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Eleventh Annual Report British Columbia Hospital Insurance Service JANUARY 1ST TO DECEMBER 31ST 1959 British Columbia. Legislative Assembly 1960

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 PROVINCE OF BRITISH COLUMBIA
HOSPITAL INSURANCE ACT
Eleventh Annual Report
British Columbia Hospital
Insurance Service
JANUARY 1st TO DECEMBER 31st
1959
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1960  Victoria, B.C., January 28th, 1960.
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 Eleventh Annual Report of the
British Columbia Hospital Insurance Service covering the calendar year 1959.
E. C. MARTIN,
Minister of Health Services and Hospital Insurance. British Columbia Hospital Insurance Service,
Victoria, B.C., January 28th, 1960.
The Honourable E. C. Martin,
Minister of Health Services and Hospital Insurance,
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 1959.
D. M. COX, F.A.C.H.A.,
Deputy Minister of Hospital Insurance. DEPARTMENT OF HEALTH SERVICES AND HOSPITAL INSURANCE
British Columbia Hospital Insurance Service
The Honourable Eric Martin, Minister of Health Services and Hospital Insurance.
Senior Administrative Staff
D. M. Cox, F.A.C.H.A., F.C.I., F.C.I.S., Deputy Minister of Hospital Insurance.
L. F. Detwiller, A.F.C., M.A., M.H.A., M.A.C.H.A., M.R.S.H.,
Assistant Deputy Minister.
W. J. Lyle, F.C.I.S., Manager, Hospital Finance Division.
A. W. E. Pitkethley, Esq., Manager, Hospital Construction Division.
J. W. Mainguy, M.H.A., Manager, Hospital Consultation and Inspection Division.
W. A. Fraser, O.B.E., E.D., M.D., CM., F.A.C.S., Medical Consultant.
K. G. Wiper, Esq., Administrative Assistant.
Mrs. G. Whelen, B.Com., Director, Research Division.  CONTENTS
Page
General Introduction  9
B.C.H.I.S. Manual of Policy, Organization and Procedure  10
British Columbia's Plan Subject of Numerous Studies  11
The Hospital Insurance Act  11
The Hospital Act  12
Methods of Payment to Hospitals   12
Application for Hospital Insurance Benefits   13
Persons Entitled to or Excluded from the Benefits under the Hospital Insurance
Act  13
Entitled to Benefits  13
Excluded from Benefits  13
Hospital Benefits Available in British Columbia  14
In-patient Benefits  14
Emergency Services and Minor Surgery  14
Hospital Benefits Available outside British Columbia  14
Organization Chart  16
Organization and Administration  15
Office of the Assistant Deputy Minister of Hospital Insurance  15
Hospital Finance Division  15
Hospital Accounting  17
Hospital Claims  18
Hospital Consultation and Inspection Division  20
Victoria Office  20
Vancouver Office  21
Hospital Construction Division  22
Hospital Projects Completed during 1959  23
Hospital Projects under Construction at Year-end     24
Projects in Advanced Stages of Planning and for Which Working
Drawings Are Completed or in the Process of Preparation  25
Additional Projects Developed through Various Planning Stages in
1959  25
Sundry Building Improvement Projects, Including the Installation of
Fixed Equipment  25
Medical Consultation Division  25
Administrative Assistant  26
Third Party Liability Section  27
Eligibility Section  27 T 8 BRITISH COLUMBIA
Organization and Administration—Continued
Research Division  28
General Office  28
Public Information  29
Hospitals as Defined under the Hospital Insurance Act  30
Public Hospitals  30
Outpost Hospitals  31
Federal Hospitals  31
Private Hospitals (Providing General Hospital Services)  31
Statistical Data  32
Table I.—Patients Discharged and Days of Care and Proportion Covered
by British Columbia Hospital Insurance Service, 1949-59  33
Table IIa.—Patients Discharged, Total Days' Stay, Average Length of Stay
According to Type and Location of Hospital, and Days of Care per
Thousand of Covered Population, 1949-59  34
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients and Short-
stay Patients, 1949-59  3 5
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 1959  35
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 1959  35
Graphs—
Major Diagnostic Categories of Illness, Excluding New-borns, in Acute-
care Hospitals in British Columbia, 1958  36
A Cumulative Percentage Distribution of the Total Number of Patients
Discharged from Hospital by Age-group with a Cumulative Percentage
Distribution Comparison by Sex Shown as Components of the Total,
1958  38
A Cumulative Percentage Distribution of Total Patient-days of All Patients
Discharged from Hospital by Age-group with a Cumulative Percentage
Distribution Comparison by Sex Shown as Components of the Total,
1958  39
Average Length of Stay of Patients in Acute-care Hospitals in British
Columbia by Major Diagnostic Categories (Excluding New-borns),
1958  40
Distribution of Patient Loads in Hospitals Providing General Service by
Type of Clinical Service, 1958  41
Statement of Receipts and Disbursements for the Fiscal Year Ended March 31st,
1959  42 Eleventh Annual Report of the
British Columbia Hospital Insurance Service
GENERAL INTRODUCTION
D. M. Cox, F.A.C.H.A., F.C.I., F.C.I.S.,
Deputy Minister of Hospital Insurance
The British Columbia Hospital Insurance Service completed its eleventh year
of operation on December 31st, 1959. This Province's comprehensive hospital
insurance programme has resulted in the establishment and maintenance of good
and efficient hospital service for the people of British Columbia.
The four most important functions of the Hospital Insurance Service are:—
To safeguard the residents of the Province from the financial burden associated
with hospitalization. Individual health standards have been raised 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 improve substantially their service to the public, by
assuring them of a steady income.
To assist communities to provide adequate facilities by administering the
grant-in-aid programme under which the Provincial Government pays 50
per cent of approved hospital-construction costs and 331/- per cent of
equipment purchases and building improvements.
To help hospitals to establish and maintain high standards of patient-care by
providing professional consultative services.
Since the inception of the Service on January 1st, 1949, approximately
$293,000,000 has been paid toward 3,190,307 hospital accounts. Of those persons
in receipt of hospital insurance benefits, 2,455,813 were in-patients in British
Columbia's acute-care public hospitals, 706,761 received benefits as emergency or
minor surgery out-patients, and 27,733 received benefits after incurring hospital
accounts while outside the Province. In addition to this financial aid extended to
hospitalized residents, grants for hospital construction and equipment have amounted
to approximately $32,000,000. At the present time, payments to British Columbia
hospitals by the Hospital Insurance Service are made at the rate of over $115,000
daily for patient-care.
During 1959 an estimated 96 per cent of all patients in the Province's 87 acute-
care general hospitals received coverage under the Hospital Insurance Service.
(This compares with an average of approximately 85 per cent coverage experienced
prior to terminating the premium-payment programme on March 31st, 1954.) The
remainder were primarily non-residents, Workmen's Compensation Act patients,
armed forces personnel, and veterans with pensionable disabilities. The average
hospital bill paid by the Service in 1959 was $145. However, beneficiaries are
covered for as long as they require hospital care for the treatment of acute conditions, and many individual bills exceeding $5,000 were paid; the largest paid in
1959 amounted to $26,166.20.
9 T  10 BRITISH COLUMBIA
From January 1st, 1949, to March 31st, 1954, eligibility for benefits was
dependent upon individual premium payments. Effective April 1st, 1954, this plan
was terminated, the registration of residents was discontinued, and twelve months'
consecutive residence within the Province became the determining factor for eligibility. On July 1st, 1958, the elegibility period for entitlement to benefits was
reduced to three consecutive months' permanent residence in British Columbia,
when the Province became a participating member of the Federal-Provincial hospital
insurance programme.
Prior to April 1st, 1959, the British Columbia Hospital Insurance Service
operated as one of the three branches of the Department of Health and Welfare.
On March 20th, 1959, this Department was reorganized to comprise three branches,
namely, Health, Mental Health Services, and Hospital Insurance—and its name
was changed to the Department of Health Services and Hospital Insurance. At the
same time the Hospital Insurance Commissioner's title was changed to Deputy
Minister of Hospital Insurance and the Assistant Commissioner became the Assistant Deputy Minister.
The continuing development of the Federal-Provincial hospital insurance programme required frequent correspondence and conferences with the Federal authorities, including visits of Federal staff to Victoria and trips by B.C.H.I.S. personnel to
Ottawa. During 1959 the Minister of National Health and Welfare set up an
Advisory Committee on Hospital Insurance and Diagnostic Services with representatives from all participating Provinces. The meetings of the Committee replace
the former Federal-Provincial Technical Conferences on Hospital Insurance. The
Deputy Minister of Hospital Insurance and the Manager of the Hospital Finance
Division were named as B.C. members of that Committee, with the Administrative
Assistant serving in an advisory capacity. In addition, the Federal Minister made
provision for technical subcommittees. The Assistant Deputy Minister and the
Director of the Research Division were designated as B.C. members of the Subcommittee on Quality of Care, Research, and Statistics.
Reports relating to the activities of the various divisions of the Service appear
elsewhere.
B.C.H.I.S. MANUAL OF POLICY, ORGANIZATION, AND PROCEDURE
From the beginning of the British Columbia Hospital Insurance Service, all
policies and procedures relating to hospitals had been outlined in a series of circular
letters which were retained on hospital files. It became apparent that there was a
need to consolidate all these instructions into a compact manual. A request of this
nature was contained in a resolution passed at the Forty-first Annual Convention of
the B.C. Hospitals Association in October, 1958. Wishing to co-operate with
hospitals through their association, the British Columbia Hospital Insurance Service
commissioned Mr. J. A. M. Moir to prepare a comprehensive manual on policy,
organization, and procedure. Mr. Moir, former supervisor of the Hospital Claims
Section and presently attending the University of British Columbia, co-ordinated the
preparation of the manual during the summer months, with the assistance of the
division managers and other senior personnel.
Copies of the completed manual, comprising 220 pages of letter-size paper,
were distributed to hospitals in October. In addition, extracts from the manual
dealing with hospital construction and admitting procedures were bound under
separate cover for use by hospital planning boards and admitting staffs. Future
changes to the manual will be made on loose-leaf paper to facilitate permanent
maintenance, and will be forwarded to all manual-holders under cover of a serial
letter of instruction. HOSPITAL INSURANCE SERVICE,  1959
T 11
The manual will be of considerable assistance to hospital personnel in the
interpretation and implementation of B.C.H.I.S. policies and procedures. Numerous
hospital administrators and administrative heads of other Provincial plans have
complimented the British Columbia Hospital Insurance Service on the preparation
of the comprehensive manual.
BRITISH COLUMBIA'S PLAN SUBJECT OF NUMEROUS STUDIES
British Columbia is considered a " pioneer " in the field of hospital insurance,
being the second Province in Canada to initiate such a programme and having completed eleven years of successful operation. As a consequence, representatives of
numerous countries and planning organizations have expressed considerable interest
in the administration and operation of the Province's plan, and the British Columbia
Hospital Insurance Service is often " host" to delegates on fact-finding missions.
In the past two years the Service has been visited by representatives from the British
Ministry of Health, the National Health Service of Chile, the Republic of Indonesia,
and the Government of Puerto Rico, as well as numerous visits from Governmental
officials of several of the Provinces and the Government of Canada.
The following list of visitors to the Service during 1959 is indicative of the
continuing interest in British Columbia's plan for hospital insurance coverage:—
March: Mr. W. J. Brown, Deputy Commissioner of the Northwest Territories,
and his assistant, Mr. R. J. Orange.
April:  Col. Laval Fortier, O.B.E., Q.C., Deputy Minister of Citizenship and
Immigration of the Government of Canada.
June: Mrs. Palmira Loyola de Lopez, representing the Government of Puerto
Rico, and Dr. Gabriela Venturini, of the School of Public Health, Santiago,
Chile.
July: Dr. E. H. Lossing, M.D., M.P.H., Dr. J. H. Horowics, LL.D., and Mr.
J. E. Sparks, from the Department of National Health and Welfare.
September:   A group of students from Iran studying at the University of
Southern California; Miss F. McCubbin, of the School of Social Work,
University of British Columbia; and Dr. Matthew Ross, medical director
of the American Psychiatric Association, and Dr. H. Vaughan.
October:  Mr. K. S. McLaren, representing the extension course on "Hospital
Administration and Management," of the University of Toronto.
November:  Miss Maja Van Steensel, chief of the Dutch section of the C.B.C.
international service, from Montreal.
December: Arrangements were being completed at the request of Dr. Louis S.
Reed,  Ph.D.,  Associate Professor of Medical Economics  at Cornell
University, Ithica, N.Y., for a visit early in January.
THE HOSPITAL INSURANCE ACT
The Hospital Insurance Act is the Statute which establishes and controls the
operation of the Hospital Insurance Service. Its main provisions may be summarized as follows:—
(1) Generally speaking, all persons who have permanently resided in British
Columbia for three consecutive months prior to going to hospital are
entitled to hospital benefits.
(2) Payment of hospital accounts for acute hospital care, including the acute
phase of any illness, and chronic conditions requiring in-patient care in
approved public hospitals. T  12 BRITISH COLUMBIA
(3) Benefits include standard ward accommodation, food and general nursing
services, the use of the operating-room, caseroom, 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. The Deputy Minister of the Hospital Insurance
Service is also the Chief Inspector of Hospitals for British Columbia under this
Statute.
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.
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. It is generally recognized that the addition of a few more
patient-days does not add proportionately to patient-day costs because certain overhead expenses (such as heating, etc.) are not affected. However, some additional
supplies will be consumed, and it is the cost of these variable supplies which 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 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. 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, which are all-inclusive; that is, the daily rate covers the cost of all the regular HOSPITAL INSURANCE SERVICE,  1959 T 13
hospital services, such as X-ray, laboratory, operating-room, etc., provided to
patients, in addition to bed, board, and nursing care.
APPLICATION FOR HOSPITAL INSURANCE BENEFITS
When admitted to an acute-care hospital, a patient wishing to apply for coverage under the hospital insurance programme is required to make an application for
benefits. The hospital is responsible for verifying the patient's statements regarding
length of residence, etc., to determine if the patient is a qualified resident as denned
under the Act and regulations. Payment of the account is then requested from the
Hospital Insurance Service, which may reject any account where statements regarding residence do not meet requirements (see Eligibility Section, p. 27).
PERSONS ENTITLED TO OR EXCLUDED FROM THE BENEFITS
UNDER THE HOSPITAL INSURANCE ACT
Entitled to Benefits
A person is considered entitled to benefits if he qualifies as a beneficiary under
the Hospital Insurance Act. Generally speaking, a person is a beneficiary if he
proves to the satisfaction of the Deputy Minister of Hospital Insurance that:—
(a) He is the head of a family or a single person who has made his home in
the Province and has lived continuously therein during the preceding three
consecutive months; or
(_>) 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.
During the three-month residence qualification period, a person is permitted
to be temporarily absent from British Columbia for a total of one month without
suffering any postponement of the date on which he becomes a beneficiary.
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.
The foregoing general description may be varied somewhat by the special
arrangements that are in effect regarding persons who move to British Columbia
from another Province which has a Federal-Provincial hospital insurance plan in
effect.
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; or
(£>) A resident who leaves British Columbia and fails to return and re-establish
residence within twelve months;  or
(c) An inmate of a Federal 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 a war veteran who receives treatment for
a pensionable disability; or T 14 BRITISH COLUMBIA
(/) Persons entitled to receive hospital treatment from the Government of
Canada or any other government; for example, members of the armed
forces or Royal Canadian Mounted Police.
HOSPITAL BENEFITS AVAILABLE IN BRITISH COLUMBIA
In-patient Benefits
In addition to standard ward accommodation with meals and general nursing
services, a beneficiary may receive any of the other services available in the hospital,
which may include:—
Laboratory and X-ray services.
Drugs, biologicals, and related preparations (with certain exceptions).
Use of operating-room and caseroom facilities.
Use of anaesthetic equipment, supplies, and routine surgical supplies.
Use of radiotherapy and physiotherapy facilities where available.
Active treatment of the acute stage of chronic disease (where it is proven to
the Deputy Minister of Hospital Insurance that treatment in an acute
general hospital is an urgent medical necessity).
Other approved services rendered by employees of the hospital.
(Note.—Private or semi-private rooms cost more to maintain than standard
wards, and a patient is required to pay extra for such accommodation.)
Emergency Services and Minor Surgery
The following services are also provided in British Columbia hospitals to
persons who do not require in-patient care:—
Emergency treatment rendered within twenty-four hours of being accidentally
injured.
Operating-room or emergency room services for minor surgery, including
application and removal of casts.
The hospital charges beneficiaries $2 for each visit. The remainder of the
cost is paid by the British Columbia Hospital Insurance Service. However, if the
patient receives treatment from a private physician, he is responsible for paying
for the doctor's services, as such charges are not payable by the Hospital Insurance
Service.
HOSPITAL BENEFITS AVAILABLE OUTSIDE BRITISH COLUMBIA
Benefits are available anywhere in the world to a beneficiary under British
Columbia's plan, if he is admitted to an approved general hospital for medically
necessary in-patient care for an acute illness or condition, within the first three
months after leaving British Columbia. This applies both to beneficiaries who are
temporarily absent from the Province and those who have moved elsewhere. The
maximum period during which coverage can be provided is three months, and this
applies only to in-patient benefits; emergency services and minor surgery rendered
to out-patients are excluded.
If hospitalization takes place in another Province that has a Federal-Provincial
hospital insurance plan, the British Columbia Hospital Insurance Service will pay
the hospital at the standard ward rate approved by the Provincial authority concerned, less $1 per day. If the daily rate includes a capital charge related to the
cost of hospital buildings or equipment, it is payable by the patient because such
items are not included in the rates charged by British Columbia hospitals.   Else- HOSPITAL INSURANCE SERVICE,  1959
T 15
where, payment will be made at a rate not exceeding $12 per day ($4 for newborn infants).
A written application for benefits must be received by the British Columbia
Hospital Insurance Service within six months of the date of admission to hospital.
If any accounts have been paid in full or in part by the patient, the application
should include receipts together with itemized statements. It is essential that
particulars of diagnosis and treatment be included. All of this information is required by the British Columbia Hospital Insurance Service before the claim may
be paid.
ORGANIZATION AND ADMINISTRATION
The British Columbia Hospital Insurance Service is a branch of the Department of Health Services and Hospital Insurance. The administrative head is the
Deputy Minister of Hospital Insurance.
The following reports give a brief outline of the work carried out by the office
of the Assistant Deputy Minister and by the various divisions and sections which
comprise the administrative structure of the branch.
Office of the Assistant Deputy Minister of Hospital Insurance
L. F. Detwiller, A.F.C., M.A., M.H.A., M.A.C.H.A., M.R.S.H.
In addition to routine administrative work, including personnel management
and liaison with the Civil Service Commission, during the year this office conducted
several studies and also took part in conferences held in Ottawa relative to the
Federal-Provincial hospital insurance plan. In this regard, the incumbent is a
member of the working party of the Sub-committee on Quality of Care, Research,
and Statistics, which has been established to review and make recommendations on
terminology, statistical data, etc., in order to establish uniformity in these fields
across Canada.
Early in the year a survey of the hospital facility requirements of the Lower
Mainland was commenced and was still under way at the year-end. Primary
analyses brought some interesting facts forward, which resulted in additional information being required in connection with the number of beds likely to be required
in Greater Vancouver for patients referred from other parts of the Province. The
British Columbia Division of the Canadian Medical Association and the Faculty of
Medicine at the University of British Columbia are conducting surveys which deal
with this problem. In addition, a metropolitan hospital committee has been formed
in Greater Vancouver which will work in co-operation with the Hospital Insurance
Service in analysing the hospital-bed allocations for the area.
This office also worked in conjunction with other divisions of the Hospital
Insurance Service in reviewing the Provincial infirmary programme.
Hospital Finance Division
W. J. Lyle, F.I.C.S, Manager
The Hospital Finance Division performs two main functions—hospital accounting and payment of hospital claims. The Division is also responsible for the
approval of equipment grants, and in 1959 recommended grants of over $600,000,
after a review of 4,000 applications received from hospitals. During 1959 the
Division Manager was appointed to the Advisory Committee on Hospital Insurance
and Diagnostic Services, which is an advisory body to the Minister of National
Health and Welfare.   Two meetings were attended in Ottawa.   Federal policies in
4 T  16
BRITISH COLUMBIA
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respect to sharing the 1958 cost of equipment grants and payments to contract,
Federal, and out-of-Province hospitals were such that the Federal Government
would have paid only one-half of its obvious share of these costs. During the
meetings in Ottawa and through correspondence, strong representations were made
for a revision of these policies. The Service received assurance that an adjustment
will be made for 1958 which will result in the sharing of these payments on an
equitable basis. It is estimated that this will increase the Federal payments
relating to 1958 hospital costs in British Columbia by at least $300,000.
During 1959, groups of officials from Ottawa, representing the Federal Departments of Finance, and Health and Welfare, visited the British Columbia Hospital
Insurance Service on three occasions to develop estimates of hospital costs, review
the situation in British Columbia, and determine what hospital services would
qualify as shareable under the agreement. The methods and procedures to be used
in arriving at shareable costs, particularly as they related to 1958 (a part year under
the agreement), involved considerable discussion and negotiation.
The Division Manager continued to perform duties as a member, and secretary,
of the Hospital Rate Board and to represent the British Columbia Hospital Insurance
Service on the Radiology Advisory Council, which acts in an advisory capacity
on the development of radiology services and purchase of equipment by general
hospitals.
The following is an outline of the duties, activities, and responsibilities of the
two sections of the Finance Division: —
Hospital Accounting
G. L. Morris, C.A., Supervisor
The Hospital Accounting staff is concerned with hospital financial operations
in relation to the budgets approved by the, Hospital Rate Board. This entails
visits to hospitals to review financial and statistical records and procedures. These
visits, extending from three days to three weeks, were made to eighty-five public
hospitals during 1959. Accounting assistance and instruction were also provided
on request to smaller public hospitals in the Province.
Other functions performed by the Hospital Accounting staff included:—
(a) The tabulation of monthly statistical and financial reports from hospitals
and the correlating of these with the approved budgets.
(b) The determination of the semi-monthly cash advances to be made to
hospitals.
(c) Checking and amending annual financial and statistical reports prepared
by hospitals for the Dominion Bureau of Statistics and the Department
of National Health and Welfare.
(d) The carrying-out of accounting inspections and cost studies of nursing
homes and chronic institutions upon the request of the Social Welfare
Department for welfare payment purposes.
(e) The auditing of accounts of hospital-construction projects to determine
the amount of construction grants payable by the Province.
During 1959 fifteen completed construction projects, involving an expenditure
of over $10,500,000, were audited and the required statements prepared for the
Federal Government in order that Federal construction grants could be claimed by
the hospitals.
Experience during the first few years' operation of the British Columbia Hospital
Insurance Service indicated that operating costs required serious consideration when
planning new hospitals and additions to existing hospitals.   In order to ensure that T 18 BRITISH COLUMBIA
plans for new hospitals or hospital additions are 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 area. These estimates are
submitted to the British Columbia 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 addition compare 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 the hospital board to revise its 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 British Columbia Hospital
Insurance Service, the hospital boards are required to provide written guarantees
relative to the projected operating cost. It is considered that this method of
approaching the operating picture for proposed hospital facilities ensures more
satisfactory planning, efficient use of hospital personnel, and an economical
operation.
The sharing of hospital costs by the Federal Government from July 1st, 1958,
resulted in the Hospital Accounting Section becoming responsible for the preparation
of much additional financial and statistical information required under the provisions
of the Federal Hospital Insurance and Diagnostic Services Act. This has also
required changes in the accounting system of British Columbia hospitals, involving
more detailed Departmental financial accounts and an extension of statistical
requirements. Close liaison with Federal Health and Treasury Department officials
was maintained and procedures developed for further co-operation. During the
year our accounting staff reviewed hospital operating statements for 1958 and
prepared the required schedules for submission to the Federal Treasury auditors
for eighty-four public hospitals. As the Federal hospital insurance sharing arrangement is complex, particularly for a part year, this procedure called for a considerable
amount of detailed work, in order that the numerous items of revenue and expenditure which are not shareable under the agreement might be accurately determined
and deducted from each hospital's operating expenses.
In co-operation with the Comptroller-General for British Columbia, monthly
claims, covering payments already made by the Province, were prepared and forwarded to Ottawa. The 1958 Annual Report on Hospital Statistics for British
Columbia was prepared by this office.
Hospital Claims
W. J. Wade, Supervisor
During the year, in addition to the routine work described on the following
pages, this staff undertook to consolidate all instructions to hospitals for the completion of the admission-discharge form so that an initial chapter of a proposed manual
for hospitals could be written. This work was commenced in March and the completed draft presented in June. Further portions of the manual subsequently were
prepared in respect to other matters involving hospital accounts and procedures.
The Hospital Claims staff is responsible for processing all admission-discharge
records which hospitals submit for each patient, and approving for payment all
acceptable claims. Every claim is checked by this office, whether it is payable
by the British Columbia Hospital Insurance Service or by the patient or other agency.
Approximately 1,300 claims were processed each working-day during 1959. HOSPITAL INSURANCE SERVICE,  1959 T  19
The sections participating in this work and a brief outline of their duties
follow.
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 are checked with the verifying documents.
Discrepancies may be checked either with the hospital concerned or by referral for
investigation by 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 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, such as the British Columbia Hospital Insurance, the Workmen's Compensation Board, the Department of Veterans' Affairs, or perhaps another
Province having a plan in force.
During the year a total of 290,709 accounts were paid, compared with 274,694
in 1958 and 257,398 in 1957. A good portion of the increase of 26,015 resulted
from the adoption of a three-month residence requirement from July 1st, 1958,
prior to which a twelve months' residence was required to obtain insurance benefits.
The larger number of accounts paid can also be attributed to the British Columbia
Hospital Insurance Service accepting responsibility for bills incurred by recipients of
war veterans' allowance, sick mariners, and others, whose hospital care prior to the
signing of the Federal-Provincial Hospital Insurance Agreement was a responsibility
of the Federal Government. The increase in the number of hospital beds during
the year was another contributory factor.
The Social Welfare Records Section maintains an alphabetical file of all health
services identity cards issued to welfare recipients for this Province. Hospital
accounts incurred by welfare patients are checked against this file to determine
eligibility for hospital benefits. This file is used as a source of reference by the
Department of Social Welfare.
The Vouchering and Key-punch Sections are responsible for batching and
voucherins checked accounts in order to determine the amounts payable to each
hospital, and for the preparation of I.B.M. cards to record statistical, financial, and
medical data.
Approximately 2,000 cards were processed daily, which formed the basis
from which this office prepared tabulated listings of accounts paid to hospitals.
The Out-of-Province Section administers the screening and pavment of accounts
incurred bv B.C. residents in hospitals outside the Province. This includes obtaining
an Application for Benefits and establishing that the patient is entitled to have
payment made on his behalf.
Diirinrr 1959 a total of 2,910 accounts, amounting to $351,750 were p^'d
on behalf of qualified residents who were hospitalized in other Provinces of Canada,
the United States, Mexico, British West Indies, the United Kingdom, Eire, Australia,
France, Switzerland, Italy, Holland, West Germany, Norway, Denmark, Sweden,
Hong Kong, and Japan.
The commencement of hospital insurance plans in other Provinces under the
Federal Hospital Insurance and Diagnostic Services Act resulted in certain problems
related to the pavment of out-of-Province accounts. These payments are now
made at the standard per diem rates established by the Province concerned (less
the $l-a-dav charge) as compared to the previous flat rate for all out-of-Province
hospitals. Hospital insurance plans were previously in effect in Alberta, Saskatchewan, Manitoba, and Newfoundland, and during 1959 the following commenced T 20 BRITISH COLUMBIA
operations: Ontario, January 1st, 1959; Nova Scotia, January 1st, 1959; New
Brunswick, July 1st, 1959;  and Prince Edward Island, October 1st, 1959.
The Filing Section sorted and filed an average of 4,000 forms and letters
daily. Patients' records for the year 1958 were microfilmed by the Central Microfilm Bureau of the Provincial Library: 846,872 documents were processed, using
29,000 feet of film. An additional 1,900 feet of film was used to process out-of-
Province accounts and rejected claims. This use of a microfilm eliminated the
need for approximately sixty steel filing-cabinets. It also provided the Service
with a set of duplicate records by running two copies of the film.
The Hospital Claims office continued to maintain close co-operation with the
Medical Consultant's staff, obtaining technical advice on medical data for all in-
Province and out-of-Province claims.
Hospital Consultation and Inspection Division
J. W. Mainguy, M.H.A., Manager
This Division consists of two offices—the Victoria office, which is chiefly
concerned with work related to the Province's approved public hospitals, and the
Vancouver office, whose major activity is in connection with the licensing and
inspection of private hospitals.
Victoria Office
During 1959 this office was involved in a variety of activities, which included
visits to hospitals; the analysis related to budget preparation carried out in conjunction with the Finance Division; the review of draft by-laws with the Administrative Assistant; the provision of tabulated wage-rate information and other
personnel information to hospitals; assisting in reviewing plans for new hospitals
and for renovations; participation in activities related to the responsibilities of the
Hospital Rate Board, of which the Manager of the Division is a member; and the
provision of information to hospitals and Provincial plans in answer to widely
diversified questions on administrative problems.
Compared with 1958, there was an increase in the number of inspections made
by the Victoria office to private hospitals and a decrease in the number made to
general hospitals. The resignation of a Hospital Inspector in mid-year to accept
a position at the University of Toronto was a significant factor in the decrease
of general hospital inspections, as a replacement could not be secured until late in
the year. Thirty-five visits were made to private hospitals to assist the Vancouver
office, specifically in the field of nursing care, and forty-seven visits were made to
thirty-six public general hospitals, some of which lasted up to four days, and were
carried out by two members of the Division.
Working in conjunction with the Health Branch, members of this office helped
to prepare and to conduct a dietary institute at Prince George, where twenty-four
cooks from twenty-two hospitals and institutions which do not have dieticians
were in attendance for five days. The course, which stimulated considerable interest,
was a successor to the one held at Cranbrook in 1958. Facilities were provided by
the Prince George Hospital. The Victoria office also participated in the preparations
for the civil defence orientation course for hospital administrators, organized by
the Provincial civil defence authorities and held in Victoria in November. Assistance
is also being provided for a course for directors of nursing in January, 1960.
The Division Manager continued to represent the British Columbia Hospital
Insurance Service on the Laboratory Advisory Council, which acted in an advisory
capacity on matters related to laboratory services and equipment in general hospitals.
In this capacity the Manager participated in a survey by a sub-committee of the
Council of regional pathology services in the West Kootenay. HOSPITAL INSURANCE SERVICE,  1959 T 21
A close relationship was maintained with the Provincial Fire Marshal during
the year in order that fire safety in hospitals could be improved upon.
Members of this Division maintain close liaison with the Health Branch.
Contact was made with Medical Health Officers and their staffs in the field; with
the Technical Supervisor, Clinical Laboratory Services; and the Technical Adviser
of Radiology. During the year the services of a dietician from the Health Branch
were made available to the Division, and inspection visits have been carried out
to hospitals as the result of close working relations between the dietician and
members of this Division.
The Division assisted the Hospital Construction Division on a project to develop
detailed plans of nurses' stations and utility rooms.
Considerable information was obtained from hospitals regarding their drug
formularies and methods of developing these. This material was made available
to the Faculty of Pharmacy of the University of British Columbia for its continuing
survey on pharmacy practices in hospitals, undertaken at the request of the
Hospital Insurance Service.
A member of the Victoria office is on the Institute Planning Committee for
directors of nursing, which will be holding an institute early in 1960 for directors
of nursing under the auspices of the Registered Nurses' Association of British
Columbia.
Assistance was given to the Public Information Office in the preparation and
editing of articles of general interest in hospital operation which were printed in
the British Columbia Hospital Insurance Service Bulletin. A revised personnel
manual was made available to hospitals.
Vancouver Office
One of the functions of the Hospital Insurance Service is the administration
of the Hospital Act, and matters pertaining to hospitals which are licensed under
Part II of the Act are handled chiefly through this office. The category " private
hospital" includes some small general hospitals, most of which are operated in
remote areas by industrial concerns, but includes, chiefly, facilities giving skilled
nursing care to the aged sick. Most of these facilities are operated for profit by
private operators or companies.
This office maintained a continuing programme of food service inspection and
consultation, under the guidance of a part-time consulting dietician. A three-week
rotating menu pattern was sent to all hospitals to give guidance in the provision
of nutritious meals which can be served attractively yet inexpensively. The dietician
visited fifty private hospitals during the year. The consulting dietician from this
office took an active part in the Food Service Institute in Prince George.
In addition to the dietary inspections mentioned above, ninety-two regular
inspections and eight special visits were made by this office, and thirty-five additional visits were made by personnel from the Victoria office, making a total of 185
visits to private hospitals during the year by the Division. Provincial and
municipal fire, electrical, and sanitary inspectors also carried out inspections.
At the request of the Health Branch, a special study was undertaken of the
type of patient accommodated and the service provided in the licensed private
hospital in Vancouver operated by the British Columbia Cancer Foundation. The
study was carried out jointly by personnel from the Victoria and Vancouver offices.
Forty-seven new private-hospital beds were licensed in 1959. There were
137 inquiries from persons actively interested in establishing private hospitals. This
was an increase of sixty-three over last year. At the year-end there were 130
private-hospital beds under construction, of which eighty-six were beds in new T 22 BRITISH COLUMBIA
buildings designed for private-hospital operation. A number of plans for new
private hospitals were on the planning boards of architects. Beds in operation at
the end of 1959 were: 1,860 beds for the aged and infirm, licensed in fifty-six
private hospitals, and 170 beds licensed in seven private acute hospitals, making
a total of 2,030 beds.
The Manager of the Division has been appointed to the Welfare Institutions
Board, and this will help to maintain an even closer liaison between this Division
and those involved in the licensing of boarding homes.
Another major activity of this office is in the field of hospital clearance. This
procedure is a method of moving, from acute general hospitals to more suitable
facilities, welfare patients who no longer require the specialized services of an acute
general hospital but who do need care beyond that which could be given in their
own home. The actual work of placing these people is done by the Department of
Social Welfare at the request of this office. In 1959 this office asked Social Welfare
to arrange placement for 110 patients.
Hospital Construction Division
A. W. E. Pitkethley, Manager
This Division has three main responsibilities:—
(1) Providing a consultative service to general hospitals when planning new
hospital facilities, renovations, or additions to existing buildings.
(2) Processing and recommending for approval applications for Provincial
grant assistance toward the cost of capital construction and improvements. Preparing applications for submission to the Federal Government
for Federal grants toward the cost of construction projects.
(3) The administrative supervision of the Marpole Provincial Infirmary, in
Greater Vancouver, and the branch in Victoria and Haney. (The
Manager of this Division serves as secretary of the Advisory Board of
Management of the Provincial Infirmaries.) These institutions have a
total bed capacity of 283 beds, and during the year had occupancies
ranging from 80.6 to 83.7 per cent.
A great deal of time is spent reviewing plans of proposed new facilities forwarded by hospitals. Special attention is given to the design and layout of each
building to ensure that it can provide an excellent standard of patient-care, efficient
and economical operation, and adequate service and clinical facilities for potential
future expansion. With the co-operation of other divisions of the Hospital Insurance
Service and the Health Department, hospital boards are provided with a complete
consultative service. Assistance is secured from the Consultation and Inspection
Division and the Finance Division and Research Division of the British Columbia
Hospital Insurance Service, as well as the Division of Public Health Engineering, the
Consultant in Nutrition, the technical adviser to the Laboratory Advisory Council,
the technical adviser to the Radiological Advisory Council, and the Public Health
Officers, all of the Provincial Department of Health. In addition, the Professor of
Paediatrics of the Department of Medicine of the University of British Columbia gave
valuable assistance in reviewing plans for paadiatric and nursery facilities. The chief
of the Hospital Design Division of the Federal Government gave advice on selected
problems in hospital design. Consultant services on selected engineering problems
were also available to this Division, through the co-operation of the Provincial
Public Works Department.
During the year, arrangements were concluded with the Provincial Public
Works Department whereby architectural and drafting services were allocated to HOSPITAL INSURANCE SERVICE,  1959
T 23
this Division. Intensive study has been given to various components of hospital
design and layout, and in particular a detailed survey and study was undertaken of
the layout of nursing units. To assist in making the study, a seventy-page questionnaire was circulated to representative hospitals asking for comments and observations
from hospital personnel at the nursing level. The valuable information contained
in the answers to the questionnaire is at present under study, but has already been
used as a basis for developing sketches for the hospitals and the architects retained
by them.
The Division maintained liaison with the Hospitals Committee of the
British Columbia Medical Association, which is co-operating in the study of selected
problems referred to it.
Special study committees were set up by the Registered Nurses' Association of
British Columbia to study and report, from a nursing view-point, on projects
referred to them by the Hospital Construction Division. These projects include a
study of nursing units and nurses' stations and the concept of " progressive patient-
care."
The Architectural Institute of British Columbia has formed a hospital committee as a liaison body to work with the British Columbia Hospital Insurance Service on special problems, such as the relationship of architects and their consultants,
and the interpretation to be placed on the terms respecting their conditions of
engagement.
The number of inspection trips to hospitals carried out by this Division
increased considerably over previous years.
(a)  Hospital Projects Completed during 1959
Surrey Memorial Hospital.—The new hospital, officially opened on January
31st, 1959, was originally planned to provide 62 beds, with space for an additional
44 beds left in an unfinished state. However, before the end of 1959 the tremendous
growth of the area made it necessary to bring 106 beds into operation. Eleven of
these beds met a particular need for additional pa_diatric accommodation in the area.
Future expansion of this hospital can be achieved by construction of wings to bring
the eventual capacity to over 300 beds.
Tofino General Hospital.—Early in 1959 the new 9-bed staff residence became
available for accommodation.
Lillooet District Hospital.—On May 6th, 1959, the official opening was held
for the new 16-bed hospital. In addition to the 16 beds, there is unfinished space
for 4 additional beds that can be quickly brought into operation when necessary.
A separate staff residence to accommodate ten persons was also completed.
Burnaby General Hospital.—The official opening ceremony for the new
addition was held on May 9th, 1959. The wing accommodates 100 active-treatment
beds and also provides space for the emergency department, laboratory, physiotherapy facilities, and a new operating suite. The alterations to the existing hospital
building were completed in October, 1959, and provided a net gain of 23 beds.
Prince George and District Hospital.—The new 45-bed staff residence was
officially opened on May 13th, 1959. The residence is a frame-constructed two-
story building and is generously provided with recreation and lounge facilities.
Chilliwack General Hospital.—The completion of the new wing and the
renovations to the former main building were commemorated at an official opening
ceremony on June 6th, 1959. The hospital now has accommodation for 146 adults
and children, together with 28 bassinets for the new-born. T 24 BRITISH COLUMBIA
Bella Coola General Hospital.—The new staff residence was completed in
June, 1959. The building replaces the old two-story frame residence and provides
accommodation for fifteen hospital employees.
Vancouver General Hospital Centennial Pavilion.—The opening and dedication
ceremonies for the Centennial Pavilion were held on June 30th, 1959. The construction of this ten-story building commenced in August, 1955. It includes a
separate laundry building and emergency department connected to and forming
part of the new unit. The bed accommodation and services include 504 acute beds
in single and 4-bed rooms, surgeries, a 16-bed recovery ward, X-ray department,
laboratory, dietary department, administrative areas, stores, and central sterile-
supply department.
The hospital also converted its heating-boilers from coal-firing to gas-firing,
with oil as a stand-by fuel.
Grace Hospital, Vancouver.—On July 3rd, 1959, the new wing was officially
opened. This addition to the hospital constitutes the main part of a building
programme which included alterations to the existing hospital building and a new
boiler-house. The increase in bed capacity totals 44 beds and 55 bassinets, the
new wing accounting for 30 beds and 32 bassinets.
Kootenay Lake General Hospital, Nelson.—The hospital society took possession of the new 12-bed staff residence on August 1st, 1959.
Shuswap Lake General Hospital, Salmon Arm.—This new 50-bed hospital
was officially opened on October 9th, 1959. The hospital is a two-story reinforced-
concrete building in the form of a modified " T," and has been planned for future
expansion to 85 beds.
St. Mary's Hospital, New Westminster.—During the latter part of 1959, structural changes were completed at this hospital which made it possible to increase the
pa-diatric bed accommodation by 24 beds. The revised capacity figure for the hospital is now 170 A. and C. beds. It is of interest to note that the co-operation of
St. Mary's Hospital and the Surrey Memorial Hospital, in providing, at a nominal
cost, increased accommodation for paediatrics met a very urgent and immediate need
for additional children's beds in the area. Their action also saved the Royal Columbian Hospital expending approximately $300,000 on a Class B type of unit intended
to be used for paediatrics on a temporary basis.
(ft)  Hospital Projects under Construction at Year-end
Burns Lake Hospital:  New 36-bed hospital building.
Golden General Hospital:  New 24-bed hospital building.
Kimberley and District Hospital: New 48-bed hospital building.
King's Daughters' Hospital, Duncan:  Addition for a recovery ward.
Kitimat General Hospital: New 82-bed hospital, plus accommodation for
thirty-nine hospital employees. (Note.—The initial patient accommodation at this
hospital has been reduced from 113 to 82 beds. This reduction is a result of a cutback in expansion plans of the Aluminum Company of Canada.)
Lions Gate Hospital, North Vancouver: Construction of a new 283-bed hospital.
Prince George and District Hospital: A new 125-bed hospital.
St. Joseph's General Hospital, Dawson Creek: A new 60-bed hospital building.
Vancouver General Hospital:  Mechanical services project. HOSPITAL INSURANCE SERVICE,  1959 T 25
(c)  Projects in Advanced Stages of Planning and for Which Working
Drawings Are Completed or in the Process of Preparation
Matsqui-Sumas-Abbotsford General Hospital, Abbotsford: Completion of 17
additional beds.
Nanaimo General Hospital:   158 beds.
Royal Columbian Hospital, New Westminster: Nurses' residence and training-
school, and new laundry building.
Royal Jubilee Hospital, Victoria: 64 additional beds, plus areas for diagnostic
treatment facilities.
Terrace and District Hospital:  40 beds.
Vancouver General Hospital: Construction of combined locker area; alterations to physical medicine department.
Wrinch Memorial Hospital, Hazelton: Addition for emergency and administration areas.
(d)  Additional Projects Developed through Various Planning Stages in 1959
Children's Hospital, Vancouver:  Expansion plans.
Langley Memorial Hospital, Murrayville:  Expansion programme.
Mater Misericordias Hospital, Rossland: Demolition of old wing and replacement of essential facilities.
McBride and District Hospital:  21 beds.
Mission Memorial Hospital:  54 beds.
Nicola Valley Hospital, Merritt:  New hospital.
Powell River General Hospital:  Expansion plans.
Providence Hospital, Fort St. John:  60 beds.
Royal Inland Hospital, Kamloops: Alterations and additions to bring capacity
up to 230 beds.
St. John Hospital, Vanderhoof:  Addition.
St. Joseph's Hospital, Victoria: 31 additional beds, plus alterations to existing
building.
St. Paul's Hospital, Vancouver:  Laboratory department and laundry addition.
Vancouver General Hospital:  Renovation of Laurel Pavilion.
Vernon Jubilee Hospital:   Addition to provide 21 additional beds.
War Memorial Hospital, Williams Lake:   70 beds.
(e)  Sundry Building Improvement Projects, Including the Installation of
Fixed Equipment
During the year this Division processed almost 250 applications for grants to
assist in financing the cost of structural improvements and building alterations, including fixed equipment. The cost of these projects totals approximately $183,000,
and ranged in cost from over $25,000 to less than $50.
Medical Consultation Division
W. A. Fraser, O.B.E., E.D., M.D., CM., F.A.C.S., Medical Consultant
Under the Hospital Insurance Act and regulations, benefits are available to
qualified persons admitted to hospital upon recommendation of the attending physician. Each admission to hospital is subject to a medical eligibility review, which is
one of the main responsibilities of the Medical Consultant's Division, with particular
attention being paid to length of stay in hospital of patients receiving hospital insurance benefits.   For statistical purposes this Division is also responsible for the check- T 26 BRITISH COLUMBIA
ing and accurate coding of the diagnoses and other pertinent medical data on the
discharge records.
The work of coding according to the Manual of the International Statistical
Classification of Diseases, Injuries, and Causes of Death has been made more efficient by the addition of two medical coders, making a total of five. This has made
it possible to furnish the Research Division with additional information concerning
bed distribution in the Province. A breakdown of the discharge diagnoses into bed
services, such as adult medical, adult surgical, obstetrical, new-born, pa_diatric
medical, pediatric surgical and psychiatry, has been instituted. This information
has been of considerable value to the Research and Hospital Construction Divisions
in determining bed requirements in areas where new hospital construction is contemplated.
Comparative studies were carried out on the length of stay in five of the larger
hospitals in the Province, and assistance was given to a survey of patient transfers
being carried out to determine Lower Mainland hospital requirements. Posting of
all alcoholic admissions to hospitals throughout the Province is maintained to establish the number of apparent cures.
Early in January, 1959, negotiations were started with the College of Physicians
and Surgeons of British Columbia and the Canadian Medical Association, British
Columbia Division, for the setting-up of a Medical Consultation Board. On April
17th, 1959, Order in Council No. 784 authorized the establishment of a Medical
Consultation Board to consist of four medical practitioners " for the purpose of
reviewing and advising on questions of medical eligibility for hospital insurance
benefits and other medico-administrative matters affecting the operation of the
British Columbia Hospital Insurance Service." Undoubtedly, this Consultation
Board will prove of great assistance to the Medical Consultant.
Recently the Vancouver General Hospital appointed an administrative assistant
—medical, whose duties will include answering queries concerning hospital admissions and medical eligibility for hospital insurance benefits. Due to the size of the
hospital and its position as the principal teaching unit of the Medical Faculty, this
appointment should be of advantage to the Medical Consultant's Division and will
result in a more efficient method in handling hospital claims of the Vancouver
General Hospital.
Mrs. Margaret Morrison, Assistant to the Medical Consultant, successfully
completed a two-year extension course to qualify as a medical record librarian.
As this Division deals extensively with hospital medical record departments, Mrs.
Morrison's qualifications will result in a better liaison with the various hospital staffs
and medical record librarians.
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 is 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. HOSPITAL INSURANCE SERVICE,  1959 T 27
This office collaborates with the Water Rights Branch of the Department of
Lands and Forests and the Chief Electoral Officer in assisting communities in
unorganized territory to establish hospital improvement districts for the purpose
of raising funds by money by-laws for constructing and improving hospital facilities
in the area. At the end of 1959 there were twenty-six such districts in operation
and a number of others in the process of formation. Descriptive material outlining
the procedure for establishing such a district is supplied upon request to interested
groups.
During 1959 considerable time was spent on matters connected with the
Federal-Provincial hospital insurance plan. Statutes, regulations, and the Federal-
Provincial agreement were amended and extensive discussions were held with
officials of the Federal Government and other Provincial plans to remove administrative difficulties and provide for better liaison.
This official was also a member of the editorial board which edited the manual
described elsewhere in this Report and is responsible for co-ordinating the processing of future amendments to this manual.
The Administrative Assistant is responsible for over-all supervision of the
Eligibility and Third Party Liability Sections.
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.
Eligibility Section
In order to ensure that only qualified British Columbia residents receive
hospital insurance benefits, the staff of the Eligibility Section review all applications
for benefits made by or on behalf of patients admitted to hospital. A detailed check
is made of all doubtful applications, resulting in a considerable number of unqualified claims for B.C.H.I.S. benefits being rejected.
Eligibility Inspectors visit hospitals on a regular schedule to see the B.C.H.I.S.
eligibility procedures are being properly carried out. The Inspectors also assist
in the training of new hospital admission and eligibility staff members. In this
regard, regional meetings were held in 1959 in a number of centres for the purpose
of bringing together hospital personnel for panel discussions dealing with problems
connected with the admission of patients to hospital and their status under the
Hospital Insurance Act.
This Section has provided the great majority of employers in British Columbia
with books of employers' certificates. The Inspectors maintain close liaison with
these firms to ensure their continuing co-operation in providing their employees
with proof of residence for hospital insurance purposes by means of these certification forms. T 28 BRITISH COLUMBIA
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.
Research Division
Mrs. G. E. Whelen, B.Com., Director
The main functions of the Research Division are:—
(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 compilation of data which are not directly available from other divisions in
the Service.
In 1959 reassessments of bed needs were made for the Prince George and
District Hospital, the new Fort St. John Hospital, the Matsqui-Sumas-Abbotsford
Hospital, the Mission Memorial Hospital at Langley, the new Lions Gate General
Hospital in North Vancouver, and the Terrace and District Hospital. A study of the
bed needs in the Cariboo region and the McBride area was also completed during
the year and the findings published. Statistical tables were completed and referred
to the local planning committees in a report entitled " Interim Statistical Tables Pertaining to Hospital Facilities in the Lower Mainland Area." Work is continuing on
the study of bed needs in the Southern Okanagan and Central Border region, and
the results will be published next year.
Many requests for statistical data were received during the year, not only from
other divisions in the Service, but also from hospital administrators and unallied
organizations such as the Myasthenia Gravis Foundation of Vancouver, the Canadian Arthritis and Rheumatism Society, the Committee on Welfare of the Aged,
Community Chest Council of Greater Vancouver, and the British Columbia Safety
Council.
The Director of Research was sent to Ottawa as a representative of British
Columbia to attend the meeting of the Sub-committee on Quality of Care, Research,
and Statistics, held in conjunction with the Federal-Provincial hospital insurance
plan. The purpose of this Committee was to provide for an exchange of information
relating to Provincial experiences and plans and to make decisions regarding the type
of Provincial statistical information required under uniform terminology. This will
enable the Federal Government to assess health needs on a country-wide basis. The
conclusions reached at this meeting and forthcoming meetings will likely result in
some reassessment of the work procedures in this Division.
General Office
C. R. Leighton
The General Office is responsible for the recording and accounting of all
receipts and expenditures incurred in the administration and operation of the Hospital Insurance Service. All requisitions, vouchers, or warrants emanating from
divisions or sections are reviewed by this office and passed to the appropriate Government department for further action.
The General Office accounting responsibilities include a check of certain
accounts and the preparation of estimates. Departmental purchasing is handled by
this Office, which also assumes responsibility for furniture inventories, stock-supplies, HOSPITAL INSURANCE SERVICE,  1959 T 29
operation of the teletype service, operation of office equipment, and the storage and
dispatch of forms for hospitals.
Certain personnel matters are dealt with by the General Office, and pay and
personnel records are kept by the pay clerk.
The preparation of Infirmary estimates is supervised by the General Office.
Expenditures are controlled by routing all requisitions and vouchers through this
office, which also audits the Infirmary accounting and prepared monthly statements
of expenditures.
The monthly comfort allowance received by all Infirmary patients is paid to
Mount St. Mary patients by General Office personnel. This office also acts as liaison
between the Mount St. Mary authorities and the Infirmary business manager.
Public Information
R. H. Thompson
It is the responsibility of this office to develop and administer the public information activities of the Service. The following is a brief outline of the methods
by which these responsibilities were carried out:—
B.C.H.I.S. Bulletin.—The principal purpose of the Bulletin is to serve as an
administrative aid to clarify, for hospitals, policy and procedure changes.
Regular editions of the Bulletin were distributed to over 100 B.C.
hospitals. During the year certain articles of general interest to hospital
authorities were included; such as, " Fire Prevention and Training,"
" Principles for the Purchasing Agent," " Laundry Operation," " The
Teen-age Volunteer," etc.
Pamphlets.—The pamphlet " Serving You," distributed to hospitals in 1956,
was considerably revised and will be reprinted early in the new year under
the title "At Your Service." Its main purpose is to assist hospitals in
explaining various aspects of the Hospital Insurance Service and hospital
routine to the patient. The " General Information " pamphlet was revised
in October and in April, and copies were distributed to the general public,
hospitals, civic organizations, business firms, etc.
Press Releases.—Weekly releases on the Service's grant-in-aid programme were
sent to the Province's newspapers and rad'o and television stations.
During the year a photographic record was made of each new hospital, by
a member of the Photographic Branch of the Department of Recreation
and Conservation, in conjunction with the news coverage of the official
opening.
Articles.—Several articles on various aspects of the Service, such as the extensive hospital-construction programme under way during the year, were
prepared for submission to B.C. newspapers and the British Columbia
Government News, and regular contributions were submitted each month
to The Canadian Hospital, official journal of the Canadian Hospital Association.
Displays.—At the request of the executive of the British Columbia Hospitals'
Association, a display illustrating the accomplishments of eleven years of
hospital insurance was prepared for its forty-second convention in Vancouver. This display was also exhibited at the Public Health Institute
held in Victoria in October. Assistance was also provided in the development of a new B.C.H.I.S. exhibit in the British Columbia Building at the
Pacific National Exhibition. T 30
BRITISH COLUMBIA
Film Library.—Numerous hospitals made use of the 16-mm. sound films for
instructional purposes regarding hospital operation and activities. The
films are available on a loan basis.
Miscellaneous duties included answering letters of general inquiry; writing
special material, for example, " Ten Years in Review," "A Community Builds a
Hospital," and " Reference Material on B.C.H.I.S." (a comprehensive review of
the programme since its inception); supervising the production and distribution
of the B.C.H.I.S. manual and subsequent additions; maintaining the newspaper-
clipping files; writing material requested by various organizations for use in information pamphlets, etc., and preparing and producing the Eleventh Annual Report.
During the year, assistance was given to the office of the Provincial Civil Defence Co-ordinator in the handling of public relations activities for civil defence
orientation courses for hospital personnel, held in Victoria.
HOSPITALS AS DEFINED UNDER THE HOSPITAL INSURANCE ACT
(Designated by Order in Council No. 1391 of 1958, Effective July 1st, 1958)
Part I
Hospitals defined as such under section 2 of the Hospital Act:—
(a) Public Hospitals
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.
Castlegar and District Hospital, Castlegar.
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,
Enderby.
Esperanza General Hospital-, Ceepeecee.
Fernie Memorial Hospital, Fernie.
Fort Nelson General Hospital, Fort Nelson.
Golden General Hospital, Golden.
Grace Hospital, Vancouver.
Grand Forks Hospital, Grand Forks.
Kelowna General Hospital, Kelowna.
Kimberley and District General Hospital
(McDougall 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.
Maple Ridge Hospital, Haney.
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, Victoria.
Queen Charlotte Islands General Hospital,
Queen Charlotte City.
Queen Victoria Hospital, Revelstoke.
Quesnel General Hospital, Quesnel.
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. HOSPITAL INSURANCE SERVICE,  1959
T 31
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.
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.
(b) Outpost Hospitals
Red Cross Outpost Nursing Station, Alexis
Creek.
Red Cross Outpost Nursing Station, Atlin.
Red Cross Outpost Nursing Station, Bam-
field.
Red Cross Outpost Nursing Station, Blue
River.
Red Cross Outpost Nursing Station, Edge-
wood.
Red Cross Outpost Nursing Station, Hudson
Hope.
Red Cross Outpost Nursing Station, Kyu-
quot.
Red Cross Outpost Nursing Station, Lone
Butte.
Red Cross Outpost Nursing Station, Masset.
Sacred Heart Nursing Home, Hanceville.
Stewart General Hospital, Stewart.
(c) Federal Hospitals
Veterans' Hospital, Victoria.
Shaughnessy Hospital, Vancouver.
Coqualeetza Indian Hospital, Sardis.
Miller Bay Indian Hospital, Prince Rupert.
Nanaimo Indian Hospital, Nanaimo.
R.C.A.F. Station Hospital, Holberg.
Part II
Private hospitals which are defined as such under section 8 of the Hospital Act,
and with which the Province has entered into an agreement requiring the hospital
to furnish the general hospital services provided under the Hospital Insurance Act:—
Bralorne Private Hospital, Bralorne.
Cassiar Asbestos Corporation Private Hospital, Cassiar.
Chatham House Private Hospital, Vancouver.
Gold Quartz Hospital, Wells.
Hollywood Sanitarium, New Westminster.
Kitimat Hospital, Kitimat.
Medical-Dental Hospital Unit, Vancouver.
Port Alice Private Hospital, Port Alice. T 32 BRITISH COLUMBIA
STATISTICAL DATA
The tables on the following pages represent statistical data compiled by the
Hospital Finance Division. The data deal with the volume of hospital insurance
coverage provided to the people of British Columbia through the Hospital Insurance
Service. Eighty-seven public hospitals were approved in 1959 to accept B.C.H.I.S.
patients. In addition, care was provided in nine outpost hospitals, six Federal hospitals, and eight private hospitals (see page 31). Data for the year 1959 have
been estimated from reports submitted by hospitals to November 30th, and are subject to revision when actual figures for the year are submitted.
Table I shows that in 1959 the British Columbia Hospital Insurance Service
paid public hospitals in British Columbia for 2,267,728 days of care for adults and
children, an increase of 97,831 days or 4.5 per cent over 1958. A total of 235,068
B.C.H.I.S. adult and children patients were discharged from British Columbia public
hospitals in 1959, an increase of 13,022 or 5.9 per cent over the previous year.
This table also shows that 96 per cent of the total patients discharged from British
Columbia public hospitals in 1959 were covered by hospital insurance, compared
with 91.8 per cent in 1957 and 94.1 per cent in 1958. The increase in the percentage
of insured patients, to a large extent, is due to a reduction in residence requirements
on July 1st, 1958, from twelve to three months.
As is shown in Table IIa, the average length of stay of B.C.H.I.S. adult and
children patients in British Columbia public hospitals during 1959 was 9.65 days,
a slight decrease from the preceding year. The increase from 1,626 days of care per
thousand population in 1957 to 1,724 in 1959, as shown on the notation to Table
Ha, is in part due to the inclusion of War Veterans' Allowance patient-days, which
were previously paid for by the Federal Government, but under the Federal-Provincial hospital insurance programme are a Provincial responsibility. HOSPITAL INSURANCE SERVICE,  1959
T 33
Table I.—Patients Discharged and Days of Care and Proportion Covered
by British Columbia Hospital Insurance Service, 1949-59
Total Hospitalized
Covered by B.C.H.I.S.
Adults
and
Children
Newborn
Total
Adults
and
Children
Newborn
Total
Patients discharged—
1949  	
1950 	
1951       	
1952     	
1053
164,964
172,645
181,160
188,355
200,893
206,992
216,743
227,359
228,917
236,859
245,881
26,272
26,205
27,096
28,675
30,712
31,984
33,190
35,118
37,376
38,374
38,936
191.236
198,850
208,256
217,030
231,605
238,976
249,933
262,477
266,293
275,233
284,817
140,168
144,959
150,116
154,336
169,167
189,713
199,774
208,293
209,485
222,046
235,068
84.9
84.0
82.9
81.9
84.2
91.7
92.2
91.6
91.5
93.7
95.6
1,430,646
1,476,615
1,467,102
1,569,974
1,712,878
1,954,823
2,005,165
2,041,854
2,076,336
2,169,897
2,267,728
85.0
83.6
81.7
81.9
83.9
90.4
91.2
91.2
91.2
93.4
94.5
24,640
23,943
24,172
25,023
27,830
29,483
31,515
33,174
34,963
37,045
38,406
93.8
91.4
89.2
87.3
90.6
92.2
95.0
94.5
93.5
96.5
98.6
200,585
193,307
187,891
184,160
197,100
213,587
212,514
217,252
223,079
232,390
240,756
93.8
90.8
87.7
85.8
89.5
94.5
93.3
93.1
92.6
95.1
96.8
164,808
168,902
174,288
179,359
196,997
1954...  	
1955                          	
219,196
231,289
1956             	
241,467
1957                               	
244,448
19581                                       	
259,091
273,474
1QSQ2
Percentage of total, patients discharged—
1949 -  .	
86.2
1950  —                                  -
	
84.9
1951 ___  	
83.7
1952-	
82.6
1953  _ -.    -
 —
	
85.1
1954     	
91.7
1955    '
	
92.5
1956     	
	
92.0
1957 	
91.8
19581 	
	
941
19592    -
213,874
212,979
214,285
214,701
220,208
226,031
227,674
233,402
240,872
244,429
248,675
96.0
Patient-days—
1949  - _
1,682,196
1,766,680
1,795,438
1,916,486
2,041,615
2.162,002
2.198.863
2,239,646
2,277,567
2,322,796
2,399,383
1,896,070
1,979.659
2,009,723
2,131,187
2,261,823
2,388,033
2,426,537
2,473,048
2,518,439
2,567,225
2,648,058
1,631,231
1950               ...
1,669,922
1951               .    	
1,654,993
1952    ...                                	
1,754,134
1953                .                         	
1,909,978
1954                        	
2,168,410
1955  	
2,217,679
1956                             	
2 259 106
1957                                              	
2,299,415
2,402,287
2,508,484
86 0
19581   _        _
1959 s                                     	
Percentage of total, patient-days—
1949                     _       	
1950  .                            	
	
84 4
1951                      _   __	
82.3
1952 	
	
82 3
1953     _.    ...
	
84 4
1954                   	
90 8
1955 - - _  	
91.4
1956—	
91.3
1957 _
91 3
19581     . - .
93 6
19592
	
94.7
1 Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to November 30th, 1959. T 34
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, 1949-59.
Total
Adults
and
Children
Newborn
B.C. Public
Hospitals
Adults
and
Children
Newborn
Other B.C. Hospitals
Including Federal
and Private
Adults
and
Children
Newborn
Institutions
Outside B.C.
Adults
and
Children
Newborn
Patients discharged-
1949 	
1950 	
1951 	
1952 	
1953  -
1954... 	
1955 	
1956	
1957 	
19581 	
19592 	
Patient-days—
1949 	
1950 _ 	
1951 — 	
1952  _ 	
1953	
1954 	
1955 	
1956 	
1957 _	
1958»  	
1959= 	
Average days of stay-
1949	
1950 _ _
1951  	
1952 	
1953 	
1954 _
1955  _.
1956	
1957 	
1958» .  	
1959= 	
149,280
154,643
159,739
164,379
180,149
199,974
209,999
219,218
221,585
236,770
251,518
,498,121
,564,222
,551,954
,663,149
,814,344
,046,087
,100,386
,141,445
,188,765
,332,502
,461,330
10.03
10.11
9.71
10.12
10.07
1,0.23
10.00
9.77
9.88
9.85
9.79
24,989
24,336
24,587
25,492
28,381
29,761
32,035
33,783
35,813
37,924
39,191
203,197
196,333
190,948
187,923
200,738
215,507
215,980
221,022
228,875
238,112
245,906
8.13
8.07
7.76
7.37
7.07
7.24
6.74
6.54
6.39
6.28
6.27
140,168
144,959
150,116
154,336
169,167
189,713 |
199,774 |
208,293
209,485
222,046
235,068
1,430,646
1,476,615
1,467,102
1,569,974
1,712,878
1,954,823
2,005,165
2,041,854
2.076,336
2,169,897
2,267,728
10.21
10.19
9.77
10.17
10.13
10.30
10.04
9.80
9.91
9.77
9.65
24,640
23,943
24,172
25,023
27,830
29,483
31,515
33,174
34,963
37,045
38,406
200,585
193,307
| 187,891
I 184,160
197,100
213,587
212,514
217,252
223,079
232,390
240,756
8.14
8.07
7.77
7.36
7.08
7.24
6.74
6.55
6.38
6.27
6.27
7,093
7,617
7,308
7,431
8,173
7,602
8,313
9,473
10,023
12,506
13,800
45,960
65,326
62,771
68,892
75,518
66,960
75,599
79,428
93,980
141,925
167,500
6.48
8.58
8.59
9.27
9.24
8.81
9.09
8.38
9.39
11.35
12.14
151
173
171
161
229
199
361
457
668
665
525
1,146
1,288
1,155
974
1,353
1,251
2,271
2,740
4,299
4,113
3,200
7.59
7.44
6.75
6.05
5.91
6.29
6.29
6.00
6.44
6.19
6.10
2,019
2,067
2,315
2,612
2,809
2,659
1,912
2,050
2,077
2,218
2,650
21,515
22,281
22,081
24,283
25,948
24,304
19,622
20,163
18,449
20,680
26,102
10.66
10.78
9.54
9.29
9.24
9.14
10.26
9.84
8.88
9.45
9.85
198
220
244
308
322
79
159
159
182
214
260
1,466
1,738
1,902
2,789
2,285
669
1.195
1,030
1,497
1,609
1,950
7.40
7.90
7.79
9.06
7.10
8.47
7.52
6.48
8.23
7.51
7.50
1 Amended as per final reports received from hospitals.
2 Estimated, based cn hospital reports to November 30th, 1959.
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; 1958, 1,665; 1959, 1,724. (1954 and subsequent years based on assumption that total population is covered by British Columbia Hospital Insurance Service.) Population figures
revised according to latest census figures. HOSPITAL INSURANCE SERVICE,  1959
T 35
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients and
Short-stay Patients, 1949-59
Total Adults,
Children, and Newborn In-patients
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
257,398
274,694
290.709
29,000
44,502
47,656
46,767
52,582
63,621
70,553
76,375
83,530
91,883
100,292
203,269
1950	
223,481
1951	
231,982
1952   	
236,638
1953 	
261,112
1954 _  	
1955 _  _ _
293,356
312,587
1956      	
1957 _   _	
329,376
340,928
19581  	
366,577
1959*    _ _
391,001
Totals - _   _ 	
2,483,546
706,761
3,190,307
[ Amended as per final reports from hospitals.
'■ Estimated, based on hospital reports to November 30th, 1959.
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 1959.1
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Hospitals
Patients discharged—
Adults and children
235,068
38,406
2,267,728
240,756
9.65
6.27
82,330
11,464
1,011,050
77,756
12.28
6.78
43,295
8,227
388,094
50,871
8.96
6.18
57,216
11,799
478,540
71,635
8.36
6.07
31,444
4,432
239,294
25,959
7.61
5.86
13,085
1,808
96,882
10,760
7.40
5.95
7,698
676
Patient-days—
Adults and children
53,868
3,775
7.00
5.58
Average days of stay—
Adults and children	
New-born.- 	
1 Estimated, based on hospital reports to November 30th, 1959.
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 1959.l
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Hospitals
Patients discharged—
100.00
100.00
100.00
100.00
35.02
29.85
44.58
32.30
18.42
21.42
17.11
21.13
24.34
30.72
21.10
29.75
13.38
11.54
10.55
10.78
5.57
4.71
4.27
4.47
3.27
1.76
Patient-days—
2.39
1.57
1 Estimated, based on hospital reports to November 30th, 1959. T 36
BRITISH COLUMBIA
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BRITISH COLUMBIA
15. 56
Neoplasms
Circulatory
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13.05
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in British Columbia by
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(Excluding New-borns)   1958
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'////.    Supplementary
v/M    Classifications HOSPITAL INSURANCE SERVICE,  1959
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— CN m ^ct cri ^O T 42 BRITISH COLUMBIA
STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE
FISCAL YEAR ENDED MARCH 31st, 1959
Administration—■
Salaries—Permanent         $355,086.93
Temporary assistance  4,131.26
Sub-total, salaries   $359,218.19
Office expense  22,310.84
Travelling expense   30,083.02
Office furniture and equipment  2,124.31
Printing and publications  12,780.53
Tabulating and rentals  3,412.93
Motor-vehicles and accessories   129.80
Incidentals and contingencies  632.80
Technical surveys  1,008.14
Payments to hospitals—
Claims   $37,597,836.51
Vancouver General Hospital re out-patients (Hospital Insurance Act, sec. 35 (30))  229,678.14
$431,700.57
$37,827,514.65
Less collections, third-party liability  144,133.52
37,683,381.13
Grants in aid of construction and equipment of hospitals       6,114,382.02
$44,229,463.72
Recoveries—
Registration fees  $1,220.28
Federal share of hospital cost     12,784,038.88
Municipal per diem grants (arrears applicable to 1957/58
not previously taken to account)  214,008.30
     12,999,267.46
Total, Hospital Insurance Service  $31,230,196.26
Add transfer, Vote 143, re salary revision for Provincial Infirmaries  24,588.00
Total, Vote 346  $31,254,784.26
Certified correct and in accordance with the Public Accounts for the fiscal year ended
March 31st, 1959.
C. J. Ferber, C.A.,
Comptroller-General.
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1960
510-160-2339  

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