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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PROVINCE OF BRITISH COLUMBIA "HOSPITAL INSURANCE ACT" Third Annual Report B.C. Hospital Insurance Service… British Columbia. Legislative Assembly [1952]
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Title | PROVINCE OF BRITISH COLUMBIA "HOSPITAL INSURANCE ACT" Third Annual Report B.C. Hospital Insurance Service JANUARY 1ST TO DECEMBER 31ST 1951 |
Alternate Title | HOSPITAL INSURANCE SERVICE REPORT, 1951 |
Creator |
British Columbia. Legislative Assembly |
Publisher | Victoria, BC : Government Printer |
Date Issued | [1952] |
Genre |
Legislative proceedings |
Type |
Text |
FileFormat | application/pdf |
Language | English |
Identifier | J110.L5 S7 1952_V03_14_KK1_KK20 |
Collection |
Sessional Papers of the Province of British Columbia |
Source | Original Format: Legislative Assembly of British Columbia. Library. Sessional Papers of the Province of British Columbia |
Date Available | 2017 |
Provider | Vancouver : University of British Columbia Library |
Rights | Images provided for research and reference use only. For permission to publish, copy or otherwise distribute these images please contact the Legislative Library of British Columbia |
CatalogueRecord | http://resolve.library.ubc.ca/cgi-bin/catsearch?bid=1198198 |
DOI | 10.14288/1.0343342 |
AggregatedSourceRepository | CONTENTdm |
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