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Eighth Annual Report British Columbia Hospital Insurance Service JANUARY 1ST TO DECEMBER 31ST 1956 British Columbia. Legislative Assembly 1957

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 PROVINCE OF BRITISH COLUMBIA
"HOSPITAL INSURANCE ACT"
Eighth Annual Report
British Columbia Hospital
Insurance Service
JANUARY 1st TO DECEMBER 3 1st
1956
VICTORIA, B.C.
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
1957  Victoria, B.C., February 7th, 1957.
To His Honour Frank Mackenzie Ross, C.M.G., M.C.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned has the honour to present the Eighth Annual Report of the British
Columbia Hospital Insurance Service covering the calendar year 1956.
E. C. MARTIN,
Minister of Health and Welfare. British Columbia Hospital Insurance Service,
Victoria, B.C., February 7th, 1957.
The Honourable E. C. Martin,
Minister of Health and Welfare,
Parliament Buildings, Victoria, B.C.
Sir,—I have the honour to present herewith the Report of the British Columbia
Hospital Insurance Service covering the calendar year 1956.
D. M. COX, F.A.C.H.A.,
Commissioner, British Columbia Hospital
Insurance Service. CONTENTS
Page
General Introduction     7
British Columbia Hospital Insurance Service Highlights for 1956     7
Planning for Chronic Treatment and Convalescent Care     8
Organization Chart     9
Sources of Revenue   10
Methods of Payment to Hospitals  10
Hospital Services  10
Hospital Finance Division  11
Hospital Accounting Section  11
Hospital Claims Section  11
Hospital Consultation and Inspection Division  13
Victoria Office   13
Vancouver Office  13
Medical Consultation Division  14
Hospital Construction Division  15
Projects Commenced during 1956  16
Projects Completed during 1956  17
Project Commenced during 1955 and Under Way in 1956  17
Projects in Advanced Stages of Planning  17
Research Division  18
Administrative Assistant  20
Third Party Liability Section  20
Eligibility Section  20
General Office  21
Public Relations  22
Classes of Persons Entitled to or Excluded from the Benefits of the " Hospital Insurance Act"   22
Entitled to Benefits  22
Excluded from Benefits  23
Benefits inside the Province, 1956  24
Emergency or Short-stay Care  24
Benefits outside the Province  24
General Hospital Care  25
Hospitals  26
Table I.—Patients Discharged and Days of Care in British Columbia Public
Hospitals, 1949-56, and Proportion Covered by British Columbia Hospital
Insurance Service  27
Table IIa.—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, 1949-56  28
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients and Short-stay
Patients, 1949-56  28
Table III.—Patients Discharged, Total Days' Stay, and Average Length of Stay
in British Columbia Public Hospitals for B.C.H.I.S. Patients Only, Grouped
according to Bed Capacity, Year 1956  29
Table IV.—Percentage Distribution of Patients Discharged and Patient-days for
B.C.H.I.S. Patients Only, in British Columbia Public Hospitals, Grouped
according to Bed Capacity, Year 1956  29 AA 6
BRITISH COLUMBIA
Graphs—
Percentage Distribution of Discharged Cases and Patient-days by Major Diagnostic Categories of Illness, 1955	
Average Length of Stay	
Case Fatality Rates	
Comparison Showing the Percentage Distribution of Cases and Days Accumulated by Social Assistance and Others 70 Years and Older	
Comparison Showing the Percentage Distribution of Cases and Days Accumulated by Social Assistance and Others, All Ages	
Statement of Receipts and Disbursements for the Fiscal Year Ended March 31st,
1956	
Page
30
32
33
34
35
36 Eighth Annual Report of the British Columbia
Hospital Insurance Service
GENERAL INTRODUCTION
On December 31st, 1956, the British Columbia Hospital Insurance Service completed eight years of operation. It was established as a protective measure and has two
main objectives—to protect residents of the Province from the financial burden of hospitalization and to protect hospitals from a progressively increasing number of non-
collectable accounts, which had ranged as high as 55 per cent.
Since the inception of the Service, 2,090,000 hospital accounts have been paid at
an approximate total cost of $178,000,000. Of those persons in receipt of hospital
insurance benefits, 1,639,000 were in-patients in British Columbia acute-care general
hospitals, 431,000 received benefits as emergency or short-stay out-patients, and 20,000
received benefits while hospitalized outside the Province of British Columbia.
In addition to the financial assistance extended B.C. residents, the Hospital Insurance Service has provided a total of over $13,000,000 to B.C. hospitals toward construction and equipment costs. Since January 1st, 1949, the number of active-treatment beds
in B.C. general hospitals has increased from 5,431 to 7,225. A further 606 new active-
treatment beds will be available when projects are completed which were started or were
already under way in 1956. At the present time, payments by the British Columbia
Hospital Insurance Service to B.C. hospitals are made at the rate of over $80,000 each
day.
From January 1st, 1949, to March 31st, 1954, eligibility for benefits was dependent
upon individual premium payment, made under certain specified conditions. Effective
April 1st, 1954, the premium payment plan was terminated and the registration of all
residents was discontinued. Length of residence within British Columbia became the
determining factor for eligibility.
All persons eligible for benefits receive comprehensive protection against the expense
of acute in-patient care by being provided with substantially all available hospital services. Benefits consist of payment at the standard ward level for treatment that can be
obtained only in an acute-care general hospital, payments for emergency treatment (short-
stay benefits, and payments for treatment in hospitals outside British Columbia (out-of-
Province benefits). Persons receiving hospital insurance benefits in a British Columbia
hospital are required to pay $1 for each day's coverage by the Service.
BRITISH COLUMBIA HOSPITAL INSURANCE SERVICE
HIGHLIGHTS FOR 1956
During 1956 the British Columbia Hospital Insurance Service paid approximately
$30,000,000 on behalf of an estimated 250,000 hospitalized residents of the Province
and paid over $2,000,000 toward the cost of hospital construction and equipment.
In addition, construction projects which started, or were already under way in 1956,
will require a further $5,000,000 in Provincial grants before completion.
The average hospital account paid by the Service amounted to approximately $123,
but several claims paid for acutely ill in-patients exceeded $5,000. Included in those
receiving hospital benefits were over 2,000 British Columbians who received in excess
of $160,000 toward hospital expenses incurred in various parts of the world, including
Mexico, Ireland, Holland, Italy, Japan, and the British West Indies, as well as all Provinces in Canada and most States in the United States. AA 8
BRITISH COLUMBIA
Effective May 1st, 1956, servicemen were permitted to voluntarily register their
dependents for benefits under the " Hospital Insurance Act." The registration fee is
$10 for a wife and $2.50 for each child, with a maximum fee of $20 per family. During
the first eight months over 1,600 dependents registered, paying a total of approximately
$7,900 in fees. They incurred an estimated 348 hospital claims, and British Columbia
Hospital Insurance Service paid close to $25,000 on their behalf. During the twelve
months covered by the fee, it is estimated that over $35,000 will be paid in hospital
claims for servicemen's dependents.
Of the seven hospital projects completed during the year, the three largest were the
57-bed addition to Mount St. Joseph's, Vancouver, the radiology addition to the Vancouver General, and the new 24-bed Windermere District Hospital at Invermere, which
opened November 17th. Four other projects were commenced during the year. These
included new hospitals for Campbell River, Ladysmith, and New Westminster, and a
new nurses' home at Invermere. In addition, a total of twenty other projects, including
the new Queen Alexandra Solarium at Victoria, are in the advanced stages of planning,
and nine others were proposed. The British Columbia Hospital Insurance Service pays
one-half the cost of all hospital construction, one-third the cost of renovations, and one-
third the cost of most hospital equipment.
B.C.H.I.S. research personnel completed a detailed survey of hospital bed requirements for Vancouver Island and reassessed the acute-care bed requirements on the North
Shore of Burrard Inlet in connection with proposed new construction at the North Vancouver General Hospital.
Other staff consultants carried out hospital surveys and inspections and assisted
with problems of an administrative or operational nature.
During 1956, licences were issued to nine new private hospitals, totalling 222
chronic and convalescent beds and 6 acute beds. Four of the hospitals are located in
Greater Vancouver and one each at Victoria, Port Coquitlam, Comox, Whalley, and
Cassiar.
It is estimated that 92 per cent of all patients admitted to acute-care B.C. hospitals
are covered by the British Columbia Hospital Insurance Service.
PLANNING FOR CHRONIC TREATMENT AND CONVALESCENT CARE
At a Federal-Provincial Health Conference held in Ottawa during January, 1956,
the Minister of Health and Welfare, assisted by the Deputy Minister of Health and the
Commissioner of the Hospital Insurance Service, presented a brief to the Federal Government on British Columbia's recommendations for the introduction of a Federal health
insurance plan. Although the Federal proposals had not yet been accepted by the
required majority of Provinces, on February 1st, 1956, the Minister of Health and Welfare accepted the proposals on behalf of the Province but urged an expanded programme.
On March 16th, 1956, the Minister announced that the Provincial Government would
extend coverage to chronic sufferers who are receiving rehabilitative treatment or intensive corrective service, and expected that the plan would be in force in about one year.
Following the announcement, conferences were held between the British Columbia
Hospital Insurance Service staff, the Federal Deputy Minister of Health, and other members of the health services from the Federal Government.
The results of those studies were collated by a committee consisting of senior staff
members of the Hospital Insurance Service, with a steering committee comprising the
Medical Consultant, the Manager of the Hospital Finance Division, and the Manager of
the Hospital Consultation and Inspection Division. At the year-end, their brief was
being discussed and finished, under the chairmanship of the Commissioner, with all
Hospital Insurance Service divisions participating. This brief was designed for submis-
mission to a representative group from all parts of the Province at a meeting held in
Vancouver early in January, 1957. HOSPITAL INSURANCE SERVICE,  1956
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BRITISH COLUMBIA
SOURCES OF REVENUE
Government funds for the operation of the Hospital Insurance Service are provided
by an amount transferred from the Consolidated Revenue Fund pursuant to the " Hospital
Insurance Act" (social services tax). Another source of revenue for the Hospital
Insurance Service is Provincial and municipal per diem grants. The Provincial Government pays the Hospital Insurance Service 70 cents for each day's treatment in acute-care
general hospitals in British Columbia. City and district municipalities pay 70 cents for
each day's treatment provided to those persons defined as " municipal residents " under
section 32 of the "Hospital Act."
When admitted to an acute-care general hospital, a patient wishing coverage with
the Hospital Insurance Service is required to complete an application for benefits. The
hospital is responsible for verifying the statements regarding length of residence, to
determine if the patient is a resident as defined under the Act and regulations. Payment
of the account is then requested from the Hospital Insurance Service, which reserves the
right to reject any account where statements regarding residence do not meet requirements
(see Eligibility Section, page 20).
METHODS OF PAYMENT TO HOSPITALS
A system of firm budgets for hospitals was introduced, effective January 1st, 1951,
providing for a review of hospitals' estimates by the Rate Board of the Hospital Insurance
Service. Hospitals were advised they would be required to operate within their approved
budgets, with the exception of fluctuation in days' treatment and other similar items. They
were further advised that deficits incurred through expenditures in excess of the approved
budget would not be met by the Provincial Government. The value of variable supplies
used in patient-care was calculated. When the number of days' treatment provided by
the hospital differed from the estimate, the budgets were subject to the number of days'
difference multiplied by the patient-day value of the variable supplies. Individual studies
were made in those instances where large fluctuations in occupancy involved additions or
reductions in stand-by costs, and budget adjustments were made.
The firm-budget procedure was followed in 1956; however, hospital budgets were
established on the basis of 1955 salary rates. For those hospitals where wage agreements
were not in existence in 1955, salaries were accepted up to the level paid in 1955 in
near-by comparable hospitals with union contracts.
The majority of hospital accounts are the responsibility of the British Columbia
Hospital Insurance Service (a small percentage are Workmen's Compensation recipients,
non-qualified residents, etc.), and the Service pays each hospital monthly the proportion
of one-twelfth of the yearly budget represented by B.C.H.I.S. insured days, as compared
to the total days' treatment. By the month's end each hospital is advanced the approximate amount required to cover B.C.H.I.S. patients, including those remaining in hospital
at the end of the month. Qualified patients are charged $1 per day, which is deductible
when calculating payments due hospitals from the Service. Non-qualified residents are
charged the hospitals' established per diem rates.
In 1956 approximately 92 per cent of all patients were covered by the Service. This
compares with an average of approximately 85 per cent coverage experienced prior to
the introduction of new policies on April 1st, 1954.
HOSPITAL SERVICES
The group of staff consultants who share the responsibility of maintaining high
standards of patient-care are organized into the following divisions: Hospital Finance,
Hospital Consultation and Inspection, Medical Consultation, Hospital Construction,
Research, Administrative Assistant, and the General Office. HOSPITAL INSURANCE SERVICE,  1956 AA 11
The work of the Service is such that several specialists may have to be consulted on
a particular problem, and often two or more divisions may therefore be involved.
Hospital Finance Division
W. J. Lyle, Manager
Hospital Accounting Section
This Section is primarily concerned with hospital financial operations in relation to
the budgets approved by the Hospital Rate Board. As a part of this function, frequent
inspections are made of hospital financial, statistical, and accounting records. When the
smaller hospitals require accounting assistance, this Section, upon request, provides
accounting aid and instruction.   .
This Section also checks and amends financial and statistical reports prepared by
hospitals for the Dominion Bureau of Statistics; studies and recommends for approval
requests made by hospitals for payment of grants in connection with capital expenditures
for equipment; audits accounts relating to hospital construction projects, in collaboration
with Federal Treasury officials; carries out accounting studies in nursing homes and
chronic hospitals, at the request of the Provincial Social Welfare Branch, to assist in
establishing rates to be paid for the care of Social Welfare patients; collates with the
approved budget statistical reports and revenue and expenditure statements received from
hospitals on a monthly basis; calculates cash advances forwarded to hospitals semimonthly.
The Annual Report on Hospital Statistics for 1955 was also prepared.
Experience during the first few years' operation of the Hospital Insurance Service
indicated that operating costs required serious consideration when planning new hospitals
and additions to existing hospitals. In order to ensure that plans for new hospitals and
(or) hospital additions were prepared with economical and efficient operation in mind,
a system of pre-construction operating budgets was set up. The procedure is that a hospital prepare an estimate of staff and other costs based upon a reasonable occupancy for
the new areas. These estimates are submitted to the Hospital Insurance Service and are
reviewed by the Hospital Rate Board in the same manner as normal operating estimates.
It is essential that the estimated operating costs of the new hospital, or new wing, be one
that compares favourably with other hospitals actually in operation. Where the hospital's
pre-construction operating estimates do not indicate a reasonable operating cost, it is
necessary for them to revise their plans to bring about the desired situation. Once a
satisfactory pre-construction operating estimate has been agreed upon by the hospital
officials and the Hospital Insurance Service, the hospital boards are required to provide
written guarantees relative to the projected operating cost. With the large increase in
planning for hospital construction during 1956, the amount of work, correspondence, and
meetings with hospital officials in connection with pre-construction operating estimates
increased. It is considered that this method of approaching the operating picture for
proposed hospital facilities will help ensure more satisfactory planning, efficient use of
hospital personnel, and an economical operation.
Hospital Claims Section
The Hospital Claims Section is responsible for screening the admission-discharge
records that are submitted by hospitals in respect of every patient admitted, whether the
account is charged to the Service, to the patient, or to some other agency. Over 1,000
accounts are screened daily for statistical and accounting purposes.
In addition, this Section reviews every Application for Benefits made under the
"Hospital Insurance Act" where the patient claims to be a resident. Each hospital
account charged to British Columbia Hospital Insurance Service is carefully checked AA  12
BRITISH COLUMBIA
before the account is approved for payment to ensure the charges are correct. All hospital
accounts are checked for possible third-party liability when the hospital care resulted from
accidental injury. During 1956 a total of 251,038 accounts were paid, compared with
242,034 in 1955 and 229,735 in 1954.
In addition to the above duties, this Section also administers the billing and collection of municipal per diem grants, and all hospital accounts are checked individually to
determine correct municipal responsibility. During the year approximately $1,070,000
was collected through per diem grants.
In the Hospital Claims Section all admission-discharge records are reviewed to determine
responsibility for payment. Mr. J. A. M. Moir, Section Supervisor, is pictured at the desk of
his assistant, Mr. W. J. Wade.
A complete alphabetic file of all recipients of Social Welfare assistance in the Province is maintained. Hospital accounts incurred by Social Welfare patients are checked
against this file in order to determine eligibility for hospital benefits, including the dollar-
a-day charge. Information regarding medical identity numbers allotted to recipients is
provided at the request of Welfare authorities, doctors' offices, etc.
A key-punch section is responsible for punching I.B.M. cards which record the
statistical, financial, and medical data shown on each admission-discharge record. Nearly
1,300 cards are punched daily and are used to provide tabulated listings of accounts paid
to hospitals and of individual charges billed to municipalities in respect of per diem
grants. The punched cards are also used to provide statistical data required by the
Research Division.
In addition to the payments made to hospitals- located in British Columbia, 2,246
accounts, totalling $162,387, were paid on behalf of B.C. residents who were hospitalized
in other Provinces of Canada, the United States, Alaska, Hawaii, Mexico, British West
Indies, the United Kingdom, Ireland, France, Holland, West Germany, Italy, and Japan. HOSPITAL INSURANCE SERVICE,  1956
AA  13
Close co-operation is maintained with the Medical Consultant's Division in screening
of hospital accounts for both in-Province and out-of-Province patients.
Patients' records for the previous year were again microfilmed by the Central Microfilm Bureau of the Provincial Library. Approximately 720,000 documents were processed, using 23,000 feet of film. This work was completed over a period of three months.
Hospital Consultation and Inspection Division
J. W. Mainguy, Manager
Victoria Office
Hospital inspection and administrative assistance have always been regarded as the
main function of this office. However, it also plays an active part in the financial arrangements between the Hospital Insurance Service and the public hospitals. During 1956, as
in 1955, there was more emphasis on work connected with hospital operating estimates.
In addition to this, there was increased work connected with operating estimates submitted
by groups planning new hospital construction. Work performed by this Division involves
reviewing these pre-construction estimates to ensure that new buildings, when constructed,
can be staffed economically. This work is carried out in conjunction with the Hospital
Finance Division.
Administrative assistance in respect to particular problems was given to numerous
hospitals—in some cases by mail, in others by a visit by a member of the staff. A management survey of the operation of one hospital was completed and required the services
of two consultants, for over two weeks each, at the hospital. An intensive survey of
another hospital was almost completed at the year-end. One member of the staff of this
office assisted the Vancouver office in nursing studies in private hospitals and also in a
special study made into the type of service rendered in certain unlicensed buildings in
Vancouver.
Studies in connection with the proposed chronic treatment and convalescent coverage
programme were made by this office, and members of the staff participated in the conferences held concerning this programme.
Concentration on the work connected with estimates, intensive surveys, studies in
connection with the chronic treatment and convalescent coverage programme, plus the
additional work with private hospitals reduced the number of regular inspections of
general hospitals below the level achieved in the past.
This office continued its work of processing draft by-laws of hospital societies in
conjunction with the Administrative Assistant. Reviews of complete revisions for twelve
societies were handled, as well as numerous amendments. Model by-laws for hospital
societies were distributed to a number of hospitals for their guidance. Standard reference
material was provided to hospitals whose medical staffs were active in reviewing their
by-laws.   Assistance was given with drafts of medical-staff by-laws sent in for review.
Information on personnel matters was distributed to hospitals.
The office assisted other divisions of the Service in such matters as reviews of hospital plans, requests for equipment grants, and surveys of hospital bed requirements.
Nutrition consultants and the Technical Supervisor, Clinical Laboratory Services,
all of the Health Branch, worked closely with this office in connection with certain problems. At the request of hospitals, nutrition consultants visited eleven hospitals to give
assistance with dietary problems. As in the past, liaison was maintained with hospitals
and the Health Branch in the reporting and follow-up of infections in hospitals. Instructions were given to many hospitals regarding technique in handling infectious cases.
Vancouver Office
The primary activity of this office is the inspection of private hospitals and consultation with their owners.   Annual visits were made to all hospitals to appraise the plant, AA 14
BRITISH COLUMBIA
equipment, and quality of care. During the summer an intensive study into nursing care
in private hospitals in the Vancouver area was made in conjunction with a member of the
staff of the Victoria office. In addition to the licensing and inspection of private hospitals,
information was given to eighty-four persons who inquired about requirements for establishing a private hospital.
As of December 31st, 1956, there were sixty-two licensed private hospitals, varying
in size from 2 beds to 95 beds, the average size being 20 beds. Three private hospitals
closed and nine new hospitals opened during the year. The total beds increased to 1,597,
or about 16.5 per cent over 1955. Of the total beds, 1,464 were for nursing-home-type
patients and 133 were for acutely ill patients. The majority of the latter beds were in
hospitals operated by mining or other industrial concerns who have established hospitals
in remote areas primarily to look after their employees.
The next most important activity of this office is in the field of hospital clearance.
Hospital clearance is a method of moving welfare patients from acute general hospitals
to suitable facilities when these patients no longer require the specialized services of an
acute general hospital but still need some form of care and cannot be sent home. The
work is carried out by the Social Welfare Branch upon request by this office. During
1956 there were 150 referrals from acute general hospitals asking for assistance in the
removal of problem cases, of which 139 were placed.
The third task of this office is to make special investigations, as required by the Chief
Inspector, into various aspects of hospital care in the Lower Mainland area. In the past
year thirteen problems were investigated. Studies were carried out in connection with
the proposed new chronic treatment and convalescent coverage programme.
In co-operation with the metropolitan health authorities, an investigation was made
into the type of service being rendered in unlicensed homes which appeared to offer
nursing-home-type services in the Shaughnessy area of the City of Vancouver.
Medical Consultation Division
Dr. W. A. Fraser, Medical Consultant
The principal function of the Medical Consultant and his staff is to review all admission and discharge records from the standpoint of medical qualification prior to processing for payment.
In this field, trends of admissions and types of care are reviewed. When necessary,
certain recommendations are made to the departments concerned. This Division also
provides a source of technical knowledge for use by all branches of the Service.
Hospital claims are reviewed for length of stay and other pertinent data, with particular attention being given the claims of short-stay and chronic patients. Out-of-
Province claims are reviewed to comply with the out-of-Province regulation, and the
hospitals concerned are checked to ensure they meet the required standards.
A further responsibility of the Division entails a careful study of discharge diagnoses,
which are coded in accordance with the Manual of International Statistical Classification
of Diseases, Injuries, and Causes of Death. In this regard, approximately 1,000 discharge notices are reviewed daily.
Close liaison is maintained with the Research Division in the compilation of the
morbidity studies.
This Division has been pleased to assist and provide some in-service training for the
students of the Medical Record Librarians' School, Royal Columbian Hospital, New
Westminster.
During the year the Medical Consultant attended exercises at the Civil Defence
headquarters in an advisory capacity, and in November, 1956, was an observer at the
Civil Defence operation " Dogwood." This was the first time-motion study of the evacuation of a Canadian hospital. HOSPITAL INSURANCE SERVICE,  1956
AA 15
The Medical Consultation Dtvision reviews the medical qualifications of all admission and
discharge records prior to being processed for payment. Assistant Mrs. E. McFadden RN is
shown (above) at the desk of Dr. W. A. Fraser, Medical Consultant '
Hospital Construction Division
A. W. E. Pitkethley, Manager
The primary function of this Division is to assist hospitals and architects in providing new hospital facilities or renovations or additions to existing ones. The design and
layout of a hospital can have a marked influence on the efficient and economical operation of the hospital and, to a degree, on the standard of care that can be rendered
With the co-operation of other divisions of the Service, a high-quality consultation
service is provided to hospital boards throughout the Province. The various branches
of the Health Department, including Environmental Management, the Consultant in
Nutrition, and Clinical Laboratory Services, as well as the Department of Pediatrics
under the Faculty of Medicine, are all consulted in relation to any new plans where it is
felt they can contribute. The Federal Government, through the Chief of the Hospital
Design Division, also assists in an advisory capacity.
The other main function of this Division is the processing of all applications for
grant assistance toward the cost of capital construction and improvements, other than
equipment, and, in addition, preparing applications for submission to the Federal Gov
ST"       FCderal grantS tOWard thC C°St °f purchases that 1ualify within their regu-
As an indication of the activity of the Division, it is interesting to note that during
JoJrd members meetmgS ^ hdd ^ dekSations comprising architects and AA 16
BRITISH COLUMBIA
The following is further evidence of the activity of this Division throughout the
calendar year 1956: —
Projects Commenced during 1956
Campbell River and District Hospital, Campbell River.—This hospital building,
which was commenced early in 1956, will be a reinforced-concrete structure of three
stories, in addition to a full-basement floor. The building has been structurally designed
to allow for future expansion by the addition of a fourth floor for patient accommodation.
Initially, the hospital will contain 58 active-treatment beds and 22 regular nursery bassinets for new-born. Certain patient accommodation area in the building is planned to
be left in an unfinished stage of completion.   This arrangement permits a ready increase
The Hospital Construction Division assists hospital boards and architects in planning new
facilities, renovations, and additions. Mr. A. W. E. Pitkethley, Manager (right), and his assistant, Mr. E. M. Browning, are shown reviewing hospital plans.
in bed capacity when warranted. The Campbell River and District Hospital will be
the first hospital to come into operation in British Columbia featuring the so-called
" double corridor " design. The estimated cost of the project is approximately $910,000
and is expected to be completed during the summer of 1957.
St. Mary's Hospital, New Westminster.—This is a reinforced-concrete building of
150 beds designed in the shape of a " T." The stem contains four floor levels which
will be largely for service areas and the bar crossing the stem to have patient accommodation made up for five floors, plus a ground floor, in addition to a basement, and sub-
basement for further services. The top floor will have living accommodation for staff.
The estimated cost of the project is $2,480,000 and is expected to be completed early
in 1958.   It will replace the existing obsolete hospital of 63 beds.
Ladysmith General Hospital, Ladysmith.—This will be a one-story 32-bed building
of frame construction on reinforced-concrete floors, plus generous basement area, the HOSPITAL INSURANCE SERVICE,  1956
A A  17
exterior to be of stucco finish. The existing hospital of 31 beds will be torn down when
the new building is completed early in 1957. The new building is situated on the site
in such a way that it was necessary to tear down and temporarily patch up a portion of
the existing hospital.    The estimated cost is $273,600.
Windermere District Hospital Nurses' Home.—This is a small one-story frame-
constructed nurses' home, expected to be completed early in 1957. The estimated cost
is $26,400.
Projects Completed during 1956
Windermere District Hospital, Invermere.—This 24-bed hospital is a frame building with a concrete floor. Part of the slab is on grade and the remainder is over
reinforced-concrete basement. The exterior is mainly stucco. The estimated cost was
$271,280.
Stewart General Hospital, Stewart.—The Stewart Hospital of 9 beds is probably
the smallest hospital building constructed in British Columbia for some years. It is a
one-story frame building on a concrete slab.   The estimated cost was $86,832.
Mount St. Joseph's Hospital, Vancouver—Addition.—The addition to this hospital
provided 33 active-treatment beds and also 24 chronic beds. This four-story addition
is of reinforced-concrete construction, brick-veneer exterior. The project included
alterations to the existing buildings, plus the construction of a hospital chapel. The
estimated cost was $738,474.
Royal Jubilee, Victoria—Psychiatric Unit.—This 9-bed unit is the second addition
to the Psychiatric Unit at the Royal Jubilee Hospital, Victoria. The unit is a separate
building on the hospital-site and is a reinforced-concrete structure. The estimated cost
was $31,466.
Lady Minto Hospital, Ashcroft—Addition.—The addition to the building, which
provides 17 beds, also provides a new operating and delivery suite on the ground floor
and new kitchen and laundry in the basement. This addition will form the nucleus of
an entirely new building at some future date.   The estimated cost was $65,140.
Vancouver General Hospital, Vancouver—Addition.—This reinforced-concrete
addition to the existing radiology department will provide approximately 3,800 square
feet of floor area.   The estimated cost was $171,920.
Golden General Hospital Nurses' Home, Golden.—This is a single-story frame
structure with a partial basement and an exterior surface of wood siding. The estimated
cost was $26,000.
Project Commenced during 1955 and Under Way in 1956
Vancouver General Hospital 504-bed Acute Unit, Vancouver.—The construction
of the Vancouver General Acute Unit continued through 1956, and it is now expected
that this building will be complete some time in 1958. When these 504 beds come into
operation, the Vancouver General Hospital will be one of the largest hospitals in Canada.
Construction on the Acute Unit commenced in 1955.   The estimated cost is $7,974,530.
Projects in Advanced Stages of Planning
Working drawings and specifications were in the process of being developed or
were completed during 1956 for the following hospitals, and it is anticipated that construction will get under way in 1957. Intensive study was given to these projects during
the year, and many reviews were completed by the Hospital Construction Division. The
total estimated cost of all projects is $18,000,000. AA 18 BRITISH COLUMBIA
Number of Beds
Maple Ridge Hospital, Haney   63
Queen Alexandra Solarium, Cobble Hill  64
Lady Minto Gulf Islands Hospital, Ganges  171
Chilliwack General Hospital, Chilliwack (addition and nurses'
home)   962
Vancouver Preventorium, Vancouver   70
Fraser Canyon Hospital, Hope   20
Surrey Memorial Hospital, Surrey   63
Prince George and District Hospital, Prince George  151
Kootenay Lake General Hospital, Nelson  94
Kimberley and District General Hospital, Kimberley  62
Castlegar and District Hospital, Castlegar  35
Kitimat General Hospital, Kitimat   100
Burnaby General Hospital, Burnaby (addition)   125
Queen Victoria Hospital, Revelstoke (addition)   32
Lillooet District Hospital, Lillooet   12
Campbell River and District Hospital (nurses' home), Campbell
River   15
Grace Hospital, Vancouver (addition)   65
St. Joseph's General Hospital, Dawson Creek  50
Salmon Arm General Hospital, Salmon Arm  55
Prince Rupert General Hospital, Prince Rupert (alterations)  15
Powell River General Hospital, Powell River (chronic addition) 40
St. John Hospital, Vanderhoof (nurses' residence)  14
1 Plus nurses' residence.
2 Plus 36 nurses' beds.
Plans for the following projects were also being developed and preliminary drawings
studied during 1956:—
New Westminster:  Royal Columbian Hospital Nurses' Home.
North Vancouver:  New hospital.
Nanaimo:  New hospital.
Duncan:  Addition or new hospital.
Fort St. John:   New hospital.
Kamloops: Addition.
Burns Lake: New hospital.
Terrace: New hospital.
Research Division
Mrs. G. E. Whelen, Director
The principal research undertaken by this office during the year 1956 resulted in a
two-volume report entitled "A Study of the Hospital Bed Requirements for Care of the
Acute-sick on Vancouver Island, British Columbia," which delineated those factors
influencing the need for, and location of, new general hospital accommodation and made
suggestions as to the optimum bed size of proposed construction in the extensive area
examined. The report recommended that the amount of general hospital accommodation on Vancouver Island be increased by some 255 beds and that, in addition, 229 of
the existing beds be replaced with more modern facilities through construction to commence prior to 1961. These recommendations were made primarily as guides to the
administration of the Hospital Insurance Service and to local hospital authorities but
were not statements of Government policy. HOSPITAL INSURANCE SERVICE,  1956
AA 19
To enable forecasts of the size of future accommodation, methods had to be devised
to project the population of small areas and to examine the results in light of present
and proposed economic development. While these projections were in themselves studies
of some magnitude, they could only serve as the foundation for estimates of future patient
loads on Vancouver Island. The crux of the study was the correlation of the population
projections with estimates of future rates of individual hospital utilization which is governed initially by the location of facilities, the patients' choice of hospitals, and by the
amount of sickness evident in the communities which form the hospital catchments.
A special tabulation which related the age of patients with the type of illness experienced
in the Vancouver Island hospitals, from which comparisons could be drawn with the
Provincial average experienced in 1954, assisted in this correlation.
The Research Division conducts studies relating to hospital occupancy and prepares medical and financial data pertaining to hospital bed requirements. Shown above is Mrs. G. E.
Whelen, Director (left), and her assistant, Miss M. Martinson.
Although smaller in scope and less time-consuming, studies of a nature similar to
that described above were undertaken and completed to determine the need and size of
proposed hospital facilities in North and West Vancouver, Lillooet, Salmon Arm, Prince
George, Burns Lake, and Vanderhoof. Reassessments of studies completed in previous
years concerning the Langley, Surrey, Trail, Nelson, Castlegar, Fort St. John, and Dawson Creek areas were undertaken to align recommendations with current population
growth and community action. As a preliminary to intensive study of general hospital
bed requirements, a field-trip was made during December in the catchment areas of the
hospitals located at Golden, Revelstoke, Salmon Arm, Armstrong, Enderby, Vernon,
Kamloops, and Williams Lake. Data gathered at this time will be incorporated into a
regional study similar to that completed on Vancouver Island. AA 20
BRITISH COLUMBIA
Of prime importance, and as a concomitant with the actual research attempted,
have been the annual collection, tabulation, and compilation of series of statistical data
derived from information contained in the admission-discharge record completed for
each patient treated in a British Columbia hospital. More than a quarter of a million
records were processed this year to disclose sex, age, morbidity, length of stay, residence,
and other patient characteristics. New codes were utilized to produce information concerning the use of hospitals by residents of municipalities as well as school districts.
Special series were inaugurated concerning social assistance recipients. Geographical
codes were constantly amended and extensive cross-checks placed on tabulation procedures.
Extensive compilations were completed to produce facts concerning the periods of
hospitalization of various classifications of Provincial welfare cases, Indians, and the
general self-supporting population in relation to age, sex, and marital status.
Material was gathered for presentation to the Royal Commission on Canada's
Economic Prospects and to the Department of National Health and Welfare and other
interested agencies.
Unfortunately, the shortage of trained staff and the rapid turnover in personnel
during the year greatly hindered the progress of hospital morbidity studies. Summer
assistants were hired to assist in clerical procedures developed from tabulation series, but
the pressure for completion of bed requirement studies necessitated delay of the analysis
of the causes of illness and death in British Columbia hospitals.
L
Administrative Assistant
K. G. Wiper
The Administrative Assistant's office is responsible for the preparation of legislation,
regulations, and Orders in Council, and therefore maintains a close liaison with the
Attorney-General's Department. It is also responsible for providing a uniform interpretation of the various Acts and regulations to the other divisions of the Hospital Insurance
Service.
In conjunction with the Hospital Consultation and Inspection Division, advice and
assistance are given to hospitals in regard to problems connected with by-laws and their
application. Changes in hospital by-laws are reviewed for the purpose of bringing them
to the stage where Government approval may be obtained. A set of model by-laws for
use as a guide in making revisions is available to hospitals.
This office collaborates with the Water Rights Branch of the Department of Lands
and Forests in assisting communities in unorganized territory to establish hospital improvement districts for the purpose of raising funds by money by-laws for improving hospital
facilities in the area. At the end of 1956 there were fifteen such districts in operation
and a number of others in the process of formation. Descriptive material outlining the
procedures for establishing such a district are supplied to interested groups by the office
of the Administrative Assistant.
Third Party Liability Section
The hospitalization reports that are completed by hospitals for every patient admitted
with accidental injuries are processed by the Third Party Liability Section. This Section
also handles the arrangements under which the British Columbia Hospital Insurance
Service receives reimbursement from public liability insurance companies and self-insured
corporations for hospital bills paid by this Service on behalf of accident victims.
Eligibility Section
In order to ensure that only qualified B.C. residents receive hospital insurance
benefits, the staff of the Eligibility Section review the Application for Benefits made by HOSPITAL INSURANCE SERVICE,  1956 AA 21
General Office
W. H. Parker, Supervisor
Service is a £,esponsiS^t tolce. °' "" '^ S'"« "* ^P™ rf «*
mail.   ,„c„mlng _,,„ i, stawn betag oVi ,„T ..^ p„X »,, ""rib,",0n °f *"
to the Mount St Ma,y Ir,„rmarv ,fi£ft&£ Xing" hfv^r'0" "
of accounting was drawn up bv the General nffi.„ ; urln§ ttle year the new system
General, creating a new ^f^^^^S^T^ ** ** ^P*01^
The General Office admi^m*rStm^°!f'peiSOrel Posted ^ British Columbia.
applications are preccSHSpJ isS and LsLTr^T' Whereby duly certified
first eight months of 1956, 650^^ AA 22 BRITISH COLUMBIA
total of approximately $7,900 in fees. The British Columbia Hospital Insurance Service
paid $25,000 on behalf of 348 hospitalized dependents, and it is estimated that a total
of $35,000 will be paid during the twelve-month period covered by those registering up
to December 31st, 1956.
A new duplicating-machine and a copying-machine were purchased for use in this
office, the latter resulting in a considerable saving in time in the typing of statements,
documents, forms, and out-of-Province receipts.
Public Relations
The main responsibility of the Public Relations Section was the preparation of
advisory bulletins which were distributed to hospitals. The information was primarily
an administrative aid which clarified changes in B.C.H.I.S. policies and procedures, but
on occasion it also included articles on isolation techniques and other general information
and data. This Section also arranged for the preparation of pre-admission slips for use
in elective hospital admission, whereby residency information could be noted on the slip
prior to hospital admission, resulting in a saving of time and effort on the part of hospital
admitting clerks. Out-patient Benefit slips were also prepared and distributed to hospitals to assist them in explaining minor surgery and emergency-treatment benefits to
out-patients. Bulletin-board notices and individual kits containing an Application for
Registration, a return addressed envelope, and a General Information pamphlet were prepared for use by the armed forces to assist service personnel in registering their dependents
for hospital insurance protection. A new General Information pamphlet was also prepared and printed. An exhibit was designed for use at the Western Canada Institute for
Hospital Administrators and Trustees held in June in Vancouver. Revisions were made
to the Hospital Insurance Service display in the Department's exhibit at the Pacific
National Exhibition. A library of 16-mm. sound films of an educational nature was also
maintained for use by hospitals and other interested groups. This section also compiled
and edited the Eighth Annual Report.
CLASSES OF PERSONS ENTITLED TO OR EXCLUDED FROM
THE BENEFITS OF THE "HOSPITAL INSURANCE ACT"
Entitled to Benefits
A person is considered entitled to benefits if he qualifies as a " resident of the Province " under the " Hospital Insurance Act." Generally speaking, a person is qualified
if he proves to the satisfaction of the Hospital Insurance Commissioner that:—
(a) He is the head of a family or a single person who is living within the Province and has lived continuously therein during the preceding twelve consecutive months;  or
(b) Having qualified under item (a), he leaves the Province and returns after
an absence of less than twelve months and resumes residence within the
Province;  or
(c) He is living within the Province and is a dependent of a resident of the
Province;   or
(d) He is a person who has been certified by the Deputy Minister of Welfare
to be a person entitled to health services.
During the one-year residence qualification period, a person is permitted to be temporarily absent from British Columbia for a total of less than three months without
suffering any postponement of the date on which he becomes a qualified resident. HOSPITAL INSURANCE SERVICE,  1956 A A 23
With regard to item (c) above, a dependent is either the spouse of the head of a
family or a child under 21 years of age who is mainly supported by the head of a family.
If a man's wife and dependent children arrive in British Columbia after he does,
they are entitled to assume his residential status as of the date of their arrival.
B
Servicemen not qualified as residents of British Columbia under the " Hospital
Insurance Act," who are posted to this Province for purposes other than discharge, short-
term inspectional, instructional, or other special duties, may qualify their dependents for
hospital insurance benefits. An application for registration, completed and certified by
a unit officer in the prescribed manner, together with the required registration fee, must
be received by the Commissioner within twenty-one days of the serviceman's most recent
date of arrival in British Columbia. The registration fee is $10 for the spouse and $2.50
for each dependent child, with a maximum fee of $20 for a family. Benefits become
available from the date the application is certified.
(a) Dependents arriving more than twenty-one days after the serviceman, and
who are not already registered, may be registered for half the standard
registration fee any time within six months of the serviceman's arrival.
The dependents then become eligible as soon as the serviceman has been
in British Columbia for six months.
(b) If a serviceman marries a non-resident during his first year in British
Columbia, he may register his wife by making application for registration
within three weeks of the date of marriage. Benefits become available
from the date the application is certified.
(c) If a serviceman stationed in British Columbia is unable to make application because of temporary duty outside of Canada or in an isolated area,
his spouse or dependent child may register on his behalf in the manner
outlined above.
(d) Hospital benefits are available only in approved B.C. public hospitals.
(e) When the registered dependents of a serviceman permanently leave British
Columbia within a year of the serviceman's arrival, a portion of the registration fee will be refunded, provided an application for refund is made
within one month of departure, and provided none of the dependents have
received benefits under the " Hospital Insurance Act."
Excluded from Benefits
Some of the main classes of persons either permanently or temporarily excluded from
benefits are as follows:—
(a) A person who works full or part time in British Columbia but who resides
outside the Province:
(b) A resident who leaves British Columbia and fails to return and re-establish
residence within twelve months; or
(c) A patient or inmate of a Provincial or Federal institution, or a person
committed to a gaol or penitentiary; or
(d) A patient in a Provincial tuberculosis sanatorium;  or
(e) A resident who receives hospital treatment provided under the "Workmen's Compensation Act" or the " Canada Shipping Act," or a war
veteran who receives treatment for a pensionable disability; or
(/) Persons entitled to receive hospital treatment from the Government of
Canada, or any other government; e.g., members of the armed forces, etc. AA 24
BRITISH COLUMBIA
BENEFITS INSIDE THE PROVINCE 1956
The general hospital services to be provided to a qualified person pursuant to the
Act shall include such of the following services as are recommended by the attending
physician and as are available in or through the hospital to which the person is admitted
as an in-patient, provided that no qualified person shall be entitled to receive, as an
in-patient benefit, any treatment or diagnostic service not connected with the illness or
condition which necessitated the person's being admitted as an in-patient and which could
normally be rendered to such person as an out-patient:—
(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:
(e) Anaesthetic supplies and the use of anaesthesia equipment:
(/)  Such drugs, prescriptions, and similar preparations as may be designated
by the Commissioner from time to time:
(g) 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 clause may
include:—
(i)  Radiological, diagnostic, and therapeutic services, including the
services of a radiologist:
(ii)  Clinical laboratory and other diagnostic procedures, including
the services of a pathologist:
(iii)  The services of an anaesthetist:
(iv) Physiotherapy services:
(h) Care of the acute stage of chronic diseases where, in the opinion of the
Commissioner, such care is necessary and desirable. Such chronic diseases 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 Venereal 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.
Emergency or Short-stay Care
Limited out-patient benefits are extended, in British Columbia hospitals, in addition
to the in-patient benefits available, to qualified residents and dependents. These services
include emergency treatment rendered within twenty-four hours of being accidentally
injured, as well as operating-room or emergency-room services for minor surgery which
does not require admission to hospital as an in-patient. The hospital charges $2 for
each visit.
BENEFITS OUTSIDE THE PROVINCE
Provided a beneficiary has not been absent from British Columbia for more than
three months when he goes to hospital outside the Province, he is entitled to have payment
made on his behalf at the rate fixed by the Commissioner, in relation to the public-ward
charge made by the hospital.   Payment by the Hospital Insurance Service is made only HOSPITAL INSURANCE SERVICE,  1956
AA 25
to hospitals approved by the Commissioner, and cannot exceed $3.50 per day for newborns and $8 per day for other beneficiaries, for a period of time determined by the
Commissioner, and in any event not exceeding thirty days unless authorized by the
Minister of Health and Welfare.
GENERAL HOSPITAL CARE
Statistical data compiled by the Hospital Finance Division are presented in the
tables on the following pages. The data deal with the volume of hospital care provided
to the people of British Columbia through the Hospital Insurance Service. Eighty-two
general hospitals were approved to accept B.C.H.I.S. patients. In addition, a proportion
of care was given in Red Cross outpost units, veterans' hospitals in Victoria and Vancouver, private hospitals, R.C.A.F. Station hospitals, Indian Health Services hospitals,
and in company-operated hospitals in remote areas.
Data for the year 1956 have been prepared from preliminary unrevised reports
submitted by hospitals, and consequently are subject to minor revision.
The average length of stay of B.C.H.I.S. adult and children patients in British
Columbia general hospitals decreased from 10.04 days in 1955 to an estimated 9.87 days
in 1956. Total adult and children days covered by the Service in British Columbia
general hospitals during 1956 was 2,042,590, an increase of 37,425 or approximately
2 per cent over 1955.
During 1956 a total of 207,028 B.C.H.I.S. adult and children patients were discharged from British Columbia public hospitals, an increase of 7,254 or approximately
3.6 per cent over 1955.
On pages 30 to 35, graphs, prepared by the Research Division of the British
Columbia Hospital Insurance Service, depict data compiled from the individual admission-
discharge record received for each person hospitalized for acute care in British Columbia
during 1955. AA 26
BRITISH COLUMBIA
HOSPITALS
The following hospitals are designated under the Act as hospitals required to furnish
the general hospital services provided under the Act or such of them as are available in
the hospital:—
Queen Alexandra Solarium for Crippled Children, Cobble Hill.
Queen   Charlotte   Islands   General   Hospital,
Queen Charlotte City.
Queen Victoria Hospital, Revelstoke.
Quesnel General Hospital, Quesnel.
Red Cross Outpost Nursing Station, Alexis Creek.
Red Cross Outpost Nursing Station, Atlin.
Red Cross Outpost Nursing Station, Bamfield.
Red Cross Outpost Nursing Station, Blue River.
Red Cross Outpost Nursing Station, Edgewood.
Red Cross Outpost Nursing Station, Hudson
Hope.
Red Cross Outpost Nursing Station, Kyuquot.
Red Cross Outpost Nursing Station, Lone Butte.
Red Cross Outpost Nursing Station, Masset.
Rest Haven Hospital and Sanitarium, Sidney.
Royal Columbian Hospital, New Westminster.
Royal Inland Hospital, Kamloops.
Royal lubilee Hospital, Victoria.
R. W. Large Memorial Hospital, Bella Bella.
St. Bartholomew's Hospital, Lytton.
St. Eugene Hospital, Cranbrook.
St. George's Hospital, Alert Bay.
St. John Hospital, Vanderhoof.
St. Joseph's General Hospital, Comox.
St. Joseph's General Hospital, Dawson Creek.
St. Joseph's Hospital, Victoria.
St. Martin's Hospital, Oliver.
St. Mary's Hospital, Garden Bay.
St. Mary's Hospital, New Westminster.
St. Paul's Hospital, Vancouver.
St. Vincent's Hospital, Vancouver.
Salmon Arm General Hospital, Salmon Arm.
Slocan Community Hospital, New Denver.
Squamish General Hospital, Squamish.
Stewart General Hospital, Stewart.
Summerland General Hospital, Summerland.
Terrace and District Hospital, Terrace.
Torino General Hospital, Torino.
Trail-Tadanac Hospital, Trail.
University Health Service Hospital, University
of British Columbia, Vancouver.
Vancouver General Hospital, Vancouver.
Vernon Jubilee Hospital, Vernon.
Victorian Hospital, Kaslo.
War Memorial Hospital, Williams Lake.
West Coast General Hospital, Port Alberni.
White Rock District Hospital, White Rock.
Windermere District Hospital, Invermere.
Wrinch Memorial Hospital, Hazelton.
Armstrong and Spallumcheen Hospital, Armstrong.
Arrow Lakes Hospital, Nakusp.
Bella Coola General Hospital, Bella Coola.
Bulkley Valley District Hospital, Smithers.
Burnaby General Hospital, Burnaby.
Burns Lake Hospital, Burns Lake.
Chemainus General Hospital, Chemainus.
Children's Hospital, Vancouver.
Chilliwack General Hospital, Chilliwack.
Creston Valley Hospital, Creston.
Cumberland General Hospital, Cumberland.
Enderby and District Memorial Hospital, En-
derby.
Esperanza General Hospital, Ceepeecee.
Fernie Memorial Hospital, Fernie.
Golden General Hospital, Golden.
Grace Hospital, Vancouver.
Grand Forks Hospital, Grand Forks.
Kelowna General Hospital, Kelowna.
Kimberley and District General Hospital (Mc-
Dougall Memorial), Kimberley.
King's Daughters' Hospital, Duncan.
Kootenay Lake General Hospital, Nelson.
Lady Minto Hospital, Ashcroft.
Lady Minto Gulf Islands Hospital, Ganges.
Ladysmith General Hospital, Ladysmith.
Langley Memorial Hospital, Murrayville.
Lillooet District Hospital, Lillooet.
Lourdes Hospital, Campbell River.
McBride and District Hospital, McBride.
Mater Misericordiae Hospital, Rossland.
Matsqui, Sumas, and Abbotsford General Hospital, Abbotsford.
Michel Hospital, Michel.
Mission Memorial Hospital, Mission City.
Mount St. Joseph's Hospital, Vancouver.
Nanaimo General Hospital, Nanaimo.
Nicola Valley General Hospital, Merritt.
North Vancouver General Hospital, North Vancouver.
Ocean Falls General Hospital, Ocean Falls.
Penticton Hospital, Penticton.
Pouce Coupe Community Hospital, Pouce
Coupe.
Powell River General Hospital, Powell River.
Prince George and District Hospital, Prince
George.
Prince Rupert General Hospital, Prince Rupert.
Princeton General Hospital, Princeton.
Providence Hospital, Fort St. John. HOSPITAL INSURANCE SERVICE,  1956
AA 27
Table I.—Patients Discharged and Days of Care in British Columbia General
Hospitals, 1949-56, and Proportion Covered by British Columbia Hospital
Insurance Service.
Total Hospitalized
Covered by B.C.H.I.S.1
Adults and
Children
New-born
Total
Adults and
Children
New-born
Total2
Patients discharged—
1949   	
1950 ' ~
1951 	
1953
164,964
172,645
181,160
188,355
200,893
206,992
216,743
226,236
26,272
26,205
27,096
28,675
30,712
31,984
33,190
34,425
191,236
198,850
208,256
217,030
231,605
238,976
249,933
260,661
140,168
144,959
150,116
154,336
169,167
189,713
199,774
207,028
84.9
84.0
82.9
81.9
84.2
91.7
92.2
91.5
1,430,646
1,476,615
1,467,102
1,569,974
1,712,878
1,954,823
2,005,165
2,042,590
85.0
83.6
81.7
81.9
83.9
90.4
91.2
91.2
24,640
23,943
24,172
25,023
27,830
29,483
31,515
32,476
93.8
91.4
89.2
87.3
90.6
92.2
95.0
94.3
200,585
193,307
187,891
184,160
197,100
213,587
212,514
218,019
93.8
90.8
87.7
85.8
89.5
94.5
93.3
93.2
164,808
168,902
174,288
179,359
196,997
1954   	
19553
219,196
231,289
19564	
Percentage of total, patients discharged—
1949	
239,504
86.2
1950. 	
	
84.9
1951                                                    	
83.7
1952	
82.6
1953	
	
85.1
1954
91.7
19553..	
92.5
1956*	
91.9
Patient-days—
1949    	
1950...	
1951   _ 	
1952	
1953 	
1,682,196
1,766,680
1,795,438
1,916,486
2,041,615
2,162,002
2,198,863
2,240,420
213,874
212,979
214,285
214,701
220,208
226,031
227,674
233,975
1,896,070
1,979,659
2,009,723
2,131,187
2,261,823
2,388,033
2,426,537
2,474,395
1,631,231
1,669,922
1,654,993
1,754,134
1,909,978
1954   	
19553
2,168,410
2,217,679
2,260,609
19564	
Percentage of total, patient-days—
1949	
86.0
1950 	
	
84.4
1951	
	
	
82.3
1952. 	
82.3
1953 	
	
84.4
1954	
90.8
19553  	
     |     ...      .
91.4
19564	
.         1
91 4
1
1 British Columbia Hospital Insurance Service excludes Workmen's Compensation Board patients and days.
2 New-born total included.
3 Amended as per final reports received from hospitals.
4 Estimated, based on hospital reports to November 30th, 1956. AA 28
BRITISH COLUMBIA
Table IIa.—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, 1949-56.
Total*
Adults and
Children
Newborn
B.C. General
Hospitals
Adults and
Children
Newborn
B.C. Private
Hospitals
Adults and
Children
Newborn
Institutions
outside B.C.
Adults and
Children
Newborn
Patients discharged—
1949	
1950	
1951	
1952	
1953.	
1954......
1955 2	
19563....
Patient-days-
1949	
1950	
1951	
1952. 	
1953..
1954..
19552
19563
Average days of stay-
1949 	
1950  	
1951	
1952 	
1953....
1954....
19552..
19563.
I
149,280
154,643
159,739
164,379
180,149
199,974
209,999
217,953
1,498,121
1,564,222
1,551,954
1,663.149
1,814,344
2,046,087
2,100,386
2,142,078
10.03
10.11
9.71
10.12
10.07
10.23
10.00
9.83
24,989
24,336
24,587
25,492
28,381
29,761
32,035
33,085
203,197
196,333
190,948
187,923
| 200,738
| 215,507
| 215,980
I 221,799
I
8.13
8.07
7.76
7.37
7.07
7.24
6.74
6.70
I
140,168
144,959
150,116
154,336
169,167
189,713
199,774
207,028
1,430,646
1,476,615
1,467,102
1,569,974
1,712,878
1,954,823
2,005,165
2,042,590
10.21
10.19
9.77
10.17
10.13
10.30
10.04
9.87
24,640
23,943
24,172
25,023
27,830
29,483
31,515
32,476
200,585
193,307
187,891
| 184,160
| 197,100
j 213,587
212,514
218,019
I
8.14
8.07
7.77
7.36
7.08
7.24
6.74
6.71
7,093
7,617
7,308
7,431
8,173
7,602
8,313
8,875
45,960
65,326
62,771
68,892
75,518
66,960
75,599
79,325
6.48
8.58
8.59
9.27
9.24
8.81
9.09
8.94
151
173
171
161
229
199
361
450
1,146
1,288
1,155
974
1,353
1,251
2,271
2,750
7.59
7.44
6.75
6.05
5.91
6.29
6.29
6.11
i
2,019
2,067
2,315
2,612
2,809
2,659
1,912
2,050
21,515
22,281
22,081
24,283
25,948
24,304
19,622
20,163
10.66
10.78
9.54
9.29
9.24
9.14
10.26
9.84
I
198
220
244
308
322
79
159
159
1,466
1,738
1,902
2,789
2,285
669
1,195
1,030
7.40
7.90
7.79
9.06
7.10
8.47
7.52
6.48
1 New-born totalled separately.
2 Amended as per final reports received from hospitals.
3 Estimated, based on hospital reports to November 30th, 1956.
Estimated days per thousand of population covered by British Columbia Hospital Insurance Service: 1949, 1,528;
1950, 1548; 1951, 1,496; 1952, 1,545; 1953, 1,638; 1954, 1,786; 1955, 1,782; 1956, 1,747. (1954 and subsequent years
calculated on basis of total B.C. population (estimated) covered by British Columbia Hospital Insurance Service.)
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients
and Short-stay Patients, 1949-56
Total Adults,
Children, and Newborn In-patients
Estimated Number
of Short-stay
Patients
Total Receiving
Benefits
1949	
174,269
178,979
184,326
189,871
208.530
229,735
242,034
251,038
29,000
44,502
47,656
46,767
52,582
63,621
70,553
76,375
203,269
1950	
1951                   .   ...            	
223,481
231,982
1952 ~	
236,638
1953                                        	
261,112
1954	
19551   	
19562                                 	
293,356
312,587
327,413
Totals                                  	
1.658.782                            431.056             I          2.089.838
1 Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to November 30th, 1956. HOSPITAL INSURANCE SERVICE,  1956
AA 29
Table III.—Patients Discharged, Total Days' Stay, and Average Length of Stay
in British Columbia General Hospitals for B.C.H.I.S. Patients Only.
Grouped according to Bed Capacity, Year 1956.1
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Patients discharged—
207,028
32,476
2,042,590
218,019
9.87
6.71
78,247
10,082
948,393
75,680
12.12
7.51
39,612
7,081
367,568
47,465
9.28
6.70
44,839
9,676
379,027
60,138
8.45
6.22
28,206
3,765
219,064
23,254
7.77
6.18
10,710
1,476
80,706
9,138
7.54
6.19
5,414
396
Patient-days—
47,832
2,344
Average days of stay—
8.83
5.92
1 Estimated, based on hospital reports to November 30th, 1956.
Table IV.—Percentage Distribution of Patients Discharged and Patient-days
for B.C.H.I.S. Patients Only, in British Columbia General Hospitals,
Grouped according to Bed Capacity, Year 1956.1
Bed Capacit.
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
37.80
31.05
46.43
34.71
Per Cent
19.13
21.80
18.00
21.77
Per Cent
21.66
29.79
18.56
27.58
Per Cent
13.62
11.59
10.72
10.67
Per Cent
5.17
4.55
3.95
4.19
Per Cent
2.62
1.22
Patient-days—
2.34
1.08
1 Estimated, based on hospital reports to November 30th, 1956. AA 30
BRITISH COLUMBIA
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AA 31
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BRITISH COLUMBIA
Days
19. 16
Infective and
Parasitic
16. 08
15.88
15.88
Circulatory-
System
Neoplasms
Congenital
Malformations
14.83
Bones
13.88
Blood
13.06
Early Infancy
12.83
Nervous System
12.80
Allergic,   etc.
10.52
A ccidents
9.85
9.79
9. 77
9.68
Genito-urinary
System
Skin
Mental
Digestive
System
7. 75
7.47
Live Births
Supplementary
Classifications
Average
Length of Stay
6.81
6. 77
6.23
Symptoms,
Senility,   etc.
Deliveries,
Pregnancy,   etc.
Respiratory
System
OF PERSONS HOSPITALIZED
IN BRITISH COLUMBIA
BY MAJOR DIAGNOSTIC
CATEGORIES
1955 HOSPITAL INSURANCE SERVICE,  1956
AA 33
Key
7
12. 1
11.6
14
15
3.8
2. 1
3.5
2. 1
16
2.0
1.7
1.7
1.5
Case Fatality Rates
PER  100 PATIENTS
HOSPITALIZED IN BRITISH COLUMBIA
BY MAJOR DIAGNOSTIC CATEGORIES
1955
17
1.3
1.2
10
.9
19 y .3
5 0.2
12g.2
13 g. 2
11.0
Key to Major Diagnostic Categories
1. Infective and Parasitic       10.
2. Neoplasm 11.
3. Allergic,   etc. 12.
4. Blood 13.
5. Mental 14.
6. Nervous System 15.
7. Circulatory System 16.
8. Respiratory System 17.
9. Digestive System 18.
Genito-urinary System
Deliveries,   Pregnancy,   etc.
Skin
Bones
Congenital Malformations
Early Infancy
Symptoms,   Senility,   etc.
Accidents,   etc.
Live Births
19.    Supplementary Classification AA 34
BRITISH COLUMBIA
Per Cent
100
A COMPARISON SHOWING THE PERCENTAGE DISTRIBUTION OF
90
BO
70
60
50
CASES AND DAYS ACCUMULATED BY SOCIAL ASSISTANCE AND OTHERS
ACCORDING TO PERIOD OF HOSPITALIZATION IN BRITISH COLUMBIA
HOSPITALS--BASED ON LIVE DISCHARGES
70 YEARS AND OLDER
I
Cases       Days
SOCIAL
ASSISTANCE
Cases Days
OTHER
LIVE DISCHARGES
40
30
20
10
-clO Days
10-19 Days 20-29 Days 30-59 Days
LENGTH OF STAY IN DAYS
'59 Days HOSPITAL INSURANCE SERVICE, 1956
AA 35
Per Cent
100 I
A  COMPARISON SHOWING THE PERCENTAGE DISTRIBUTION OF
90
CASES AND DAYS ACCUMULATED BY SOCIAL ASSISTANCE AND OTHERS
ACCORDING TO PERIOD OF HOSPITALIZATION IN BRITISH COLUMBIA
HOSPITALS--BASED ON LIVE DISCHARGES
ALL AGES
<10 Days 10-19 Days 20-29 Days 30-59 Days >59Days
LENGTH OF STAY IN DAYS AA 36 BRITISH COLUMBIA
STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE FISCAL
YEAR ENDED MARCH 31st,  1956
Administration—
Salaries         $280,834.94
Temporary assistance   17,306.32
$298,141.26
Office expense   33,650.53
Travelling expense   21,702.69
Office furniture and equipment  1,398.21
Rental and services, Kelowna  630.79
Tabulating and rentals  2,453.49
Payments to hospitals—
Claims   $28,696,392.82
Vancouver General  Hospital re out-patients   ("Hospital Insurance  Act," sec. 35 (30))  157,617.01
$357,976.97
$28,854,009.83
Less collections, third-party liability  100,826.87
Grants in aid of construction and equipment of hospitals     $1,605,664.28
Less payable from Hospital Construction Fund.... $1,337,167.89
Less recovery from Federal Government of Federal share of construction costs advanced by
Province in previous years  35,189.17
       1,372,357.06
28,753,182.96
Less Provincial per diem grants ("Hospital Insurance Act," sec.
40 (1))      $1,714,230.70
Less municipal per diem grants ("Hospital Insurance Act," sec.
40 (2))        1,086,705.60
233,307.22
$29,344,467.15
       2,800,936.30
Total, Hospital Insurance Service  $26,543,530.85
Certified correct and in accordance with the Public Accounts for the fiscal year ended March
31st, 1956.
C. J. Ferber, C.A.,
Comptroller-General.
VICTORIA, B.C.
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
1957
500-257-6558

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