. rehabilitation, Financial eligibilitydisabilities. rehabilitation services. and other assessed for clientprofessional contribution for homeservices. support.PEl No Yes Seniors' homecare program, Nursing, Personal care, All professional IT services No charges. Incomepalliative care at home, occupational therapy, respite care, and non- may be assessed for abilityhospital discharge/follow-up, physical therapy. home support. professional contracted out. to pay for homeequipment loan/rental, services. support.in-home respite.Nova Yes No 7Acute Home Care. Nursing, Personal care, Case mgmt., 75% of nursing No charges. Fees mayScotia Schronic home care. home oxygen service, home support assessment, services and be assessed on a,paediatric home care, physician service on service. and 25% of 100% of home sliding scale based on"rehabititanon home care, an as needed basis. nursing support income and familynextraordinary assistance home services. services. size for home support.care, Home oxygen12palliative home care, service.1:1self-managed home care.New No Yo> Non-acute home nursing care. Acute care services, Homemaker/ All professional Home support No charge for Extra-Brunswick Active treatment home care- rehabilitation, housekeeper service, services. and meals-on- Mural Prg. For LTC,provides acute care services in social work, meals-on-wheels, wheels. income and assetspeople's homes as well as in speech therapy, seniors day care. assessed. Clients,residential facilities - is the respiratory services. except low income,alternative to in-patient care. pay for medications.Quebec ** ** Post-operative care, Nursing, Horne care support, All professional Home support No charges for acutepalliative care, occupational therapy, personal care. services, for disabled care. For LTC,seniors' home care, physical therapy, personal care, persons and financial eligibilityequipment loan/rental, inhalation therapy, and home respite care. assessed (localrespite care & emerg. services. social work. support for high criteria). Whererisk clients. services are availableoutside home careplan, clients payaccording to theirability to do so.... contrnuedPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaoTable 3 (continued) Health Reform Initiatives in Canada by Province/Territory, 1997· Home CareProvince/ I Private Clinics Home CareTerritory Integrated with LTC Types of Home Care Professional Personal Services Sen-ice Deliverv Coverage and& CC 2~' Sen-ices Public Contracted Co-paymentVes No Yes No Emnlovccs" Out ChargesOntario No Yes ** Physical therapy, Home support, Some Professional No charges for needsoccupational therapy, personal care. professional and non- assessedservicesnursing, and non- professional. up to service limits.social work. professionalspeech therapy, services.respiratory services.Manitoba Yes No ** Nursing, Home support, Professional No charge forrehabilitation, personal care. and non- professional nursingsocial work. professional and therapy services,respiratory services services. personal care, home(home oxygen support. Equipmentservice). and medication ismixed public/privatepay.Sask. No Yes Acute care/hospital substitution, Nursing, Homemaking service, Professional Rarely. No charges forLTC/special care home occupational therapy, meal services, and non- nursing, therapies, andsubstitution, physical therapy, home maintenance professional case mgmt. deliveredmaintenance of health/prevention mental health. services. services. by DHBs. Income-of functional breakdown, assessed fees forpalliative care. home support. Somemedications andnursing supplies arecovered.Alberta No ** Nursing, Homemaking, Assessment. Home support, No charge for nursing,rehabilitation, social caregiving, case mgmt., some direct rehab, persona! care,work, respiratory meal preparation. discharge plannin nursing care. assessment andservices. case mgmt. Clientmay pay for homesupport. Equipmentand medication ismixed public/privatepay.... contmuedPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaTable 3 (continued) Health Reform Initiatives in Canada by Province/Territory, 1997 - Home CareProvince/ I Pri vnte Clinics Home CareTerritory Integrated with LTC Types of Home Care Professional Personal Services Service Delivery Coverage and& CC z~~ Services Public Contracted Co-paymentVes No Ves No Emp!oyees.l Out ChargesS.C No Yes "Community support services. Nursing, Homesupport. All professional Home support No charge for directrehabilitative services. services. care services byservices. professionals. Incometest for home support.Deductablc for drugs.Yukon IS No No " Assessment and treatment, Nursing, Home support All professional None. No charges.personal support. occupational therapy, services, and non-social support, physical therapy, personal care. professionalrespite services. social work support. services.palliative care.NWf ** Yes Used to be primarily Nursing. Home support. All professional None. No charges.focused on hospital personal care. and non-follow-up. professionalservices.Sources: Health System Reform in Canada, 1997 (Review conducted by Health Canada); and Home Care Development. Provincial and Territorial Home Care Programs: A Synthesis for Canada,June, 1999 Health Canada.** Indicates no information was provided.I Refer to the presence of private clinics in the respected province for which the province is being fined by the Government of Canada for contravening the Canada Health Act.2 LTC - Long term care.3 CC _Continuing care.4 Public Employees includes employees of regional health authorities or publicly funded agencies.5 Home management includes light housekeeping, laundry. meal planning and food preparation, Shopping and banking, etc.6 Personal care includes personal hygiene. transferring in and out of bed, walking, feeding, etc.f Acute Home Care is for individuals receiving treatment at home for an acute illness. those who have been diverted from hospital, or who have been discharged early from hospital.S Chronic Home Care is for individuals who are convalescing, chronically ill, disabled or experiencing the debilities of old age.9 Paediatric Home Care is for disabled and acutely ill children under the age of 16.10 Rehabilitation Home Care is for convalescents with demonstrated rehabilitation potential.11 Extraordinary Assistance Home Care is for chronically ill hospital patients whose condition has stabilized.12 Palliative Home Care is for individuals who are dying.13 Self-managed Home Care is for people with long-term disabilities.14 Includes home support, adult day care. meals programs. respite for caregivers, residential services.15 Information received directly from the Yukon Territory.16 However, there is coordination of services.Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaContracting out for home support services occurs in most of the provinces, the exceptions being those in (d)above. However, for Quebec, home support services for disabled persons are contracted out (Health Canada,1999).Provinces do not charge clients for professional nursing services. However, some provinces have servicelimits either in terms of the number of hours of service to be provided or they have set dollar maximums inpublic funds for these services (Health Canada, 1999).Public coverage for services of other health professionals (e.g. occupational therapists, physical therapists,social workers, speech therapists) varies with the province, but is usually limited (Health Canada, 1999).Table 4 illustrates public home care expenditures by province from 1988-89 to 1997-98. Public home careexpenditures in Canada were $2,096 M. in 1997-98, an increase of 4.8 percent over the previous year. In thelast seven years, public home care expenditures have more than doubled (from $1,028 M. in 1990-91 to$2,096 M. in 1997-98), an average annual rate of increase of almost 11.0 percent. Public home care spendingaccounts for a small but increasing percentage of total public health spending in Canada: 4.0 percent in 1997­98, up from 2.3 percent at the beginning of the decade (1990-91). The growth in spending experiencedthroughout the 1990's is the result of more aeute, rehabilitative and long-term care services being provided athome (Health Canada, 1975-76 to 1997-98).A number of provinces have some arrangement for assessment of a client's ability to pay for home support,homemaking, and other non-professional services, particularly for long-term care clients. New Brunswick'slong-term care program and Newfoundland consider assets (excluding the client's home) as well as incomefrom other sources as part of their financial assessment arrangements. Alberta charges $5.00 per hour forhome support services and considers client income as well. British Columbia, New Brunswick and NovaScotia apply any third-party insurance the client may have to cover a portion or all of the costs of needed homecare services. Manitoba, Ontario, Quebec, Yukon and the Northwest Territories do not have an officialincome/means assessment process for home support services (Health Canada, 1999).Within individual jurisdictions (as opposed to nationally across jurisdictions), there appear to be five majortrends emerging from current initiatives undertaken by the provinces and territories regarding home care(Health Canada, 1999):a) Provinces are investing significant resources for the establishment of health information networks tofacilitate the collection and transmission of timely, accurate information for home care, as well as betweenhome care and other sectors (e.g. Alberta, Saskatchewan, New Brunswick, Newfoundland).b) Provinces and territories are developing and/or reviewing standardized provincial and territorialassessment instruments and care coordination tools (e.g. British Columbia, Alberta, Saskatchewan,Manitoba, Ontario, Quebec, New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland,Northwest Territories).c) Provinces are either in the process of developing an accountability framework for the health systemincluding home care and/or they are attempting to apply accountability mechanisms to this sector throughthe development of performance measures and evaluation of outcomes (e.g. British Columbia, Alberta,Saskatchewan, Manitoba, Ontario, New Brunswick, Prince Edward Island, Newfoundland).12d) Within their respective jurisdictions, provinces and territories are making a concerted effort to developstandards for the services provided under their home care programs and for new classifications of workerswho are charged with delivering these services (e.g. Saskatchewan, Ontario, New Brunswick, NovaScotia, Northwest Territories).e) Provinces and territories, for the most part, are promoting the increased integration of direet services (e.g.British Columbia, Saskatchewan, Manitoba, Quebec, New Brunswick, Nova Scotia, Prince EdwardIsland, Newfoundland, Yukon, Northwest Territories).Table 4Public Home Care':' Expenditures':" by Province/Territory,Canada, 1988·89 to 1997·98Year Nild. P.E.!. N.S. N.B. Que. Onl. I Man. I Susko Alta. B.C. N.W.T. Yukon Canada(EXPCllditur~ ill $' ooJ)1988·89 11,029.5 2,430.3 13,275.1 29,636,5 151,338.6 159,327.9 41,376.9 25,460.4 40,238.2 89.894.0 2,617.7 623.6 767,248,61989-90 15,623.9 2,757,6 16,636.6 30,498.1 171,159.2 388,544.4 49.696.6 28,767.8 54,484.2 107,655.9 3,882,9 768,0 870,475.4IlJ90-9J 19,980.9 3,162.8 23,285.7 15,564.8 189,387.2 474,647.2 59,023.3 31,665.2 55,371.7 132,526,2 2,770.8 762.1 1,028,148.11991-92 24,544.4 3,823.9 24,401.2 39,924.5 214,630.6 584,413.0 65,507.6 34,088.1 68,901.4 152,371.1 2,630.5 846.5 1,217,082.71992-93 .3?.'.~~7:.1.. 4,137.9 ...~~:~?7:? 47,021.9 .?n:,I..I,~:7. ....6.5.2.,6.3.1;] ...1~~~?)'} .)?.'.~.?.~:.? ...2~~2~2.1 .~.?~.'.~~.?:~ ... ~:~~~:9. 907.1 J:~~~,1.??:.1.................. .............. .............1993-94 32,676.1 3,921.8 26,668.6 55,147.6 251,569.8 835,010.9 70,756.8 44,437.6 95,158.2 189,394.9 4,014.6 1,189.1 1,609,946.01994-95 39.931.5 3,689.3 29,786.7 62,574.4 241,445.4 945,199.6 77,398.6 58,590.8 102,446.1 204,175.2 3,725.9 1,111.5 1,770,075.01995-96 42,320.3 3,593.3 53,755.1 66,910.1 256,402.5 883,740.0 91,596.3 61,945.6 131,967.5 217,959.8 3,827.6 1,265.2 1,815,283.41996_975 44,114.9 4,192.1 63,505.6 68,472.3 267,945.0 989,551.2 112,612.9 67,356.9 142,404.5 232,397.6 6,384.2 1,430.8 2,000,367.91997-986 51,991.2.....1.'.?~.q:.~ .. 7~:27~:~ ...?.?.'g.?.~:.~ 277,198.3 ..1...9}.?-.?.?.?:.? ..J.9.~:~~?:? ...??.'.3.?~:~ .149,317.8 244,113.1 ...~:~~?:? .1,427.2 2,095,975.2(As II % of total public health expenditures]1988·89 1.44 1.46 UO 3.07 1.60 2.51 2.48 1.80 1.06 2.08 U6 1.34 2.001989·90 1.90 1.53 1.26 2.88 1.68 2.41 2.74 1.83 l.31 2.24 1.57 1.55 2.061990·91 2.18 1.64 1.63 3.13 1.74 2.75 2.98 1.84 1.26 2.43 1.02 1.40 2.251991·92 2.62 1.87 1.61 3.39 1.81 3.02 3.26 1.93 1.47 2.53 1.17 1.29 2.441992·93 3.06 1.95 1.54 3.95 1.94 3.28 3.51 2.18 1.59 2.67 1.07 l.38 2.64.................. ................. ............. ..............1993-94 3.43 1.78 1.77 4.61 2.04 4.26 3.40 2.67 1.98 2.73 1.26 1.51 3.111994-95 4.06 1.66 1.95 5.09 1.94 4.79 3.66 3.36 2.15 2.85 U8 l.32 3.381995·96 4.17 1.85 3.53 5.35 2.10 4.48 4.29 3.55 2.64 2.95 U9 l.38 3.451996-97 4.39 2.05 4.30 5.46 2.24 4.99 5.35 3.86 2.75 3.07 2.05 1.47 3.791997-98 5.15 2.29 5.07 5.80 2.39 5.30 4.96 3.89 2.77 3.10 2.08 1.75 3.98...............................Source: Health Cunadu. Public Home Cure Expenditures in Canada, 1975-76 to 1997-98. [cited 1999September 9). Available from URL:hup:llwww.hc-sc.gc.ca/nwin/hc/web/datapcb/datahesalEJlOme.hUll.I Public sector home care includes home care expenditures funded by provincial, territorial and municipal governments, Workers' Compensation Boards,and those made directly by the federal govcmncut (e.g. Health Canada's home cafe programs for First Nations and Veterans Affairs home carespending for veterans). Hospital-based home care is included in estimates.2 Hone care services include: assessment and case management, health care and treatment services (nursing care, physiotherapy, occupational, speechand respiratory therapy, nutritional counselling), personal SUppOJ'l services (homemaking. personal care, meat services), minor home repair andmaintenance, and social assistance services, social contact and security services, when they arc dtrectcd to a person because of an illness,a health condition or a health-related need.:'I Drugs, medical equipment and supplies (wheelchairs. ussistivc devices, hospital equipment for dialysis, etc.) arc not captured in these estimates.4 Respite services arc included as long as they arc provided at horne. Respite services provided by institutions, duy care centres or group homes are not included.5.61996_97 and 1997-98 figures are estimates.133. Health Human ResourcesIn general, most provinces are actively undertaking some action with respect to health human resources in theirjurisdictions, whether it be through the establishment of human resources planning units. the establishment ofworking groups to examine health human resources requirements, the establishment of advisory councils orcommittees, or the development of health human resources management plans. Table 5 illustrates the range ofhealth human resources activities taking place across Canada.Currently, in almost all provinces, much of the focus of health human resources planning and management ison physician and nurse resources. Some provinces have struck specific advisory committees to assist with thedevelopment of physician and/or nurse resources management plans.Two provinces in Canada (Newfoundland and Ontario) have established nurse practitioner training programs.Almost all provinces have reported midwives and nurse practitioners as having emerging roles in theirrespective provinces. In addition, Manitoba also reported physician assistants as having an emerging role inthat province.Three provinces in Canada have enacted legislation to consolidate the separate statutes regulating some healthprofessions in their jurisdictions. In Alberta, the Health Professions Act (Bill 22, Health Professions Act, 3nlSess. 24'h Let. Alberta, 1999 [ascended to 19 May 1999]), will consolidate legislation for twenty-nine healthprofessions, while in British Columbia, nine health professions are currently designated under theirAct (HealthProfessions Act, R.S.B.C. 1996, Chapter 183), and another ten are being reviewed for designation (HealthProfessions Council).In order to complete the picture on health human resources activities during this period of health reform, abrief overview on nursing education (from our survey reported in Volume III of this study) is included in thisdiscussion on structural reform initiatives. According to the information provided on nursing education by theprovinces/territories, five provinces stated that they have only baccalaureate degree as entry to practice forRegistered Nurses (RNs), (i.e. Manitoba, Newfoundland, New Brunswick, Prince Edward Island, and NovaScotia). British Columbia, Saskatchewan, Alberta and Ontario have collaborative RN education programsthat give students a choice of finishing with a diploma or continuing and obtaining a Bachelor's degree.British Columbia's collaborative nursing education programs are funded so that there is a diploma exit andonly a proportion of baccalaureate seats are funded (approximately 50%). All ten provinces train LicensedPractical Nurses/Registered Nursing Assistants.14Table 5 Health Reform Initiatives in Canada by Province/Territory, 1997 - Health Hnman ResonrcesProvince/ Health Human Resources FundingTerritory % of Provincial l Per CapitaBudget Allocated HealthGeneral Phvslcian Remuneration Nursing Education Changes in Legislation Emerging Roles to Health Care ExnendituresNfld. Provincial Human Increased pay scale for rural Diploma nursing prgs Legislation has been enacted Midwifery - under 28% 52,339.45Resources Steering physicians. being phased out & in regard to Nurse Practitioner consideration.Committee Isolation bonus program for baccalaureate nursing Prg. Nurse Practitioners.salaried general practitioners education required Amendment to Physiotherapywho commit to a min. of 2 years for RNs. Act 1999 (is underway).service in a designated rural Nurse Practitioner Prg.area of province. Nursing AssistantTraining Prg.PEl Working Group to ;;<* ** Health Services Payment Act ** 37% 52,389.89examine provincial was amended to formallyhealth human establish the Physicianresource requirements. Resource Planning Committee.Nova Working Group on ** Moving towards ** Midwifery. 36.9% 52.258.83Scotia Heal th Human Baccalaureate as Nurse Clinicians.Resources. entry to practice byPhysician Resource year 2000.Section (responsible& accountable for allissues related tophysician numbers,locations, recruitment& training).New Provincial Physician Fee-for-service under a hard cap Baccalaureate degree ** Roles & responsibility 30% 52,520.62Brunswick Resource Manage- contract; (cap at 5280,000 for as entry to the of RNs, Registeredment Plan. family practitioners & 5406,000 profession by year Nursing Assistants,Nursing Services & for specialists). 2000 & support personnelResource Manage- Salary. are being examined.ment Plan. Sessional payments.Rehabilitation ServiceAdvisory Committee.Quebec Professional Code: Fee-for-service. Creation of a nursing ** Midwives. 27.7% 52,383.21Quebec Professions Salary. network of AIDS Expanded role forBoard set up under Fixed fee and an hourly rate. educators. communitythis code to ensure University program in pharmacists ineach professional pre-operative nursing promotion &order makes care (development prevention.provisions for the of operating roomprotection of public. nursing staff).. .. continnedPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaTable 5 (continued) Health Reform Initiatives in Canada by Provincefferritory, 1997 - Health Human ResourcesProvince! Health Human Resources FundingTerritory % of Provincial I Per CapitaBudget Allocated HealthGeneral Physician Remuneration Nurslna Education Chanaes in Legislation Emeretns Roles to Health Care ExpendituresOntario HST Ap2 - established Fee- for -service. Nurse Practitioner Developments in the area of "'* 33% $2.647.43to help workers Salary. Training Program. nurse legislation on primaryaffected by labour Capitation. care so that nurses can exerciseforce adjustment to Blended, a greater role as multi-disciplinaryre-train for future Rural physicians guaranteed health-care providers.employment. annual income of $194.000HPRAC' - provides plus a bonus of S 10,000-$25,000ongoing advice to at completion of a 3-yr contract.Minister of Health onregulation of healthprofessions.Manitoba Human Resource Fee-for-service. z-year diploma prg In the process of reviewing and Midwifery. 34% $2,692.99Planning Unit recently Alternate payment arrangements for RNs is being revising Registered Nurses Act. Expanded role forestablished. including block funding, salaried phased out; the RNs in WestmanProvincial Health contracts, capitation and required training Nurse Managed CareCare Labour sessional arrangements. for RNs will be a EmergencyfOPDAdjustment Salary incentives provided to 4-year bachelor of which allows nursesCommittee - to develop rural physicians and increased nursing degree. to decide if a patient& coordinate compensation provided to Training prg for LPNs needs to see a doctor.implementation of physicians providing after hours has been expanded. Physician Assistants.comprehensive Human emergency care.Resource AdjustmentStrategy.Manitoba NursingProfessions AdvisoryCouncil - to developnursing resource plan.Sask. 4 3 standard bargaining Fee-for-service. New RN education Sask. Dental Hygienist Midwifery (but not 39% $2,411.26units created in order Sessional fees. prog that gi ves Assoc. licenses and insured service under (excluding debtto promote integration Contract for service. students a choice of regulates its own members. Medicare). reduction)of health services Direct employment. finishing after 3 years Amendment to Optometric & Advanced Clinicaldelivery & consistency Funding is determined using a with a diploma or Opthalmic Dispensing Profession Nursing Program.of employment population-based model and flows continuing for 1 more Act to allow optometrists to Chiropodistsconditions. through to the districts who then year at Univ of Sask. prescribe drugs & treat infectious proposes to expandSask. Medical contract with the physician or for bachelor's degree. eye disease. scope to that ofCouncil. physician group. (NB: above is A new Psychologists Act podiatrists.agreement between which allows individuals withSIAST5 & Univ of Sask) Master's degrees to be licensedSIAST offers an as psychologists.Advanced Clinical Midwifery Act passed in May, 1999.Nursing Program.. .. continuedPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaTable 5 (continued) Health Reform Initiatives in Canada by Provincefferritory, 1997 - Health Human ResourcesProvince/ Health Human Resources FundingTerritor)' % of Provincial 1 Per CapitaBudget Allocated HealthGeneral Phvslclan Remuneration Nursing Education Chanees in Lcztslatlon Emeralna Roles to Health Care ExoendlturesAlberta Health Professions Most physicians are paid on a ** Registered Nurses Providing Midwifery. 28% S2316.86Act to consolidate fee-for-service basis Extended Health Services Community Nurselegislation re: 29 Regulation (permitted repeal of Practitioners.Health Professions. Nursing Services Act).Optometry Profession Standardof Practice Regulation (amendedto permit optometrists withcertification to provide therapeuticpharmaceutical agents &remove foreign bodies from eye).Medical Profession Act(amended to allow registeredpractitioners to providecomplementary services).B.c. Health Professions While fee-for-service is still RN Education Health Professions Council is Midwifery. 35.8% $2.63945Act - currently 9 largely the most common Programs are conducting scope of practice Acupuncturists.Health Professions method of payment, some designed to graduate reviews of all currently regulateddesignated under physicians are selecting 50% of students with health professions includingthis Act. salaried and other alternate diploma and 50% with registered nurses, registeredHealth Professions modes of payment. baccalaureate psychiatric nurses, and licensedCouncil - advisory to APB 7 funding may be in the form degrees. practical nurses.Minister of Health - of salaries, sessional fees,legislative and scope or service contracts.of practice review ofall regulatedprofessions underway.HEABC6 - singleemployers'organization.Health Labour Accordbetween provincialgovernment and 3major hospital unions.. .. contmuedPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia00Table 5 (continued) Health Reform Initiatives in Canada by Province/Territory, 1997 . Health Human ResourcesProvince/ Health Human Resources FundingTerritory % of Provincial I Per CapitaBudget Allocated HealthGeneral Phvslcian Remuneration Nursine Education Chanees in Leaislatlon Emcretne Roles to Health Care ExoendlturesYukon8 2 major HHR FFS. None Medical Professions Act under Nurse Practitioner - 16% S3,456.05employers: Yukon Sessional fees. review. expanded roleHosp Corp. (acute Contracts. Pharmacists' Act changed to supported by policy.care) & Gov't of Yukon allow Nurse Practitioners to(LTC, community prescribe within strict guidelines.health, home care). Changing Scope of Practice ofJoint Management Optometrists to allow them toCommittee - Physician prescribe eye medications.Resource Planning Administrative changes to DentalCommittee. Professions Act.Working Group on A number of health professionsNursing Resources. are not regulated e.g.physiotherapists, occupationaltherapists.Yukon Dept of Justice administershealth protessionatlcgislanon.NWT Human resource plan ** ** ** Expanded scope of 21.6% S5.051.69currently being practice for nursesdeveloped for all (i.e. nurse practitioner).health & social Midwifery.service providers. Augmenting role ofphysicians to includesupport & educationto community teams.Sources: Health System Reform in Canada, 1997 (Review conducted by Health Canada); and National Health Expenditure Database and National Health Expenditure Trends, 1975~1997, Cllll.** Indicates no information was provided or that the information provided was unclear.1 Per capita health expenditure figures were obtained from National Health Expenditure Database. National Expenditure Trends, 1975-1997, CIHl.2 HSTAP _Health Sector Training and Adjustment Program3 HPRAC _Health Professions Regulatory Advisory Council4 AI! information with the exception of per capita health expenditure figures were received directly from Policy and Planning, Saskatchewan Health.5 SIAST ~ Saskatchewan Institute of Applied Sciences and Technology6 HEABC - Health Employers' Association of B.c.7 APB _ Alternate Payments Branch.S All information with the exception of per capital health expenditure figures were received directly from the Yukon.Prepared by:Health Human Resources UnitCentre for Health Services and Polk)' ResearchThe University of British Columbia4. Long Term CareTable 6 presents the number of public and private long term care facilities and the number of public andprivate long term care beds in each province. An interesting trend emerges in the Atlantic provinces withregard to the number of public and private facilities and the number of public and private beds. In two of theAtlantic provinces (Nova Scotia and Prince Edward Island). there are approximately equal numbers of publicand private facilities, but there are approximately 600 more public beds in Nova Scotia than private beds andtwice as many public beds in PEl than private beds. Newfoundland has four times as many private facilitiesas public, but there are approximately 100 more public long term care beds. Similarly, New Brunswick hastwice as many private facilities as public, but there are approximately 1500 more public long term care bedsthan private ones. One reason for the above trend may be that there are a large number of private facilities inthe Atlantic provinces, but these facilities are very small in size.Table 6Health Reform Initiatives in Canada by Province/Territory, 1997 - Long Term CareProvince Long Term CareNumber of Facilities Number of BedsPublic Private Total Public Private TotalNewfoundland 19 81 100 2,016 1,907 3,923Prince Edward Island 9 8 17 690 332 1,022Nova Scotia 74 70 144 4,038 3,423 7,461New Brunswick 70 160 230 3,660 2,200 5,860Quebec 274 145 419 27,547 8,347 35,894Ontario 253 490 743 27,803 40,007 67,810Manitoba 136 50 186 7,025 3,235 10,260Saskatchewan 1,2 111 48 159 4,992 4,016 9,008Alberta 54 47 101 4,660 4,607 9,267British Columbia 3 204 20 224 15,128 1,586 16,714Yukon 4 3 0 3 98 0 98Northwest Territories 4 0 4 28 0 28Source:Guide to Canadian Healthcarc Facilities, Vol. 5, 1997-1998; Prepared by Canadian Healthcare Association.1 Information received directly from Policy and Planning, Saskatchewan Health.2 Private bed numbers in Saskatchewan include nonprofit affiliated facilities and nonprofit contracted facilities.~ Information received directly fromtheB.C. Ministry of Health and Ministry Responsible for Seniors.4 Information received directlyfrom theYukonTerritory.19III. DEMOGRAPHIC ANALYSESAll of the demographic analyses discussed below have been undertaken using 1996 Census data prepared byStatistics Canada. The Population Estimates Tables for all provinces and territories have been organized bycensus division. Census division (CD) is a term applied by Statistics Canada to areas established byprovincial law which are intermediate geographic areas between the municipality (census subdivision) and theprovince level. Census divisions represent counties, regional districts, regional municipalities and other typesof provincially legislated areas. In Newfoundland, Manitoba, Saskatchewan and Alberta, provincial law doesnot provide for these administrative geographic areas, so, census divisions have been created by StatisticsCanada in cooperation with these provinces for the dissemination of statistical data. In the Yukon Territory,the census division is equivalent to the entire territory (Statistics Canada, 1998).The census division was chosen as the geographic descriptor for each province/territory because StatisticsCanada officially utilizes this designation for the dissemination of statistical data and it was felt that using astandardized unit of analysis across all provinces and territories would be useful for comparison purposes.In 1996, there were approximately 29 million people in Canada (see Table 7). Over sixty percent of thepopulation is concentrated in central Canada (i.e. 37% in Ontario and 25% in Quebec) and approximatelythirty percent in western Canada. The Atlantic provinces make up eight percent of the population and theterritories the remainder.In general, there is little gender variation by age in the Canadian population. While there are more womenthan men in the 65+ age group, there are virtually equal numbers in the younger age groups (see Figure Ibelow for Canada, and the Figures in Appendix 2 for the individual provinces/territories). Looking at thecensus information by province and territory and by smaller age categories provides more detailed informationregarding the distribution of males and females in each age group (see Figure 2 below for Canada, and theFigures in Appendix 2 for the individual provinces/territories). Note that in general, the territories haveslightly more males than females and that in the 65 and older age category, the number of females overtakesthe number of males in the 75-79 and older age group for the Yukon and the 80-84 and older age group for theNorthwest Territories. In contrast, in all other provinces, the number of females overtakes the number ofmales beginning with the 65-69 age group.The Northwest Territories has a relatively young population; approximately 40% of the population in theNorthwest Territories is aged 0-19 years, as opposed to provinces such as Quebec and British Columbia,where only 26% of the population is aged 0-19 years.20Table 7Population Estimates in Canadaby Province!ferritory by Age and Sex1996<25 25-34 3544 45-54 55-64 65+ SublOOdprovince M F M F M F M F M F M F M F TOOdNewfoundland 100,950 97,235 41,140 43,865 45,005 46,695 36.620 36.275 22,470 22,075 26,375 33,090 2725(JJ 279,235 551,795Prince EdwardIsland 24,740 23,765 9,570 9,790 10,270 10,475 8,440 8,500 5,725 5,830 7,305 10,135 66,050 68,495 134,545NovaScotia 154,075 149,720 67,475 70,455 73,065 76,495 59,420 59,955 39,215 40,340 49,110 69,975 44~360 466,940 'JO),"iXlNewBrunswick 127,825 122,755 55,765 56,925 60,630 61,970 48,670 47,870 30,860 31,695 39,195 53,955 36~945 375.170 738,115Quebec 1,182,%5 1,137,120 545,960 545,395 615,770 623,855 483.370 492,605 315,480 335,425 349,705 510,870 3,493,250 3,645,270 7,J3R520Ontario 1,845,%5 1,769,745 843,505 873.515 869,900 909,260 675,995 691,775 460,035 479,785 562,570 771.540 5,257,970 5,495,620 10,753,59::>Manitoba 203,485 194,965 82,085 82,475 87,470 87,800 66,250 66,485 44,695 46,060 63525 88.610 547,510 5(Xj.395 1,113,XlSSaskatchewan 189,lJO J80,805 66,100 67.920 76,480 75,790 54,160 53.285 40.050 40.915 63,535 82,035 489,435 500,750 gw,l85Alberta 507,080 484.390 217,465 218,580 242,975 236,830 161.920 157.750 10~050 100,900 116,825 150,050 1,348,315 1,34RSOO 2,W6,815BritishColumbia 622,120 596,805 289,155 294,125 313,015 321,800 246.930 243,645 161,140 159.885 207,895 267,920 1,840,255 1,884,180 3,724,435Yukon 5,945 5,530 2,570 2,795 3,225 3,115 2,330 1,955 1,085 855 725 635 15,800 14,885 30,765Northwest Territories 16,100 15,240 6,150 6,080 5,155 4,635 3,375 2,790 1,560 1,325 990 910 33,32{) 30,900 64,310tvTOTAL 4,980,360 4,778,075 2,226,940 2,271,920 2,402,960 2,458,720 1,847,480 1,862,890 1,224,365 1,265,090 1,487,755 2,039,725 14,169,80) 14,676,420 28,846,2&JPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaFigure 1: Proportion of Males and Females in Canada by AgeGroup, 1996II Femalesa Males100.00 .90.0080.0070.00C 60.00~e 50.00~ 40.0030.00 .20.0010.000.00 W=-+--LCLe-L'-'L-+-L...J-+...L..-Lt--l.:...L-j-.LL,---L...L..;-1=--10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ AllAgesAge Groups12.011.010.09.08.01: 7.0~e 6.0~ 5.04.03.02.01.00.0Figure 2: Percent of Males and Females in Canada by Age Group, 1996(NS: Total Male= 49.12%; Total Ferrale e 50.88%)00000 ,1 ~-... _- ill I - -----0 i1 ~- a MalesI~I I I_. ,0 Ii I I: r, iil~ - 1 i, ;; ~ III ill FemalesIii ~ II ~0 li[- -- li~1m ~ I m Ii I:0"I:'Ii rFIi I'-Ilr II !im ;: [; m0 Ii , f! a Ii.~ " Ii" " , Ii IIII lit I rn0 I , nI::II~ ,11- li- lf I ~ ..- 1.1 l-rllhJ1111,- Ii ~~ 11111 10 I II- I I Iii -li~l- - ii, _.0 1,! " ~! m " ., Ii Ii Ii ,~ Ii-o- c» ..- m ..- m -r m -e m -c- m -sr c» -r en -r +6"'6 ')J '7 '7 1" 1" '\' '\' '\' '\' ~ ~ '\' to6"'co 0"'0 io 0 io 0 io 0 co 0 co~ ~ N N'" '"..- ..-"'io co co ,... ,... coAge GroupsA population pyramid is a visual representation of demographic events over the past 80 or 85 years in aparticular population. Changes such as the impact of immigration/emigration, wars and famines, and changesin birth and death rates can readily be seen in such a graph. The graph represents the age-sex structure of apopulation, which is dependent on the birth and death rates in the population over time (Anderson, 1999).The age-sex pyramid for Canada (see Figure 3) generally depicts a 'stable' pyramid, which tends to haverelatively straight sides and tapers gradually at the top. However, note that Canada's pyramid also shows the"baby boomers" (i.e. ages 30-34 through to ages 45-49, in 1996). Adjusting for this "bulge", one would seethe straight sided pyramid which is typical of a stable population (i.e. where birth and death rates are low andnearly equal).22Figure 3: Male and Female Population in Canada by Age Group, 1996Male Population in Canada by Age Group1400000 1200000 1000000 800000 600000 400000 200000PopulationPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia85+80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0Female Population in Canada by Age Group200000 400000 600000 800000 1000000 1200000 1400000PopulationThe boomer effects are stronger in some provinces; Saskatchewan, Newfoundland, Prince Edward Island, andthe Northwest Territories all appear as if they have a replacement boom, while Nova Scotia, New Brunswick,Quebec, Ontario, British Columbia, and the Yukon do not (see Figures in Appendix 3). The fact that thereplacement boom is not to be found in the most populous provinces/territories indicates its limits in terms ofthe potential for replacing the existing workforce.When the age-sex pyramids are looked at for individual provinces and territories, two provinces stand out asbeing different. First, in comparison to other provinces, Saskatchewan has a large proportion of its populationin both the younger and older age groups. Approximately 30% of Saskatchewan's population falls into the 0­19 age category and 15% of the population is distributed in the 65 and older category.The Northwest Territories is the other province/territory with a unique age-sex pyramid. It appears as thoughthe population in the Northwest Territories is growing at a fast rate, as the younger cohorts are much largerthan the older cohorts, Adjusting for baby boomers, one would see an 'expanding' pyramid implying a lowdeath rate and a high birth rate or, alternatively, the death rate declining much faster than the birth rate.Nationally, in the 85 and older cohort, there are more than double the number of females than males,particularly in Quebec. The relative difference in number of males and females in that province is even largerthan that seen for Canada.The pie charts illustrate the relative distributions of different age groups for all provinces and territories as of1996, each chart depicting a single age group (see Figures 4-6). The proportions are calculated relative toeach provincial total and not the Canadian total, so the relative distributions in each pie chart do not add up toone hundred percent.The purpose of plotting the relative proportions of different age groups by province was to identify andillustrate which provinces have the highest relative proportion of children, youth, elderly, etc. A province thathas a relatively high proportion of young people will have different health care and health service deliveryneeds compared to a province that has a relatively high proportion of the elderly.It is important to note that if one looks at the pie charts alone or at the age-sex pyramids alone, the informationobtained may reflect only part of the story. For example, if one looks at the relative proportion of 0-19 yearolds in each province using only the pie charts, one would think that there was really no difference betweenAlberta and Saskatchewan, as Alberta has 29.88% of its population in the 0-19 age group, whileSaskatchewan has 30.82% of its population in the 0-19 age group. One could argue that in both provinces,approximately 30% of their population is 0-19 years of age. However, when one examines the age-sexpyramids for each province, a different picture emerges: Saskatchewan appears to have a replacement boomand Alberta does not. Similarly, if one just looked at the pyramids without looking at the pie charts, thepyramids may overstate certain aspects of demographic differences between the provinces.24r-------------·-------------------,Figure 4: Relative Proportion of 0-19 Year Olds in each ProvincerrerritoryNWT40.91%NF28.17%PBYT30.59%BC26.26%AB29.88%SK30.82% MB28,93%ON27.08%NS26.63%NB26.80%PO26.14%NB: Thedenominator for each province is different as eachprovince has a different totalpopulation, thus the percentagesdo not add up to 100.,------------------------_._------Figure 5: Relative Proportion of 20-29 Year Olds in each ProvincerrerritoryNWT NF17.07% 15.06%PB13.53%NSBC 13.59%13.75%NB14.09%AB14.25%POSK 13.10%12.60% ONMB13.61% 13.73%NB: Thedenominator for each province isdifferent as each province has a different total populationthus, thepercentages donotaddupto 100.25Rgure 6: Relative Proportion of 65-79 Year Olds in each ProvincerrerritoryBeAB7.69%SK10.72%MB10.10%YT NWT3.74% 2.46%ON9,71%NF8.42%PO9.53%PBNS9.86%NB9.56%NB: The denominator for each province is different as each province has a different totalpopulation thus, the percentages do not add up to 100.26IV. BED TO POPULATION RATIOSWhen calculating the bed to population ratios by province/territory, it was thought that it would be useful toseparate acute care beds and long term care (LTC) beds. Thus, separate tables were developed for the numberof acute care beds per 1,000 population and the number of acute care beds per 1,000 population 65 and older(see Tables 8 and 9, respectively), as well as for the number of LTC beds per 1,000 population and thenumber of LTC beds per 1,000 population aged 65 and older (see Tables 10 and 11, respectively).The acute care bed counts for most provinces and the Northwest Territories were obtained from the Guide toCanadian Healthcare Facilities, Vol. 5, 1997-1998 (see Appendix 4). The acute care bed numbers for Albertawere obtained from Health Care '98: A Guide to Health Care in Alberta, July, 1998. For Saskatchewan andthe Yukon, the acute care bed numbers were provided directly by the respective health ministries.The LTC bed counts for most provinces and the Northwest Territories were obtained from the Guide toCanadian Healthcare Facilities, Vol. 5, 1997-1998. For British Columbia, Saskatchewan, and the Yukon, theLTC bed numbers were provided directly by the respective health ministries.In counting the total number of acute care beds, the following types were included:• general beds (this category includes general beds, isolation beds, medical/surgical beds, and T.B.!respiratory beds);• psychiatric/mentally handicapped beds;• pediatric beds;• rehabilitation/convalescent beds;• extended care/chronic beds.Note however, that when calculating the acute care beds per 1,000 population aged 65 and older, the totalnumber of acute care beds included all of the above bed types with the exception of pediatric beds since it isinappropriate to include these beds, given the population of interest.In calculating the total number of LTC beds, the figures include both public and private LTC beds in eachprovince.For acute care beds, it appears that Alberta has the highest number per 1,000 population at 7.95, followed byQuebec (5.87) and Manitoba (5.42). Alberta's acute care bed ratio is much higher than the acute care bedratio for Canada as a whole (4.88) (see Table 8).When examining the number of acute care beds per 1,000 population aged 65 and older, and after omitting theNorthwest Territories (which is an outlier), Alberta still has the highest number of acute care beds per 1,000population aged 65 and older because of its relatively small percentage of 65+ population (see Table 9).27Table 8Acute Care Beds per 1,000 Population by Province/TerritoryPopulation Total # of # Acute CareProvince in Thousandsl Acute Care Hcds2 Beds/IOOO PonulatlonNewfoundland 551.80 959 1.74Prince Edward Island J34.55 7J7 5.33Nova Scotia 909.30 3,928 4.32New Brunswick 738.J2 3,J71 4.30Quebec 7J38.52 4J,938 5.87Ontario 10,753.59 4J,347 3.84Manitoba J,J 13.9J 6,033 5.42Saskatchewan' 990.J9 3,326 3.36Albcna4 2,696.82 2 J,452 7.95British Columbia 3,724.44 17,7J7 4.76Yukon s 30.77 59 1.92Northwest Territories 64.31 260 4.04Total 28846.32 J40907 4.88Sources: Guide to Canadian Healthcarc Facilities, Vol 5, 1997·1998, prepared by Canadian Healthcare Association;and HealthCare '98: A Guide to Health Care ill Alberta. July, 1998.I Population datu obtained from 1996 census data prepared by Statistics Canada.2 Total number of acute care beds includes the following types of beds: General Beds (this category includes general beds,isolation beds, medical/surgical beds, and T,BJrespiratory beds), Psychiatric/Mentally Handicapped beds,Pediatric beds, Rehabilitation/Convalescent beds, lind Extended care/Chronic beds.l Acute care beds numbers (as of Mar I, 1999) received directly from Policy and Planning, Saskatchewan Health.•1 Acute care beds numbers received directly Iromthc Alberta Ministry of Health.:;Acute care beds numbers received directly from the Yukon Territory Ministry of Health,Table 9Acute Care Beds per 1,000 Population Aged 65 and Older by Province/TerritoryPopulation 65+ Total# of # Acute CareProvince in Thousands] AcuteCare Beds2,3 Heds/IOOO Ponulatlon 65+Newfoundland 59.47 901 15.15Prince Edward Island J7.44 667 38.25Nova Scotia J J9.09 3,673 30.84New Brunswick 93.15 3,056 32.81Quebec 860.58 41,059 47.7JOntario J334.ll 39,68J 29.74Manitoba J52.14 5,68J 37.34Saskatchewan,J45.57 3,064 21.05Albcrta-~ 266.88 2J,139 79.21British Columbia 475.82 J7,190 36.13Yukon 6 1.36 53 38.97Northwest Territories 1.90 208 109.47Total 3527.5J 136372 38.66Sources: Guide to Canadian Healtbcarc Facilities, Vol 5, 1997-1998, prepared by Canadian Hcalthcure Association;and Health Care '98: A Guide to Health Care in Alberta, July, 1998.I Population data obtained from 1996 census data prepared by Statistics Canada.ZTotalllumber of acute care beds includes the following t)1les of beds: General Beds (this category includes general beds,isolation beds, medical/surgical beds, and T.B.lrespiratory beds), Psychiatric/Mentally Handicapped beds,Pediatric beds, Rehabilitation/Convalescent beds, and Extended care/Chronic beds.'Total number of acute care beds in this table docs not include Pediatric beds as they lire not applicable. Therefore,the total number of acute care beds shown here will be less than tile total shown in Table 8.4 Acute care beds numbers (as of Mar I, 1999) received directly from Policy and Planning, Saskatchewan Health.5 Acute cure beds numbers received directly from the Alberta Ministry of Health.6 Acute care beds numbers received directly from the Yukon Territory Ministry of Health.28Regarding the number of LTC beds per 1,000 population, Manitoba has the highest (9.21), followed bySaskatchewan (9.10), and Nova Scotia (8.21) (see Table 10). When looking at the number of LTC beds per1,000 population aged 65 and older, after omitting the Yukon as an outlier, Manitoba still has the highestnumber of beds at 67.44 beds per 1,000 population aged 65 and up, followed by Newfoundland (65.97), andNew Brunswick (62.91) (see Table 11). The number of LTC beds per thousand population aged 65 and olderfor Canada as a whole is 47.44 and the provinces discussed above seem to all be substantially higher than thenumber for Canada.Table 10Long Term Care Beds per 1,000 Population by Province/TerritoryPopulation Total # #LTCProvince in Thousands' of LTC Bcds2 Heds/IOOO PcnulationNewfoundland 551.80 3,923 7.11Prince Edward Island 134.55 1.022 7.60Nova Scotia 909.30 7,461 8.21New Brunswick 738.12 5.860 7.94Quebec 7138.52 35,894 5.03Ontario 10,753.59 67,810 6.31Manitoba 1,113.91 10,260 9.21Saskatchewan' 990.19 9,008 9.10Alberta 2.696.82 9.267 3.44British CoJumbia 4 3,724.44 16,714 4.49Yukon 5 30.77 98 3.18Northwest Territories 64.31 28 OMTotal 28846.32 167,345 5.80Source: Guide to Canadian Hcalthcarc Facilities, Vol 5, 1997-1998, prepared by Canadian l-lcalthcarc Association.I Population data obtained from J 996 census Jaw prepared by Statistics Canada.2Includes the number of public and privatc long term care beds in the respective province/territory.J Long term care bed numbers received directly from Policy and Planning, Saskatchewan Health.4 Long term cure bed numbers received directly from the Ministry of Health and Ministry Responsible for Seniors in Be..\Long term care bed numbers received directly from the Yukon Territory Ministry of Health.Table 11Long Term Care Beds per 1,000 Population Aged 65 and Older by Province/TerritoryPopulation 65+ Total # of #LTCProvince in Thousands t LTC Ucds 2 Ueds/l000 Pomrlation 65+Newfoundland 59.47 3,923 65.97Prince Edward Island 17.44 1,022 58.60Nova Scotia 119.09 7,461 62.65New Brunswick 93.15 5,860 62.91Quebec 860.58 35.894 41.71Ontario 1,334.11 67.810 50.83Manitoba 152.14 10,260 67.44Saskatchewan) 145.57 9,008 61.88Alberta 266.88 9.267 34.72British Columbia4 475.82 16.714 35.13Yuko!1 5 1.36 98 72.06Northwest Territories 1.90 28 14.74Total 3527.51 167.345 47.44Source: Guide 1O Canadian l Icaltbcaro Facilities, Vol 5, 1997-1998, prepared by Canadian Hcalrhcarc Association.1 Population data obtained from 1996 census data prepared by Statistics Canada.2 Includes the number of public and private long term care beds in the respective province/territory..1 Long term care bed numbers received directly from Policy and Planning, Saskatchewan Health.4 Long term care bed numbers received directly from the Ministry of Health and Ministry Responsible for Seniors in BC., Long term care bed numbers received directly from the Yukon Territory Ministry of Health.29V. DISCUSSIONHuman resources requirements, and nursing requirements in particular, are influenced by the complexinteraction of many economic, political, and social factors (Kazanjian and Wood, 1993). The health reforminitiatives undertaken in almost all of the provinces/territories in Canada, together with the changingpopulation structure and the increased attention to health care costs, all have implications for the nurseworkforce in Canada.Regional health authorities, having been bestowed with the responsibility for health services delivery in theirregions, are challenged to provide appropriate care in a timely and cost-effective manner. Many regionalauthorities are struggling with not only the best way to provide care to their communities, but also with whoshould provide that care. This has implications for expanded scopes of practice for RNs, and a few provinceshave already developed nurse practitioner training programs which train RNs to provide primary care servicesand enable them to have more autonomy and decision-making capability. It also has implications for thedeployment of unregulated care providers. What health reform and regionalization has not addressed is theappropriate nursing mix required to carry out the range of health services, nor what the optimal nursing mixmight be for a particular region.As discussed earlier, regional health authorities receive funding to provide health care services to theirpopulations based on specific funding formulas. These funds are the primary source of nurse salaries in allregions in Canada. Approximately 65% to 75% of total hospital operating expenditures is for the payment ofsalaries and of this, approximately 30% is for registered nurse salaries (Kazanjian et al, 1984). Table 12illustrates total health expenditure by use of funds, by province/territory for 1997 and the 1997 registerednurse, physician and acute care bed supply by province and territory. Table 13 provides historical informationregarding the number of hospital beds, patient-days, physician, and nurse resources from 1980 to 1994 forCanada as a whole. Note that while the number of hospital beds and patient-days per 100,000 population havedropped 22.5% and 24.9%, respectively, over the fourteen year period, the number of physicians and nursesper 100,000 population has increased by 26.3% and 15.6%, respectively.Registered nurse, physician, and acute care bed numbers have been included in the Tables since previous work(Kazanjian et ai, 1984), clearly demonstrated that physician stock and bed stock accounted for, jointly, anappreciable proportion of the variation in registered nurse paid hours. In addition, physician expenditureshave been included in Table 12 as evidence from our very recent unpublished work suggests that payments tophysicians is also a factor affecting the demand for registered nurses.30Table 12Total Health Expenditure by Use of Funds, by Province/Territory, 1997' - Cnrrent Dollars ($' 000,000)and Registered Nurse, Physician, and Acute Care Bed Supply by Province/Territory, 1997Province! Hospital Other Institutions3 Other Health Physician Other Professionals6 Total Total # Registered Total # Active Total # Acute CareTerrirorv Exnenditures2 Expenditures Spending,Exnenditures5 Druas. Caoital Expenditures Expenditures Nurses' Civilian Phvsicians8 Beds9NF 563.4 ]55.2 ]32.7 147.8 3]5.3 1,314.3 5.210 932 959PEl 128.6 51.8 35.9 35.1 99.7 351.0 ],281 165 7]7NS 852.0 295.8 ]98.2 274.6 604.6 2.225.] 8.587 1.766 3.928NB 737.2 196.] ]84.8 226.0 417.8 1,762.0 7.412 1.]27 3.l7]PQ 6.449.7 1.545.7 2,002.6 2.2]3.3 4,922.3 l7,]33.5 59.]60 ]5.315 41.938ON 9.825.5 2,555.3 3.682.5 4.853.6 9,230.] 30,146.9 78,067 20.202 41.347MB 1.055.7 393.2 492.9 318.2 785.6 3.045.5 10,510 2.013 6.033SK 737.7 388.9 496.1 318.3 686.6 2,627.5 8.456 1.474 3.326AB 2.155.4 822.2 1.336.5 804.8 1.930.0 7,049.0 21.428 4.511 21.452Be 3,314.6 1,228.9 1.651.4 1.721.2 2,879.8 10,796.0 28,974 7,622 17.717YT 33.3 8.4 31.6 ] 1.5 22.0 106.8 252 50 59NWT 116.3 13.3 141.6 22.1 95.9 389.3 476 66 260Total 25,969.4 7,654.8 10.386.8 10.946.5 21,989.7 76,946.9 229.8]3 55,243 140.907Mean 2.164.1 637.9 865.6 912.2 1.832.5 6.412.2 ]9.151 4.604 11,742Sources: Canadian Institute for Health Information (CIHI), [cited 1999 June 28], available from: URL: http://www.CIHLca/facts/fac.htm;Guideto Canadian HealthcareFacilities, Vol. 5, 1997~1998, prepared by Canadian Healthcare Association: and Health Care '98: A Guide to Health Care in Alberta, July, 1998.1The 1997 expenditure figures for all provinces are forecasted numbers.2 Hospital expenditure figures obtained from cnn [cited 1999lune 28].3 "Other Institutions" include residential care types of facilities (for the chronically ill or disabled, who reside at the institution more or less permanently) and which areapproved, funded or licensed by provincial/territorial departments of health and/or social services. Residential care facilities include homes for the aged (includingnursing homes), facilities for persons with physical disabilities, developmental delays, psychiatric disabilities, alcohol and drug problems, and facilities foremotionally disturbed children. Source: CIHI [cited 1999 June 28].4 "Other Health Spending" includes expenditures on home care, medica! transportation (ambulances), hearing aids. other appliances and prostheses, public health,prepayment administration, health research and miscellaneous health care. Source: Clffl [cited 1999lune 28].5 Physician expenditures figures obtained from CIHI [cited 1999 June 28J.6 "Other Professionals" represent expenditures for the services of privately practicing dentists, denturists, chiropractors, massage therapists, orthoptists, osteopaths.physiotherapists, podiatrists, psychologists, private duty nurses, naturopaths. Source: Clril [cited 1999 June 28].7 Total number of registered nurses employed in nursing. Note that LPN numbers were not available. Source: CIHI [cited 19991une28J.8 See Table 8 Acute Care Beds per 1.000 Population by Province/Territory. Source: Guide to Canadian Health Care Facilities, Vol. 5, 1997-1998. For Saskatchewan.Alberta and the Yukon, acute care bed numbers were received directly from the respective provincial health ministries.9 Number of active civilian physicians obtained from CIHI [cited 1999 lune 28].Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaTable 13Number of Beds, Patient-days, Physician and Nurse Personnel, Canada, 1980 - 1994(Number per 100,000population)Year Hospital Health PersonnelBeds Patient-days Physicians Nurses'1980 725.2 202,853.0 203.1 959.51981 747.6 206,658.4 207.1 974.31982 684.9 204,908.7 212.9 975.71983 683.5 208,456.1 218.1 1,024.01984 690.7 208,901.3 220.1 1,056.31985 685.7 206,654.1 227.1 1,071.51986 679.7 205,170.1 230.8 1,098.01987 664.0 202,322.4 238.0 1,110.91988 655.9 196,780.4 244.3 1,093.61989 653.9 189,766.8 247.7 1,110.11990 642.0 175,722.5 247.4 1,107.81991 633.1 lJl,507.9 249.6 1,120.71992 583.4 162,315.9 252.4 1,119.11993 581.4 156,397.3 255.3 1,117.61994 561.7 152,355.3 256.6 1,109.5Percent change1980101994 -22-5% -24.9% 26.3% 15.6%Source: Health Canada,National Expenditures in Canada, 1975-1994, January,1996'Nurses includes nursingassistants.Table 14 provides the 1997 number of RNs, physicians and acute care beds per 1,000 population by provinceand territory and the RN to physician ratio as well as the RN to acute care bed ratio for each province andterritory,Table 14Nurses, Physicians and Acute Care Beds per 1,000 Population, by Province/Territory, 1997Province/ Population in Registered AcuteCare RatiosTerritory ThousandsI Nurses2 Physicians' Beds4 RNsto Physicians RNsto AcuteCare BedsNF 55180 9.44 1.69 1.74 5.59 5.43PEl 134.55 9.52 1.23 5.33 7.74 1.79NS 909.30 9.44 1.94 4.32 4.87 2.19Nil 738.12 10.04 1.53 4.30 6.56 2.33PQ 7,138.52 8.29 2.15 587 3.86 1.41ON 10,753.59 7.26 IS9 3.84 3.84 1.89Mil 1,113.91 9.44 lSI 5.42 5.22 1.74SK 990.19 8.54 1.49 3.36 5.73 2.54All 2,696.82 7.95 167 7.95 4.76 1.00lle 3,724.44 7.78 2.05 4.76 3.80 1.63YT 30.77 8.19 1.62 1.92 5.06 4.27NWT 64.31 7.40 1.03 4.04 7.18 1.83Total 28,846.32 7.97 1.92 4.88 4.15 1.63Sources: 1996Census Data preparedby StatisticsCanada; Canadian Institutefor Health Information (CII-H), [cited 1999June 28],available from: URL: http://www.CIHI.calfacts/fac.htm; Guide to Canadian Hcaluicarc Facilities, Vol.5, 1997-1998, preparedbyCanadian Healthcarc Association; and HealthCare '98: A Guide to Health Care ill Alberta,July, 1998.[ Population figures from 1996Census Data preparedbyStatisticsCanada.2 Registered nurses employed in nursing. Source: Cllil. [cited 1999June28]..1Active civilian physicians. Source: Cil-li. [cited 1999June 28J.,I Acutecare bed numbersobtained from the Guide (0 Canadian Health Care Facilities, Vol. 5, 1997-1998. For Saskatchewan,Alberta and the Yukon, acute care bed numberswerereceived directlyfromthe respective health ministries.32Table 15 provides the total number of RNs by province/territory in 1998 and the number ofRNs per 1,000population in 1998. The number of RNs per 1,000 population provided in Table 14 compares well to the1998 data provided in Table 15, taking note that in calculating the number ofRNs per thousand population in1997,1996 census data was utilized.Table 15Registered Nurses per 1,000 Population, by Province/Territory, 1998Province/Territor' Po iulation in Thousands' Total Number of Reaistered Nurses,Reeistcrcd Nurses ocr 1,000 PopulationNF 543.83 5,340 9.82PEl 136.53 1,277 9.35NS 934.24 8,525 9.13Nil 752.96 7,456 9.90I'Q 7.334.50 56.825 7.75ON 11,413.65 78,825 6.91Mil 1,138.67 10,185 8.94SK 1,024.28 8,455 8.25All 2,91454 21.988 7.5413(' 4,008.95 28,004 6.99YT 3 I.7 1 241 7.60NWT 67.34 530 7.87Sources: 1998 Registered Nurse numbers from Canadian Institute for Health Information (eIH!), {cited 1999 June 10],available from URL: http://www.cihi.cahncdrlsltbIOmay/tablcl,hLm; and 1998 Population data from Statistics Canada,[cited 1999 September 28], available from URL: htlp://www.slaLcan.ca/cnglish/Pgdb/Pcoplc/Population/dem031a.htm.11998 Population.2Rcgistcrcd nurses employed in nursing, 1998.Viewing Table 14, New Brunswick has the highest number of RNs employed in nursing per 1,000 population(10.04) followed by Prince Edward Island (9.52), while Ontario has the lowest number ofRNs employed innursing per 1,000 population (7.26) followed closely by the Northwest Territories (7.40) and British Columbiaat 7.78 RNs per 1,000 population.Quebec and British Columbia have the highest number of physicians per 1,000 population (2.15 and 2.05,respectively), while the Northwest Territories and Prince Edward Island have the lowest (1.03 and 1.23,respectively). Consequently, Prince Edward Island and the Northwest Territories have the highest RN tophysician ratios (7.74 and 7.18, respectively) compared to British Columbia, Ontario and Quebec, which havethe lowest ratios (3.80, 3.84, and 3.86, respectively). While the low RN to physician ratios in both BritishColumbia and Quebec are due to the high physician/population ratios in these two provinces, the low RN tophysician ratio in Ontario is due to that province having the lowest RN to population ratio in the country.Canada as a whole has an average of 1.63 RNs per acute care bed. However, both Newfoundland and theYukon Territory have a substantially higher than average number of RNs per acute care bed (5.43 and 4.27respectively), while Alberta, Quebec and British Columbia have the lowest RN to acute care bed ratios (1.00,1.41 and 1.63, respectively).The policy in most provinces to shift from institutionally-based care to community-based care also hasimplications for nursing and nurse requirements, and were discussed in detail in a previous report (Kazanjianand Wood, 1993). Note however, that the current perceived "crisis" in nursing is in the acute care sector, inparticular with specialty nursing. The shift from institutional to community-based care has moved mostly non-33acute beds into the community and has left a more homogenous population of acutely ill people in theinstitutional sector, therefore possibly increasing the RN deployment per bed. The shift to community-basedcare has also resulted in some provinces having community-based facilities that can provide out-patient care aswcll as assessment and treatment services, and in other provinces (New Brunswick, Saskatchewan, NovaScotia), the expansion of home care services to provide "active treatment home care" where acute care servicesare provided in people's homes as well as in residential facilities as an alternative to in-patient care. Inaddition, many provinces also provide follow-up services npon discharge from the hospital. This expansion inhome care services has major implications for the role ofRNs in such settings.The demographics of specific provinces have an impact on the type and level of health care services provided,as well as the size of the potential nursing workforce. For example, the aging population and the fact thatpeople are living longer has an impact on services such as home care and long-term care. Saskatchewan,which has the highest relative proportions of 65-79 year olds and 85+ individuals compared to other provinces,may be expected to see a greater demand for home care services and long-term care services relative to theNorthwest Territories, where there is a larger population of people under the age of 30 years and a smallerelderly population. The type of service delivery structures, in turn, have serious implications for the nursingworkforce.With the current rhetoric that the nursing workforce is aging and that there are not enough young people goinginto nursing, an important factor to consider is the population in the 20-29 age group which islcould be thesource of an immediate replacement for the retiring nursing workforce. Reviewing the pie charts, one can seethat the Northwest Territories, followed by Newfoundland and then the Yukon, have the highest proportions of20-29 year olds relative to their provincial populations, and that Saskatchewan and Quebec have the lowestrelative proportions. Thus, one could argue that the two territories and Newfoundland are better equipped,population-wise, to replace retiring members of their nursing workforce.To conclude, in this volume of the Nursing Workforce Study, we have briefly examined and presented nationaland provincial/territorial analyses pertaining to health reform initiatives including regionalization of healthservices, downsizing of the acute care sector, and the expansion of community-based services. In addition, wehave presented demographic analyses which provide the context within which these structural changes havetaken place. Finally, it should be noted that this is a general overview of system changes and not acomprehensive discussion of relevant issues. This overview at the provincial/territorial and national levelsprovides a backdrop to the in-depth analyses of the supply, production, and deployment of nursing personnelwhich occur in the ensuing volumes of the Nursing Workforce Study.34ReferencesAlberta Health. Health care '98. A guide to health care in Alberta. Edmonton (AB): Alberta Health; July1998.Anderson, R.H. Age and sex pyramids. Denver (CO); [cited 1999 June 21]. Available from URL: http://soc­pcI.cudenver.edu/sociology/introsoc/topics/UnitNoteslPopPyramid.html.Andre P. Canada's nurses infuriated over Newfoundland's quick fix. The Globe and Mail 1999 April 3; Sect.A:4.Barer M.L, Evans RG, Hertzman C. Avalanche or glacier, health care and the demographic rhetoric.Vancouver (BC): Health Policy Research Unit, Centre for Health Services and Policy Research, University ofBritish Columbia; March 1994. HPRU 94:3D.Canadian Healthcare Association. Guide to Canadian healthcare facilities, Vol. 5, 1997-1998. Ottawa (ON):CHA Press; 1997Canadian Institute for Health Information (CIHI). National health expenditure database. National healthexpenditure trends, 1975-1997. Ottawa (ON): Canadian Institute for Health Information (CIHI); 1997.Canadian Institute for Health Information (CIHI). Registered nurses employed in nursing, by province,Canada, 1993 and 1998. [cited 1999 June 10]. Available from URL: http://www.cihi.ca/medils/tbIOmay/tablel.htm.Canadian Institute for Health Information (CIHI). Total health expenditure by use of funds, 1975 to 1998 ­current dollars. [cited 1999 June 28]. Available from URL: http://www.CIHI.ca/facts/fac.htm.Canadian Institute for Health Information (CIHI). Registered nurses employed in nursing, 1996-1997. [cited1999 June 28]. Available from URL: http://www.CIHI.ca/facts/fac.htm.Canadian Institute for Health Information (CIHI). Active civilian physicians, 1993-1997. [cited 1999 June28]. Available from URL: http://www.CIHI.ca/facts/fac.htm.Canadian Nurses Association. The future supply of registered nurses in Canada. A discussion paper. Ottawa(ON): Canadian Nurses Association; October 1997.Health Canada. National expenditures in Canada, 1975-1994. Ottawa (ON): Health Canada; January 1996.Health Canada. Health system reform in Canada, 1997. Ottawa (ON): Health Canada; 1997. (Note that anupdated version of this report will be available in November, 1999).Health Canada. Home care development. Provincial and Territorial home care programs: A synthesis forCanada. Ottawa (ON): Health Canada; June 1999.Health Canada. Public home care expenditures in Canada, 1975-76 to 1997-98. [cited 1999 September 9].Available from URL: http://www.hc-sc.gc.ca/main/hc/web/datapcb/datahesalE_home.htm.35Health Professions Council [British Columbia]. Research and reports in progress [cited 1999 September 21].Available from URL: http://www.hpc.bc.ca/hpc/activity.html.Kazanjian A, Chan S. Nurse requirements in British Columbia: An analysis of the 1979-82 trends. Part 1­Methods and preliminary findings. Vancouver (BC): Health Human Resources Unit, Centre for HealthServices and Policy Research, University of British Columbia; September 1984. HHRU 84:5.Kazanjian A, Wood L. Nursing resources in British Columbia: Trends, tensions, and tentative solutions.Vancouver (BC): Health Policy Research Unit, Centre for Health Services and Policy Research, University ofBritish Columbia; February 1993. HPRU 93:5D.Public law (Manitoba): The Regional Health Authorities Act, S.M. 1996, c.53 - cap. R34.Public law (Alberta): Health Professions Act, SA 1999, chapter H-5.5.Public law (British Columbia): Health Professions Act, R.S.B.C. 1996, Chapter 183.Ryten E, Thurber AD, Buske L. The class of 1989 and physician supply in Canada. CMAJ1998;158(6):723-8.Statistics Canada. GeoRef: 1996 Census. Ottawa (ON): Statistics Canada; 1998. Catalogue No.92F0085XCB [CD-ROM].Statistics Canada. Population by age group by province, 1998. [cited 1999 September 28]. Available fromURL: http://www.statcan.ca/englishlPgdblPeoplelPopulation/dem031a.htm.Statistics Canada. Postal Code Conversion File (PCCF) - Reference guide, glossary. Ottawa (ON): StatisticsCanada; 1998. Catalogue. No. 92F0027XDB.36Volume IDemographic Context and Health System Structurefor Nursing Services in CanadaAppendices3738IjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjAppendix 1Population Estimates by Province/Territoryby Census Division by Age and Sex39Population Estimates in Newfoundlandby Census Division by Age and Sex1996<25 25-34 35-44 45-54 55~64 65+ SubtotalCensus Division M F M F M F M F M F M F M F TotalDivision No.1 00000 45,505 44,420 19205 20,825 20,3lO 21,440 16,340 16,525 9,640 9,825 I L420 16,070 122,420 129,105 251,525Division No.2 00000 5,405 5,095 2,070 2,095 2310 2,300 L905 1,810 L020 LOOO LI80 1,540 13,890 13,840 27,730Division No.3 00000 4,140 3,800 1,690 L760 L925 1.855 1,585 L5lO 915 935 L080 1,265 1L335 11,125 22,460Division No.4 00000 4,615 4,460 1,610 1,815 2,015 2.135 1,690 1,600 LI25 LI20 1.290 1,355 12.345 12,485 24,830Division No.5 00000 7,840 7,730 3,005 3,320 3590 3,835 3,OlO 3,035 2.015 2.000 2.240 2.695 21,700 22,615 44.315Division No.6 00000 6,845 6565 2,800 3,005 3,365 3,480 2,555 2.665 1,810 L750 1,885 2,385 19,260 19,850 39,110Division No.7 00000 7,255 6.880 2,845 3,095 3,325 3,335 2,795 2.675 1,800 1,820 2,690 3.015 20.710 20.820 41,530Division No.8 00000 8.820 8.235 3.545 3,530 3.755 3.860 3,240 3.130 2.170 2,040 2.875 3.030 24,405 23.825 48,230Division No.9 00000 4.190 3,965 1.830 1,905 L890 1,890 L470 1,495 L025 885 LI45 1,180 lL550 11.320 22,870Division No.1 000000 6,335 6.085 2,540 2.515 2.520 2,565 2,030 1,830 950 700 570 555 14.945 14.250 29,195TOTAL 100,950 97,235 41,140 43,865 45,005 46,695 36,620 36,275 22,470 22,075 26"375 33,090 272,560 279,235 551,795'"'0Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in Prince Edward Islandby Census Division by Age and Sex1996< 25 25~34 35-44 45M54 55-64 65 + SubtotalCensus Division M F M F M F M F M F M F M F TotalKings County 20000 3,780 3.5J5 1,350 1.300 1.440 1.385 1.255 1.175 840 825 1,230 1,475 9,895 9,675 19570Queens County 20000 12.765 12370 4,925 5,230 SAI5 5,770 4,470 4.625 2,905 3.Q10 3,625 5320 34,105 36325 70,430Prince County 00000 8,195 7,880 3,295 3.260 3.415 3320 2.715 2,700 1,980 1.995 2,450 3340 22,050 22,495 44,545TOTAL 24,740 23,765 9,570 9,790 10,270 10,475 8,440 8,500 5,725 5,830 7,305 10,135 66,050 68,495 134,545Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in Nova Scotiaby Census Division by Age and Sex1996< 2S 25-34 35·44 45-54 55-64 65 + SubtotalCensus Division M F M F M F M F M F M F M F TotalShelburne County 00000 2,875 2,775 1.285 1,245 1,335 1,315 1,085 1,085 775 760 1.095 1.360 8,450 8,540 16,990Yarmouth County 00000 4,535 4,485 1,920 1.975 1.995 2,160 1,805 1.785 1.1l0 1,165 1.800 2.580 13,165 14.150 27.315Digby County 00000 3,045 2,950 1.500 1.450 1,590 1.545 1,365 1.370 1,010 1,055 1.550 2,075 10.060 10.445 20.505Queens County 00000 1,855 1.805 875 825 915 950 870 875 640 675 915 1.215 6,070 6.345 12,415Annapolis County 00000 3,485 3.370 1,395 1,425 1,685 1,695 1,485 1,500 1,165 1,185 1.670 2.265 10,885 11.440 22,325Lunenburg County 00000 7.370 6,815 3.120 3,230 3,880 3,980 3.345 3,265 2.325 2,445 3.410 4.370 23,450 24,105 47,555Kings County 00000 10,260 10,020 4,665 4,685 4,835 4,905 3550 3,655 2,610 2,600 3,130 4,280 29,050 30.145 59,195Hants County 00000 7,080 6,480 2,845 2,975 3.335 3,415 2,610 2570 1.760 1,710 2,060 2,650 19,690 19,800 39,490Halifax County 00000 57,850 57,160 29,840 31,325 29,035 31,090 22,065 22,790 13,100 13.510 14.100 21,1l0 165,990 176,985 342,975Colchester County 00000 8,340 8.275 3,460 3,625 3,895 4,075 3,220 3,150 2.160 2,260 2.860 3,945 23,935 25.330 49,265Cumberland County 00000 5,390 5,110 2,175 2,180 2,495 2535 2,150 2,185 1.760 1.790 2A55 3.590 16,425 17,390 33,815Pictou County 00000 8350 8.115 3,055 3.260 3,810 3,890 3330 3,230 2,055 2.130 2,980 4.520 23,580 25.145 48,725Guysborough County 00000 1,820 1.660 690 670 815 810 755 745 595 585 825 945 5,500 5A15 10,915""Antigonish County 00000 3,915 3.835 1,160 1,255 1,4<55 1,490 1,305 1.240 745 745 950 1.450 9540 10,015 19,555tv Inverness County 00000 3,820 3.595 1,270 1.275 1.565 1,585 1.510 1,380 1.010 980 1.225 1.700 10,400 10,515 20,915Richmond County 00000 1.905 1.780 630 680 785 835 765 755 525 540 885 945 5,495 5,535 11.030Cape Breton County 00000 20,710 20,035 7,050 7,870 8.965 9,570 7,605 7.800 5,470 5,835 6,645 10.285 56,445 61.395 117,840Victoria County 00000 1,470 1.455 540 505 665 650 600 575 400 370 555 690 4.230 4,245 8,475TOTAL 154,075 149,720 67,475 70,455 73,065 76,495 59,420 59,955 39,215 40,340 49,110 69,975 442,360 466,940 909,300Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in New Brunswickby Census Division by Age and Sex1996<25 25-34 35-44 45-54 55·64 65 + SubtotalCensus Division M F M F M F M F M F M F M F TotalSaint John County 00000 13,105 13,035 6,150 6,510 5,925 6.395 4,625 4.910 3,225 3.545 4.490 7.385 37,520 41.780 79,300Charlotte County 00000 4,680 4.435 1,985 2.005 2,120 2,075 1.630 1.670 U65 1.240 1.755 2585 13.335 14,010 27.345SunburyCounty 00000 4,875 4535 3,015 2,670 2,115 2,025 1.295 1.245 855 865 870 LOOO 13,025 12.340 25,365Queens County 00000 1.915 1,805 795 770 950 925 935 880 670 715 945 U75 6.210 6,270 12,480Kings County 00000 12,400 11,555 4,355 4,735 5,580 5,740 4.480 4,315 2,530 2.475 2,970 3,605 32,315 32.425 64,740Albert Coun ty 00000 4,585 4,520 1.835 L890 2,050 2,265 2,050 2,055 1,200 1.125 1.245 1.660 12,965 13515 26,480Westmorland County 0ססoo 19,590 19,225 9.375 9.410 10,025 10,250 8,000 7,850 4,910 5.255 6,715 9,905 58,615 61.895 120,510Kent County 20000 5.450 5,085 2.355 2.305 2,650 2,650 2.230 2,100 1,510 L455 2.025 2.275 16.220 15,870 32,090Northumberland CountyZOOOO 9,380 8,740 3,905 3,920 4,265 4,180 3.410 3,185 2,270 2.300 2,885 3,705 26,115 26,030 52,145York County 00000 14,950 14510 6,605 6,835 6,685 7,105 5,795 5,855 3,635 3,680 4,155 5,885 41.825 43,870 85,695Carleton County 00000 4,920 4,630 1.935 1.955 2,235 2,135 1.650 1,570 1,015 UOO 1.605 2,170 13,360 13560 26,920Victoria County 00000 4,080 3,885 1.525 1.590 1,750 1,785 1.320 1,325 870 910 1.245 1.650 10,790 11,145 21.935Madawaska County 00000 6,300 5,970 2,575 2.720 3,315 3,380 2.490 2,405 1,470 1.685 1.855 2.650 18,005 18,810 36,815"'"Restigouche County 00001 6.455 6.430 2.760 2,830 3,315 3,285 2.570 2,515 1.750 1.830 2,075 2,880 18,925 19,770 38,695w Gloucester County 00001 15,140 14.395 6.595 6,780 7,650 7,775 6,190 5,990 3,785 3.515 4.360 5.425 43,720 43,880 87,600TOTAL 127,825 122,755 55,765 56,925 60,630 61,970 48,670 47,870 30,860 31,695 39,195 53,955 362,945 375,170 738,115Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in Quebecby Census Division by Age and Sex1996<25 25-34 35-44 45-54 55-64 65 + SubtotalCensus Division M F M F M F M F M F M F M F TotalLes iles-de-la-ModeleineOOOOO 2,115 2,105 1,085 !,130 L310 1,235 1.025 965 640 615 685 885 6,860 6.935 13,795Pabok 00000 3.395 3,225 1,510 1,485 1.915 1,870 1.605 J,525 1,035 1.060 1.245 1.475 10,705 10,640 21.345La Cote-de-Gaspe 00000 3.425 3.315 1.445 [,490 1.995 1,935 l.385 1.415 935 985 1.150 1,370 10.335 10,510 20,845Dcnis-Riverin 00000 2.170 2,050 855 885 1.175 1,240 1.050 930 670 705 880 1,110 6,800 6,920 13,720Bonaventure 00000 3,230 3.085 Ll75 1.240 1.665 1,645 1.360 1,380 1,015 980 1.230 1,560 9,675 9,890 19,565Avignon 00000 2.830 2,745 1,005 1,095 1.345 1.305 1.000 970 670 69D 1.000 1,230 7,850 8,035 15.885La Matapedia 00000 3.705 3,465 1,310 1.360 1,885 1.765 1,400 1,220 880 885 1.310 l,670 10,490 10,365 20,855Matanc 00000 3.820 3,555 1,435 1,545 2,100 2,165 1.795 1,745 1.110 1.115 1,425 1.900 11.685 12,025 23,710La Mitis 00000 3.190 3,130 1.260 1.210 1.785 1,680 1.445 1,335 945 980 1,410 1.785 10.035 10,120 20.155Rimouski-Neigcttc 00000 8.815 8,670 3,385 3.560 4,880 5.110 3.785 3,9D5 2.075 2.310 2,420 3.735 25,360 27.290 52,650Les Basques 00000 1.605 1.515 565 555 850 775 69D 695 540 530 825 1,040 5.075 5.110 10.185Rivicre-du-Loup 00000 5,395 5,280 2,110 2.090 2.770 2.880 2.180 2.170 1,275 1,410 1,850 2.715 15.580 16.545 32.125Tcmiscouata 00000 4,065 3,735 1,470 1,455 1.915 1,885 1,575 1.510 1,085 1,065 1,500 1.825 11,610 11,475 23.085Kamouraska 00001 3,950 3.720 1,415 1.380 1.945 1.885 1,580 1.580 1,045 1.085 1.565 2.065 11.500 11.715 23.215Charlevoix-Est 00000 2.670 2.620 1,120 1,090 1,480 1,490 1.260 1.170 825 860 1,025 1.335 8.380 8.565 16,945Charlevoix 00010 1,960 1.930 845 79D 1,210 1.125 1.120 935 715 735 830 1,230 6,680 6.745 13,425.c,L'Islet 00001 3.205 3.065 1,330 1,250 1.710 1,600 1,345 1.255 940 1,015 1,380 1.740 9.910 9.925 19,835.c,Montmagny 00000 3,780 3,550 1,625 1,545 1.985 1,845 1,740 1.705 1,170 1.270 1,525 2.055 11,825 11.970 23.795Bcllechasse 00000 5.000 4.850 2.010 1,830 2.445 2,300 2,015 1.850 1,425 1.350 1,950 2.660 14.845 14,840 29.685L'l!e-d'Orleans 00000 1,090 1.020 410 435 565 585 610 560 395 345 410 470 3.480 3,415 6.895La Core-de-Beaupre 00000 3,360 3.105 1.485 1,515 1.995 1.920 1,660 1.570 1,065 l,065 1,270 1,630 10.835 10,805 21,640La Jacques-Cartier 00000 4,730 4.275 2.425 2.340 2,510 2.315 1,700 1,485 910 725 715 700 12.990 11,840 24.830Communaute- Urbaine-de-Quebec 77.290 75.655 39.500 38.250 42,735 45,125 35.760 38.945 22,130 25,220 23,510 40.490 240,925 263,685 504.610Desjardins 00000 8,385 8.235 3.705 3,575 4.305 4.580 3,710 3,875 2.110 2,345 2,375 4,020 24,590 26.630 51.220Les Chutes-de-la-Chaudiere 14.455 13.995 5.780 6,220 7,375 7.740 5,720 5.420 2.230 2.120 1.960 2.580 37,520 38.075 75.595La Nouvelle-Beauce 00000 4,670 4.395 1,945 1.745 2.170 2,020 1,635 1,520 1.040 1.025 1.240 1.660 12.700 12.365 25.065Robert-Cliche 00000 3,515 3.245 1.280 1.175 l.515 1,485 1,270 1,190 805 830 1,050 1.365 9.435 9,290 18.725Les Etchemins 00000 3,210 2.920 1.215 1.125 1,505 1.460 1,185 1,150 940 930 1.245 1,480 9.300 9,065 18.365Beauce-Sartigan 00000 8,725 8.275 3.590 3,405 4,010 3.890 2,955 2,950 1.775 1.845 2.100 2,795 23,155 23,160 46.315Le Grann 00000 3.785 3.440 1.450 1.320 1.850 1.765 1.430 1.270 99D 1.015 1,325 1.650 10,830 lO.460 21.290L' Arniante 00000 7,375 6,840 2.550 2.490 3.675 3.675 3,330 3.345 2.280 2.610 2.915 3.935 22,125 22,895 45.020L'Erable 00000 4,390 4.035 1.645 1.540 1.935 2.010 1.665 1.755 1.180 1.255 1.355 \,890 12,170 12.485 24.655Lotbiniere 00000 4,955 4.575 1.855 1.770 2.380 2.110 1,810 1.685 1.235 1.180 1.475 \,875 13,710 13.195 26.905Portneuf 00000 7,180 6,660 3.220 2,950 4.140 3.815 3,195 2,990 2.225 2.345 2,725 3.740 22,685 22.500 45.185Mekinac 00000 2,090 1.905 785 720 UI0 1.130 1,055 925 725 760 1.010 1.260 6.775 6,700 13.475SUB-TOTAL 227,530 218,185 99,795 97,560 120,140 121,360 98,045 98,895 61,030 65,260 71,885 104,925 678,425 706,185 1,384,610... continuedPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in Quebecby Census Division by Age and Sex1996 (continned)<25 25-34 35-44 45-54 55-64 65 + SubtotalCensus Division M F M F M F M F M F M F M F TotalLe Ccntrc-dc-Ia-Mauricie00001 10.110 9.630 3,9JO 4.010 6,030 5.980 4.695 4,715 3.245~~~ 32,430 34,690 67.120Francheville 00000 22,320 21,685 9.665 9.775 n.125 12,355 9.860 10.085 6,490 7,280 7.270 11.620 67.730 72,800 140.530Bccancour00000 3.300 3.235 1,290 1.240 1,720 J,615 lAID 1,240 930 905 J.21S 1.580 9,865 9.815 19.680Arthabaska 00000 11.490 10.730 4.350 4.305 5.335 5,280 4.230 4.240 2.715 2.770 3.135 4.330 31.255 31.655 62.910Asbestos 00000 2,405 2,285 760 760 1,135 1.155 1,185 1.075 715 820 L175 1.540 7.375 7.635 15.010Le Haut-Saint-Frencols DODO 1 3.965 3,545 1,495 1,460 1,875 1,695 1.560 1.425 1.035 995 USS 1.540 11,285 10.660 21.945Le Val-Saint-Francois 00000 6.125 5,615 2.220 2.325 2.950 2.825 2,435 2.150 1,455 1.430 1.700 2.190 16.885 16.535 33,420Sherbrooke 0000 I 22,540 22.270 10.170 9.885 10.695 11.340 8.655 9.330 5.065 5.805 6.175 10,480 63.300 69.110 132.410Coati cook 00000 2.980 2,880 1.090 1.050 1,310 1.205 1.030 975 690 700 885 Ll20 7,985 7.930 15.915Memphremagog 00000 6.060 5.875 2.435 2.515 3,025 2.950 2.815 2.815 2.155 2.125 2,495 3.185 18,985 19,465 38,450Brome-Missisquoi 00000 7,705 7.175 3.020 2.810 3.885 3.765 3.315 3.155 2.205 2.185 2.855 3.910 22.985 23.000 45.985La Haute- Yamaska 0000 I 13,485 12.810 5,830 5.740 6.845 6.975 5.055 5,070 3.175 3,365 3,555 5.100 37,945 39.060 77.005Acton 00001 2,840 2.620 1,085 },025 1,295 1,195 1.090 985 750 695 790 945 7.850 7,465 15.315Drummond 00000 14,915 13,990 6.105 5.765 7.145 7.100 5.860 5.755 3.490 3.625 4.280 6.225 41,795 42.460 84,255Nicolet- Yamaska 00000 4,055 3.835 1,460 1,515 2,080 1,920 1,545 1.530 1.125 1.155 1.380 2.075 11,645 12.030 23,675Masktnonge 00001 3,480 3,230 1.615 1.565 2.125 1.995 1,755 l.645 1.325 1.320 1.565 2,190 11,865 11.945 23,810""D'AutrayOOOOI 6.330 5.805 2,660 2.730 3.270 3,170 2,510 2.445 1.840 l.810 2,190 2.770 18.800 18.730 37,530u, Le Bas-Ricbelieu 00000 7.875 7,660 3.120 3.185 4.645 4.700 4.295 4,150 1.665 2,770 3.010 4.220 25.610 26.685 52,295Les Maskoutains 00001 13,410 12.910 5,625 5.680 6.650 6,700 5.255 5.295 3.320 3.555 3.915 60420 38.175 40.560 78,735RoU\,ilIeOOOOI 5,990 5,705 2,455 2.565 3.120 2,935 2.285 2.080 1.420 1.345 1,465 1.745 16,735 16.375 33,110Le Haur-Richclicu 00000 16,960 15,950 7.035 7.315 8.600 8,525 6.655 6,555 4.265 4,335 4.845 6,510 48.360 49,190 97,550La Vallee-du-Richelieu 00001 20.740 19.430 7,750 8.390 10.165 10.740 8.915 8.930 4.780 4,670 4,005 5.310 56.355 57,470 113,825Champlain 00000 53.380 51.140 22,965 23,220 26,130 28,430 23.245 25,545 14.060 15.005 12.360 18,845 152.140 162,185 314.315Lajernrnerais 00000 17,640 16,595 7.105 7,540 8,955 9,420 7,430 7.215 3.890 3,645 2.610 3.565 47.630 47,980 95,610L'Assompticn 00000 18,765 17.775 7,250 8,040 10.120 10.495 7.320 7,160 3.940 3,875 3.280 4,065 50,775 51.410 102,185Joliette 0000 1 8.855 8.325 3,295 3.520 4.505 4,920 3.800 3,945 2,355 1,570 2.690 4.075 25.500 27.355 52.855Matawinie 00001 6.235 5.760 2,480 2,575 3,460 3.165 2.960 2,800 2.765 2,645 3.120 3.260 21.020 20.305 41.325Montcalm 00001 6.525 6.135 1.905 2.900 3.280 3.190 2,630 2,395 2.025 1,865 2,000 2.195 19.365 18.680 38,045Lcs Moulins 00000 20,355 19.205 8.075 8.965 10.445 10,535 7.205 6,610 3,385 3,145 2.370 2.935 51.835 51.395 103.230Laval 00000 54.345 52.070 25,190 25,470 28.000 29,415 22.045 23.275 16.295 17,085 15.620 21.580 161,495 168,895 330.390Communaute-Urbai ne-de- Montreal 26L125 258.365 154.955 149,220 141.995 145,305 108.520 119,485 80.295 92.535 100,400 163,640 847.290 928.550 1,775,840Roussillon 20000 24.185 22,915 10.395 11.210 12,220 12,450 9,005 8,880 5.365 5.305 4.560 5.690 65.730 66.450 132.180Les Jardins-dc-Napiervil!o 4.115 3.775 1.705 1.660 2.025 1.920 1.590 1.435 1.110 1.020 1.115 1.440 11.660 11.250 22.910Le Ham-Saint-Laurent 20000 3.715 3,445 1,495 1,420 1.790 1.720 1,540 1,455 1,120 1.l20 1.455 1.730 11.115 10.890 22.005Beauharnois-Salaberry 00000 9.720 9.195 4.080 4.170 5.055 5.120 4,215 4.225 2.740 3,010 3,270 4.950 29,080 30,670 59.750SUB-TOTAL 698,040 673,570 337,040 335,520 364,105 372,305 287,915 300,070 194,200 210,180 218,550 329,635 2,099,850 2,221,280 4,321,130... continuedPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in Quebecby Census Division by Age and Sex1996 (continued)<25 25-34 35-44 45-54 55-64 6S + SubtotalCensus Division M F M F M F M F M F M F M F TotalVaudreuil-Soulanges 00000 16,675 16,020 7,365 7,935 9.060 9,065 6,735 6.355 3,765 3.570 3.820 4,950 47,420 47.895 95,315Deux-Montagncs 20000 14,480 13.855 5,880 6,460 7,435 7,580 5,425 5,195 2.920 2,925 2,830 3,965 38,970 39.980 78,950Therese-De Blainville OOClOO 22.630 21.770 9,930 10.485 11,475 11,570 8,140 7,775 4.025 3.965 3,240 4,250 59,440 59,815 119.255Mirabel 00000 4,200 4,140 2.285 2,435 2,125 1.875 1,305 1.260 770 710 720 845 11,405 11.265 22,670La Riviere-du-Nord 0000] 14.185 13.630 6,560 6,605 7,620 7,635 5,655 5,750 3,670 3,710 3.695 5,060 41,385 42390 83.775ArgenteuilOooOO 4,400 4,145 1,875 1.925 2.375 2,420 2.025 1,935 1.505 1.485 1,950 2,445 14,130 14.355 28,485Les Pays-d'en-Haut 00001 3,530 3,395 [,695 1.850 2.510 2,560 2,280 2,160 1,910 1,920 2.065 2,340 13,990 14.225 28,215Les Laurcnrides 00001 5,445 5,065 2.360 2,455 3,190 3.115 2.585 2,695 2.125 2,095 2,440 2,780 18.145 18,205 36.350Antoine- LabclIe 00000 5,485 5,080 2.205 2,210 3,125 2,915 2,5<Xl 2,355 1,905 1,755 2,()(X) 2,260 17,310 16.575 33,885Papineau 00001 3,120 2,885 1,245 1,320 1.685 1.585 1,460 1,420 U85 1.230 1,455 1,635 10,250 10,075 20,325Communaute~Urbaine-dc-I'Ou!<louais 38,300 37,665 18,830 19,930 20,005 21.155 14,165 14,255 7.720 8,155 6,955 10,480 105,975 111.640 217,615Les Collines-de-l'Outaouais 6.015 5.525 2.665 2.855 3,465 3,420 2,575 2,245 1,405 1,210 1.125 1.140 17,250 16.395 33,645La Vallee-de-la-Gatineau 00010 3,190 3.050 1.380 1,430 1.710 1,655 1,450 1.420 1,195 1.085 1.295 1,395 10,220 10.035 20,255Pontiac 00000 2,615 2.510 1_060 1,015 1,210 1,155 1,055 1,030 805 770 1,045 1,295 7.7<Xl 7,775 15,565Tcmiscamingue 00000 3,460 3,225 1,420 1,310 1.570 1,440 1,090 1,025 760 735 870 LlIO 9,170 8,845 18,015Rcuyn-Noranda 00000 7.755 7,630 3,3<Xl 3,420 3,935 3,825 2,835 2.595 1,635 1.685 1,720 2.205 21,270 21.360 42,630"" Abitibi-Ouest 00000 4.380 4,165 1,640 1,635 2,110 1,975 1,560 1,395 975 965 1,275 1,495 11.940 11,630 23,5700-Abitibi O()(X)O 4,960 4,680 1,840 L855 2,360 2,225 1,660 1.530 920 900 1.040 1,300 12.780 12.490 25,270vanee-de-I'Or OO(X)() 8.375 7,745 3,495 3,455 4.250 4.000 2,970 2,695 1,685 1.705 l.855 2,180 22_630 21.780 44,410Le Haut-Saint-Maurice O(X)()O 3,035 2,655 1,l35 1,105 1.420 1,325 1,045 1,035 820 760 865 1.080 8.320 7,960 16,280Le Domaine-du-Roy 00000 6,345 6.065 2,210 2,255 3.090 2,920 2.250 2,230 1,495 1.555 1.495 1,930 16.885 16,955 33,840Maria-Chapdelaine 00000 5,455 5.145 1,895 1,780 2,495 2.410 1.825 1.745 1,210 ],180 1.270 1,625 14.150 13.885 28,035Lac-Saint-Jean-Est 00000 9,850 9,205 3.520 3.340 4,790 4,670 3.335 3,275 2,405 2.545 2,460 3.000 26.360 26.035 52,395Le Fjord-du-Sagucnay 00000 31.000 29,010 11,540 11,590 15,825 15,905 11,960 11,720 7,410 8.085 7.485 10.815 85.220 87,125 172,345La Haute-Cote- Nord 00000 2,325 2,235 975 ],045 1,220 1,150 930 870 680 6]0 635 755 6,765 6.665 13.430Manicouagan 00000 6,760 6.245 2,860 2.815 3,465 3,355 2,605 2,395 1.650 1,515 1,225 1.390 18.565 17,715 36,280Sept-Rivieres - Caniapiscau 7,430 7.135 3,295 3,385 3.890 3,640 3,150 2,845 1.960 1,680 1.165 1.325 20.890 20,010 40,900Minganie - Basso-Cote-Nord 2,460 2,385 1,085 1,090 I, 115 995 750 660 460 450 590 645 6,460 6.225 12,685Nord-du-Quebec 00000 9.535 9,105 3,4<Xl 3.325 3.000 2.650 2,000 1,775 1,180 1,030 685 6]5 19.890 18,500 38,390SUB-TOTAL 257,395 245,365 109,125 112,315 131,525 130,190 97,410 93,640 60,250 59,985 59,270 76,310 714,975 717,805 1,432,780TOTAL 1,182,965 1,137,120 545,960 545,395 615,770 623,855 483,370 492,605 315,480 335,425 349,705 510,870 3,493,250 3,645,270 7,138,520Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in Ontarioby Census Division by Age and Sex1996<25 25-34 35-44 45-54 55-64 65 + SubtotalCensus Di\1510n M F M F M F M F M F M F M F TotalStomlOnl. Dundas and Glengarry United Counties 20 19,065 IS.! 85 7.215 7.595 8,830 8,850 7.285 7.080 5.175 5325 7.005 9,700 54.575 56.735 J II.3JOPrcsc<)(l and RussellUnitedCoumies (X)OOO 13.385 12.650 5.605 5.940 6,760 6.790 4,855 4.565 2.920 2.810 3.220 4.480 36.745 37.235 73,980O:tawa-Carlcton RegiolmlMUllicipalilyOOOOO 121.520 116.790 60.695 61.145 60.670 64505 47.865 49.670 28.435 29.795 32.055 48.000 351.240 369.905 72l,l 45Leeds and Gremille United Counties 00000 15500 14.815 6365 6.735 7,575 7.700 6,455 6.470 4.770 4.865 6.490 8.540 47.155 49.125 96,280L,nark COUIllY OOC!CXl 10.025 9.440 3,995 4.130 4.925 5.130 4.015 3.850 2,7J5 2.750 3.660 5.210 29,335 30.510 59.845Frontcnoc Coumy 00000 23.180 21.910 10.935 10.740 10,540 11.075 8,445 8.735 6.065 6.240 7.665 10.825 66.830 69.525 136,355Lennox and Addington County 00000 6.610 6.180 2.975 2.685 3,210 3.190 2.675 2.575 1.840 1.800 2,420 3.050 19.730 19.480 39,210Hastings COUElly 20000 20,075 19.100 8.165 8.410 9.160 9.380 7.255 7,365 5.710 5.845 7.705 10.580 58,070 60.680 118,750Prince Ed .....aro CountyOoooO 3,740 3.660 [.415 1.485 1.8l5 1.940 1.640 1.650 1.435 1.525 2.155 2.585 12.200 12.845 25,045Northumlx:rlalld County 00000 13,510 12.890 5.180 5.320 6,665 6.530 5.210 5.095 4.060 4.165 5.825 7.330 40.450 41,330 81,780Peterborough County 00000 20.200 19.645 7.440 7.955 9,195 9.770 7.825 8.000 5.710 6.285 9.125 12.310 59.495 63.965 123,460ViC/oria County 00000 11.270 10,435 3.880 4.220 5,280 5.355 4.220 4.160 3.340 3.525 5,510 6.725 33,500 34,420 67,920Durham Regional Municipality 20000 86.210 82.505 35.430 38,305 41,220 42.440 29.160 28,550 l6.725 16.680 17.510 23.880 226.255 232.360 458,615York Regional Municipality 00000 112.130 105.775 4J.l15 44.550 50,110 56.925 43.185 42.265 24,785 22.875 21.250 27.490 292.575 299.880 592.455Toronto Metropolitan Municipality 00000 366,510 355.540 219.125 227.215 189,130 200.3[5 137.685 152.065 102.485 115.495 132.760 187.090 1.147.695 1.237.720 2,385.415Peel Regional Municipalily 00000 160.170 153.510 74.190 78.035 71.990 75.655 56.115 56.595 32.865 31.925 26.325 35.[50 421.655 430,870 852.525-'"Dufferin Coo my 00000 8.800 8.225 3.470 3.715 3,835 3.900 3.045 2.875 1,790 1.600 1.855 2.540 22.795 22.855 45.650--.J \VeHington CounlyOOooo 31.075 29,625 13.735 13.630 14,030 [4.215 10.340 10.400 6.795 6.960 8.725 11.885 84.700 86.715 171.415Halton Regior~<1 Municip;:lIily 0ססoo 59.110 55.715 24.345 25.705 28,165 30,230 23.985 24.605 15.280 15.315 16.175 21.255 167.060 172,825 339,885Harniltcn-Wentwcrth Regional Muniei""lilY 00000 78.180 75.510 36.255 36.685 36,650 38.215 28.505 29.365 20.560 21.585 27.720 38.555 227.870 239,915 467,785Niagara Regional Munieipalit;· 00000 66.785 63,320 27.290 28.665 30.330 31.875 25.570 26.220 18.825 20.320 27.255 37,060 196.055 207.460 403.515Haldimand·Norfolk Regional Municipality 20000 18.380 17.380 6.450 6,685 8,535 8.525 6.540 6.275 4.680 4,690 6,235 8.195 50,820 51.750 102,570Brant County 20000 20,325 19.505 7.935 8.220 8,955 9.540 7.125 7.110 4.770 4.960 6.570 9.555 55,680 58,890 114,570\Vatcrloo Regional Municipality ססoo0 74,345 71.625 34.025 33.930 33,000 33.595 24.555 24.980 15,690 15.660 17,850 26.185 199.465 205.975 405.440PerthCoul1lyOOooo 13.325 12,630 4,965 4.920 5.675 5.625 4.165 4,180 2.980 3,090 4,315 6.235 35.425 36,680 72,105Oxford County 00000 17.430 16,760 6,910 6.870 7,640 7.665 5.765 5.750 4.050 4,375 5,860 8.070 47.655 49,490 97,145ElginCounty 00001 14.385 13.725 5.455 5,600 6,085 6.130 4.995 4.975 3.420 3,470 4,485 6,420 38,825 40.320 79,145Kent Count;· 00000 19,595 18,620 7,440 7.655 8,555 8.570 6.810 6,750 4.775 4.990 6.445 9.450 53.620 56.035 109,655Essex Coullly 00000 61,865 59,750 27,300 27.575 27.165 27,455 21,545 21.845 14,785 15,435 18,660 26,955 171.320 179.015 350,335Larnbtcn County 20001 22.745 21,845 7,785 8.190 10,170 10.460 8.555 8,310 5,960 6,305 7,990 10.660 63.205 65,770 128.975Middlesex Count;· 20001 68.355 66,135 31.330 31.980 30.610 33.030 23.400 24.710 15,280 l6,440 19.800 28.565 188,775 200.860 389,635Huron County \XXJOI 10.760 10,305 3.565 3.565 4,500 4,395 3,690 3,555 2.730 2,860 4,535 5.770 29,780 30,450 60,230Bruce County 20000 1LS15 10,890 3,525 3.765 5,225 5.255 4.460 4.110 3.250 3,330 4.590 5.755 32.565 33.105 65,670Grey County OO\XXJ 14,655 13,910 5.045 5.245 6,625 6.950 5,730 5.755 4.375 4.515 6,565 8.245 42,995 44,620 87.615Simcoe Coumy 00000 58.130 55,715 24.!20 25,820 27,570 27,985 20.170 19.750 13,725 14.135 18.565 24,195 162.280 167.600 329.880Muskcka District Municipality 2\XXJ0 7.800 7.460 3,045 3.105 3,970 3.975 3.250 3.235 2,810 2,925 3.960 4.910 24.835 25.610 50.445SUB-TOTAL 1,680,660 1,611,680 777,715 805,99Q 794,365 833,140 616,090 633,445 415,565 434,865 508,835 703,405 4,793,230 5,022,525 9,815,755... continuedPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in Ontarioby Census Division by Age and Sex1996 (continued)<25 25-34 35-44 45-54 55-64 65 + SubtotalCensus Division M F M F M F M F M F M F M F Total---- ---- ----~ --g=j5 ----Halibunon County 00000 2,145 1,960 740 770 1.110 i.ios 1,025 1.125 i,675 1,750 7,640 7.685 15.325Renfrew County 20000 16,350 15,770 7.385 6,925 7,555 7,525 5,800 5.610 4,355 4,660 6.120 8.150 47.565 48,640 96,205Nipissing District 00000 14,730 14,190 5,720 6.185 6,710 6.880 5.385 5,535 4.205 4,310 4,645 6345 41.395 43.445 84.840Parry Sound District 20000 6.205 5.630 2,265 2.365 2.940 2.975 2,740 2,755 2.495 2,445 3.310 3.780 19,955 19,950 39,905Manitoulin District 20000 2,015 1,870 675 735 805 7UJ 675 700 690 655 820 1.030 5.680 5,750 11.430Sudbury Disrrkt 20000 4.450 4,220 L750 1.735 2.095 2.100 1,835 1.670 1.460 1,295 1.380 1.465 12,970 12.485 25.455Sudbury Regional Municipalily 00000 28,840 27,980 12,220 12,555 12.620 13.755 1l.035 10.790 7.340 7,625 8.375 10.915 80,430 83.620 164.050Timiskaming Dislrict 00000 6.6UJ 6,180 2,245 2,450 2,955 2.955 2.470 2,395 1.975 1.970 2.395 3.180 18,700 19.130 37,830Cochrane Di,rricl 00000 17,490 16,645 6,950 7.095 8,095 7.695 5.920 5,470 4.060 4.030 4.360 5.420 46.875 46.355 93.230Algoma Disrricl 20000 21,390 20.500 7,835 8.410 9,950 10,500 8,175 8,260 6.645 6,700 7.650 9.425 61,645 63.795 125,440Thunder Bay Di,tncl 20000 27,420 26,405 11,710 11,875 13.715 13.365 10,045 9,565 6,715 6,660 8.750 11,385 78.355 79.255 157,610Rainy River Di.mict 20000 4.355 4,095 1,520 1.550 1,880 1.770 1.325 1,305 965 1,040 1,490 1.885 11.535 11,645 23,180Kcnora District 20000 13,255 12.620 4,775 4.875 5,105 4,735 3.555 3,300 2,540 2,405 2.765 3,405 31,995 31.340 63,335.p. SUB·TOTAL 165,305 158,065 65,790 67,525 75,535 76,120 59,905 58,330 44,470 44,920 53,735 68,135 464,740 473,095 937,83500TOTAL 1,845,965 1,769,745 843,505 873,515 869,900 909,260 675,995 691,775 460,035 479,785 562,570 771,540 5,257,970 5,495,620 10,753,590Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in Manitobaby Census Division by Age and Sex1996< 25 25-34 35-44 45·54 55-64 65 + SubtotalCensus Division M F M F M F M F M F M F M F TotalDivision No. I 00000 2,665 2,390 905 930 1,240 1,125 1.025 1,040 i.us 1,025 1.390 1.390 8.340 7,900 16.240Division No.2 00000 10.380 9,775 3,450 3.565 3,815 3.735 2.740 2,465 1,665 1.635 2.180 2.635 24.230 23.810 48.040Division No.3 00000 8,335 7.805 2.590 2.640 2.890 2.820 2.085 1,965 1.475 1.535 2,695 3,645 20,070 20,410 40,480Division No.4 00000 2.005 1.780 605 585 760 685 595 580 460 475 840 1.030 5,265 5,135 10,400Division No.5 00000 2.460 2.320 760 790 1,100 1,080 895 840 730 785 1.350 1,670 7.295 7,485 14,780Division No.6 OOOOD 1,935 1.860 605 615 745 740 595 570 425 450 900 1.085 5.205 5,320 10,525Division No.7 00000 10,275 10,205 4,035 4,200 4,235 4,435 3.200 3.315 2,230 2.370 3.640 5.105 27.615 29.630 57.245Division No.8 ooooo 3.170 2,905 905 860 1.000 935 810 770 625 585 1,075 1.265 7.585 7.320 14.905Division No.9 20000 4,360 4,140 1,550 1,605 1.825 1,835 1.300 1.285 945 975 1.410 1,965 11.390 11.805 23,195Division No. 1000000 1.920 1.685 655 660 800 785 560 500 360 335 310 320 4.605 4.285 8.890Division No. II 00000 105,335 103.265 49,500 49.615 49.965 51.270 37.245 39,130 24,015 25,905 33,160 51.675 299,220 320.860 620.080Division No. 1200000 3.360 3.180 1,105 1.240 1,715 1.715 1.365 1,260 845 775 1.075 1.075 9.465 9.245 18.710Division No. 13 00001 7,010 6.230 2.275 2.390 3.510 3,520 3.000 2,900 1,990 1.845 2.175 2.585 19.960 19.470 39.430Division No. 14 DOOao 3.275 2,820 1,305 1.075 1.595 1.460 1.160 1,055 725 645 870 1,055 8,930 8.110 17.040...-o Division No. 1500000 3,735 3,410 1,150 1,135 1,675 1,530 1.345 1.270 1,085 1.170 2.225 2,745 11.215 11,260 22,475Division No. 1600000 1,960 1,790 595 605 755 690 580 590 510 495 980 1.145 5.380 5,315 10,695Division No. 1700000 3,935 3,575 1,295 1,255 1,595 1,685 1.515 1.435 1,265 1,190 2.330 2,890 11.935 12,030 23,965Division No. 1800000 4,020 3,675 1,290 1.275 1.545 1.490 1,280 1.245 1,250 1,230 1,920 2,065 11.305 10,980 22.285Division No. 1920001 4,050 3.795 1,140 1.120 960 835 660 510 460 400 430 355 7.700 7.015 14.715Division No. 2000000 1,935 1.790 620 645 815 765 675 695 565 550 1.l00 1.280 5.710 5,725 11.435Division No. 21 00000 5,Q90 4,800 1,670 1,720 1,970 1.830 1.395 1.235 855 760 825 990 ll,805 11.335 23,140Division No. 2200000 9.735 9.305 3.145 3.ll0 2,260 2.215 1.775 1,465 850 725 500 485 18,265 17.305 35.570Division No. 23 00000 2.540 2.465 935 840 700 620 450 365 250 200 145 155 5,020 4.645 9,665TOTAL 203,485 194,965 82,085 82,475 87,470 87,800 66,250 66,485 44,695 46,060 63,525 88,610 547,510 566,395 1,113,905Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in Saskatchewanby Census Division by Age and Sex1996< 25 25-34 35-44 45~54 S5-64 65 + SubtotalCensus Division M F M F M F M F M F M F M F TotalDivision No.1 00000 6.230 5.640 2.200 2.040 2.505 2.320 I.790 1.610 1.340 L290 2.365 2.960 16.430 15.860 32.290Division No.2 00000 4.035 3.745 1.320 1.250 1.770 1.660 1.220 1.235 1.095 !.l00 2.UD 2.570 11.550 11.560 23.110Division No.3 00000 2.920 2.700 815 835 1.335 1.235 915 820 745 765 1.540 1.845 8.270 8.200 16.470Division NO.4 00000 2.270 2.060 690 720 945 885 650 670 610 570 1.025 1.200 6.190 6.105 12.295Division No.5 00000 5.930 5.695 1.770 1.815 2.515 2.335 2.045 2.020 1.710 1.715 3.375 4.110 17.345 17.690 35.035Division No.6 00000 41.340 39.975 16.080 16.910 17.905 18.300 12,390 12.700 8.485 8.950 11.420 16.145 107.620 112.980 220.600Division No.7 00000 8.760 8.275 3,125 3.135 3.870 3.785 2.725 2.570 2.045 2.145 3.785 5.075 24,310 24.985 49.295Division No.8 00000 5.460 5,235 1.785 1,860 2,625 2,420 1.780 1.715 1.395 1.490 2.575 3.310 15.620 16.030 31.650Division No.9 00000 6,170 5.935 2.035 2,120 2,585 2.505 2,150 2.165 1,955 2.055 3.975 4.930 18.870 19.710 38.580Division No. 10 00000 3.715 3,300 1.040 1.055 1.450 1.355 1.195 1.115 985 975 2.090 2A85 10.475 10,285 20.760Division No. 11 00001 44.255 43,715 17.755 18,220 18,685 19,490 12.495 12.650 8.300 8.805 11.405 16,170 112,895 119.050 231.945Division No. 1200001 4,735 4,395 1.305 1,355 2.050 1,950 1.450 1,330 1,050 1.035 1.755 2.030 12.345 12.095 24.440Division No. 13 00000 5.005 4,495 1.585 1.535 2.050 1.800 1.205 1.160 LOIS 1.025 1.805 2.175 12.665 12.190 24.855v. Division No. 1400000 7,345 6,825 2,190 2,180 2,870 2.785 2,435 2,335 2,030 1.950 3.605 4,265 20.475 20.340 40.8150 Division No. 1500000 15,955 14.910 5,055 5,250 5,955 5.825 4.500 4.405 3.465 3,440 5.320 6.605 40.250 40.435 80,685Division No. 1600000 7.430 7.080 2,255 2.230 2.645 2.620 2.035 2.005 1.670 1.665 2.780 3.320 18.815 18,920 37.735Division No. 1720000 8.780 8,210 2.690 2,795 2.815 2.725 1.960 1,730 1,395 1,280 1,945 2.185 19.585 18,925 38.510Division No. 1800000 8.775 8,615 2.405 2,615 1,905 1,795 1.220 1,050 760 660 660 655 15.725 15,390 31,115TOTAL 189,110 180,805 66,100 67,920 76,480 75,790 54,160 53,285 40,050 40,915 63,535 82,035 489,435 500,750 990,185Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in Albertaby Census Division by Age and Sex1996<25 2S-34 35~44 45·54 55·64 65+ SubtotalCensus Division M F M F M F 1\'1 F M F M F M F TotalDivision NO.1 00000 11.445 10.840 4AI0 4A40 5,370 5,195 3385 3,505 2A85 2.580 3.765 4,915 30.860 31.475 62,335Division NO.2 00000 25,095 23.580 9.185 8.940 9,765 9,795 6,880 6,865 4,755 4,785 6.685 8,855 62365 62,820 125,185Division No.3 00001 7,980 7,555 2,135 2.235 2,720 2,735 2,030 2,115 1.580 1.600 2300 2.770 18,745 19,010 37,755Division No.4 00000 2,315 2,150 865 825 1.030 865 655 635 495 450 835 940 6,195 5,865 12,060Division No.5 00000 8,545 8,090 3,035 2,895 3.640 3,345 2.565 2,480 1.770 1.700 2,500 2.995 22,055 21,505 43,560Division No.6 00000 158,045 151,105 76,115 76,510 85375 84,020 54,985 53,295 31,340 32,050 33,140 44,895 439,000 441.875 880,875Division No.7 00000 7.920 736O 2,900 2,855 3335 3,075 2315 2,165 1.675 1.650 2,680 3.235 20,825 20340 41,165Division No.8 20000 25,615 24.690 9,820 10,180 12.015 11,565 7,545 733O 5,185 5,095 6,455 8.100 66,635 66,960 133,595Division No.9 00000 3,770 3,540 L295 1.305 1.490 1.425 1,045 1,065 830 685 860 870 9,290 8.890 18,180Division No. 10 00001 14,240 13,530 5,030 5.225 6,340 6,050 4,775 4,645 3,605 3,550 5,965 7,080 39,955 40.080 80,035Division No. I I 20000 165,095 159,685 72,385 73,675 79.865 79,635 55300 55,005 34,890 35,130 37,750 50A90 445,285 453,620 898,905Division No. 1220001 12,125 11,110 4,645 4,610 4,650 4,205 2,740 2.805 2.255 1.965 2,630 2,775 29,045 27,470 56,515Division No. 1300001 12,065 10,895 4365 4,200 5,170 4,855 3,805 3,600 3,080 2,715 3,800 4,010 32,285 30,275 62,560Division No. 1400000 5,565 5,295 2,145 2,120 2,645 2,450 1.715 1,465 1,120 920 995 1.020 14,185 13,270 27,455V< Division No. 1500011 5,740 5,590 3,240 3,130 2,990 2,555 1,625 1,450 865 955 1,180 1.470 15,640 15,150 30,790Division No. 1600001 8,005 7,625 3,230 3,290 3,960 3,515 2,670 2,085 835 605 300 370 19,000 17.490 36,490Division No. 1720000 13,515 12,980 4,585 4,445 4,120 3,715 2,660 2,390 1,825 1.485 1.555 IA05 28,260 26,420 54,680Division No. 1800000 3,280 3,110 1,295 1,140 1.365 L235 980 805 595 460 400 340 7,915 7,090 15,005Division No. 1900000 16,720 15,660 6,785 6,560 7,130 6,595 4,245 4,045 2,865 2,520 3,030 3.515 40,775 38,895 79,670TOTAL 507,080 484,390 217,465 218,580 242,975 236,830 161,920 157,750 102,050 100,900 116,825 150,050 1,348,315 1,348,500 2,696,815Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in British Columbiaby Census Division by Age and Sex1996<25 25-34 35-44 45·54 55-64 65 + SubtotalCensus Di vision M F M F M F M F M F M F M F TotalEa,r KOOlcnayRegional DiSirict 00000 10.115 9.550 3.615 3,775 5.040 4,965 4.025 3.830 2.725 2.400 2,885 3.430 28,405 27.950 56.355Central Kootenay Regional Diwicl 00000 9.800 9.250 3.305 3,535 4.740 4,925 4.110 3.990 2.995 2.865 3,950 4.620 28.900 29,185 58.085Kootenay Boundary Regional District 00000 5.295 4.980 1.680 1.900 2,840 2,785 2.285 2.140 1,680 1.745 2,495 3.065 16.275 16.615 32.390Okanagan-Similkamecn Regional District 20000 10.590 10.270 3.755 4,135 5.305 5,630 4.490 4.880 4.260 4.570 8.295 9.745 36,695 39.230 75.925Fmser Valley Regional D;scr;c! 2000! 41.285 39.065 16.690 16,555 17.655 17,380 12,660 12.435 8.990 9.265 13,575 16.S45 110.S55 111.545 222.400Greater Vancouver Regional DiSlrict 20001 295.015 284,420 158.990 160.080 156.990 162.255 122.795 122,730 75.850 76,115 9L165 125.250 900.805 930.850 1,831.655Capital Regional District 20000 46,345 45570 23.095 23,275 24.860 27.065 21.010 21.840 13,205 J4.260 23.4S0 33,990 151.995 166.000 317.995Ccwicbau Valley Regional District 00000 11,965 11.550 4.140 4,470 5.745 6,135 4,835 4,620 3,455 3.385 4,995 5.690 35.135 35.850 70.985Nanaimo Regional DiSlrict 00000 19,160 IS.360 7.340 7,890 9.570 10,165 7,940 8,125 6.060 6.245 9,605 11.320 59.675 62.105 {2U80Albcrtu-Clayoquot Regional DiSlrict 00000 5.720 5,440 2,035 2,095 2.630 2.630 2.350 2,075 L550 1,425 L695 2.005 15.980 15,670 31.650Coruox,$trathcona Regional DiSlric! 20000 17.045 16.385 6,505 6.780 8.680 8.905 7.040 6.665 4.615 4,265 5,045 5,715 48.930 48,715 97,645Powell River Regional District 00000 3,280 3,O{5 1,155 1,245 1,630 L660 1.555 1,405 ],OSO 980 1.355 l,585 10,055 9.890 19.945Sunshine Coast Regional District 00000 3,730 3.705 1.310 1,460 2.075 2.175 1,845 1.705 1.265 1.335 2,020 2,285 12.245 12,665 24,910SqUltmislr·Lilloo.::!Regional Dim;c! 20000 5,620 5,135 3,235 2.995 2,855 2.565 1.900 1.530 980 855 845 895 15,435 13.975 29,410Thompson.Nicola Regional DistriCl 00000 21.685 20.575 7.820 8,425 9,885 10,300 8.215 7.965 5,715 5.360 6.020 6.825 59.340 59,450 118.790Central Okanagan Regional DistriC100000 21.840 20.990 8,910 9,420 lO.530 11,260 8.300 8.580 6,475 6.895 10,380 12.975 66,435 70.120 136.555v, Nonll Okanagan Regional District 0<XXl0 12.010 11.460 4,105 4.470 5.630 6.050 4.585 4,690 3.475 3.575 5.260 6.300 35.065 36,545 71.610tv Columbia·Shuswap Regional District 00000 8.060 7,415 2.830 2.965 4.030 4.080 3,230 3.175 2,610 2.555 3,430 3.720 24.190 23,9lO 48.100Caribcc Regional District 20000 12.840 12,205 4.515 4,725 5.775 5.790 4.805 4.395 3.070 2.695 2.855 2.795 33,860 32,605 66.465Mount Waddington Regional District 20(XX) 2,990 2.845 1.215 1.185 1,430 1.290 LllO 905 610 435 310 280 7,665 6.940 14.605Central Coast Regional District 0101 0 815 750 320 325 370 305 270 240 160 125 120 125 2,055 1,870 3.925Skecna.queen CharlotTe Regional District00001 5,050 4,840 2,J55 2,095 2.360 2.120 1.640 L400 925 705 700 805 12,830 11.965 24.795Kitirnat-Stikine Rcgional DistriCl 00001 9,365 8,680 3.490 3,460 3.830 3.660 2,990 2.520 1.645 1.415 1.290 1.260 22,610 20,995 43.605Bulkley·Ncchako Regional District 00000 8,940 8.365 3.220 3.185 3.735 3.455 2.615 2,255 1.595 1.380 1.480 1.430 21,585 20,070 41.655Fraser-Fort Geotge Regional District OO(XX) 20.100 19.085 8,150 8.265 9.085 8.930 6.640 6,185 3.830 3.060 2.725 2.920 50.530 48,445 98.975Peace River Regional District 00000 11,890 11.350 4,810 4,730 5.030 4,705 3.300 2,995 2.090 1,840 1.8lO 1.940 28.930 27.560 56.490$tikine Region 00000 260 270 120 110 105 llO 120 95 70 45 40 35 715 665 1.380Fort Nehon.Ljard Regional District OO(XX) 1.310 1.280 645 575 605 505 270 275 160 90 70 70 3,060 2.795 5.855TOTAL 622,120 596,805 289,155 294,125 313,015 321,800 246,930 243,645 161,140 159,885 207,895 267,920 1,840,255 1,884,180 3,724,435Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Estimates in the Yukonby Census Division by Age and Sex1996Census Division<25M F25-34M F35,44M F45-54M F M F65 +M FSubtotalM F TotalYukon Territory - Territoire du Yukon 00000TOTALNB: The Yukon is considered as a single census division.Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia5,9455,9455,5305,5302.5702,5702,7952,7953.2253,2253,1153,1152,3302,3301.9551,9551,0851,08585585572572563563515,88015,88014,88514,88530,76530,765Population Estimates in the Northwest Territoriesby Census Division by Age and Sex1996<25 25-34 3S-44 45-54 55-64 65 + SubtotalCensus Division M F M F M F M F M F M F M F TotalBaffin Region 00000 3,755 3,500 1,235 1,135 935 735 620 450 325 260 140 115 7,010 6,195 13.205Keewatin Region 00000 2,055 1,945 640 610 365 325 255 255 130 125 75 70 3.520 3.330 6,850Fort Smith Region 00000 6,700 6,270 2,925 3,040 2,860 2,660 1,845 1,550 735 615 525 490 15,590 14,625 30.215Inuvik Region 00000 2,155 2,120 910 805 700 645 470 370 255 220 165 180 4.655 4.340 8.995Kitikmeot Region 00000 1,435 1,405 440 490 295 270 185 165 115 105 85 55 2.555 2,490 5.045TOTAL 16,100 15,240 6,150 6,080 5,155 4,635 3,375 2,790 1,560 1,325 990 910 33,330 30,980 64,310Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaAppendix 2Proportion of Males and Females in each Province/Territory by Age Group andPercent of Males and Females in each Province/Territory by Age Group55Proportion of Males and Females in Canada by Age Group, 19961m FemalesDMales100.0090.0080.0070.00'E 60.00"~ 50.00"a. 40.0030.0020.0010.000.00 j-J........J-+-'---'-+...J........J-+-'--'-+...J........J-+-'---'-+...J........J-+-'---'-+...J........J-j0-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ AllAgesAge GroupsProportion of Males and Females in Newfoundland by AgeGroup, 1996100.0090.0080.0070.0060.0050.0040.00 .30.0020.00·10.00 .0.00 j-J---JL...t--'----'--+-'----L...;.....L....L+-L....L.--;--"--"--t--=-'--f-l-=-+--=--'--IIII FemalesDMales0-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Age GroupsAllAges,-------------------------------Proportion of Males and Females in Prince Edward Island byAge Group, 1996100.0090.00·80.0070.00C 60.00~ 50.00~ 40.0030.00·20.0010.000.00 +-J.----'-;-..L....L..;--L.......L-+-.L...L.--;--'-=--t-.L....:L..+-L-L+-=4...L-'-'---jIII FemalesDMales0-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ AllAge Groups Ages56Proportion of Males and Females in Nova Scotia by Age Group,1996100.0090.0080.0070.00'E 60.00~f: 50.00£ 40.0030.00·20.0010.000.00 +-'---'-+-'----'--1-'-----'-+---'----'--1-'-----'-+---'-----'---1-'-----'-+---'---=--+--'-'-,,---"0-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ AllAgesAge GroupsmFemaleso MalesProportion of Males and Females in New Brunswick by AgeGroup, 1996100.00 ..90.0080.0070.00C 80.00~~ 50.00-£ 400030.00·20.0010.000.00 .J-l=-+---'------'----r--L-'--'--+-=4-L-L;--1=--+-='-t---'-----'---I-'-'----'-j0-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ AllAgesAge Groups~IilIFemaleso MalesProportion of Males and Females in Quebec by Age Group, 1996100.0090.0080.0070.00C 60.00 III Females~ 50.00 0 Males~a. 40.0030.0020.0010.000.00 .J-l--'-+---'-----L;--1-----'--+--'----'---J-'--'--'--'--+-=4---'-----'--+-l=4-L...L.j0-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ AllAge Groups Ages57Proportion of Males and Females in Ontario by Age Group, 1996IiilI Femaleso Males100.0090.0080.0070.0060.0050.0040.0030.0020.0010.000.00 +-JL..JL,.-L-L+-L..JL,.-L-'-+--J-.JL,.-'--'-+--JL..J-t--'--L+--JL..JL..j0-19 20-29 30-39 40-49 50-59 60-69 70-79Age Groups80+ AllAgesProportion of Males and Females in Manitoba by Age Group,1996ill Femaleso Males100.00·90.0080.0070.00C 60.00w~ 50.00~ 40.0030.0020.0010.000.00 .I-'--J.-+--'--'-+-'---'-f--'-......L-+-==I-'--J.-+-'--'-+-=.l......f---"=--j0-19 20-29 30-39 40-49 50-59 60-69 70-79 80+Age GroupsAllAges,-------------------------------.Proportion of Maies and Females in Saskatchewan by AgeGroup, 1996100.00·90.0080.0070.0060.0050.0040.0030.0020.0010.00·0.00 -j-JL..JL+-'--'-+-JL..J-+-'--'--j-J-J.-+--'--'-+--J.-'-+--'--'-+--J.-'-IIliIFemaleso Males0-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ AllAgesAge Groups58rnJ Femaleso MalesProportion of Males and Females in Alberta by Age Group, 1996100.0090.0080.0070.0060.0050.0040.0030.0020.0010.000.00 ·f-J---'--+-'---4-L..L+-1-.-L-+-=.L.;-L-L+-J=-t--==f-L.....l-40·19 20·29 30·39 40-49 50·59 60·69 70-79 80+ AllAgesAge GroupsProportion of Males and Females in British Columbia by AgeGroup, 1996100.0090.00·80.0070.0060.0050.0040.0030.00·20.0010.00·0.00 .J-l-.-L-+-=L.;-L-L+-J=-t--==f-L-L-j-LJ'-+..L-=+-1-.-L...jlliIFerraleso Males0-19 20-29 30·39 40-49 50·59 60-69 70·79 80+ AllAgesAge GroupsProportion of Males and Females in the Yukon by Age Group,1996100.0090.0080.0070.001: 60.00~~ 50.00~ 40.0030.0020.00·10.000.00 .J-l=-+-=L.;-L...L+-1=-+-=.L.;-L...L+-1=-+-=4...L..L.im:J Femaleso Males0-19 20-29 30·39 40·49 50-59 60·69 70·79 80+ AllAgesAge GroupsL . . .. ---"59Proportion of Males and Females in the Northwest Territories byAge Group, 1996m:J Femaleso Males100.0090.0080.0070.0060.00 .50.0040.0030.00·20.0010.000.00 .j...J---l-+..L..Lc-l---L-rJLJ-+..L..Lc-l---L-t-LJL,....L..Lt--l----Li0-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ AllAgesAge GroupsPercent of Males and Females in Canada by Age Group, 1996(NB: Total Male =49.12%; Total Female =50.88%)12.0011.0010.00g.OO8.00'E 7.00~ 6.00~ 5.004.003.002.001.000.00~ ~ij- , ~,- i- e' iii Ii, ~- I: ii I IiIf ., lill- II I!i~ il'" I I: Il Ii I~ II~ " ~i~- ,iI» II Ii ... ~ Ii ii- ~ :i I' i· ~ rllIII~ L ~'-,;~~ s-. ii II Ii ill-- i :i 1;ljl~ ii I [ , lilrl~hJ:jI~r rn Ii " ~ III! ~ Ii'I ili!l- i~- i: ij- I 1'111 !, ~ ~ bini III~ II I;!"o Malesll!ill Females"1 cp " '" -e-c» -e-'"-sr'"-e r»"c»" '"-e- +')J J; ~ ? :1; "1 '1' '1' <D <D 2; r-, 00 "'0 "' 6"'6"' "'6 000"' "'0"'~ N N co'" " " "' "'<D <D r-, r-, 00Age Groups._--Percent of Males and Females in Newfoundland by AgeGroup,1996(NS: Total Males = 49.40%; Total Females = 50.60%)o MalesiiiIFemales11'].i ;I, .... "'1111. :: II 1I1111ilI~~ IHI!liJi!"Mi!12.0011.00 ·I----------------------~10.00 j--- -------------------- ­9.001--------------------- ­8.00 ·1---- b,-r,.---,.-r1lI-nn-=----------~.~~ ---1= ~- II' I~.~~ 11_llii~il_- 1- i-II~:gg i" ~ - I!100 "ILli- n. ~: 11m ! Ii0.00 ..(ll4LIll.;lA,UlI.-jtll4Ulli4lA,LIillL,.Lill4tl'4LII4t.J!l.,.ll!l-jtll4LII4tA,J..Jilll+1Jilll60..._.-Percent of Males and Females in Prince Edward Island by Age Group, 1996(NB' Total Males=49 10%; Total Females =50.90%)12.0011.0010.009.008.00"E 7.00 ,~ ~- -11;- - ;1 o MalesIi ,.~ 6.00 I~ - ii 111- " I I i i~~ IlllFemales~ I' 111- . III 111- i J!f.- i~~ 5.00 ,I ~ ~I- 'III ! ~ II~ I 11-"4.00 iil- "III ' "3.00 I , I~~ s r..·m ~ II I i~ !I II II'~ '-~- i l~ i~ .' III litlil- i li~ Ii Ii , IlL2.00 ~ "11m . ;'1111 ~II 'l=Jji' .... i~ I~~~ I rllf! ~ j, ! Iiii- ,~ ..... I Ii I il1.00 I' 1111 ' I ii ; .0.00 ' ,; III 1 I" , , , .-; ~ -e- 0) -sr 0) -e 0) -e 0) ... 0) -e- 0) ... 0) -e +;;; 2: ')' "? "? -; -; '\' en <D <D 2; r-, co ena .;, .;, 6 .;, .;, 6 coen a en a en a~ ~ cv'" '" '"... -e- en en <D <D r-, r-, coAge Groups--_ .._.1:~le~a.Percent of Males and Females in Nova Scotia by Age Group, 1996(NB:Total Males =48.65%; Total Females =51.35%)2.00 .1.00 1--....----------------------10.00 j~----------------------__i9.00 j------------------------__i8.00 , 'lh-..-=------------17.00 .... ~ I III - 1Ii- 0 Males800 1r ~I'- til:. ! II i' III~ , IlllFemales5.00 ,liI- -. I Ili'-" I " " II·!I~111!,i-.=c::---------I4.00 ·ll,l['- : II, I~ j' H i I' i ~3.00 I" I' I - !- . I I I ~ I '2 00 I I' . ; I '! I I' IIn-!1l'1-f~--",i1'00 ; II , I: I , ' ' 111'r ,I HI, I -l1~I'hl~Iil'. n; ~ Ii '~#t ~ '"' I~ i Ii Ii ;1 III-I:]I!' III0.00" ",I " ,- . ,. " 1.lllil ill~ m ~ m ~ m ~ m ~ m ~ m ~ m ~ m ~ +6 ~ 6 ~ 6 ~ ~ ~ 6 ~ 6 ~ 6 ~ 6 ~ 6 ~~ ~ ~ ~ N N ~ ~ ~ ~ m m ~ ~ 00Age Groups12.0011.0010.009.008.00"E 7.00~~ 6.00~ 5.004.003.002.001.000.00Percent of Males and Females in New Brunswick by Age Group, 1996(NB:Total Males = 49.17; Total Females = 50.83%)IIqJ' I !1= '[ m 'Ill II - ! I. : tt ~ II1.1 ill - - Iii :i i I rrn 'II ~~l~hJlla.; r " " 'I i11- I, II IIII Ii ~ - - II II~ :Ii! 5' ! ~ I1iI- II ,. 111- ii- .-,: j~ i . ~ - "i ~-; ep -sr'"...'"... en -e'"...'"... 0) -e- 0) -e- +a en ;;; 2: ')' "? co ... ... 6 :b <D <D 2; ";- OJ> en.;, co a .;, 6 .;, 6 .;, en a co'" '"co co ... -e- en en <D <D r- r- coAge Groups---------61o MalesIllil Females12.0011.0010.009.008.00'E 7.00~ 6.00~ 5.004.003.002.001.000.00Percent of Males and Females in Quebec by Age Group, 1996(NB:Total Males ~ 48.94%; Total Females ~ 51.06%)T .. ··-- ~- ·-~_·.. _· ·--.. - .. ••·.. ·•• .. ·--.. ·..···.. ···· _--~~- - - ..111- ""lll>-------------1)~ ,m-II"=- ,. oMales-- I rim- .. ,IL ~ 11-1'<,--------1II" :, I i It'I 1 Im,!~- ~ _ ~! ~ ~ II Females",H "I'tll'liIIil il~- 'I II I ill '11- 9 ii - Ii!!, Ii I ----.~Il li~- : Ii I i"- ,1- ,11,· 1- ! 11"1'- F ~ iIIJ . I' , '''' "" ".'" '.' , \!" " ! FITII I~~- 'L ~ , 111 1=' lilt- m~- 'i ;1 'I'~ ':, hI--II~ : _ LI i;' iiI- Ilil_ L ~ 11111_ II ~ Ii"'~]-i~ n i! lim I~I rn IT Ii :ml ~:' i-rUff~ m ~ m ~ m ~ m ~ m ~ m ~ m ~ m ~ +o..n" C}lC';JC'('?'1'1l.Q1.Q~<9t';_r_;_0?~o ~ a ~ 0 ~ 0 ~ 0 ~ 0 ~ 0 ~ 0~ ~ N N ~ ~ ~ ~ ~ ~ w ~ ~ ~ 00Age Groups. ._--_.....Percent of Males and Females in Ontario by Age Group, 1996(NB,Total Males ~ 48.89%; Total Females ~ 51.11 %)12.00 ......._._-.--....~--._----._--~-_...__.-._....-.~........~......... -......- .......11.0010.009.008.00·· I "IiC 7.00" ffiI:. ., I II- i! n MalesQ) 6.00 mo I- i"" I~ In I : I iI!IFemalesQ) 5.000- i ~- ~-l I4.00 ".... '! . 'r I II~ i , I3.00 ! - II "' ~IM-s ~ I H in I2.00 ~ I. " ~ II 1- ~HlhlrmiI 'II: I[~ li1.00 ·1 I' , litii I "0.00 , !i I'f cp -q'"-q r» -q en -q c» -q'"-e c» t!- c» -q +;; ')J ')J co co -q 'f 6 ? <D '\' ~ '\' io0 co J, 6 J, 6 6 000 to co to io 0 io 0~ ~'" '"co'"-e -sr co to <D <D r-, r-, 00Age Groups_.Percent of Males and Females in Manitoba by Age Group, 1996(NB:Total Males ~ 49.15%; Total Females ~ 50.85%)12.0011.0010.009.008.00C,7.00 I' " " _.. -, ! o MalesQ)6.00 11- II I' i I-IIc IIIFemales~ 500 Iii I 11- il- I '0- j 'I ., ~4.00 Ii, ~I~I~ Ii: -ii ~I:il Ii, ~3.00 . .llill. ,Iil~ :,'" i ! :: FIII~_ i '"; -liil ., I'2.00 11111- 1-1111' ., i I . 11111[- r r ~ II ~ nE1IIF;i'11111- " 1111· 11- " ij ~ IIIlil- ' ,. i'1.00 li!~ ~li!1 : Ii' i - H Ililil I ' "11111' i ii- li-0.00 I, <I '. " • .: Ii. i~ Ii Ii ~; Ii Ii-e- c» -q c» -q c» -e- r» -q c» -q c» -q c» -q c» -q +6 J, 2: ')J "? "? -q 'f '? co <D <D 2; J; 6 io6 J, co 0 io 6 co 0 J, 6 J, 00~ ~'" '"co co -q -e io co <D <D r-, r-, 00Age Groups62r--------------Percent of Males and Females in Saskatchewan by Age Group, 1996INS:TotalMales = 49.43%; TotalFemales = 50.57%)1-~ .. f,iii'I"'II';~"I";_,,!II-' ri~"-I'-11m 'Ili~~ , I Iii: .',' i'o MaleslEI Females+til..'\'sc»t;-it:9TI'fd'­111\.1'. q .11111~Rr»'I'~..'I'sc»'"onon~-~-~ s Irl-1~(J) v Q) v'? "7 't lQto 0 to 00? v v Ii)Age Groups'" ..S'J '?~ g-sr~.. '"6 JJr».;,'1oc"::"ll.Percent of Males and Females in Alberta by Age Group, 1996(NB: Total Males = 50.00%; Total Females = 50.00%)12.00 ·r···························· ....................•• •..•........•...•••..... . --•.-.- -----,11.00 j--------------------------j10.001..-----------------------19.00 j---------;=;..-I m1--------------jc ~.~~ . ~... II·· " 11 : Maless 6.00 I: ~r ~ i 1:11111 ~ ij I~ 0~ 5 00 i!. 'I' 'I i" lliili' i. ~ 't. III Femalesa. . ~ ~ Ii ! liitl ~ l.~!' [ L ~4 00 f; 19 j, : i'liil '. j, ",,.,,.--=----------j. I 'i t " "II"'" II 11'-' ..300 ,.- l " I ,1m· ,'I ill. .' ~ !i : ilill t ,,11! Ii II! Ii .2.00 ,. 11'1=- sr-r n '''11 I ,11-.1 , ..- 1'=1 H1j"'TI'"100 ! II I I II!\-II: ,I; II I: II" II ""I""''''''''''''''''0.00 ii, m II i 1111 ,li~ b I i:1 II Ii ~ {1~!1 , r1~1~ m ~ m ~ m ~ m v m v m v m v m v +" N N ~ M v v ~ ~ w ~ ~ ~ ro ~o ~ 6 JJ 6 JJ 6 JJ 6 JJ 6 ~ 6 JJ 6 JJ 6 ro~ ~ N N N M v v ~ ~ ~ ~ ~ ~ roAge GroupsPercent of Males and Females in British Columbia by Age Group, 1996(NS: TotalMales =49.41%; TotalFemales =50.59%)o MalesmlI Females.._-------c» .. c» -e c» -e- +:b (D (D 6 J; '\' on6 .;, 0 '"on (D (D r-, r-, coI~\1­IIrn "'<t OJ "<t~ $ ~ ~!... rn 1 'III~I-Im,~im!~i~IIH ,', .: i • ~i ,'1'".. c» .. c» ..0 .;, ;;; :;; 6 J; 6'"or co12.00:i::l =;~~---_.._ .._ .._-~7.00 _ n IllI-6.005.00·4.003.002.001.000.00 1111iI,H11i ,Iiic"::~Age Groups,63Percent Males and Females in the Yukon by Age Group, 199612.0011.0010.009.008.007.006.005.004.003.002.001.000.00(NB: Total Males ~ 51.62%; Total Females ~ AA OA%)! IIf--n0, ~II III II!fWi I!~ I~I II' r mI Iii Illrl~ i ill" ItIII"III~= m .,I tl 1- ~I~ il Ii I I' lilt-II m Ili!- , IIII~ ~-1111 I[rlf- II II I~~ Ii I lil- I I,.ii HI II II~I'- ii I!·- i! Illf It" -- II IHm"fll-r=m- ~--Iii I!I~ " Ii ~~r IIII ,Iii .•.. ~ "Ii 11 ~ jI IrJI Ii ~n MalesIlil!I Females(J) -:::t (J) -.::t'? 't 't lQL() 0 l() aC') "<t -:::t It)Age GroupsPercent of Males and Females in the Northwest Territories by Age Group,1996(NB: Total Males = 51.83%: Total Females ~ 48.18%)~--o MalesllllI FemalesI-IIi(J) -:::t (J) -.::t (J) -.::t m -:::t (J) -:::t m -:::t m -:::t +~ ~ ~ '? '? 't 't lQ lQ ~ ~ ~ ~ ~ ~~ ~ g ~ ~ ~ ~ ~ ~ ~ R ~ ~Age Groups664Appendix 3Population Pyramids by Province/Territory65Male Population in Canada by Age Group1400000 1200000 1000000 800000 600000 400000 200000PopulationPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia85+80-8475-7970-7465-6960-6455-5950~5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0Female Population in Canada by Age Group200000 400000 600000 800000 1000000 1200000 1400000populationMale Population in Newfoundland by Age Group Female Population in Newfoundland by Age Group25000 20000 15000 10000 500085+80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0 5000 10000 15000 20000 25000Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation PopulationMale Population in Prince Edward Island by Age Group Female Population in Prince Edward Island by Age Group6000 5000 4000 3000Population2000 100085+80-8475-7970-7465-6960-6455-5950·5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0 1000 2000 3000Population4000 5000 6000Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaMale Population in Nova Scotia by Age Group Female Population in Nova Scotia by Age Group40000 35000 30000 25000 20000 15000 10000PopulationPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia500085+80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0 5000 10000 15000 20000 25000 30000 35000 40000populationMale Population in New Brunswick by Age Group Female Population in New Brunswick by Age Group35000 30000 25000 20000 15000 10000 500085+80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0 5000 10000 15000 20000 25000 30000 35000Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation PopulationMale Population in Quebec by Age Group Female Population in Quebec by Age Groupi------350000 300000 250000 200000 150000 100000PopulationPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia5000085+80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0 50000 100000 150000 200000 250000 300000 350000PopulationMale Population in Ontario by Age Group Female Population in Ontario by Age Group500000 400000 300000 200000 10000085+80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0 100000 200000 300000 400000 500000Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation PopulationMale Population in Manitoba by Age Group Female Population in Manitoba by Age Group50000 40000 30000 20000 1000085+80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0 10000 20000 30000 40000 50000Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation Population10000 15000 20000 25000 30000 35000 40000Population5000Female Population in Saskatchewan by Age Group--------185+80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0Male Population in Saskatchewan by Age Group45000 40000 35000 30000 25000 20000 15000 10000 5000PopulationPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaMale Population in Alberta by Age Group Female Population in Alberta by Age Group140000 120000 100000 80000 60000 40000 2000085+80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0 20000 40000 60000 80000 100000 120000 140000Prepared by:HealthHumanResources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaPopulation PcpulatlonMale Population in British Columbia by Age Group180000 160000 140000 120000 100000 80000 60000 40000 20000PopulationPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia85+80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0Female Population in British Columbia by Age Group----------------------20000 40000 60000 80000 100000 120000 140000 160000 180000PopulationMale Population in the Yukon by Age Group Female Population in the Yukon by Age Group1000=-----------1600 18001000 1200 140080060040020085+80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 02004006008001800 1600 1400 1200Population PopulationPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaMale Population in the Northwest Territories by AgeGroupFemale Population in the Northwest Territories by AgeGroup4000 3500 3000 2500 2000Population1500 1000 50085+80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-40 0 500 1000 1500 2000Population2500 3000 3500 4000Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British ColumbiaAppendix 4Acute Care - Number of Facilities and Number of Bedsby Province/Territory798000Province Acute CareNumber of Facilities Number of BedsGeneral Acute Care Teaching Hospitals Correctional Total Generals PsycJMent.Handi. Pediatric RehabJConv. Ext Care/Chronic TotalHospitals 1 Facilities 2Alberta 100 2 3 105 5,431 1,851 313 335 13,522 21,452B.C. 121 5 6 132 7,345 700 5 527 517 6 8,628 7 17,717Manitoba 83 2 11 96 3,450 1,190 352 394 647 6,033Nfld, 15 1 0 16 754 42 58 24 81 959New 29 2 2 33 2,024 310 115 276 446 3,171BrunswickNWT 6 0 0 6 137 10 52 0 61 260Nova 39 0 1 40 2,506 306 255 149 712 3,928ScotiaOntario 272 21 0 293 20,071 6,227 1,666 4,077 9,306 41,347PEl 8 0 0 8 367 243 50 23 34 717Quebec 205 10 9 224 17,842 6,893 879 1,626 14,698 41,938Sask. 70 1 0 71 2816 3 248 262 0 0 3,326Yukon 4 2 0 0 2 53 0 6 0 0 59Source. GUIdeto Canadian Healthcare Facilities, Vol. 5, 1997-1998, Prepared by Canadian Heatthcare AssoctatlonSource: Information received directly from the YukonSource: Health Care '98: A Guide to Health Care in Alberta, JUly, 1998.Source: Policy and Planning, Saskatchewan Health, (numbers as at March 1, 1999)1 Includes prison hospitals in the provinces in which they exist (i.e. B.C. has 1, Saskatchewan has 1, and Ontario has 1)2 The correctional facilities provide health care, but are not classified as hospitals even though they do have beds set up (usually medical and surgical beds).3 General bed category includes general beds, isolation beds, medical/surqical beds, and T.B.lrespiratory beds.4 The Yukon also has 4 First Nations beds,S Hostel beds, and 10 short-stay (i.e. not overnight) beds.5 Includes psychiatric beds only.6 Includes rehab beds in acute and free-standing BC Rehabilitation Society beds.7 Includes 292 chronic behaviour beds and 365 D.P. Unit beds.S The category Number of Beds, General, includes beds in an "other" category - these beds may be palliative, observation. rehab, or chronic beds.Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia82Health Humau Resources UuitCentre for Health Services and Policy ResearchThe Universityof' British Columbia429 - 2194Health SciencesMallVancouver, B.C. V6T 1Z3Telephone: (604) 822.4810Fax: (604) 822-5690Some ofme early reports may not be available/or distributionHHRUOO:7HHRUOO:6HHRUOO:5HHRUOO:4HHRUOO:3HHRU 00:2HHRUOO:1HHRU99:6HHRU99:5HHRU99:4IHIRU 99:3HHRU99:2Nursing Workforce Study Volume V Changes in the Nursing Workforce and PolicyImplications. April 2000. (A. Kazanjian). ISBN 1-894066-86-3.Nursing Workforce Study Volume IV Nursing Workforce Deployment: A Survey ofEmployers.April 2000. (A. Kazanjian, S. Rahim-Jamal, A. MacDonald, L. Wood, C. Cole). ISBN 1­894066-87 -1.Nursing Workforce Study Volume III An Inventory ofNursing Program Enrolments andGraduates in Canada by Province/Territory, 1998. April 2000. (A. Kazanjian, A. MacDonald,L. Wood, C. Cole). ISBN 1-894066-88-X.Nursing Workforce Study Volume II The Supply ofNursing Personnel in Canada. April 2000.(A. Kazanjian, L. Wood, H. Yip, S. Rahim-Jamal, A. MacDonald). ISBN 1-894066-89-8.Nursing Workforce Study Volume I Demographic Context and Health System Structure forNursing Services in Canada. April 2000. (A. Kazanjian, S. Rahim-Jamal, L. Wood, A.MacDonald). ISBN 1-894066-90-1.Issues in Physician Resources Planning in B.C.: Key Determinants afSupply and Distribution,1991-96. March 2000. (A. Kazanjian, RJ. Reid, N. Pagliccia, L. Apland, L. Wood). ISBN 1­894066-91-X.The Effects of Rationed Access Days (RADs) 0/1 Physician Fee-for-service Payments in B.C.March 2000. (R. Hanvelt, R. Reid, D.G. Schneider, N. Pagliccia, K. McGrail, M.L. Barer, R.G.Evans). ISBN 1-894066-92-8.Immigration and Emigration of Physicians to/from Canada. December 1999. (M.L. Barer,William A. Webber). ISBN 1-894066-93-6.Improving Access to Needed Medical Services in Rural and Remote Canadian Communities:Recruitment and Retention Revisited. June 1999. (M.L. Barer, Greg L. Stoddart). ISBN 1­894066-94-4.INVENTORY UPDATE 98. A Regional Analysis of Health Personnel in the Province ofBritishColumbia. June 1999. ISBN 1-894066-95-2. ISSN 1196-9911.Toward Improved Access to Medical Services for Relatively Underserved Populations:Canadian Approaches, Foreign Lessons. May 1999. (M.L. Barer, L. Wood, D.G. Schneider).ISBN 1-894066-95-2.ROLLCALL UPDATE 98. A Status Report ofSelected Health Personnel in the Province ofBritish Columbia. May 1999. ISBN 1-894066-97-9. ISSN 0828-9360.83HHRU99:1HHRU98:4HHRU98:3HHRU98:2HHRU98:1IHIRU 97:4HHRU97:3HHRU97:2HHRU 97:1HHRU96:SHHRU96:4HHRU96:3HHRU96:2RHHRU96:1RHHRU 9S:SRmIRU9S:4Regional Health Hurl/an Resources Planning & Management: Policies, Issues and InformationRequirements. January 1999. (A. Kazanjian, M. Hebert, L. Wood, S. Rahim-Jamal). ISBN 1­894966-98-7.Proceedings of the Second Trilateral Physician Workforce Conference. November 14-16, 1997,Vancouver, B.C. (ML Barer, L.Wood, eds.), ISBN 1-894066-99-5.PLACE OF GRADUATION 97. A Status Report on Place ofGraduation for Selected HealthPersonnel in the Province ofBritish Columbia. August 1998. (K. Kerluke, A. MacDonald, L.Wood). ISBN 1-896459-99-4. ISSN 1200-0701.INVENTORY 97 A Regional Analysis ofHealth Personnel in the Province ofBritish Columbia.June 1998. ISSNI-896459-98-6. ISBN 1-896459-98-6.ROLLCALL 97 A Status Report ofSelected Health Personnel in the Province of BritishColumbia. July 1998. ISBN 1-896459-95-1. ISSN 0707-3542.COMMON PROBLEMS, DIFFERENT SOLUTIONS: Learning from International Approachesto Improving Medical Services Accessfor Underserved Populations. October 1997. ISBN 1­896459-96-X.INVENTORY UPDATE 96. A Regional Analysis of Health Personnel in the Province of BritishColumbia. August 1997. ISBN 1-896459-94-3. ISSN 1196-9911.ROLLCALL UPDATE 96. A Status Report ofSelected Health Personnel in the Province ofBritish Columbia. August 1997. ISBN 1-896459-95-1. ISSN 0828-9360.PLACE OF GRADUATION 95. A Status Report on Place ofGraduation for Selected HealthPersonnel in the Province of British Columbia. January 1997.. (K. Kerluke, A. MacDonald, L.Wood). ISBN 1-896459-93-5. ISSN 1200-0701.INVENTORY 95. A Regional Analysis of Health Personnel in the Province ofBritish Columbia.December 1996. ISBN 1-896459-92-7.PRODUCTION 95. A Status Report on the Production ofHealth Personnel in the Province ofBritish Columbia. October 1994. ISBN 1-896459-91-9. ISSN 1199-4010.ROLLCALL 95. A Status Report ofHealth Personnel in the Province of British Columbia.October 1994. ISBN 1-896459-90-0. ISSN 0707-3542.Identifying the Population of Health Managers in one Canadian Province: A Two-StageApproach. Apri11996. (A. Kazanjian, N. Pagliccia), ISBN 1-896459-89-7.Key Factors in Physicians' Choice of Practice Location - Level ofSatisfaction and SpousalInfluence. March 1996. (A. Kazanjian, N. Pagliccia). ISBN 1-896459-88-9.The Impact of Professional and Personal Satisfaction On Perceptions ofRural and Urban:Some Analytic Evidence. May 1995. (N. Pagliccia, L. Apland, A. Kazanjian). ISBN 1-896459­87-0.PRODUCTION UPDATE 94. A Status Report on the Production ofSelected Health Personnelin the Province ofBritish Columbia. May 1995. ISBN 1-896459-86-2.ISSN 119-4010.84nnnu 95:3HHRU 95:2HHRU95:1HHRU94:5IIIIRU 94:4HHRU94:3HHRU94:2HHRU 94:1HHRU93:8RHHRU93:7HHRU93:6HHRU93:5HHRU93:4HHRU93:3HHRU93:21I1IRU93:1Health Personnel Modelling 1975-1994: An Updated Bibliography with Abstracts. March1995. (N. Pagliccia, K. McGrail, L. Wood). ISBN 1-896459-85-4.INVENTORY UPDATE 94. A Regional Analysis of Health Personnel in the Province ofBritishColumbia. March 1995. ISBN 1-896459-84-6. ISSN 1196-9911.ROLLCALL UPDATE 94. A Status Report ofSelected Health Personnel in the Province ofBritish Columbia. March 1995. ISBN 1-896459-83-8. ISSN 0828-9360.PLACE OF GRADUATION 93. A Status Report on Place ofGraduation for Selected HealthPersonnel in the Province ofBritish Columbia. October 1994. (K. McGrail, K. KerIuke, A.MacDonald, L. Wood). ISBN 1-896459-82-X. ISSN 1200-0701.PRODUCTION 93. A Status Report on the Production ofHealth Personnel in the Province ofBritish Columbia. August 1994. ISBN 1-896459-81-1. ISSN 1199-4010.ROLLCALL 93. A Status Report ofHealth Personnel in the Province ofBritish Columbia. May1994. ISBN 1-896459-80-3. ISSN 0707-3542.Interpreting the Historical Difficult-to-Fill Vacancy Trends - A Mulitvariate Analysis. April1994. (N. Pagliccia, A. Kazanjian, L. Wood). ISBN 1-896459-79-X.Social Work Personnel in British Columbia: Defining the population and describingdeployment patterns in 1993. January 1994. (1. Finch, A. Kazanjian, L. Wood).ISBN 1-896459-78-1.Health Care Managers in British Columbia Part I: Who Manages Our System?, Part II:Exploring Future Directions. December 1993. (A. Kazanjian, N. Pagliccia).ISBN 1-896459-77-3.Fee Practice Medical Services Expenditures Per Capita, and Full-Time-Equivalent Physiciansin British Columbia, 1991-1992. December 1993. (A. Kazanjian, P. Wong Fung, L. Wood).ISBN 1-896459-76-5.Social Workers in Health Care in British Columbia, 1991. July 1993. (L.E. Apland,L. Wood, A. Kazanjian). ISBN 1-896459-75-7.Difficult-to-Fill Vacancies in Selected Health Care Disciplines in British Columbia, 1980-1991.June 1993. (A. MacDonald, A. Kazanjian). ISBN 1-896459-74-9.ROLLCALL UPDATE 92. A Status Report of Selected Health Personnel in the Province ofBritish Columbia. April 1993. ISBN 1-896459-73-0. ISSN 0828-9360.Nursing Resources in British Columbia: Trends, Tensions and Tentative Solutions. February1993. (A. Kazanjian, L. Wood). ISBN 1-896459-72-2. Also listed as Health Policy ResearchUnit Report I-IPRU 93:5D.Nursing Resources Models: Part I: Synthesis ofthe Literature and a Modelling Strategy forB.C.. February 1993. (N. Pagliccia, L. Wood, A. Kazanjian). ISBN 1-896459-71-4.Study of Rural Physician Supply: Perceptions ofRural and Urban. January 1993.(N. Pagliccia, L.E. Apland, A. Kazanjian). ISBN 1-896459-70-6.85HHRU92:8HHRU92:7HHRU92:6HIIRU 92:SRH1IRU92:4RHHRU92:3HHRU92:2HHRU92:1H1IRU91:4RHHRU 91:3HHRU91:2HHRU91:1Diagnostic Medical Sonographers in British Columbia, 1991. December 1992.(L.E. Apland, A. Kazanjian). ISBN 1-896459-69-2.Fee Practice Medical Service Expenditures per Capita, and Full-Time-Equivalent Physicians inBritish Columbia, 1989-1990. November 1992. (A. Kazanjian, P. Wong Fung, M.L. Barer).ISBN 1-896459-68-4.PLACE OF GRADUATION 91. A Status Report on Place ofGraduation for Selected HealthPersonnel in the Province ofBritish Columbia. November 1992. (A. MacDonald, K. Kerluke,L.E. Ap1and, L. Wood). ISBN 1-896459-67-6. ISSN 1200-0701.Health "Manpower" Planning or Gender Relations? The Obvious and the Oblique. June 1992.(A. Kazanjian). ISBN 1-896459-66-8.A Human Resources Decision Support Model: Nurse Deployment Patterns in One CanadianSystem. November 1992. (A. Kazanjian, I. Pulcins, K. Kerluke). ISBN 1-896459-65-X.PRODUCTION 91. A Status Report on the Production of Health Personnel in the Province ofBritish Columbia. May 1992. ISBN 1-896459-64-1, ISSN 1194010.ROLLCALL 91. A Status Report of Health Personnel in the Province ofBritish Columbia. May1992. ISBN 1-896459-63-3. ISSN 0707-3542.Information Needed to Support Health Human Resources Management. February 1992. (A.Kazanjian). ISBN 1-896459-62-5.A Single Stochastic Model For Forecasting Nurse Supply and For Estimating Life-CycleActivity Patterns, May 1991. (A. Kazanjian). ISBN 1-896459-61-7.ROLLCALL UPDATE 90. A Status Report ofSelected Health Personnel in the Province ofBritish Columbia. March 1991. ISBN 1-896459-60-9. ISSN 0828-9360.Study of Rural Physician Supply: Practice Location Decisions and Problems in Retention.Volume T. March 1991. (A. Kazanjian, N. Pagliccia, L. Apland, S. Cavalier, L. Wood). ISBN1-896459-59-5.Registered Psychologists in British Columbia, 1990: A Status Report. March 1991.(c. Jackson, L. Wood, K. Kerluke, A. Kazanjian). ISBN 1-896459-58-7.86

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