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PROVINCE OF BRITISH COLUMBIA "HOSPITAL INSURANCE ACT" Third Annual Report B.C. Hospital Insurance Service… British Columbia. Legislative Assembly [1952]

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Full Text

 PROVINCE OF BRITISH COLUMBIA
" HOSPITAL INSURANCE ACT "
Third Annual Report
B.C. Hospital Insurance
Service
JANUARY 1st TO DECEMBER 3 1st
1951
VICTORIA, B.C.
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
1952  A. D. Turnbull.
B.C. Hospital Insurance Service,
Victoria, B.C., March 11th, 1952.
To His Honour Clarence Wallace, C.B.E.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned has the honour to present the Third Annual Report of the B.C.
Hospital Insurance Service covering the calendar year 1951.
A. D. TURNBULL,
Minister of Health and Welfare. L. F. Detwiller.
B.C. Hospital Insurance Service,
Victoria, B.C., March 11th, 1952.
The Honourable A. D. Turnbull,
Minister of Health and Welfare,
Parliament Buildings, Victoria, B.C.
Sir,—I have the honour to present herewith the Report of the B.C. Hospital
Insurance Service covering the calendar year 1951.
Respectfully submitted.
L. F. DETWILLER,
Commissioner, B.C. Hospital Insurance Service. CONTENTS
Page
Introduction     7
Eligibility and Coverage     7
Premium Rates     7
Organization and Administration     8
Payroll Division  8
Direct Payment Division  8
Central Accounts Division  8
Departmental Comptroller  8
Registration and Exemption Claims  9
Registration Section  9
Exemption Claims Section  9
Record Files and Adjustments Section—.-  9
Dependency Claims Section  9
Mechanical Tabulation  10
Hospital Services Group  10
Hospital Claims Division  10
Hospital Accounting Division  11
Method of Payment to Hospitals  11
Hospital Consultation and Inspection Division, Victoria  12
Hospital Consultation and Inspection Division, Vancouver  12
Research Division  13
Hospital Construction Division  13
Statement of Revenue Receipts and Disbursements for the Fiscal Year Ended March
31 st, 1951  14
Statement Showing Cash Reconciliation with the Public Accounts of the Province of
British Columbia as at March 31st, 1951  15
General Hospital Care  16
B.C.H.I.S. Patients and Patient-days, 1951  16
Table Ia.—Patients Discharged and Days of Care in B.C. Public Hospitals, 1948-51,
and Proportion Covered by B.C. Hospital Insurance Service  17
Table Ib.—Percentage of Patients Covered by B.C. Hospital Insurance Service
During 1951  ,  17
Table Ha.—Patients Discharged, Total Days' Stay, and Average Length of Stay
According to Type and Location of Hospital, and Days of Care per Thousand
of Covered Population for B.C.H.I.S. Patients Only, Years 1949 to 1951  17
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients and Short-stay
Patients, 1949-51  18
Table III.—Patients Discharged, Total Days' Stay and Average Length of Stay in
B.C. Public Hospitals for B.C.H.I.S. Patients Only, Grouped According to Bed
Capacity, Year 1951   18
Benefits in B.C. Hospitals, 1951  19
Classes of Persons Covered by or Excluded from the Benefits of the Hospital Insurance Service  20
Benefits in Hospitals outside British Columbia  20
5  Third Annual Report of the B.C. Hospital
Insurance Service
INTRODUCTION
The most significant administrative change in the Service's third year of operation
was the establishment of a Central Accounts Division. This was done to accommodate
the records formerly held in the Vancouver, Victoria, and New Westminster district
offices which were transferred to Victoria in August. This move completed the task of
centralization which began last year, when the accounts held in the Interior offices were
brought into Victoria. To compensate for the closure of district offices throughout the
Province, five collection offices, seven collection agencies, and thirty-seven Government
Agents' offices are now established as a convenience to the public. No accounts are held
in these offices, but premiums may be paid and advice gained. As a result of these
changes, for the first time since the inception of the Service, all registrants are billed for
current premiums direct from Victoria.
On April 1st a system of co-insurance was introduced.
Toward the latter part of the year the one-month waiting period was reduced to
fourteen days and a seven-day period of grace implemented for payment of premiums
after due dates.
During the year 224,828 accounts were paid on behalf of beneficiaries requiring
hospitalization. Since the inception of the Hospital Insurance Service, over 680,000
persons have received benefits, involving an expenditure of over $51,500,000 on their
behalf.
ELIGIBILITY AND COVERAGE
Under the "Hospital Insurance Act" all persons who are residents of British
Columbia are required to participate in the plan. Exemptions are granted to those who
can show that they and their dependents are protected under Provincial or Federal
plans, or through approved private ones. A private plan, to operate in British Columbia,
must provide hospital benefits and payments to hospitals at least equivalent to those under
the Provincial Government plan.
A detailed description of classes of persons covered by the plan or excluded is
contained in the Appendix.
PREMIUM RATES
Up until June 30th, 1951, premium rates for 1951 were $21 for single persons and
$33 for the head of a family with one or more dependents. After June 30th the premium
rates were increased to $30 for single persons and $42 for the head of a family.
There are three principal methods of premium payment:—
(1) Payroll Deduction.—Persons working for firms operating the payroll-
deduction plan have their premiums deducted each month from their pay.
(2) Direct Payment.—Former Interior district-office registrants are billed four
times a year from Victoria on a cyclical basis.
(3) Central Accounts Division.—Former city district-office registrants are
billed from Victoria on a semi-annual basis. KK 8 BRITISH COLUMBIA
ORGANIZATION AND ADMINISTRATION
The activities and achievements of the Service's various departments are recorded
in the succeeding paragraphs.
Payroll Division
One hundred and ninety-five thousand registrants are now paying their hospital
insurance premiums monthly through the payroll-deduction plan. The foregoing figure
represents an increase of 35,000 individual accounts over last year. This expansion was
made possible through the formation of a further payroll section and by having all
companies on the payroll system make 100 per cent collection from their staffs.
The field representatives operating in Vancouver under the direction of the Payroll
Division assisted in the expansion of the payroll plan through the registration of new
employers and by the enrolment of their employees. Payroll Division representatives
also conducted a 100-per-cent survey of all firms registered in the last six months of
the year.
Special field work was arranged on Vancouver Island in the first six months of 1951
to contact and interview all employers registered for deductions. In September and
October representatives called on employers In the Prince George, Smithers, and Prince
Rupert area.
On December 31st, 1951, Payroll Division had 3,600 firms enrolled and registered
for compulsory deductions. During the year 1951 over 50 per cent of the premiums
collected by the Service was collected through the Payroll Division.
Direct Payment Division
During 1951 more than 126,000 accounts were converted to quarterly insurance
periods and billed accordingly. There was a continuous flow of accounts in and out of
this Division, brought about by registrants leaving or joining employer groups participating in the payroll-deduction plan of premium payment. In this regard, 46,013
accounts were transferred out of this Division and 50,890 accounts were received as
incoming transfers.
The majority of the work done by this Division during the year involved the
maintenance of 126,000 accounts; recording payments made to these accounts; and
actioning change-of-status information received relative to births, deaths, marriages,
changes of address, exemptions, and cancellations; and, in addition, ensuring the regular
billing of these accounts.
During the year 8,690 new registrations were secured from new residents of the
Province and other unregistered persons.
Central Accounts Division
This is a relatively new division of the Hospital Insurance Service, having been
organized on October 15th, 1951, to handle the 157,000 accounts formerly held in the
Vancouver, Victoria, and New Westminster offices.
After lengthy study, a new accounting system was adopted, which permits fast and
efficient handling of premium billing, payment, and adjustment entries.
All active accounts were billed in November for the first half of 1952, and at
December 31st the Divisional staff was fully engaged in handling the large volume of
mail and payments.
From October 15th to December 31st the Division established 3,000 accounts for
new registrants.
Departmental Comptroller
Revenue from every source was channelled through this Division, where it was
checked, audited, and correctly allocated to control accounts.    The Division controls, HOSPITAL INSURANCE SERVICE REPORT, 1951 KK 9
audits, and analyses all expenditures.    Internal audit of the entire Service and of all
collection agencies was undertaken during the year.
The General Office, which handled up to December all mail, forms part of this
Division, and over 500,000 pieces of mail, both incoming and outgoing, were handled
by this section.
Equipment and Supplies Section, also a part of the Division, maintains the master
inventory of all furniture and equipment for the entire Service, and also the perpetual
inventory of all forms, stationery, and supplies.
Registration and Exemption Claims
This Division contains four sections: Registration, Exemption Claims, Record
Files and Adjustments Section, and Dependency Claims Section.
Registration Section
During the year there was a total of 49,207 new registrations assigned to registrants.
Registrations cancelled due to deaths, marriages, left Province, etc., numbered 25,044.
This Section is responsible for the administration of exemption claims of registrants who
are accepted and covered under the two approved plans (Canadian Pacific Employees'
Medical Association of British Columbia, 14,000, approximately, contributing members
as at December 31st, 1951, and The Telephone Employees' Medical Services Association
of British Columbia, 3,900 contributing members as at December 31st, 1951), and for
the administration of approximately 27,000 B.C. Indian registrants.
Exemption Claims Section
During the year this Section handled exemption claims shown under the various
classifications as follows:—
Old-age pensioners and social assistance and mothers' allowance cases  5,779
D.V.A. students and war veterans' allowance cases  1,390
General   591
Christian Scientists  190
Persons covered by the Saskatchewan Hospital Services Plan 460
Institutional patients, including those in mental homes, T.B.
sanatoria, etc., and general nursing homes  831
Unemployability supplement   668
In addition to the foregoing, 15,500 adjustments were made.
Total number of medical identity cards received  17,281
Total number of adjustments to medical identity cards  14,581
Total number of hospital claims received for approval  16,882
Record Files and Adjustments Section
This Section is responsible for recording births, deaths, marriages, changes of status,
and employment.   During the year 449,291 adjustments were made.
Dependency Claims Section
This Section reviews all applications from registrants claiming relatives who are
financially dependent on the registrant by reason of physical or mental infirmity or unable
to pay the premium due to the lack of sufficient funds. KK 10 BRITISH COLUMBIA
Mechanical Tabulation
Started in July, 1950, this Division entered its second year in the process of
establishing procedures for the cyclical billing of the 125,000 accounts that had been
taken over by Direct Payment Division. Each account was billed four times during the
year, a total of 500,000 billings being printed.
This Division acquired a form-folding machine and an envelope inserter-and-sealer.
With these two pieces of equipment, operators can fold bills and insert and seal the envelopes at a rate of 3,500 an hour. The inserter is also used for mailing patients' statements
of claims paid (183,519* during the year) and for the mailing of billings for the new
Central Accounts Division.
Early in the year, plans were made for a card accounting system for the accounts
held in the district offices at Vancouver, Victoria, and New Westminster. The setting-up
of the cards for these 157,000 accounts, now held in the Central Accounts Division, and
the establishing of forms and procedures, was the most important project for the Division
in 1951. By the end of the year, Central Accounts procedures and controls were well
established and functioning smoothly.
Early in July, work was started on a visible alphabetic index for the Service
Approximately 1,000,000 cards were established for the listing of the index.
HOSPITAL SERVICES GROUP
Hospital Claims Division
The two main functions of this Division are to advise hospitals of patients' eligibility
and to process hospital accounts for payment. During 1951 a daily average of 730
admission notices and an equal number of hospital accounts were received, checked, and
processed.
Admission forms are checked by the Medical Coding Section as to diagnosis and
are then passed to the Eligibility Advice Section, which is responsible for advising the
hospitals in regard to the patients' eligibility status, "based upon the records maintained in
the Collection Divisions.
Payment of more than 183,519f hospital accounts was approved during the year.
Included in this figure were 2,068 out-of-Province accounts which were paid on behalf of
* This figure represents in-patient accounts only,
t This figure represents in-patients only. -.-
HOSPITAL INSURANCE SERVICE REPORT,  1951 KK 11
beneficiaries hospitalized in the United States, Mexico, South Africa, and a number of
European countries.
This Division is also responsible for the billing and collecting of municipal per diem
grants. All hospital accounts are scrutinized for length of residence to determine the
municipality responsible for paying the per diem grant.
With the introduction of co-insurance on April 1st, 1951, this Division became
responsible for recording and controlling co-insurance charges made to patients. In the
nine-month period to December 31st, 1951, approximately 100,000 co-insurance charge
forms were checked and filed for reference, to ensure that an individual or family unit
was not required to pay more than ten days' co-insurance charges during a year.
The Division has again reduced its filing-space requirements by microfilming all the
previous year's records, approximately 478,000 documents.
Hospital Accounting Division
This Division is primarily concerned with hospital budgets, maintaining close working
relations with the hospitals, and the inspection of hospital accounting records. Frequent
inspections are made of hospital financial and statistical records. Where smaller hospitals
have changes in accounting staff, and local assistance is not available, this Division has,
upon request, sent accountants to write up the hospital's books and to train new staff.
Monthly statistical reports and statements of revenue and expenditure are received
from hospitals and compared with the approved budgets, and advance payments are
calculated and made semi-monthly.
The Annual Hospital Report and annual statistical and financial reports, as well as
reports required by the Dominion Bureau of Statistics, are prepared by this Division. In
addition, requests for payment of grants in connection with capital expenditures made by
hospitals for equipment are studied and recommended for approval. Audits of accounts
relating to hospital-construction projects are carried out by this Division in collaboration
with Dominion Treasury officials.
METHOD OF PAYMENT TO HOSPITALS
Effective January 1st, 1951, a system of fixed or firm budgets was instituted. Under
this system, hospital budgets submitted were reviewed by the Rate Board of the Hospital
Insurance Service, and, after such adjustments as were found necessary, the resulting
budgets were established. Hospitals were advised that, with the exception of certain
items beyond their control (particularly fluctuation in days' treatment and, during 1951,
wage adjustments as a result of negotiation), they would be required to live within their
approved budgets and that deficits which were incurred through expenditures within the
control of hospitals would not be met. Calculations were made to determine the value of
variable supplies used in the care of patients. The budgets were subject to adjustment
upward or downward by the number of days by which the actual experience differed from
the estimate, multiplied by the patient-day value of the variable supplies. In the relatively
few instances where the fluctuations were sufficiently great to entail additions to or reductions in stand-by costs, individual studies were made and budget adjustments established.
Due to the fact that all hospitals treat a certain number of non-B.C.H.I.S. patients
(Workmen's Compensation Board, transients, non-insured individuals, and persons
exempt from hospital insurance coverage by reason of membership in the Canadian
Pacific Railway and B.C. Telephone medical plans), the Service is not responsible for the
entire patient-load. The Service, therefore, pays to each hospital each month the portion
of one-twelfth of the yearly budget that is represented by the B.C.H.I.S. insured days as
compared to the total days' treatment. Remittances to hospitals are made twice monthly.
At the end of any month each hospital has been paid the approximate amount of its
earnings to date for B.C.H.I.S. patients, including those remaining in hospital at the KK 12 BRITISH COLUMBIA
end of that month. Effective April 1st, 1951, a schedule of co-insurance charges was
introduced, requiring the patient to pay from $2 to $3.50 per day for the first ten days'
hospitalization per family unit per year. The amount of co-insurance collectable from
insured persons is deducted in calculating payments due to hospitals from the Service.
Hospitals collect from non-insured persons at the established per diem rates.
HOSPITAL CONSULTATION AND INSPECTION DIVISION, VICTORIA
During the year this office continued its efforts to help hospitals with their administrative and nursing problems. Regular visits of from one to three days' duration were
made to fifty-five general hospitals. Several special surveys were undertaken at the
request of hospital boards, including a personnel survey, a study of space utilization, and
visits to communities to help in assessing their need for hospital facilities. Twenty-four
hospital societies submitted their by-laws or amendments to the Service for review, most
of which were received in the closing months of the year. This office gave assistance with
the review of these. Assistance was also given with the analysis of hospital plans, hospital budgets, and requests for equipment grants. Much of the work of this office was
done in co-operation with other offices in the Service. Meetings were held with Dominion
and Provincial public health authorities about problems of hospital sanitation and other
related matters. Information on the day-to-day utilization of beds in the Vancouver, New
Westminster, and other areas was assembled throughout the year.
HOSPITAL CONSULTATION AND INSPECTION DIVISION, VANCOUVER
Responsibility for hospital consultation and inspection as it pertains to the Vancouver office is, in the main, with respect to licensing and inspection of private hospitals, the
hospital-clearance programme, and screening applications for admission to the Provincial
Infirmary. Due to the nature of the work, a definite liaison must be, and is, maintained
with the Social Welfare Branch. Investigations are made and service given in matters
referred to other divisions of the Hospital Insurance Service.
During the year 1951 there were 375 problem cases referred by general hospitals
throughout the Province, for whom request for removal from hospital was made and
which involved referral to, and investigation by, the Social Welfare Branch.
There were 111 applications for admission to the Provincial Infirmary received and
considered.   Of these, 104 were recommended for Infirmary admission.
Inquiries were made regarding the establishment of private hospitals. There were
fifty-seven such inquiries made. There were four new licences issued and two private
hospitals closed during the year.
Any inquiry made is, at the best, a rather time-consuming process and may involve
contact with numerous agencies or departments. There were eighty-seven inquiries
received which concerned situations where hospitals or persons were requesting service as
to procedure involving other departments of the Government, but which did not pertain
to either hospital clearance or private hospitals. Some of the inquiries were directed to
the Hospital Insurance Service but were not, upon investigation, necessarily Hospital
Insurance problems, and were, therefore, in turn referred to the agency or department
responsible for the case handling.
An annual visit of an inspectional nature was made to the fifty-one licensed private
hospitals. In addition, all complaints received with respect to the operations of any
private hospital were thoroughly investigated. Interpretation and guidance is given to
private hospitals upon request, and, as a result, some of the private hospitals were visited
a number of times during the year. Many of the private hospitals are seeking help in
establishing and maintaining sound administrative practices. Many of these hospitals are
establishing programmes in chronic care.
This Division continued to administer the " Mental Hospital Act," sections 6 and 7. HOSPITAL INSURANCE SERVICE REPORT,  1951
KK 13
RESEARCH DIVISION
This past year the Division maintained monthly progress reports, compiled statistics
concerning hospitalization experience, and conducted special studies on matters related
to the Service.
In addition, data were made available to various branches of the Service to aid
in answering queries from the public and to assist in dealing with routine operational
problems.
Discussions were held with public health officials and medical authorities with a view
to expanding the existing statistical programme to provide additional material for use in
medical and public health research.
HOSPITAL CONSTRUCTION DIVISION
The primary function of this Division is to render an advisory or consulting service
to hospitals or hospital groups contemplating building improvements, reconstruction,
additions to existing structures, or the construction of a new hospital. Reference material
on the planning and construction of hospitals is available and is loaned upon request to
interested groups.
In 1951 an effort was made to secure up-to-date plans of all the hospitals in the
Province, and plans for the majority of the hospitals in the Province are now available in
Victoria. Plan reviews have been completed for ten hospitals, and at the end of the year
seven other reviews were in progress. In co-operation with the Consultation and Inspection Division of this Service, a space-utilization survey was conducted in one hospital.
During the year, payments based upon progress certificates submitted by hospitals
undertaking construction projects amounted to $2,792,616, which would represent a
gross expenditure of approximately $3,733,488.
The Division also advises hospitals and hospital groups of the financing formulae of
the Dominion and Provincial Governments and outlines in detail the conditions that are
attached to their financial assistance. Dominion and Provincial grants become available
to hospitals only following the approval of the project in principle, and a detailed review
of the plans by the Hospital Insurance Service. The review is made with particular
attention being paid to ensuring that the design will permit quality of care, efficient and
economical operation, and adequate provision for expansion. Specifications and contract
documents are also submitted to this Service for review.
This Division acts on behalf of the Dominion Government to ensure that its minimum standards are met. This includes ensuring that the plans satisfy the Provincial Fire
Marshal and that minimum floor areas, corridor-widths, and adequate services exist. KK 14 BRITISH COLUMBIA
STATEMENT OF REVENUE RECEIPTS AND DISBURSEMENTS FOR THE
FISCAL YEAR ENDED MARCH 31st, 1951
Revenue receipts—
Premiums—
General   $ 11,439,378.32
Social assistance        1,041,487.75
$12,480,866.07
2,076,655.62
Municipal per diem grants        $655,972.72
Provincial statutory grants       1,420,682.90
Cash disbursements—
Administration—
Salaries      $1,152,274.07
Advisory Council  717.88
Advertising and publicity  30,240.50
Automobiles and accessories  15,297.84
Hospital and management survey  82,529.75
Office supplies and general  201,759.61
Office furniture and equipment  30,263.44
Postage   43,555.46
Rentals and maintenance  49,489.17
Retainers and expenses (sub-offices)  16,824.63
Travelling expenses  48,202.13
$14,557,521.69
$1,671,154.48
Payments to hospitals—claims     18,005,064.97
     19,676,219.45
Excess of disbursements over revenue receipts for the fiscal year ended March 31st,
1951      $5,118,697.76
The Statement of Revenue Receipts and Disbursements for the fiscal year ended March 31st,
1951, together with the Statement Showing Cash Reconciliation with the Public Accounts of the
Province of British Columbia as at March 31st, 1951, show the cash transactions only of the Hospital
Insurance Fund for the period according to the books of the Province.
J. A. CRAIG, C.A.,
Comptroller-General, Province of British Columbia. HOSPITAL INSURANCE SERVICE REPORT,  1951 KK 15
STATEMENT SHOWING CASH RECONCILIATION WITH THE PUBLIC ACCOUNTS
OF THE PROVINCE OF BRITISH COLUMBIA AS AT MARCH 31st, 1951
Period ended March 31st, 1949 (Public Accounts, page
215)   $5,305,908.18
Less financed by Provincial loans and grants—
Hospital  Insurance  Stabilization Fund        $50,000.00
"Amusements Tax Act" .....    1,445,573.40
 1,495,573.40
Operating receipts over disbursements  $3,810,334.78*
Fiscal year ended March 31st,  1950 (Public Accounts,
page 147)   $4,550,580.32
Add financed by Provincial loans and grants—
Hospital   Insurance  Stabilization Fund  $1,950,000.00
" Revenue   Surplus   Appropriation Act, 1950" .....    2,500,000.00
$4,450,000.00
"Amusements Tax Act" (fiscal year 1949 above)....    1,445,573.40
     3,004,426.60
Operating disbursements over receipts    7,555,006.92
Fiscal year ended March 31st, 1951 (Public Accounts, page 144)—Operating disbursements over receipts    5,118,697.76
Operating disbursements over receipts, 1949-51  $8,863,369.90
Less balances at March 31st, 1951 (Public Accounts, page 144)—
Amount adjusted on advances to hospitals  $1,934,062.62
Credit balance, Hospital Insurance Fund     1,616,388.72
Financed by Provincial loans and grants, 1949-51—Hospital Insurance
Stabilization Fund—
Public Accounts, 1948-49, page 210       $50,000.00
Public Accounts, 1949-50, page 134     1,950,000.00
317,673.90
  $8,545,696.00
$2,000,000.00
"Revenue Surplus Appropriation Act,   1950"—Public Accounts,
1949-50, page 134     2,500,000.00
Amount voted under Vote 118, 1950-51    2,545,696.00
"Revenue Surplus Appropriation Act,  1951"—Public Accounts,
1950-51, page 144     1,500,000.00
 8,545,696.00
» Credit. KK 16 BRITISH COLUMBIA
?-™«^»/1«j
GENERAL HOSPITAL CARE
Statistical data dealing with the volume of hospital care provided to the population
of British Columbia by the Service are presented in the tables on the following pages.
Seventy-six public hospitals are approved to accept B.C.H.I.S. patients. In addition, a
proportion of care has been given in the Province's licensed private hospitals, including
company-operated hospitals in remote areas. The private-hospital classification in the
tables also includes eleven Red Cross Outpost units and the Veterans' hospitals at Vancouver and Victoria.
The 1951 data given have been prepared from preliminary unrevised reports submitted by the hospitals of the Province and are subject to minor revision.
B.C.H.I.S. PATIENTS AND PATIENT-DAYS,  1951
The average length of stay of B.C.H.I.S. adult and children patients in British
Columbia public hospitals decreased from 10.19 days in 1950 to 9.8 days in 1951. The
total adult and children days covered by B.C. Hospital Insurance Service were 1,469,034
during 1951—a decrease of 7,581 over 1950 in spite of the fact that an additional 4,889
patients were covered by the Service.
If the length of stay for adult and children patients had remained at the 1950 level,
B.C. Hospital Insurance Service would have been required to accept responsibility for
approximately 57,400 additional days of hospital care.
This average reduction of 0.4 day per patient or 57,400 days per year represents the
utilization of approximately 200 beds for the entire year operating at 80 per cent capacity.
To construct these beds would have cost more than $2,000,000, and the annual operating
cost would be approximately $700,000 per year. It is obvious that the shorter stay had
a very definite effect in modifying the pressure for beds. HOSPITAL INSURANCE SERVICE REPORT,  1951
KK 17
Table Ia.—Patients Discharged and Days of Care in B.C. Public Hospitals,
1948-51, and Proportion Covered by B.C. Hospital Insurance Service
Total Hospitalized
Covered by B.C.H.I.S.1
Adults and
Children
New-born
Total
Adults and
Children
New-born
Total
Patients discharged—
1948
155,894
164,964
24,704
26,272
26,195
27,057
180,598
191,236
24,640
93.8
23,943
91.4
24,167
89.3
200,585
93.8
193,307
90.8
188,153
87.8
1949    	
140,168
84.9
144,959
84.1
149,848
82.6
164,808
86.2
19503      	
172,225
198,420
168,902
85.1
1951          	
1« 1,409
208,466
174,015
83.5
Patient-days—
1948          	
1,475,901
1,682,196
1,763,722
200,180
213,874
212,979
214,379
1,676,081
1,896,070
1,976,701
2,009,970
1949   	
1,430,646
85.0
1,476,615
83.7
1,469,034
81.8
1,631,231
86.0
19502                                   	
1,669,922
84.5
1951	
1,795,591
1,657,187
. 82.5
1 B.C.H.I.S. excludes Workmen's Compensation Board patients and days.
2 Amended as per final reports received from hospitals.
Table Ib.—Percentage of Patients Covered by B.C. Hospital
Insurance Service during 1951
Per Cent
Patients charged to agencies—Workmen's Compensation Board, approved insurance plans, and
Dominion Government
Self-responsible—Non-B.C residents
Subject to B.C.H.I.S. coverage.-	
8.2
1.2
90.6
100.0
Percentage of B.C.H.I.S. patients hospitalized (83.5 per cent, see Table Ia) in relation to proportion of patients subject to insurance coverage (90.6 per cent, see Table Ib)  	
92.2
Table Ha.—Patients Discharged, Total Days' Stay, and Average Length of Stay
According to Type and Location of Hospital, and Days of Care per Thousand of Covered Population for B.C.H.I.S. Patients Only, Years 1949 to
1951.
Total
B.C. Public
Hospitals
B.C. Private
Hospitals
Institutions
outside B.C.
Adults and
Children
Newborn
1
Adults and I    New-
Children  I    born
1
Adults and!    New-
Children  I    born
1
Adults and
Children
Newborn
Patients discharged—
1949                            	
149,293
154,144
159,002
1,498,538
1,559,536
1,549,503
10.04
10.12
9.75
24,991
24,287
24,517
203,209
195,953
190,746
8.13
8.07
7.78
140,168 |    24,640
144,959 |    23,943
149,848 j    24,167
1,430,646 | 200,585
1,476,615 j 193,307
1,469,034 | 188,153
10.21  |        8.14
10.19 j        8.07
9.80 1        7.79
7,093
7,617
7,280
45,960
65,326
62,594
6.48
8.58
8.60
151
173
156
1,146
1,288
1,129
7.59
7.45
7.24
2,032
1,568
1,874
21,932
17,595
17,875
10.79
11.22
9.54
200
19501                                 —_
171
1951            	
194
Patient-days—
1949              -	
1,478
19501                         	
1,358
1951                             	
1,464
Average days of stay—
1949                         - _	
7.39
19501	
7.94
1951	
7.55
1 Amended per final reports received from hospitals.
Days per thousand  of population  covered  by B.C.  Hospital  Insurance  Service:
1951, 1,550.
1949,   1,496.6;    1950,   1,565.6; KK 18 BRITISH COLUMBIA
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients and
Short-stay Patients, 1949-51
1949
19501
1951
Total
Total adults, children, and new-born in-patients	
174,284
29,000
178,431
44,502
183,519
41,309
536,234
114,811
Total receiving benefits.. _	
203,284
222,933
224,828
651,045
1 Amended per final reports received from hospitals.
Table III.—Patients Discharged, Total Days' Stay and Average Length of Stay
in B.C. Public Hospitals for B.C.H.I.S. Patients Only, Grouped According
to Bed Capacity, Year 1951.
Bed Capacity
•
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Patients discharged—
149,848
24,167
1,469,034
188,153
9.80
7.79
66,018
9,433
763,044
78,041
11.56
8.27
14,683
2,158
134,826
15,993
9.18
7.41
42,047
8,786
354,268
67,210
8.43
7.65
14,200
2,107
114,386
15,172
8.06
7.20
8,536
1,383
62,415
9,649
7.31
6.98
4,364
300
Patient-days—
40,095
2,088
Average days of stay—
9.19
6.96
Table IV.—Percentage Distribution of Patients Discharged and Patient-days
for B.C.H.I.S. Patients Only, in B.C. Public Hospitals, Grouped According
to Bed Capacity, Year 1951.
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Patients discharged—
Per Cent
100.00
100.00
100.00
100.00
Per Cent
44.06
39.03
51.93
41.48
Per Cent
9.80
8.93
9.18
8.50
Per Cent
28.06
36.36
24.12
35.72
Per Cent
9.48
8.72
7.79
8.06
Per Cent
5.70
5.72
4.25
5.13
Per Cent
2 90
1 24
Patient-days—■
2.73
1 11
In Tables III and IV those public hospitals in which B.C. Hospital Insurance Service
does not cover certain types of hospitalization have been shown under the heading
" Special."   The figures, however, include only B.C.H.I.S. patients. HOSPITAL INSURANCE SERVICE REPORT,  1951 KK 19
>
|Ml,f: \.%i
BENEFITS IN B.C. HOSPITALS, 1951
The general hospital services to be provided shall include such of the following
services as are recommended by the attending physician and as are available in the
hospital to which the person is admitted as an in-patient and when there is definite
medical necessity for in-patient care:—
{a)  Public-ward accommodation:
{b) Operating-room facilities, including the use of all equipment and material
required in the proper care of surgical cases:
(c)   Case-room facilities, including the use of all equipment and material
required in the proper care of maternity cases:
{d) Surgical dressings and casts as required, as well as other surgical materials
and the use of any equipment which may be required while in hospital:
O)  Anesthetic supplies and the use of anaesthesia equipment:
(/) All other services rendered by individuals who receive any remuneration
from the hospital, provided that the provision of such services in a particular hospital is approved by the Commissioner.   Services which may
be approved by the Commissioner for the purpose of this section may
include:—
(1) Radiological, diagnostic, and therapeutic services, including the
services of a radiologist:
(2) Clinical laboratory and other diagnostic procedures, including
the services of a pathologist:
(3) The services of an anaesthetist:
(4) Physiotherapy services:
{g) Care of the acute stage of chronic diseases where, in the opinion of the
Commissioner, such care is necessary and desirable. Such chronic disease shall include cardiac disease, tuberculosis, mental disease, and acute
anterior poliomyelitis, the acute stage of venereal disease only where
general hospital care is recommended by the Division of Veneral Disease
Control; the acute stage of drug addiction where overdosage and poisoning have to be given prompt treatment; and the acute stage of alcoholism,
provided in the case of acute alcoholism that hospitals establish under their
own by-laws the conditions under which such persons may be admitted
to hospital: KK 20 BRITISH COLUMBIA
{h) Such drugs and related preparations listed in the British Columbia Formulary and such other preparations as the Commissioner may from time to
time prescribe.
CLASSES OF PERSONS COVERED BY OR EXCLUDED FROM THE
BENEFITS OF THE HOSPITAL INSURANCE SERVICE
A. Covered by the Plan upon Payment of the Required Premium
Every person who is a resident of the Province. Participation in the plan is compulsory, except for those in the far northern areas who may voluntarily pay premiums
and be entitled to benefits.
B. Covered by the Plan by the Provincial Government
1. Those old-age security recipients and recognized dependents who were in receipt
of an old-age pension on December 31st, 1951, together with those persons who apply to
the Provincial Department of Health and Welfare and who are granted free health services.
2. Old-age assistance cases, blind pensioners, and their dependents.
3. Mothers' allowance cases, and their dependents.
4. Social allowance cases to which the Provincial Government contributes financially.
5. Child welfare cases (wards only).
C. Excluded from the Operation of the Plan
1. Members of the Canadian Armed Forces (but not their dependents).
2. Members of the Royal Canadian Mounted Police (but not their dependents).
3. Students in training under the Department of Veterans' Affairs (but not their
dependents).
4. Veterans in receipt of war veterans' allowance (but not their dependents).
5. Members of the Christian Science Church and residents in certain far northern
regions of the Province who have claimed, and been granted, exemption. Such persons,
if they pay premiums voluntarily, are entitled to the benefits under the Act.
6. A person who is a patient or an inmate of an institution maintained by the
Province.
7. Persons in a Provincial T.B. sanatorium.
8. Employees of the Canadian Pacific Railway and B.C. Telephone Company, who
operate the only private plans approved under the Act.
9. Persons committed to a gaol or penitentiary.
BENEFITS IN HOSPITALS OUTSIDE BRITISH COLUMBIA
Payments for hospital services rendered by hospitals outside the Province of British
Columbia to persons who are beneficiaries under the Act shall be made on the basis of
not more than $6.50 per day (new-borns, $3 per day) and for a period of time not to
exceed thirty days. Payments for a longer period of time than thirty days may be authorized by the Commissioner where he is satisfied that further care of a type provided for
under the Act is required.
Where a beneficiary produces receipts showing that he has himself paid an account
to a hospital situated outside the Province, he may be reimbursed within the limitations
and subject to the conditions provided in the regulations under the Act.
victoria, B.C.
Printed by Don McDtarmid. Printer to the Queen's Most Excellent Majesty
1952
1,295-252-3528

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