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Ninth Annual Report British Columbia Hospital Insurance Service JANUARY 1ST TO DECEMBER 31ST 1957 British Columbia. Legislative Assembly 1958

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Full Text

 PROVINCE OF BRITISH COLUMBIA
"HOSPITAL INSURANCE ACT"
Ninth Annual Report
British Columbia Hospital
Insurance Service
JANUARY 1st TO DECEMBER 31st
1957
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1958  Victoria, B.C., January 23rd, 1958.
To His Honour Frank Mackenzie Ross, C.M.G., M.C., LL.D.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned has the honour to present the Ninth Annual Report of the British
Columbia Hospital Insurance Service covering the calendar year 1957.
E. C. MARTIN,
Minister of Health and Welfare. British Columbia Hospital Insurance Service,
Victoria, B.C., January 23rd, 1958.
The Honourable E. C. Martin,
Minister of Health and Welfare, . 7 . ;-«
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 1957.
D. M. COX, F.A.C.H.A.,
Commissioner, British Columbia Hospital
Insurance Service. CONTENTS
Page
General Introduction  7
The " Hospital Insurance Act"  7
The " Hospital Act"  8
Sources of Revenue  8
Methods of Payment to Hospitals-
Application for Hospital Insurance Benefits  9
Persons Entitled to or Excluded from the Benefits of the " Hospital Insurance Act"____ 9
Entitled to Benefits  9
Excluded from Benefits  10
Benefits inside the Province, 1957  10
Emergency or Short-stay Care  11
Benefits outside the Province  11
Organization Chart  12
Organization and Administration of B.C.H.I.S  13
Hospital Finance Division  13
Hospital Accounting  13
Hospital Claims  14
Hospital Construction Division  15
Hospital Projects Completed during 1957  16
Hospital Projects under Construction at Year-end  16
Projects in Advanced Stages of Planning  16
Additional Projects Developed through Various Planning Stages in 1957  17
Hospital Consultation and Inspection Division  17
Victoria Office  17
Vancouver Office  18
Medical Consultation Division  19
Research Division  19
Administrative Assistant  20
Eligibility Section  20
Third Party Liability Section  21
General Office  21
Public Relations .__  21
Approved Public Hospitals  22
The Federal-Provincial Hospital Insurance Programme  23
General Hospital Care  23
Table I.—Patients Discharged and Days of Care and Proportion Covered by
British Columbia Hospital Insurance Service, 1949-57  24
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, 1949-57  25
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients and Short-stay
Patients, 1949-57  25
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 1957  26
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 1957  26
Statement of Receipts and Disbursements for the Fiscal Year Ended March 31st, 1957 27
J  Ninth Annual Report of the British Columbia
Hospital Insurance Service
GENERAL INTRODUCTION
The British Columbia Hospital Insurance Service completed its ninth year of
operation on December 31st, 1957. The objective of this Provincial programme of
comprehensive hospital insurance has been to ensure good and efficient hospital service
for the people of British Columbia.
Since the establishment of the Service on January 1st, 1949, its four most important
functions have been:—
To safeguard the residents of the Province from the financial burden associated
with hospitalization.   In so doing, it has helped to raise individual health
standards by removing the financial barrier, which  otherwise  would
prevent many people from seeking early hospital care for conditions that
might seriously impair their health if neglected.
To enable hospitals to substantially improve their service to the public, by
assuring them of a steady income and relieving them of a progressively
increasing number of uncollectible accounts.
To assist communities in providing fully adequate facilities by paying 50 per
cent of approved hospital-construction costs, which is the most generous
rate of Provincial assistance in Canada.
To help hospitals in establishing and maintaining high standards of patient-care
by providing professional consultative services.
Since the inception of the Service nine years ago, approximately $210,000,000 has
been paid toward 2,132,000 hospital accounts.   In addition to this financial aid extended
to hospitalized residents, grants for hospital construction and equipment have exceeded
$18,500,000.   Of those persons in receipt of hospital insurance benefits, 1,900,000 were
in-patients in British Columbia's acute-care public hospitals, 510,000 received benefits
as emergency or short-stay out-patients, and 22,000 received benefits while hospitalized
outside the Province.
At the present time, payments made to British Columbia hospitals by the Hospital
Insurance Service are at the rate of over $90,000 daily.
From January 1st, 1949, to March 31st, 1954, eligibility for hospital insurance
benefits was contingent 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. One year's residence within British
Columbia became the determining factor for eligibility.
THE "HOSPITAL INSURANCE ACT"
The " Hospital Insurance Act" is the law that controls the operation of the Hospital
Insurance Service.   Its main aspects may be summarized as follows:—
(1) Generally speaking, all persons who have resided in British Columbia for
the year prior to going to hospital are entitled to hospital benefits.
(2) Payment of hospital accounts covers acute hospital care. This includes
the acute phase of any illness, including chronic conditions requiring
in-patient care in approved public hospitals. Y 8 BRITISH COLUMBIA
(3) Benefits include standard ward accommodation, the use of the operating-
room, case-room, almost all drugs and dressings, and in fact practically
all services that are provided by the hospital.
(4) The patient is required to pay $1 per day (except Welfare recipients).
(5) In addition to in-patient care, the use of out-patient facilities required
within twenty-four hours of an accident, or for minor surgery, are provided
as benefits.   (The patient pays a nominal charge of $2.)
(6) The residents of British Columbia are entitled to limited out-of-Province
hospital insurance benefits if hospitalized during their first three months'
absence.
THE "HOSPITAL ACT"
One of the important functions of the Hospital Insurance Service is the administration of the " Hospital Act." This is actually quite apart from the " Hospital Insurance
Act," but for convenience and efficiency it was assigned to the British Columbia Hospital
Insurance Service. The Commissioner of the Hospital Insurance Service is also the Chief
Inspector of Hospitals for British Columbia.
The " Hospital Act" controls the organization and operation of hospitals and
specifies three different types, as follows:—
(1) Public hospitals—operated by non-profit organizations for acute care.
(2) Private hospitals—generally privately owned and profit-making units.
(3) Chronic and convalescent hospitals—these are non-profit hospitals
approved under Part III of the " Hospital Act," and are operated primarily
for the treatment and rehabilitation of chronic patients.
The " Hospital Act," among other things, enables the Provincial Government to
make grants to non-profit hospital organizations to assist in the construction and equipping
of non-profit hospitals. The 50-per-cent grants for hospital construction and fixed equipment, made by the Government of British Columbia, are the most generous Provincial
grants in Canada. Grants of one-third are also available on movable depreciable equipment purchased by general hospitals and chronic public hospitals.
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 public 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."
METHODS OF PAYMENT TO HOSPITALS
A system of firm budgets for hospitals, which has been in use since January 1st,
1951, provides for a review of hospitals' estimates by the Rate Board of the Hospital
Insurance Service. Under the firm-budget procedure, hospitals are required to operate
within their approved budgets, with the exception of fluctuation in days' treatment and
other similar items. They are further advised that deficits incurred through expenditures
in excess of the approved budget will not be met by the Provincial Government. The
value of variable supplies used in patient-care has been determined. When the number
of days' treatment provided by the hospital differs from the estimated occupancy, the
budgets are increased or decreased by the number of days' difference multiplied by the HOSPITAL INSURANCE SERVICE, 1957 Y 9
patient-day value of the variable supplies. Individual studies and additional budget
adjustments are made in those instances where large fluctuations in occupancy involve
additions or reductions in stand-by costs.
The majority of hospital accounts are the responsibility of the British Columbia
Hospital Insurance Service (a small percentage are workmen's compensation recipients,
non-residents, etc.). Every month the Service pays each hospital 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 1957 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
terminating the premium-payment programme on March 31st, 1954.
APPLICATION FOR HOSPITAL INSURANCE BENEFITS
When admitted to an acute-care public 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.)
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.
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. Y 10 BRITISH COLUMBIA
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 British Columbia 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
(_?) 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—for example, members of the armed
forces, etc.
BENEFITS INSIDE THE PROVINCE, 1957
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 HOSPITAL INSURANCE SERVICE,  1957
Y 11
(b)
(c)
{d)
(e)
(/)
(g)
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.
Operating-room facilities, including the use of all equipment and material
required in the proper care of surgical cases.
Case-room facilities, including the use of all equipment and material
required in the proper care of maternity cases.
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.
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.
Ah 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.
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.
(h)
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 to hospitals approved by the Commissioner, and cannot exceed $3.50 per day for Y 12
BRITISH COLUMBIA
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new-borns 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.
ORGANIZATION AND ADMINISTRATION OF B.C.H.I.S.
The Hospital Insurance Service operates as a branch of the Department of Health
and Welfare under the Minister of Health and Welfare. It is administered by a Commissioner, who has the status of a Deputy Minister. In this manner the policies of the
Hospital Insurance Service and the amount of funds allocated to hospital care are controlled by the elected representatives of the people.
The main administrative divisions of the Hospital Insurance Service and their
functions are as follows:—
(1) The Hospital Finance Division inspects hospital records, assists hospitals
in maintaining accounting and statistical records, and pays hospital
accounts, amounting to over 2Vi million dollars each month.
(2) The Hospital Construction Division reviews all plans for new hospitals
and provides a consultative service to hospitals and their architects.
(3) Qualified hospital administrators in the Hospital Consultation and Inspection Division assist hospitals with problems of an administrative and
operational nature.
(4) The Medical Consultant is responsible for reviewing all hospital claims
to ensure that hospitalization charged to the Service complies with the
medical requirements set forth in the " Hospital Insurance Act" and
regulations.
(5) Staff consultants in the Research Division conduct detailed surveys to
establish the need for acute-care hospital bed requirements.
Hospital Finance Division
W. J. Lyle, Manager
The Hospital Finance Division performs two main functions—hospital accounting
and payment of hospital claims. Other responsibilities include the control of hospital
requests for grants in connection with capital expenditures for equipment and recommending approval for payment. It also supervises the appropriation covering long-term
pasdiatric care.
The following is a brief outline of the methods by which the Division's main functions
are carried out.
Hospital Accounting
The Hospital Accounting staff is concerned with hospital financial operations in
relation to the budgets approved by the Hospital Rate Board. This work entails frequent
inspectional visits to hospitals to review financial, statistical, and accounting records, and
eighty-two of the approved public hospitals were visited at least once during the year.
When the smaller public hospitals in the Province require accounting aid and instructions,
assistance is provided by the staff, upon request.
Other functions performed by the Hospital Accounting staff include:—
(1) Checking and amending financial and statistical reports prepared by hospitals for the Dominion Bureau of Statistics.
(2) Auditing accounts, in collaboration with Federal Treasury officials, relating to hospital-construction projects. Y 14 BRITISH COLUMBIA
(3) Assisting the Provincial Social Welfare Branch in establishing rates to be
paid for the care of Social Welfare patients by carrying out accounting
studies in nursing homes and chronic hospitals.
(4) Collating statistical reports and revenue and expenditure statements
received from hospitals on a monthly basis, with the approved budget.
(5) Calculating cash advances forwarded semi-monthly to hospitals.
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 or
hospital additions were prepared with economical and efficient operation in mind, a
system of pre-construction operating budgets is used. The procedure requires a hospital
to 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 construction plans to ensure efficient and economical
operation. 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 continuing increase in planning for hospital construction during 1957, 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.
As in previous years, this office prepared the Annual Report on Hospital Statistics
for 1956.
Hospital Claims
The Hospital Claims staff is responsible for screening and, where applicable, approving for payment all admission-discharge records which hospitals submit in respect of
every patient. Every claim is checked by this office, whether it is charged to this Service,
to the patient, or to some other responsible agency. Approximately 1,200 claims are
processed daily.
This office comprises a number of sections, each having responsibility for a particular phase of screening and processing claims.
The Admission Control Section reviews each Application for Benefits made by
patients who claim to be qualified for benefits under the " Hospital Insurance Act."
Details of residence and employment provided by the patient are checked with the verifying documents attached to the claim by the hospital. This Section works closely with
the Eligibility Division Inspectors. Advice and assistance are given to hospital admitting
staffs regarding proper completion of admission-discharge records and methods of obtaining proof of the patient's residence.
The Accounts Payment Section verifies the total charges made to this Service and
ensures that all information shown on the claim is completed for statistical purposes. This
Section screens each claim to determine that the account has been charged to the correct
agency—that is, British Columbia Hospital Insurance Service, Workmen's Compensation
Board, Department of Veterans' Affairs, etc. A monthly reconciliation of accounts is
carried out with each hospital. In addition, this office screens all claims which may
involve third-party liability and, where necessary, obtains further data. During the year
a total of 257,956 accounts were paid, compared with 253,001 in 1956 and 242,034 in
1955. HOSPITAL INSURANCE SERVICE,  1957 Y 15
The Social Welfare Records Section maintains a complete alphabetical file of all
medical identity cards, issued to Welfare recipients for this Province. Hospital accounts
incurred by Welfare recipients are checked against this file to determine eligibility for
hospital benefits, including the dollar-a-day charge. Information regarding medical
identity numbers is provided on request to Welfare authorities, doctors' offices, and certain
other agencies.
The Vouchering and Key-punch Sections are responsible for batching and voucher-
ing fully checked accounts, in order to determine the total amounts payable to each
hospital and to prepare I.B.M. punch-cards recording statistical, financial, and medical
data. Approximately 1,500 punch-cards are processed daily and form the basis from
which this office prepares tabulated listings of accounts paid to hospitals and listings of
per diem charges to municipalities.
The Out-of-Province Section administers the screening and payment of accounts
incurred in hospitals outside British Columbia. This Section is responsible for obtaining
an Application for Benefits and for checking to ensure that the patient is entitled to receive
out-of-Province benefits. During 1957 a total of 2,259 accounts, in the amount of
$158,763.89, were paid on behalf of qualified residents who were hospitalized in other
Provinces of Canada, the United States, Alaska, Hawaii, Mexico, British West Indies,
the United Kingdom, Eire, Australia, France, Holland, West Germany, Norway, Sweden,
Hong Kong, and Japan.
The Filing Section sorts and files an average of 3,800 forms and letters daily.
Patients' records for the year 1956 were microfilmed by the Central Microfilm Bureau of
the Provincial Library, and 783,708 documents were processed, using 25,700 feet of film.
The Hospital Claims office continues to maintain close co-operation with the Medical
Consultant's Division, which provides technical advice to the various sections and also
screens medical data on all in-Province and out-of-Province claims.
Hospital Construction Division
A. W. E. Pitkethley, Manager
This Division has three main responsibilities:—■
(1) Assisting hospitals and their architects when planning new hospital facilities, or renovations and additions to existing buildings.
(2) Processing all applications for Provincial grant assistance toward the cost
of capital construction and improvements, other than movable equipment,
and preparing applications for submission to the Federal Government for
Federal grants toward the cost of construction projects that qualify within
their regulations.
(3) The administrative supervision of the Marpole Provincial Infirmary in
Greater Vancouver and the two branches in Victoria and Haney. (The
manager of this Division serves as secretary of the Provincial Infirmary
Board of Management.) These institutions have a total bed capacity of
298 beds, and during the year had an average occupancy of 86.8 per cent.
A great deal of time is spent reviewing plans of proposed new facilities, forwarded by
hospitals throughout the Province. Special attention is given to the design and layout of
a building to ensure that it can provide efficient and economical operation, a good standard
of patient-care, and adequate facilities for potential future expansion. With the co-operation of other divisions of the Service, hospital boards are provided with excellent consultative services. These services are augmented by various branches of the Health Department, including Environmental Management, the Consultant in Nutrition, and Clinical
Laboratory Services, as well as the Department of Paediatrics of the Faculty of Medicine
of the University of British Columbia and the offices of the Steam-boiler Inspector and Y 16 BRITISH COLUMBIA
Electrical Energy Inspector, which assist in examining heating and electrical plans. The
Federal Government, through the Chief of the Hospital Design Division, also assists in
an advisory capacity.
The following resume of construction is evidence of the activity of this Division
throughout the calendar year 1957. It is interesting to note that, on an average, the
Division held two meetings a week with hospital delegates.
(a) Hospital Projects Completed during 1957
Lady smith General Hospital, Lady smith.—A new hospital replaced the old building
and provides 32 active-treatment beds, 2 recovery, 1 labour, and 8 bassinets.
Royal Jubilee Hospital, Victoria.—Physiotherapy Department alterations and improvements. The alterations provide a net gain of approximately 800 square feet for this
Department.
Campbell River and District General Hospital, Campbell River.—A new hospital,
containing 56 beds, 2 labour beds, 2 recovery beds, and 12 regular bassinets in nurseries.
The Lourdes Hospital at Campbell River, which had been operated by the Sisters of St.
Ann since 1926, ceased to operate when the new hospital opened its doors for patients.
A staff residence of 15 beds was also constructed by the Campbell River and District
General Hospital.
Terrace and District Hospital, Terrace.—A temporary addition, providing 12 additional beds.
Vancouver General Hospital, Vancouver.—Alterations to existing areas.
Windermere District Hospital, Invermere.—A new nurses' residence provides accommodation for eight staff members.
(b) Hospital Projects under Construction at Year-end
Vancouver General Hospital, Vancouver:   Acute unit, 504 beds.
St. Mary's Hospital, New Westminster:   150 beds, 47 bassinets.
Fraser Canyon Hospital, Hope:  26 beds, 8 bassinets.
Surrey Memorial Hospital, North Surrey:  62 beds, 17 bassinets.
Maple Ridge Hospital, Haney:  63 beds, 14 bassinets.
Burnaby General Hospital, Burnaby:  Addition, 122 beds, 41 bassinets.
Lady Minto Gulf Islands Hospital, Ganges:  21 beds, 6 bassinets.
Lady Minto Gulf Islands Hospital, Ganges:  8 nurses' beds in separate residence.
Castlegar and District Hospital, Castlegar:   33 beds, 10 bassinets.
St. Paul's Hospital, Vancouver:   Interns' residence, 23 beds (interns).
Queen Alexandra Solarium for Crippled Children, Victoria:   64 beds.
Chilliwack General Hospital, Chilliwack:  Addition, 97 beds, 15 bassinets.
Chilliwack General Hospital, Chilliwack:  30 nurses' beds in separate residence.
Vancouver Preventorium, Vancouver:  Addition, 70-bed chronic hospital.
St. John Hospital, Vanderhoof:   14-bed nurses' residence.
Kootenay Lake General Hospital, Nelson:  95 beds, 30 bassinets.
Prince Rupert General Hospital, Prince Rupert:   Alterations and improvements to
provide additional beds and improved service departments.
Lillooet District Hospital, Lillooet:   New 17-bed hospital plus nurses' residence.
(c) Projects in Advanced Stages of Planning and for Which Working
Drawings Have Been Prepared
Prince George and District Hospital, Prince George:   154 beds plus staff beds.
Kitimat General Hospital, Kitimat:   119 beds plus nurses' beds.
Grace Hospital, Vancouver:  Addition, 30 beds, 32 bassinets. HOSPITAL INSURANCE SERVICE,  1957 Y 17
(d) Additional Projects Developed through Various Planning Stages in 1957
Royal Columbian Hospital, New Westminster: Nurses' home and training school,
214' nurses' beds.
Salmon Arm General Hospital, Salmon Arm:  50 beds.
Kimberley and District General Hospital, Kimberley (McDougall Memorial): 60
beds.
Golden General Hospital, Golden:  22 beds.
Burns Lake Hospital, Burns Lake:   36 beds.
St. Joseph's General Hospital, Dawson Creek:  60 beds.
Providence Hospital, Fort St. John:  60 beds.
Langley Memorial Hospital, Murrayville:  75 beds.
Nanaimo General Hospital, Nanaimo:   158 beds.
North Vancouver General Hospital, North Vancouver:   283 beds.
Powell River General Hospital, Powell River:  Diagnostic areas.
Terrace and District Hospital, Terrace:  40 beds.
Royal Jubilee Hospital, Victoria:   64 beds.
St. Joseph's Hospital, Victoria:  31 beds.
War Memorial Hospital, Williams Lake:  70 beds.
Tofino General Hospital, Tofino:   10 staff beds.
Royal Jubilee Hospital, Victoria:   Radiotherapy Department.
St. Paul's Hospital, Vancouver:  Laboratory.
Kootenay Lake General Hospital, Nelson:  Nurses' residence.
Prince George and District Hospital, Prince George:  Nurses' residence.
Bulkley Valley District Hospital, Smithers:   Addition to staff quarters.
Hospital Consultation and Inspection Division
J. W. Mainguy, M.H.A., Manager
Victoria Office
Hospital inspection and administrative assistance have always been regarded as the
main functions of this office. However, it also plays an active part in the financial arrangements between the Hospital Insurance Service and public hospitals. Considerable time is
spent on work connected with hospital operating estimates, and during the last two years
there has been a steadily increasing amount of work done on operating estimates submitted by groups planning new hospital construction. These pre-construction estimates
are reviewed to ensure that new buildings can be staffed economically after they have
been constructed. The work on all operating estimates is carried out in conjunction with
the Hospital Finance Division.
Administrative assistance on a variety of problems was given to hospitals during
inspectional visits by members of the staff and through the mail. A management survey
of the operation of one hospital was made during the year, which required the services
at the hospital of three consultants for over eight days each. A similar survey of another
hospital which was started in 1956 was completed during the year. A member of the staff
of this office assisted the Vancouver office in a special study made into the type of service
rendered in certain unlicensed buildings in Vancouver. Inspectional visits were made
to hospitals in all parts of the Province.
This office continued its work in processing draft by-laws in conjunction with the
Administrative Assistant. By-law revisions for eleven societies were reviewed and suggestions made for their improvement. 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, and
assistance was given in drafts of medical-staff by-laws sent in for review. Y 18 BRITISH COLUMBIA
Information on personnel matters was distributed to hospitals.
Studies in connection with the proposed chronic treatment and convalescent coverage programme were made by this office, and members of the staff participated in
numerous conferences held in connection with this programme.
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.
The Nutrition Consultant and the Technical Supervisor, Clinical Laboratory Services, both of the Health Branch, worked closely with this office in connection with
certain problems. At the request of hospitals, the Nutrition Consultant visited fourteen
hospitals to give assistance with dietary problems. As in the past, liaison was maintained
with hospitals and the Health Branch on the problems of aseptic technique and the handling of infectious cases.
In June the Faculty of Pharmacy of the University of British Columbia, in co-operation with this Service, commenced a survey of pharmacy services in the hospitals in this
Province.
Vancouver Office
The primary activity of this office is the administration of Part II of the " Hospital
Act," dealing with private hospitals. One hundred and twenty visits were made to private hospitals to assess the quality of care and the adequacy of buildings and equipment.
A special survey to assess the quality of food service in licensed private hospitals was
carried out by a consultant dietician under general direction from this office. The final
report of this survey will not be available until after the year-end.
During the year a second intensive study was made into the type of service being
rendered in buildings in Vancouver which were not licensed by this office, but which
were being used possibly to care for persons who were patients as defined under the
" Hospital Act." The study was made jointly by the Metropolitan Health Department
and members of the staff of both the Victoria and Vancouver offices of this Division.
As a result of this survey, two persons were charged under the " Hospital Act " for operating private hospitals without a licence. One of these persons was found guilty in
Police Court; the trial of the second person charged had not taken place by the year-end.
A second major activity of this office is in the field of hospital clearance. Hospital
clearance is a method of moving, from acute public hospitals to suitable facilities, Welfare patients who no longer require the specialized services of an acute public 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 1957 there were 137
referrals from acute public hospitals asking for assistance in the removal of problem
cases, of which 130 were placed.
Working in close co-operation with the Victoria office and other divisions of the
Service, this office was able to revise several of the records and procedures used in its
work. A new patients' register for private hospitals was introduced, which will establish
a uniform method of compiling data on patients in these hospitals, and additional visits
were made to hospitals in connection with its use. A new private-hospital licence was
designed and utilized. The form " Report of Social Problem Cases in Hospital" was
completely revised. The new form has proved to be easier to complete and more useful
as a source of information than the previous form.
Seventy-six inquiries, including one from Italy, were received and answered as to
the requirements for the establishment of licensed private hospitals in British Columbia.
Two new private hospitals were licensed—one at Nelson and one at Victoria. Several
of the existing hospitals added new accommodations to their buildings. At the year-end
there were sixty-four licensed private hospitals in British Columbia. hospital insurance service, 1957 y 19
Medical Consultation Division
Dr. W. A. Fraser, O.B.E., E.D., M.D.C.M., F.A.C.S., Medical Consultant
The main functions of the Medical Consultant and his staff are to review all hospital admission and discharge records, and to recommend, from the medical aspect, that
portion of the patient's length of stay which may be approved for payment by British
Columbia Hospital Insurance Service.
The number of records being processed by this Division has continued to increase,
and in 1957 over 1,200 were reviewed daily, as compared to 1,000 in 1956. Particular
attention is given to those accounts which either exceeded or were less than the average
length of hospital stay. Trends of admission and types of patient-care were noted, and
medical coders made a careful study of discharge diagnoses and other pertinent data,
which were coded in accordance with the Manual of International Statistical Classification of Diseases, Injuries, and Causes of Death. Close liaison was maintained with the
Research Division, particularly in respect to morbidity studies and related statistics.
This Division continued to provide a source of in-service training for the students
of the Medical Record Librarians' School, Royal Columbian Hospital, New Westminster,
and for the hospital administrators in training at the University of British Columbia.
Research Division
Mrs. G. E. Whelen, B.Comm., Director
The main functions of this Division are as follows:—
(1) To survey geographic areas within the Province, in order to determine
the need and size of new hospital construction.
(2) To tabulate, compile, and analyse morbidity statistics, noted in the
admission-discharge records forwarded to the Service from British Columbia acute-care hospitals in respect to all in-patients.
(3) To assist the administration of the Service and other agencies with compilations of data which are not directly available from other divisions
within the Service.
The high rate of Provincial population growth and the fact that there is almost
universal coverage of the people living in British Columbia (96 per cent) have been
largely responsible for the direction of the research undertaken in this Division during
1957. The increasing numbers of people in the Province have, in many areas, placed
a strain on existing hospital accommodation, and it has been necessary to further concentrate the resources of this office on the assessment of the need for new hospital beds.
To produce forecasts of bed requirements and make subsequent recommendations,
it was necessary to study extensively the economic and population growth within the
areas concerned. The findings were related to the volume of hospitalized illness, which
was determined through tabulation of the patient data contained in the admission-
discharge records processed for all in-patients treated in British Columbia acute-care
hospitals.
Four regional studies, covering sixteen school districts and adjacent non-school
district territory, were therefore undertaken during the past twelve months. These
studies will be used as administrative guides in determining the amount of hospital construction to be undertaken during the next five years in the following regions: Kamloops-
Revelstoke and North Okanagan, Cariboo, Terrace, and Golden. Summarized, the
recommendations which were made foresee a need to increase the hospital facilities
within the regions specified by a total ranging from 225 to 255 beds.   If implemented, Y 20 BRITISH COLUMBIA
these proposals will represent a 44- to 50-per-cent increase in the over-all current bed
capacity of the four regions. It was also recommended that approximately 35 per cent
of the existing beds be replaced.
Preliminary survey work on hospital bed needs was also commenced on a section
of the Province which has been designated for study purposes as the Central Border and
South Okanagan region. The terms of reference of this study were designed to evaluate
the requirements in eight school districts covering an area of some 8,000 square miles.
Recommendations made by this office in previous years were reviewed and opinions
reaffirmed or adjusted in line with more recent population data and the local or community developments in the Langley, Surrey, Burns Lake, Fort St. John, and Mission
areas.
During 1957 the annual production of data relevant to in-patients involved revision
of coding series, including checking procedures and reorganization of tabulation schedules
and redesigning of tabulation instructions. Particular emphasis was given to the fact that
the current tabulations would relate to the official Canadian census data, and thus provide
valuable demographic material relative to morbidity or other social studies.
Material was gathered and summarized in connection with Provincial participation
in the implementation of the Federal " Hospital Insurance and Diagnostic Services Act,"
and studies were made dealing with the proposed chronic treatment and convalescent
coverage programme.
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 1957 there were seventeen such districts in
operation and a number of others in the process of formation. Descriptive material outlining the procedures for establishing such a district is supplied to interested groups by the
office of the Administrative Assistant, upon request. In addition, this official is responsible for over-all supervision of the Eligibility and Third Party Liability Sections.
Eligibility Section
In order to ensure that only qualified British Columbia residents receive hospital
insurance benefits, the staff of the Eligibility Section review the Application for Benefits
made by patients at the time of admission to hospital. In addition to investigating doubtful applications, Eligibility Inspectors visit hospitals regularly to see that B.C.H.I.S.
eligibility procedures are being properly carried out. Inspectors are located at Victoria,
Vancouver, Prince George, Kelowna, Kamloops, and Nelson and perform their duties
under the direction of the Eligibility Supervisor in Victoria. HOSPITAL INSURANCE SERVICE,  1957 Y 21
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. The
Senior Eligibility Inspector in Vancouver is also responsible for maintaining a third-party
liability clearing-house for the convenience of solicitors and insurance adjusters in the
Greater Vancouver area. Up-to-date information regarding the hospitalization of accident victims is available through this branch office, and negotiations may be carried out
in person or by telephone, thus avoiding the necessity of corresponding with the head
office in Victoria.
General Office
W. H. Parker
The main responsibility of the General Office is the recording and accounting of all
receipts and expenditures incurred in the administration and operation of the Hospital
Insurance Service. Accounting responsibilities also include an internal audit and preparation of the annual estimates. Other duties comprise the handling of personnel matters;
the requisitioning and maintenance of supplies, furniture, and equipment; the sorting and
distribution of mail; and the shipment of forms to hospitals.
This office also processes requisitions, vouchers, and credits with respect to the Provincial Infirmaries (Marpole in Vancouver, Mount St. Mary in Victoria, and Allco in
Haney), and distributes the $5 Comfort Fund payment to the patients at Mount St. Mary.
During this year, amendments were made in respect to the control of patients' pension
cheques, resulting in greater safety of their handling.
This office is responsible for the administration of Hospital Insurance Regulation 8,
whereby armed forces personnel may voluntarily register their dependents for hospital
insurance benefits. During the year 720 servicemen registered over 1,900 dependents,
paying approximately $10,200 in registration fees. For the same period the Hospital
Insurance Service paid $41,000 toward the hospital expenses incurred by 576 registered
dependents.
The supervisor of this office acts as Building Warden and Civil Defence Officer for
the Service, and in this capacity conducted surveys on hospital disaster planning for the
Provincial Civil Defence Co-ordinator.
Public Relations
R. H. Thompson
This section is primarily concerned with maintaining liaison with the eighty-two
approved public hospitals in the Province and assisting them wherever possible with their
public relations programmes. In this regard a Public Relations Guide for Hospitals was
prepared dur'ng the year and will be published early in 1958. It is a comprehensive
pamphlet dealing with the hospital's various publics (medical staff, employees, patients,
visitors, community organizations, etc.) and is intended to assist hospitals when planning
a formal programme of public relations.
As in previous years, the B.C.H.I.S. Bulletin was published on a regular basis and
distributed to all public hospitals. It is an advisory circular clarifying changes in those
B.C.H.I.S. policies and procedures which affect hospital administration. During the year
several articles on the Service were also prepared for publication in British Columbia
newspapers and a national hospital magazine. Y 22
BRITISH COLUMBIA
Extensive revisions were made to the Hospital Insurance Service display in the
Department's exhibit at the Pacific National Exhibition in order to incorporate a Centennial theme in conjunction with the Province's 100th birthday celebrations. In this
regard, historical material was loaned to the Service by many hospitals and microfilm
copies were made by the office of the Provincial Archivist, to be used as a valuable addition in recording the permanent history of British Columbia public hospitals. At the
request of the executive of the British Columbia Hospitals' Association, a display was
prepared for use during the association's fortieth annual convention, held in Vancouver
in October.
A library of 16-mm. sound films of an educational and instructional nature, covering
such subjects as the occurrence of fire within a hospital, was maintained for use by
hospitals and other interested organizations. This office also compiled and edited the
Ninth Annual Report.
APPROVED PUBLIC 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:—
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.
Campbell River and District General Hospital,
Campbell River.
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.
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.
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 Jubilee 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. HOSPITAL INSURANCE SERVICE,  1957
Y 23
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.
Tofino General Hospital, Tofino.
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.
THE FEDERAL-PROVINCIAL HOSPITAL INSURANCE
PROGRAMME
During 1957 senior officials of the British Columbia Hospital Insurance Service
made an intensive study of the Federal Government's proposals for development of a
Federal-Provincial hospital insurance programme.
Representatives of the Department of National Health and Welfare visited the Service to discuss the Federal Act and the draft regulations. Subsequently, a nine-Province
conference was held in September, in Toronto, attended by officials of the Service. In
December a Federal-Provincial technical conference was convened in Ottawa, at which
the policies of the British Columbia Hospital Insurance Service were outlined fully, and
definite recommendations were made in respect to certain phases of the Federal programme which were considered unsatisfactory.
Throughout the year, representatives of other Provinces visited the Hospital Insurance Service to study this Province's programme of comprehensive hospital insurance,
and numerous inquiries were received from nine of the Provinces in Canada.
GENERAL HOSPITAL CARE
The tables on the following pages present statistical data compiled by the Hospital
Finance Division. The data deal with the volume of hospital coverage provided to the
people of British Columbia through the Hospital Insurance Service. Eighty-two public
hospitals were approved to accept B.C.H.I.S. patients. In addition, care was given in
nine Red Cross Outpost Nursing Stations, two veterans' hospitals in Vancouver and
Victoria, three private hospitals, two R.C.A.F. Station hospitals, three Indian Health
Service hospitals, and six company-operated hospitals. Data for the year 1957 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 public hospitals increased from 9.80 days in 1956 to 9.91 days in 1957. Total
adult and children days covered by the Service in British Columbia public hospitals during 1957 was 2,078,978, an increase of 37,124 over 1956. A total of 209,706 B.C.H.I.S.
adult and children patients were discharged from British Columbia public hospitals, an
increase of 1,413 over 1956. Y 24
BRITISH COLUMBIA
Table I.—Patients Discharged and Days of Care and Proportion Covered by
British Columbia Hospital Insurance Service, 1949-57
B.C. Public Hospitals
Total Hospitalized
Covered by B.C.H.I.S.
Adults and
Children
New-born
Total
Adults and
Children
New-born
Total
Patients discharged—
1949    	
164,964
172,645
181,160
188,355
200,893
206,992
216,743
227,359
229,292
26,272
26,205
27,096
28,675
30,712
31,984
33,190
35,118
37,310
191,236
198,850
208,256
217,030
231,605
238,976
249,933
262,477
266,602
140,168
144,959
150,116
154,336
169,167
189,713
199,774
208,293
209,706
84.9
84.0
82.9
81.9
84.2
91.7
92.2
91.6
91.5
1,430,646
1,476,615
1,467,102
1,569,974
1,712,878
1,954;823
2,005,165
2,041,854
2,078,978
85.0
83.6
81.7
81.9
83.9
90.4
91.2
91.2
91.3
24,640
23,943
24,172
25,023
27,830
29,483
31,515
33,174
34,860
93.8
91.4
89.2
87.3
90.6
92.2
95.0
94.5
93.4
200,585
193,307
187,891
184,160
197,100
213,587
212,514
217,252
221,997
93.8
90.8
87.7
85.8
89.5
94.5
93.3
93.1
92.3
164,808
1950
168,902
1951        _    _ 	
1952      __        	
1953 _  _	
1954.     __	
1955 _	
174,288
179,359
196,997
219,196
231,289
19561  _	
19572 _ _	
Percentage of total, patients discharged—
1949
241,467
244,566
86.2
1950
84.9
1951
	
83.7
1952
82.6
85.1
1954
91.7
1955   	
-
	
92.5
92.0
213,874
212,979
214,285
214,701
220,208
226,031
227,674
233,402
240,596
91.7
Patient-days—■
1949. _	
1950   	
1951.. __         _
1952                       	
1,682,196
1,766,680
1,795,438
1,916,486
2,041,615
2,162,002
2,198,863
2,239,646
2,278,330
1,896,070
1,979,659
2,009,723
2,131,187
2,261,823
2,388,033
2,426,537
2,473,048
2,518,926
1,631,231
1,669,922
1,654,993
1,754,134
1953                              _
1,909,978
1954	
1955   	
19561              —_
2,168,410
2,217,679
2,259,106
19572                       _   	
2,300,975
Percentage of total, patient-days—
1949
86.0
1950
	
84.4
1951
82.3
1952
82.3
1953
	
	
84.4
90.8
1955
91.4
91.3
91.3
1 Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to November 30th, 1957. HOSPITAL INSURANCE SERVICE,  1957
Y 25
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, 1949-57.
B.C.H.I.S
. Patients
J               ■     1
Total
B.C. Public
Hospitals
B.C. Private
Hospitals
Institutions
outside B.C.
Adults and
Children
Newborn
Adults and
Children
Newborn
Adults and
Children
Newborn
Adults and
Children
Newborn
Patients discharged—
1949
149,280
154,643
159,739
164,379
180,149
199,974
209,999
219,218
222,268
1,498,121
1,564,222
1,551,954
1,663,149
1,814,344
2,046,087
2,100,386
24,989
24,336
24,587
25,492
28,381
29,761
32,035
33,783
35,688
203,197
196,333
190,948
187,923
200,738
215,507
215,980
221,022
228,359
8.13
8.07
7.76
7.37
7.07
7.24
6.74
6.54
6.40
140,168
144,959
150,116
154,336
169,167
189,713
199,774
208,293
209,706
1,430,646
1,476,615
1,467,102
1,569,974
1,712,878
1,954,823
2,005,165
2,041,854
2,078,978
10.21
10.19
9.77
10.17
10.13
10.30
10.04
9.80
9.91
24,640
23,943
24,172
25,023
27,830
29,483
31,515
33,174
34,860
200,585
193,307
187,891
184,160
197,100
213,587
212,514
217,252
221,997
8.14
8.07
7.77
7.36
7.08
7.24
6.74
6.55
6.37
7,093
7,617
7,308
7,431
8,173
7,602
8,313
9,473
10,485
45,960
65,326
62,771
68,892
75,518
66,960
75,599
79,428
92,390
6.48
8.58
8.59
9.27
9.24
8.81
9.09
8.38
8.81
151
173
171
161
229
199
361
457
646
1,146
1,288
1,155
974
1,353
1,251
2,271
2,740
4,865
7.59
7.44
6.75
6.05
5.91
6.29
6.29
6.00
7.53
2,019
2,067
2,315
2,612
2,809
2,659
1,912
2,050
2,077
21,515
22,281
22,081
24,283
25,948
24,304
19,622
20,163
18,449
10.66
10.78
9.54
9.29
9.24
9.14
10.26
9.84
8.88
198
1950  .   ..
220
1951            _   __
244
1952    	
1953 __  :	
1954   _	
308
322
79
1955   	
19561   	
19572  	
Patient-days—
1949    - .            	
159
159
182
1,466
1950.	
1951	
1,738
1,902
1952       _   .   .
1953  	
2,789
2,285
1Q54
669
1955
1,195
19561 .                           	
2,141,445
2,189,817
10.03
10.11
9.71
10.12
10.07
10.23
10.00
9.77
9.85
1,030
19572     	
Average days of stay—
1949  ' ■	
1950   ....
1951      -                           -   _
1,497
7.40
7.90
7.79
1952 _ ".     .
1953 ,  	
1954 	
1955                                    	
9.06
7.10
8.47
7.52
19561.   _
19572	
6.48
8.23
1 Amended as per final reports received from hospitals.
2 Est'mated, based on hospital reports to November 30th, 1957.
Estimated patient-days (including new-born days) per thousand of population covered by British Columbia Hospital
Insurance Service: 1949, 1,528; 1950, 1,548; 1951, 1,496; 1952, 1,527; 1953, 1,600; 1954, 1,733; 1955, 1,720; 1956,
1,688; 1957 1,626. (1954 and subsequent years based on assumption that total population is covered by British Columbia Hospital Insurance Service.)   Population figures adjusted to 1956 Census.
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients
and Short-stay Patients, 1949-57
Total Adults,
Children, and Newborn In-patients
1 Amended as per final reports from hospitals.
2 Estimated, based on hospital reports to November 30th, 1957.
Estimated Number
of Emergency and
Minor-surgery
Patients
Total Receiving
Benefits
1949  	
174,269
178,979
184,326
189,871
208,530
229,735
242,034
253,001
257,956
29,000
44,502
47,656
46,767
52,582
63,621
70,553
76,375
83,530
203 269
1950    _  	
223,481
1951   _    	
231,982
1952 _ 	
236,638
261,112
293,356
312,587
329,376
341,486
1953  	
1954    _ 	
1955 _	
19561      	
19572   __
Totals , _ __ _	
1,918,701
514,586
2,433,287 Y 26
BRITISH COLUMBIA
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 1957.1
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Hospitals
Patients discharged—
209,706
34,860
2,078,978
221,997
9.91
6.37
79,098
11,290
969,275
77,209
12.25
6.84
39,782
7,249
368,100
46,503
9.25
6.42
45,870
10,113
387,143
61,292
8.44
6.06
28,159
4,081
215,730
24,138
7.66
5.91
11,236
1,532
85,887
9,422
7.64
6.15
5,561
595
Patient-days—
52,843
3,433
Average days of stay—
9.50
5.77
i Estimated, based on hospital reports to November 30th, 1957.
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 1957.*
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Hospitals
Patients discharged—
Per Cent
100.0
100.0
100.0
100.0
Per Cent
37.72
32.39
46.62
34.78
Per Cent
18.97
20.79
17.71
20.95
Per Cent
21.87
29.01
18.62
27.61
Per Cent
13.43
11.71
10.38
10.87
Per Cent
5.36
4.39
4.13
4.24
Per Cent
2.65
1.71
Patient-days—
2.54
1.55
i Estimated, based on hospital reports to November 30th, 1957. r
HOSPITAL INSURANCE SERVICE,  1957
Y 27
STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE
FISCAL YEAR ENDED MARCH 31st, 1957
Administration—
Salaries (permanent)
Temporary assistance
Office expense
Travelling expense  	
Office furniture and equipment
Printing and publications 	
Tabulating and rentals
Incidentals and contingencies ...
Payments to hospitals—
Claims 	
Vancouver General Hospital re out-patients (" Hospital Insurance Act," sec. 35 (30))	
Less collections, third-party liability
$313,081.68
10,223.14
$323,304.82
22,171.53
20,158.97
279.48
13,322.89
1,680.00
347.84
$29,703,986.02
178,022.86
$29,882,008.88
121,549.59
Grants in aid of construction and equipment of hospitals     $2,224,094.21
Less payable from Hospital Construction Fund  $1,426,421.14
Less stand-by services, Vancouver General Hospital   11,148.82
       1,437,569.96
$381,265.53
29,760,459.29
786,524.25
Less Provincial per diem grants ("Hospital Act," sec. 4 (1))     $1,763,604.50
Less municipal per diem grants ("Hospital Act," sec. 32 (1))       1,116,377.91
Less registration fees ("Hospital Insurance Act," Reg. 8)  9,451.65
$30,928,249.07
Total, Hospital Insurance Service
2,889,434.06
$28,038,815.01
1957.
Certified correct and in accordance with the Public Accounts for the fiscal year ended March 31st,
C. J. Ferber, C.A.,
Comptroller-General.
Printed by Don McDiakm_d, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1958
510-158-3750 

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