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Twelfth Annual Report British Columbia Hospital Insurance Service JANUARY 1ST TO DECEMBER 31ST 1960 British Columbia. Legislative Assembly 1961

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 PROVINCE OF BRITISH COLUMBIA
HOSPITAL INSURANCE ACT
Twelfth Annual Report
British Columbia Hospital
Insurance Service
JANUARY 1st TO DECEMBER 31st
1960
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1961
  Victoria, B.C., January 26th, 1961.
To Major-General the Honourable George Randolph Pearkes,
V.C., PC, C.B., D.S.O., M.C.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour :
The undersigned has the honour to present the Twelfth Annual Report of the
British Columbia Hospital Insurance Service covering the calendar year 1960.
E. C. MARTIN,
Minister of Health Services and Hospital Insurance.
 British Columbia Hospital Insurance Service,
Victoria, B.C., January 26th, 1961.
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 1960.
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.
VV. 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.
G. D. Sotiroff, Ph.D., F.R.Econ.S., Director, Research Division.
  CONTENTS
Page
General Introduction  9
Introduction of Rehabilitation, Chronic Treatment, and Convalescent Care Plan 10
The Hospital Insurance Act  13
The Hospital Act  13
Persons Entitled to or Excluded from the Benefits under the Hospital Insurance
Act  14
Entitled to Benefits  14
Excluded from Benefits  14
Hospital Benefits Available in British Columbia  14
In-patient Benefits  14
Emergency Services and Minor Surgery  15
Application for Hospital Insurance Benefits  15
Hospital Benefits Available outside British Columbia  15
The Hospital Rate Board and Methods of Payment to Hospitals  16
Organization Chart  17
Organization and Administration          18
Office of the Assistant Deputy Minister of Hospital Insurance  18
Hospital Finance Division  18
Hospital Accounting  19
Hospital Claims  20
Hospital Consultation and Inspection Division  22
Hospital Construction Division  23
Hospital Projects Completed during 1960  25
Hospital Projects under Construction at Year-end  25
Projects in Advanced Stages of Planning  26
Additional Projects Developed through Various Planning Stages  26
Sundry Building Improvement Projects  26
Medical Consultation Division  27
Administrative Assistant  2 7
Third Party Liability Section  30
Eligibility Section  30
Research Division  34
Public Information  3 4
General Office  35
Hospitals as Defined under the Hospital Insurance Act  36
Public Hospitals  3 6
Outpost Hospitals  36
Federal Hospitals  3 7
Private Hospitals (Providing General Hospital Services)  37
Rehabilitation, Chronic, and Convalescent Hospitals  37
Statistical Data  39
Table I.—Patients Discharged and Days of Care and Proportion Covered
by British Columbia Hospital Insurance Service, 1949-60, B.C. Public
Hospitals Only  40
7
 W 8 BRITISH COLUMBIA
Statistical Data—Continued Paoe
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, 1949-60  41
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients and Short-
stay Patients, 1949-60  42
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 1960  42
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 1960  42
Charts  43
Causes of Illness (Major Diagnostic Groups), Percentage Distribution of
Patient-days, 1959  44
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,
1959  46
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,
1959  47
Average Length of Stay of Patients in Acute-care Hospitals in British
Columbia by Major Diagnostic Groups (Excluding New-borns),
1959  48
Percentage Distribution of Patients and Patient-days by Type of Clinical
Service, 1959  49
Hospitalization by Diagnoses According to the Canadian List of Diseases
and Causes of Death, 1959  50
Statement of Receipts and Disbursements for the Fiscal Year Ended March 31st,
1960  54
 Twelfth 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
1960 was the twelfth year of operation for the British Columbia Hospital
Insurance Service. During the year the Service continued to ensure that the residents of British Columbia were provided with a good standard of hospital services by
pursuing the four main functions carried out since its inception on January 1st,
1949: to safeguard the residents of the Province from the financial burden associated with hospitalization; to enable hospitals to improve substantially their services by assuring them of a steady income; to assist communities to provide adequate
facilities by administering the grant-in-aid programme; and, finally, to help hospitals
to establish and maintain high standards of patient-care by providing professional
consultative services.
It is of interest to note that an estimated $340,000,000 has been paid on behalf of 2,788,000 hospital accounts incurred during the twelve-year period of operation. (Payments of hospital accounts to British Columbia hospitals in 1949, on a
daily basis, were $50,000; during 1960 daily payments averaged $130,000.) In
addition to this financial aid extended to hospitalized residents, grants for hospital
construction and equipment have amounted to approximately $35,000,000. The
Provincial Government pays 50 per cent of approved hospital construction costs
(both acute and chronic) and 33-1/3 per cent of equipment purchases and building
improvements and renovations.
At the present time 96 per cent of all patients in the Province's acute-care
general hospitals receive coverage from the British Columbia Hospital Insurance
Service. (This compares with an average of approximately 85 per cent coverage
experienced during the years of compulsory premium payment, January, 1949, to
April, 1954.) The remaining 4 per cent are primarily non-residents, workmen's
compensation recipients, armed forces personnel, and veterans with pensionable
disabilities.
A major development that took place in 1960 was the commencement of the
Rehabilitation, Chronic Treatment, and Convalescent Care Plan, on September 1st
(for further details regarding this plan see page 10). Reports relating to the activities
of the various divisions of the Service appear elsewhere. It is not intended that the
Annual Report cover all aspects of the Hospital Insurance Act and regulations in
detail, and persons interested in a detailed study are advised to refer to the Act and
regulations.
9
 W  10 BRITISH COLUMBIA
INTRODUCTION OF REHABILITATION, CHRONIC TREATMENT,
AND CONVALESCENT CARE PLAN
On September 1st, 1960, the Province of British Columbia commenced a
coverage programme for rehabilitation, chronic treatment, and convalescent care.
The new plan is being administered by the British Columbia Hospital Insurance
Service, and participation is limited to approved active-treatment chronic hospitals
or active-treatment chronic units of general hospitals that present satisfactory
evidence of ability and intention to provide a full chronic-treatment service.
The advice and guidance of the Canadian Medical Association (British Columbia Division) and the Faculty of Medicine of the University of British Columbia
were sought in the development of the plan. The president, executive director, and
members of the executive of the association and the Dean and members of the
Faculty of Medicine very kindly consented to serve on an advisory committee. The
Provincial Health Branch is also represented on the committee. The success that
has been achieved in the initial stages of the plan reflects the expert medical guidance
given by that profession, whose continued assistance will be most essential as the
programme progresses.
Coverage is extended to the in-patient care of rehabilitation and convalescent
patients who no longer require the intensive diagnostic and treatment services of an
active-treatment general hospital, and who are certified by competent medical
authority to be likely to benefit from rehabilitation treatment services to the extent
that they may be returned to their homes or to foster homes and, if possible, to useful employment. A broad interpretation is placed on " rehabilitation," and it applies
to all age-groups. A patient of 75 who can be improved sufficiently to enable him to
return to his home, even for a few months, is considered to be a rehabilitation
patient just as a youth of 19 who, with proper treatment, can take employment.
The classes of patients entitled to coverage are:—
(a) Those persons who will obviously benefit from rehabilitation procedures;
and
(b) The test or observation group comprising patients who appear to be those
who can benefit by rehabilitation, but whose rehabilitation potential can
be established only after a trial period of intensive rehabilitative treatment.
The cost to the patient is $1 per day. Coverage in rehabilitation, chronic
treatment, and convalescent hospitals does not include hospitalization outside the
Province.
Benefits do not include treatment of tuberculosis, mental disease, or alcoholism
or the provision of out-patient service, " take home " drugs, prescriptions, or appliances.
This entire coverage programme has been designed to fit properly within the
scope of the Federal-Provincial hospital insurance programme. Due to the fact
that there is a very limited background of experience, it has not been possible to
define policies and procedures as clearly as in the acute general hospital field. Therefore, coverage limitations will be subject to review from time to time as experience is
gained in this new programme.
In July the Hospital Insurance Service was fortunate to obtain the services of
Dr. B. M. Fahrni on a part-time basis. Dr. Fahrni, Associate Professor of Medicine
and head of the Department of Geriatrics at the University of British Columbia, is
serving in an advisory capacity. The Medical Consultant and Dr. Fahrni, accompanied by the Managers of the Hospital Construction Division and Hospital Consultation and Inspection Division, formed a team whose members visited hospitals on
 HOSPITAL INSURANCE SERVICE, 1960 W 11
the Island and in the Interior of British Columbia. Explanatory discussions were
held with the boards of directors, medical staffs, and medical societies regarding
implementation of the plan in the various hospitals. Owing to such factors as
scarcity of trained hospital staff, available hospital space, and other related and
limiting problems, an early start on the plan in many of the hospitals is not immediately possible. However, in those hospitals equipped to handle chronic care and
rehabilitation of patients, treatment has commenced and is progressing satisfactorily.
Planning and study are continuing, and expansion of the plan will take place as soon
as it becomes feasible. In order to further such expansion, a request was made to
Dr. T. D. Bain, Senior Treatment Medical Officer, Shaughnessy Hospital, for permission to use the training facilities available at this hospital. The Service was
gratified to learn from Dr. Bain that approval had been received from the Director-
General of Treatment Services, Dr. J. N. Crawford, to have Shaughnessy Hospital
serve as a centre for a training programme. This will be of great value in supplying
trained personnel, which are so necessary in the carrying-out of treatment under
the Rehabilitation, Chronic Treatment, and Convalescent Care Plan.
 Gorge   Road   Hospital,
Victoria.
REHABILITATION,
CHRONIC   TREATMENT,
AND   CONVALESCENT
CARE  HOSPITALS
Also
Holy Family Hospital, Vancouver.
Pearson Hospital (Poliomyelitis Pavilion ), Vancouver.
Shaughnessy Hospital (Military),
Vancouver.
Veterans' Hospital (Military), Victoria.
Queen Alexandra Solarium for Crippled Children,
Victoria.
G. F. Strong Rehabilitation Centre, Vancouver.
 HOSPITAL INSURANCE SERVICE,  1960 W 13
THE HOSPITAL INSURANCE ACT
This is the Statute which authorizes British Columbia's hospital insurance plan
and under which the British Columbia Hospital Insurance Service is established.
Its main provisions may be summarized as follows:—
(1) Generally speaking, every permanent resident who has made his home in
British Columbia for at least three consecutive months prior to going to
hospital is entitled to benefits under the Act.
(2) Approved hospitals are paid an all-inclusive per diem rate for the acute
hospital care rendered to qualified persons. In addition, the plan was
expanded on September 1st, 1960, to provide active care for persons
requiring rehabilitative procedures or those suffering from a chronic illness or disability. The payment made to a hospital by the British
Columbia Hospital Insurance Service amounts to $1 less than the per
diem rate approved for the particular hospital, and the patient is responsible for paying the remaining dollar. The Provincial Government pays
the dollar-a-day charge on behalf of Provincial social welfare recipients.
(3) The benefits provided under the Act include standard ward accommodation, food and necessary nursing services, the use of the operating-room,
caseroom, anaesthetic equipment and supplies, routine surgical supplies,
almost all drugs, and all other services that are provided by the hospital.
(4) In addition to acute in-patient care, qualified persons are entitled to the
use of a hospital's out-patient facilities for emergency care within twenty-
four hours of an accident or for minor surgery for a nominal charge of $2
for each visit.
(5) Qualified persons who are temporarily absent from British Columbia are
entitled to the benefits described elsewhere in this Report during the first
three months following their departure from the Province.
THE HOSPITAL ACT
One of the important functions of the British Columbia Hospital Insurance
Service is the administration of the Hospital Act. The Deputy Minister of Hospital
Insurance is also the Chief Inspector of Hospitals for British Columbia under this
Statute.
The Hospital Act controls the organization and operation of hospitals, which
are classified as follows:—
(1) Public hospitals—non-profit hospitals caring for acutely ill persons.
(2) Private hospitals—generally privately owned and profit-making units.
This category includes:—
(a) Small general hospitals, most of which are operated in remote
areas by industrial concerns primarily for their employees.
(_>) Nursing homes, most of which are operated for profit by private
operators or companies. Several are operated as non-profit organizations
by religious and other groups.
(3) Rehabilitation, chronic, and convalescent hospitals—these are non-profit
hospitals approved under Part III of the Hospital Act, primarily for the
treatment of persons who will benefit from intensive rehabilitative care.
 W 14 BRITISH COLUMBIA
PERSONS ENTITLED TO OR EXCLUDED FROM THE BENEFITS
UNDER THE HOSPITAL INSURANCE ACT
Entitled to Benefits
A person is entitled to benefits if he qualifies as a beneficiary under the Hospital
Insurance Act. Generally speaking, a person is a beneficiary if he proved 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
(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, and provided also that the provision of hospital-care benefits
is a medical necessity.
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.
Generally speaking, 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
(b) A resident who leaves British Columbia temporarily and fails to return
and re-establish residence within twelve months, or who establishes his
home elsewhere; or
(c) An inmate of a Federal penitentiary; or
(d) 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
(e) 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:—
 HOSPITAL INSURANCE SERVICE,  1960 W 15
Laboratory and X-ray services.
Drugs, biologicals, and related preparations (with certain exceptions).
Use of operating-room and caseroom facilities.
Use of an_esthetic equipment, supplies, and routine surgical supplies.
Use of radiotherapy and physiotherapy facilities where available. Active treatment of chronic illness, with particular emphasis on patients whose
rehabilitation potential has been established. 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 benefits are also provided in British Columbia public hospitals
to beneficiaries 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. Non-beneficiaries are required to pay the full hospital charge for such
services.
APPLICATION FOR HOSPITAL INSURANCE BENEFITS
At the time of admission to 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 defined
under the Hospital Insurance Act and regulations. Payment of the account is then
requested by the hospital from the British Columbia Hospital Insurance Service,
which may reject any account where either the patient's status as a qualified resident
or the medical necessity for his receiving hospital care benefits has not been established.    (See Eligibility Section, page 30.)
HOSPITAL BENEFITS AVAILABLE OUTSIDE BRITISH COLUMBIA
Benefits are available anywhere in the world to a beneficiary under British
Columbia's plan, when 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 buldings or equipment, it is payable by the patient, because such items are
 W 16 BRITISH COLUMBIA
not included in the rates charged by British Columbia hospitals.   Elsewhere, payment will be made at a rate not exceeding $12 per day ($4 for new-born 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.
THE HOSPITAL RATE BOARD AND METHODS OF PAYMENT
TO HOSPITALS
The Hospital Rate Board, appointed by Order in Council in January, 1951, is
composed of the Deputy Minister of Hospital Insurance, the Hospital Finance
Manager, and the Hospital Consultation and Inspection Manager. The purpose of
the Board is to advise the Deputy Minister in regard to the rates of payments 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. Under a
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 (approximately 96 per cent) 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 services, such as X-ray, laboratory, operating-room, etc., provided to patients, in addition to bed, board, and nursing care.
 HOSPITAL INSURANCE SERVICE,  1960
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 W 18 BRITISH COLUMBIA
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.
This office is responsible for certain administrative functions, including personnel management and liaison with the Civil Service Commission. During the year
the Assistant Deputy Minister actively participated in conferences held in Ottawa,
in connection with Federal-Provincial hospital insurance planning, through membership on a working party and the Sub-committee on Quality of Care, Research,
and Statistics. This body was created for the purpose of reviewing the methods
used by the Provinces in these fields and making recommendations to ensure
uniformity of measurement and compilation across Canada. As a result of these
studies, a series of tabulations has been recommended which will be the basis of
evaluation of hospital experience within the Province and interprovincial comparisons in the hospital field. One of the major contributions emerging from the project
is the devolpment of a " 98-category diagnostic Canadian list."
The survey of hospital facility requirements of the Lower Mainland, which was
commenced last year, resulted in the development of a series of statistical tables
which were published later in the year. A final report was completed during the
summer of 1960. The Assistant Deputy Minister worked with the newly formed
Metropolitan Hospital Planning Council and co-ordinates studies undertaken by
the Research Division of the British Columbia Hospital Insurance Service with those
of the Council.
This office also worked in conjunction with other divisions in continuing their
review of 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 1960 recommended grants of over $600,000,
after a review of 3,500 applications received from hospitals. During 1960 the
Division Manager attended two meetings in Ottawa of the Advisory Committee on
Hospital Insurance and Diagnostic Services, which is an advisory body to the
Minister of National Health and Welfare. The Manager, who has also been
appointed as the representative of British Columbia on a Sub-committee on Finance
and Accounting, attended a two-day meeting in Ottawa prior to one of the Advisory
Committee conferences. The Sub-committee reviewed financial control methods,
employee pension plans, hospital audits, and technical aspects of the Federal sharing
of hospital costs.
The benefits of the Municipal Superannuation Act were made available to all
public hospitals in British Columbia from July 1st, 1960. The Division Manager,
working in co-operation with the Commissioner of Municipal Superannuation,
assisted hospitals in making the necessary applications and carrying out required
 HOSPITAL INSURANCE SERVICE,  1960 W  19
documentation relative to the past service of hospital employees. To provide as
broad a pension coverage and benefits as considered reasonable, policies were
established by the Provincial Government so that any employee of a hospital, at
the commencement date, who could complete ten years' pensionable service in public
hospitals in British Columbia before reaching retirement age would be eligible, and
pension credits would be allowed for all years of prior service (except for the first
twelve month's employment). The hospital employee was not required to contribute to the cost of providing a pension for years of service prior to July 1st, 1960.
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 Radiological 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 four weeks, were made to eighty-seven public hospitals
during 1960. 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 reviews and cost studies of nursing homes
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 1960 sixteen completed construction projects, involving expenditures in
excess of $18,500,000, were audited and the required statements prepared for the
Federal Government, in order that the Federal construction grants could be claimed
by the hospitals.
As a result of the introduction from September 1st, 1960, of the Rehabilitation,
Chronic Treatment, and Convalescent Care Plan, investigations of financial and
statistical records of certain designated hospitals were made to determine the bases
of payment on behalf of British Columbia Hospital Insurance Service patients covered in such hospitals. With the anticipated extension of the number of approved
hospitals providing this type of care, a considerable increase is expected during 1961
in the volume of work of this nature to be undertaken by this Section.
Experience during the first few years' operation of the British Columbia Hospital Insurance Service indicated that operating costs required serious consideration
 W 20 BRITISH COLUMBIA
when planning new hospitals and additions to existing hospitals. In order to ensure
that 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.
Under the terms of the Federal Hospital Insurance and Diagnostic Services
Act, whereby the Federal Government has been sharing in the costs of in-patient
care in this Province from July 1st, 1958, monthly cash advances are made to the
Province by Ottawa, based on payments made by the Province during the previous
month. These advances are later taken into account when the total amount payable
by the Federal Government is determined for the calendar year. The final calculation for the year is based on the annual audited financial reports of each public
hospital, after the hospitals' records have been inspected by accountants from this
Section and approved by Federal Treasury auditors. Compilation of the necessary
data required by the Federal authorities for purposes of the final settlement involved
a considerable amount of additional work, before agreement on the amount shareable in respect of the first period (July 1st to December 31st, 1958) was reached in
the early months of 1960. Some changes in procedures are in effect for the second
period (calendar year 1959), but with the entry into the Federal-Provincial scheme
of Ontario and three other Provinces in 1959 no earlier settlement of the final
shareable costs for that year can be anticipated, since agreement on the costs of all
participating Provinces has first to be reached before the national shareable costs
can be determined.
The Annual Report on Hospital Statistics, issued by the Department of Health
Services and Hospital Insurance and covering the administration of the Hospital Act
for the preceding year, is prepared by this office.
Hospital Claims
W. J. Wade, Supervisor
Hospital Claims is responsible for processing all admission-discharge records
(accounts) 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 1960, and, in
addition, an average of over 400 emergency-service or minor-surgery accounts were
handled each day.
In addition to the normal processing of hospital claims, as outlined in subsequent paragraphs, improvements were made in internal procedures to facilitate the
processing of a greater volume of accounts resulting from the increase in the number
 HOSPITAL INSURANCE SERVICE,  1960 W 21
of hospital beds and the expansion of coverage to chronic units. Close co-operation
was continued with the Medical Consultation Division for advice on the medical
aspects of claims, and for the control of the daily volume of work.
The introduction in October, 1959, of the British Columbia Hospital Insurance
Service manual for hospitals has resulted in an improvement in hospital procedures.
This was most noticeable in the year-end cut-off of accounts, with this phase of the
work being completed at an early date by most hospitals. The co-ordination of the
designing and planning for the introduction of a new admission-discharge form and
I.B.M. statistical card was carried out, with the object of commencing new procedures by January 1st, 1961. This revision resulted from a desire for standardization
by all Provinces participating under the Federal-Provincial agreement.
The sections participating in this work and a brief outline of their duties follows.
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 are checked with the verifying documents, and discrepancies
referred back to the hospital or to the Eligibility Inspectors. Over 6,000 hospital
claims or some 2 per cent of the total received from hospitals were returned for
further information. Advice and assistance were given to hospital admitting staffs
on the proper methods of admission and discharge affecting the patient's residential
qualifications. This was carried out by correspondence, by actual visit to the hospital, or by attendance at a hospital regional meeting.
The Accounts Payment Section verifies the charges made to the British Columbia Hospital Insurance Service and ensures that all information shown on each claim
is completed for statistical purposes and that it is charged to the correct agency, such
as the British Columbia Hospital Insurance Service, Workmen's Compensation
Board, Department of Veterans' Affairs, or another Province which has a plan of its
own. During the year an average of 400 queries per month were addressed to
British Columbia hospitals on accounting matters. In 1960 a total of 300,991
accounts were paid, compared to 287,685 in 1959 and 272,262 in 1958. The
increase in accounts paid was mainly due to an increase in beds within the acute-
care hospitals and a further increase in claims accepted for D.V.A. hospitals under
the Federal-Provincial agreement, plus some Rehabilitation, Chronic Treatment,
and Convalescent Care cases.
The Social Welfare Records Section continues to maintain the alphabetical file
of all health services identity cards issued to welfare recipients in this Province.
Welfare hospital accounts are checked to this file to determine eligibility for hospital
benefits. This file is used by the Department of Social Welfare as a source of information.
The Voucher and Key-punch Sections are responsible for batching and vouch-
ering the checked accounts, in order to determine the amounts payable to each
hospital and for the punching of an I.B.M. card for each account. The cards are
punched daily to record statistical, financial, and medical data, and are also used
to tabulate remittance listings of payments due to hospitals.
The Out-of-Province Section handles all claims for hospital accounts incurred
by British Columbia residents in hospitals outside the Province. This includes
establishing eligibility and the payment of claims. During 1960 a total of 3,176
accounts, amounting to $410,860, was paid on behalf of qualified residents who
were hospitalized in the other Provinces of Canada, in practically all States of the
United States, Australia, Belgium, British West Indies, Eire, France, Holland, Hong
Kong, Italy, Japan, Jugoslavia, Mexico, Norway, Peru, Portugal, South Africa,
Spain, Sweden, Switzerland, United Kingdom, and West Germany.
 W 22 BRITISH COLUMBIA
The Filing Section sorted and filed an average of 3,600 documents and letters
daily. This is a reduction of approximately 10 per cent when compared with the
previous year, despite an increase in total hospital accounts handled, and resulted
from improvements to procedures. During the year all 1959 claims were microfilmed by the Central Microfilm Bureau; 757,688 documents were photographed
on 25,900 feet of film. Out-of-Province Section claims were also microfilmed.
The film was duplicated, and the duplicate stored separately in case of loss or damage
to the original film. The space occupied by sixty steel filing-cabinets has been saved
each year by microfilming.
Hospital Consultation and Inspection Division
J. W. Mainguy, M.H.A., Manager
This Division is concerned not only with responsibilities relating to the administration and operation of approved public hospitals, but also with the licensing and
inspection of private hospitals. The category " private hospital" includes those
nursing-home facilities which provide skilled nursing care to the aged sick, and also
includes some small general hospitals, most of which are operated in remote areas
by industrial concerns. The majority of the nursing-home facilities are operated for
profit by private operators or companies. Another activity of the Division is in the
field of hospital clearance. This procedure is a method of moving welfare patients
from acute general hospitals to more suitable facilities when they no longer require
the specialized services of an acute general hospital, but do need care beyond that
which could be given in their homes. The actual work of placing these people is
done by the Department of Social Welfare at the request of this Division. In 1960
this office asked Social Welfare to arrange placement for 128 patients.
With regard to work relating to public hospitals, this Division, during the year,
worked with the Finance Division on the analysis of hospital estimates. The
Manager of the Division continued as a member of the Hospital Rate Board. Other
functions included the reviewing of hospital by-laws with the Administrative Assistant, and providing hospitals and other organizations with information on a wide
variety of hospital problems (that is, wage analysis, personnel management, etc.).
Staff members made a total of forty-six visits to public hospitals, usually involving
a day or more at the hospital.
A close working relationship continued with Health Branch personnel in
matters dealing with hospital care. The staff of the Division was in close contact
with the Medical Health Officers and their staffs, the Technical Supervisor of Clinical
Laboratory Services, and the Technical Adviser in Radiology, whose specialized
fields also require them to visit hospitals. Their Nutrition Consultant made dietary
inspections in eight public hospitals. Working in conjunction with the Health
Branch, this Division helped to prepare and to conduct a dietary institute at Nanaimo
where cooks from twenty-six hospitals and institutions which do not have dieticians
were in attendance for five days. This course was similar to those held in 1959
at Cranbrook and Prince George.
The Division continued to represent the British Columbia Hospital Insurance
Service on the Laboratory Advisory Council, which acts in an advisory capacity on
matters dealing with laboratory services and equipment in public hospitals.
A further activity of the Division during the year was participation in preparing
for the Civil Defence Orientation Course for directors of nursing, and also participation in the course held for physicians. The Division represented the British Columbia Hospital Insurance Service on the Emergency Health Services Advisory Committee, and also on a committee to review hospital disaster plans.
 HOSPITAL INSURANCE SERVICE,  1960
W 23
Close liaison was maintained with the Provincial Fire Marshal during the year
in order that fire safety in hospitals could be improved upon.
In private hospital licensing and inspection, 204 visits were made to the hospitals. Of these, fifty-four were made by the part-time consulting dietician, who
assists the Division in maintaining a continuing programme of food-service inspection and consultation.
During 1960 a total of 109 new private hospital beds were licensed. Numerous inquiries were received from persons actively interested in establishing private
hospitals. At the end of the year a new private hospital building of 55 beds was
under construction in Richmond. Beds in operation at the end of 1960 were 1,950
for nursing-home type patients licensed in fifty-seven private hospitals, and 100 beds
licensed in six private acute hospitals, making a total of 2,050 beds. (In 1959 there
were 170 private acute hospital beds. The figure was reduced to 100 in April, 1960,
when the private hospital at Kitimat ceased operating after transferring its patients to
the newly constructed Kitimat General Hospital.)
The Manager of the Division continued as a member of the Welfare Institutions
Board, which is involved in the licensing of numerous facilities, including boarding
homes for the aged. This has helped to maintain a close liaison between the licensing of private hospitals and of boarding homes. On the authority of the Minister of
Health Services and Hospital Insurance, this Division appointed representatives to
serve with a committee of the Greater Vancouver Health League in the study of
nursing-home and boarding-home licensing. Informative discussions were held
during the year with this committee.
A Province-wide survey of nursing-home bed requirements was carried out
during the year with the assistance of doctors, hospitals, and social workers.
The British Columbia Hospital Insurance Service was represented by the
Manager of the Division at the Western Provinces' Rehabilitation Workshop called
by the Civilian Rehabilitation Branch of the Federal Department of Labour. The
workshop was attended by representatives of the Provincial Departments of Health,
Welfare, and Education, and members of other Government departments or agencies
concerned with this problem.
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 76.02
to 80.05 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 a good standard of patient-care, efficient and
economical operation, and adequate service and clinical facilities for potential future
 W 24 BRITISH COLUMBIA
expansion. Close attention is given to the design and extent of the mechanical
facilities proposed for hospital buildings; these include heating, ventilating, and air-
conditioning systems. With the co-operation of other British Columbia Hospital
Insurance Service divisions and the Health Branch, hospital boards are provided
with a complete consultative planning service. Assistance is given by 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 Health Branch. In
addition, the Professor of Paediatrics of the Department of Medicine of the University of British Columbia gave valuable assistance in reviewing plans for pasdiatric
and nursery facilities. The chief of the Hospital Design Division of the Federal Government gave advice on selected problems in hospital design. The supervisor of
physiotherapy of the Canadian Arthritis and Rheumatism Society (British Columbia
Division) is co-operating in the review of proposed plans for physiotherapy departments in small and medium-sized hospitals.
The Construction Division also has the services of an architect, on loan from
the Public Works Department. He assisted in the compilation of a survey questionnaire on nursing units distributed to twenty-one of the major hospitals in the Province in the summer of 1959. The answers received have been used as a source of
reference material in preparing typical floor-plan arrangements, and drawings involving detailed cabinetwork, shelving, and cupboard arrangements, plumbing, and
many other features that take into consideration the specialized requirements of
qualified nursing personnel. During the year, studies were made of the survey
material, and approval was received for financial assistance from National health
grants to assist in the completion of the study.
The Division maintained liaison with the Hospital Committee of the British
Columbia Medical Association, which is co-operating in the study of selected problems referred to it, and also with the Registered Nurses' Association of British
Columbia.
Meetings were held with the Hospitals Committee of the Architectural Institute
of British Columbia. The functions of this Committee include co-ordinating and
presenting to the British Columbia Hospital Insurance Service the view-points of
the Institute members on matters relating to hospital construction projects. It also
acts as a liaison body to work with the British Columbia Hospital Insurance Service
in developing and standardizing procedures relating to architectural and engineering services on hospital projects. At the suggestion of the Manager of the Construction Division, and with the fine co-operation of the Architectural Institute of British
Columbia, a seminar of architects was held during October. It is believed that this
was the first seminar of its kind held in Canada.
Investigations into the operation and efficiency of air-sterilizing equipment,
used in conjunction with air-recirculating and air-conditioning systems for operating-
rooms, were carried out by the Manager of the Division, members of The Association of Professional Engineers of British Columbia, and a bacteriologist on the staff
of the Vancouver General Hospital. Visits were made to hospitals to examine and
evaluate two types of aseptic air systems in actual operation.
During the year the Division made a number of inspection trips to hospitals in
British Columbia. With the advent of chronic-care coverage in the Province, it was
considered advisable to examine the physical facilities and operation of hospitals
providing chronic care, and the Division Manager, therefore, made inspectional
visits to rehabilitation centres in other areas.
 HOSPITAL INSURANCE SERVICE,   1960 W 25
(a)  Hospital Projects Completed during 1960
Prince George Regional Hospital.—On January 16th, 1960, the Minister of
Health Services and Hospital Insurance officially opened the new 125-bed hospital.
There is space in unfinished sections of the building for 38 additional beds. Major
equipment and services installed in the hospital are of sufficient capacity to provide
for beds which could be accommodated on a fifth floor.
Vancouver General Hospital.—The mechanical services project, which involved the replacement of the 40-year-old incinerator, renovations of the old boiler-
house, the old morgue and laboratory building, and the generator-house, was completed early in 1960.
Golden and District General Hospital.—On March 5th, 1960, the new hospital
was officially opened. The hospital provides accommodation for 23 active-treatment
beds, plus space which has been left in an unfinished state and can be completed to
provide additional bed accommodation when required. The hospital is a single-
story structure, of frame construction on a reinforced-concrete slab, with a concrete
and masonry basement.
Kitimat General Hospital.—Official opening ceremonies for the Kitimat General Hospital were held on March 26th, 1960. Due to cut-backs in the expansion
plans of the Aluminum Company of Canada, all the beds included in the initial
design capacity of 113 beds have not been made available for occupancy. The
hospital opened with 82 beds placed in service, and the top floor of the hospital is
being used temporarily for accommodation of hospital personnel.
Matsqui-Sumas-Abbotsford General Hospital.—A previously unfinished area
of this hospital was completed on May 1st, 1960, to provide 17 additional active-
treatment beds.
Burns Lake and District Hospital.—The new 33-bed hospital, officially opened
on August 15th, 1960, replaces the old 16-bed hospital built in 1931. Generous
solaria are provided in the new building, which can readily accommodate additional
beds when required.
Kimberley and District General Hospital.—The new hospital of 50 beds was
officially opened by the Minister of Health Services and Hospital Insurance during
ceremonies held on December 10th, 1960. It replaces the existing building, which
has been in service for over thirty years. The three-story, reinforced-concrete structure includes areas for 22 additional beds for use as required at a future date.
(b)  Hospital Projects under Construction at the Year-end
St. Joseph General Hospital, Dawson Creek: A new 71-bed hospital. (During
the year approval was granted to increase the number of beds from the original plan
for 60 to 71.*)    Construction should be finished early in 1961.
Nanaimo Regional General Hospital: A new 160-bed hospital, due for completion in the summer of 1962.
Royal Columbian Hospital, New Westminster: Nurses' Residence and
Training-school of 195 nurses' beds.
Royal Jubilee Hospital, Victoria: Ancillary projects are under way, as preparatory work to building a proposed new wing.
Terrace and District Hospital: A new hospital of 40 beds; completion expected early in 1961.
Vancouver General Hospital: Construction of a combined locker-room area
plus alterations to the physical medicine department.
 W 26 BRITISH COLUMBIA
Lions Gate Hospital, North Vancouver: A new 283-bed hospital plus sixth
and seventh floors.
St. Paul's Hospital, Vancouver:    Boiler-house and power-plant expansion.
(c)  Projects in Advanced Stages of Planning and for Which Working
Drawings Are Completed or in the Process of Preparation
War Memorial Hospital, Williams Lake: New hospital of 70 beds—out to
tender.
Providence Hospital, Fort St. John:  New hospital of 80 beds.
St. Paul's Hospital, Vancouver:   Laboratory and laundry.
Fort Nelson:  New hospital.
Queen Alexandra Solarium, Victoria: Additional 16 beds plus unfinished
areas.
Terrace and District Hospital: Nurses' Residence—10 nurses' beds.
Chemainus General Hospital: New addition—out to tender.
Wrinch Memorial Hospital, Hazelton: New addition.
Royal Columbian Hospital, New Westminster: Laundry and maintenance-
shop.
St. Bartholomew's, Lytton: New elevator and renovations.
(d) Additional Projects Developed through Various Planning Stages in 1960
King's Daughters' Hospital, Duncan: New hospital.
Boundary Hospital, Grand Forks: New hospital.
McBride and District: New hospital.
Mission Memorial Hospital: New hospital.
Royal Inland Hospital, Kamloops: Addition and renovations, also nurses'
residence and training-school.
Vernon Jubilee Hospital:  Addition and renovations.
St. Joseph's Hospital, Victoria:  Addition and renovations.
St. Joseph's General Hospital, Comox:  Addition and renovations.
St. Mary's Hospital, Sechelt: New hospital.
Nicola Valley General, Merritt:  New hospital.
Langley Memorial Hospital, Murrayville:  New hospital.
Prince Rupert General Hospital:  Alterations and addition.
Powell River General:  Alterations and addition.
Quesnel General Hospital:  Addition.
Mater Misericordia. Hospital, Rossland:  Alterations.
Richmond Hospital:  New facility.
Children's Hospital, Vancouver:  Alterations and addition.
St. John Hospital, Vanderhoof:  Addition.
Vancouver General Hospital: Laurel Pavilion alterations.
Gorge Road Hospital, Victoria:  Alterations.
Penticton Hospital:   Air-conditioning.
Ladysmith General Hospital:  Addition.
(e) Sundry Building Improvement Projects, Including the Installation of
Fixed Equipment
During the year the Division received over 300 applications from hospitals for
grants to assist in financing the cost of structural improvements and building alterations, including fixed equipment. The cost of these approved projects totalled
approximately $418,000.
 HOSPITAL INSURANCE SERVICE,   I960 W 27
Medical Consultation Division
W. A. Fraser, O.B.E., E.D., M.D., CM., F.A.C.S., Medical Consultant
All in-Province and out-of-Province admissions to acute-care general hospitals
are assessed by the Medical Consultation Division to establish medical eligibility for
entitlement to coverage under the Hospital Insurance Act. In addition, admissions
to hospitals designated to receive and treat patients under the Rehabilitation, Chronic
Treatment, and Convalescent Care Plan are also assessed for medical eligibility.
Medical report forms on all patients in hospital are submitted by the attending
physicians to the Medical Consultation Division for review. When necessary, letters
of inquiry on medical eligibility are sent to hospitals in respect of patients whose stay
in hospital appears to be too lengthy.
The final discharge diagnosis, submitted by hospitals, is checked by the six
medical coders on staff and coded according to the Manual of the International
Classification of Diseases, Injuries, and Causes of Death. In addition, the coding
shows the kind of service given in the hospital—that is, medicine, surgery, maternity, etc.—and the information is used by the Hospital Construction Division for
bed requirement studies. During the year a survey was carried out on new-borns
and adults by this Division to study the infections acquired in hospital. A pedestrian
traffic accidents study on children (up to 15 years) and adults was also made.
A further study was conducted on all tuberculosis cases treated in acute-care general
hospitals.
The Chief Supervisor, Medical Records and Medical Coders, who is also a
registered nurse and a trained medical record librarian, received authorization to
carry out hospital inspections and has commenced visiting the record departments
of hospitals on Vancouver Island and the Lower Mainland. During these visits
particular attention is paid to the patients' medical documents, and guidance is
given to the hospital record librarian.
Commencing on March 15th, 1960, initial exploratory meetings were held in
Vancouver with representatives of the Canadian Medical Association (British
Columbia Division) and the Faculty of Medicine in anticipation of the announcement by the Government of a plan for the care of patients requiring rehabilitation,
chronic treatment, and convalescence. These meetings continued at frequent intervals until early in November, and proved to be very profitable to the Hospital
Insurance Service. The various problems that arose concerning the implementation
of the plan were thoroughly discussed, and decisions were tentatively arrived at for
consideration of Government final approval. (Also see " Introduction of Rehabilitation, Chronic Treatment, and Convalescent Care Plan" on page 10.)
During the year the Medical Consultant attended the following medical meetings: The Canadian Medical Association (British Columbia Division), the British
Columbia Surgical Association, and the American College of Surgeons. In addition,
he also attended a meeting in Ottawa of the Working Party of the Sub-committee on
Quality of Care, Research, and Statistics on August 22nd and 23rd, 1960. At the
meeting an intensive study was made of problems related to the preparation of
uniform medical statistics across Canada. The presence of Medical Consultants of
several hospital insurance plans at the meeting permitted a valuable exchange of
information on the medical review procedures in effect in the various Provincial
Administrative Assistant
K. G. Wiper
The office of the Administrative Assistant is responsible for the drafting of
legislation, regulations, and Orders in Council for the British Columbia Hospital
 ?*'
.ctHos?v^
tf*cE    .   -,vd.n&a,.-u A960-
ope'
ue-A
Th6
ne^
u5.toedVvo^a,5atvuatV
A 6*.
Golden and District General Hospital
Opened March 5th, 1960, the new hospital provides 23 beds plus
unfinished areas for future use.   It cost approximately $343,000.
Kimberley i
Built at a cost of $1,01
I
(Model b:
 and the ?"* hoSpita] Kt^AT c
^OiOcJi
at/'o/,
r n   6e*
Pers°nneL
fo.
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ice
'otal
■■    .     ■■
^W^ggyjj        kTi**Wi
\l Hospital
ied hospital was opened
IcCulloch. Trail and Vancouver.)
Burns Lake Hospital
The new 33-bed hospital, opened August 15th. I960, cost
an estimated $342,000.
 W 3(1 BRITISH COLUMBIA
Insurance Service. In the performance of these duties a close working relationship
exists between this office and the Attorney-General's Department. A further
responsibility is to provide a uniform interpretation of the various Acts and regulations to other B.C.H.I.S. officials.
Assistance is given, upon request, to hospital societies in regard to problems
connected with hospital constitutions and by-laws, and their application. This is
done in conjunction with the Hospital Consultation and Inspection Division. This
office also reviews changes made in hospital by-laws for the purpose of bringing
them to the stage where Government approval may be obtained as required under
the Hospital Act. The British Columbia Hospital Insurance Service has developed
a set of model by-laws, which is available to hospitals for use as a guide in making
revisions.
The Administrative Assistant assists committees in unorganized territory to
establish hospital improvement districts, which are necessary for the raising of funds
by money by-law for the construction of new hospital facilities or the improvement
of existing buildings. This work is carried out in conjunction with the Water Rights
Branch of the Department of Lands and Forests and the Chief Electoral Officer of
the Provincial Secretary's Department. At the end of 1960 there were twenty-eight
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 1960 considerable time was spent on matters connected with the
Federal-Provincial hospital insurance plan. Extensive discussions were held with
the officials of the Federal Government and other Provincial plans to consider
means of removing administrative difficulties and provide better liaison.
A considerable amount of time was spent in working with other B.C.H.I.S.
officials to make the necessary arrangements for the Rehabilitation, Chronic Treatment, and Convalescent Care Plan which was inaugurated on September 1st, 1960.
The Administrative Assistant also participated in a series of meetings held by
a joint committee on nursing homes and boarding homes comprising representatives
of the Greater Vancouver Health League, the Department of Social Welfare, and the
British Columbia Hospital Insurance Service.
The Administrative Assistant is also responsible for over-all supervision of the
Third Party Liability and Eligibility 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 expenses paid by this Service on
behalf of accident victims. The Senior Eligibility Inspector in Vancouver is 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
the Vancouver 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
 HOSPITAL INSURANCE SERVICE,  1960
W  31
benefits made by, or on behalf of, persons admitted to hospital. A detailed check is
made of all doubtful applications, resulting in a considerable number of unqualified
claims for hospital insurance benefits being rejected.
Eligibility Inspectors visit hospitals on a regular schedule to see that the
B.C.H.I.S. eligibility procedures are being properly carried out. These Inspectors
also assist in the training of new hospital admitting and eligibility staff members. In
this regard, regional meetings were held in 1960 in a number of centres for the purpose of bringing together hospital personnel for panel discussions to deal with problems connected with the admission of patients to hospitals and their status under the
Hospital Insurance Act.
This Section has provided the great majority of employers in British Columbia
with a supply of employers' certificates, on which an employee's length of employment can be recorded. The Inspectors maintain close liaison with these firms to
ensure their continuing co-operation in providing their employees with this form of
proof of residence for hospital insurance purposes.
Since the introduction of the Rehabilitation, Chronic Treatment, and Convalescent Care Plan, the Inspectors visited those hospitals participating in the plan,
explaining to the personnel involved the completion of the admission/discharge
form, the residential requirements for eligibility, and the various methods of obtaining proof of residence. It is anticipated that special attention will have to be given
to these hospitals during the initial stages of this plan.
 . ■■■■■... ■■■
'rr_   T-./-M
HOSPITAL
PROJECTS
UNDER
CONSTRUCTION
AT YEAR-END
Nanaimo
The new Nanaimo Regional General Hospital of 160 beds, due for
completion in 1962.
(Architects:  Gardiner, Thornton, Gathe & Associates, Vancouver.)
WWIM^S
*'■''
Victoria
Preparatory work
is under way
for building
a new addition
to the Royal
lubilee Hospital.
(Architects:  Townley & Matheson, Vancouver.)
 Also
Terrace:   A new 40-bed hospital.
Dawson Creek: A new 71-bed
hospital.
Vancouver: Construction of a combined locker-room plus alterations to the physical medicine
department of the Vancouver
General Hospital, and a boiler-
house and power-plant expansion at St. Paul's Hospital.
New Westminster
A 195-bed nurses' residence and training-school at the
Royal Columbian Hospital.
(Architects:  Townley & Matheson, Vancouver.)
North Vancouver
The new 283-bed
Lions Gate Hospital,
plus sixth and
seventh floors.
 w 34 british columbia
Research Division
G. D. Sotiroff, Ph.D., F.R.Econ.S., 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, recorded in the
admission-discharge forms 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 sources.
During the year, work continued on the studies of bed needs in the Southern
Okanagan and Central Border regions of British Columbia. Similar studies were
initiated for smaller areas in other parts of the Province. Since the month of September, when the British Columbia Hospital Insurance Service entered the field of
chronic care, the work of the Research Division has expanded in that direction as
well.
Statistical information was supplied in answer to requests received from a
number of public, private, and semi-private organizations.
Mention was made in the 1959 Annual Report of the activities of the Committee on Quality of Care, Research, and Statistics at Ottawa, consisting of representatives of the Federal Government and the Provincial insurance plans. In 1960
certain recommendations were adopted by the Committee, aiming to improve the
quality and presentation of hospitalization and morbidity statistics throughout
Canada. The Research Division has taken an active part in the preliminary work
to these recommendations, and more work of this nature is in progress. Although
this Federal-Provincial study has increased the work load of the Research Division,
there is reason to believe that, in the end, more accurate information on the health
condition of the Canadian people will become obtainable through these efforts.
This, in turn, is a prerequisite to improved health services. Specific areas in which
progress has been made include the statistical coverage of operations, the grouping
of statistical data by geographical characteristics, and the classification of diseases
on a national basis.
Public Information
R. H. Thompson
It is the responsibility of this office to develop and administer the public information activities of the Service. This year's programme was much the same as that
outlined in the Eleventh Annual Report.
During the year regular editions of the Bulletin were prepared and distributed
to over 100 B.C. hospitals. Although intended primarily as an administrative aid
to clarify policy and procedural changes which affect hospitals, the Bulletin continued to carry more articles of general interest because of their value, particularly
to the smaller hospital. Such articles included " We Held a Hospital Fire Drill,"
" No Yardstick of Efficiency," " The Accreditation of Smaller Hospitals," " Responsibilities of Hospital Trustees," and " Meeting Medical Record Problems in Smaller
Hospitals."
The weekly press release, sent to the Province's news media, carried information on the Government's grant-in-aid programme, the opening of new hospitals, and
such items as the payment of patients' claims and the accreditation of hospitals.
Through the co-operation of the Photographic Branch of the Department of Recrea-
 HOSPITAL INSURANCE SERVICE,  1960 W 35
tion and Conservation, a photographic record was made of new hospital facilities
completed during the year.
The major pamphlet printed during the year was titled "At Your Service," and
was prepared for use by B.C. public hospitals to be distributed to patients and their
visitors. It contained information on hospital insurance benefits and eligibility
requirements, and also familiarized the reader with the main aspects of hospital
routine. A few minor revisions were made to the " General Information " pamphlet, and the revised edition was printed in July. A new pamphlet, printed in two
colours, is being prepared for future production. An important source of distribution of the " General Information " pamphlets was developed during the year
through the co-operation of the British Columbia supervisor of the Welcome Wagon
Service. Welcome Wagon hostesses, located in Victoria, Vancouver, New Westminster, Prince George, Vernon, Kelowna, Penticton, Gabriola Island, Port Alberni,
Chilliwack, Haney, and other B.C. centres, distribute the pamphlet to newly arrived
residents of the Province.
Several hospitals made use of the film library of 16-mm. sound film for instructional purposes as part of their in-service training programmes. An important addition to the library during the year was the outstanding film " Hospital Sepsis—A
Communicable Disease."
To keep the public and hospital personnel advised on the functions and
achievements of the Provincial hospital insurance plan, two displays were prepared,
one for use during the summer months in the rotunda of the main Parliament
Building and one for the Western Canada Institute of Hospital Administrators and
Trustees held in Vancouver in September. The latter display was designed so that
it can be used indefinitely by merely changing the showcard material. Assistance
was also given in the development of the permanent B.C.H.I.S. exhibit in the
British Columbia Building located on the grounds of the Pacific National Exhibition.
Miscellaneous functions included answering letters of general inquiry; writing
special material for hospital magazines, civic information pamphlets, and the British
Columbia Government News; maintaining the newspaper clipping file; acting as
liaison with the Queen's Printer for all printing; and preparing and producing the
Twelfth Annual Report.
General Office
C. R. Leighton
The General Office is responsible for the review of requisitions, vouchers, and
warrants prepared by the various divisions, and forwarding them to the appropriate
Government department for further action.
Departmental purchasing is handled by this office, which also assumes responsibility for furniture inventories, stock-supplies, operation of the teletype service,
operation of office equipment, and the storage and dispatch of forms for hospitals.
General personnel matters are dealt with by the office, and pay and personnel
records are maintained by the pay clerk. Stenographic services (including correspondence, typing, and transcribing) are provided from time to time to other divisions
of the British Columbia Hospital Insurance Service.
The preparation of Infirmary estimates is supervised by the General Office.
Certain expenditures are controlled by processing all requisitions and vouchers
through this office, which also audits the Infirmary accounting and prepares monthly
statements of expenditures.
The monthly comfort allowance received by all Infirmary patients is paid to
Mount St. Mary patients by the General Office, which also acts as liaison between
the Mount St. Mary authorities and the Infirmary business manager.
 VV 36
BRITISH COLUMBIA
HOSPITALS AS DEFINED UNDER THE HOSPITAL INSURANCE ACT
Part I
Hospitals defined as such under section 2 of the Hospital Acu-
(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, Esperanza.
Fernie Memorial Hospital, Fernie.
Fort Nelson General Hospital, Fort Nelson.
Fraser Canyon Hospital, Hope.
Golden and District 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.
Kitimat General Hospital, Kitimat.
Kootenay Lake General Hospital, Nelson.
Lady Minto Hospital, Ashcroft.
Lady Minto Gulf Islands Hospital, Ganges.
Ladysmith  and  District  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  Regional   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 General Hospital, Dawson Creek.
St. Joseph's General Hospital, Comox.
St. Joseph's Hospital, Victoria.
St. Martin's Hospital, Oliver.
St. Mary's Hospital, Garden Bay P.O.
St. Mary's Hospital, New Westminster.
St. Paul's Hospital, Vancouver.
St. Vincent's Hospital, Vancouver.
Shuswap Lake General Hospital, The, Salmon
Arm.
Slocan Community Hospital, New Denver.
Squamish General Hospital, Squamish.
Summerland General Hospital, Summerland.
Surrey Memorial Hospital, North Surrey.
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.
 HOSPITAL INSURANCE SERVICE,  1960 W 37
Red Cross Outpost Nursing Station, Edge- (c) Federal Hospitals
wood.
Red Cross Outpost Nursing Station, Hudson
Hope
Veterans' Hospital, Victoria.
Shaughnessy Hospital, Vancouver.
Red  Cross  Outpost Nursing  Station,  Kyu- Coqualeetza Indian Hospital, Sardis.
qUOt. Miller Bay Indian Hospital, Prince Rupert.
Red Cross Outpost Nursing Station, Masset. Nanaimo Indian Hospital, Nanaimo.
Stewart General Hospital, Stewart. 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. Gold Quartz Hospital, Wells.
Cassiar Asbestos Corporation Private Hos- Hollywood Hospital Ltd., New Westminster.
pital, Cassiar. Medical-Dental Hospital Unit, Vancouver.
Chatham House Private Hospital, Vancou- Port Alice Private Hospital, Port Alice.
Part III
Rehabilitation, chronic, and convalescent hospitals, as defined under section
24a of the Hospital Act:—
G. F. Strong Rehabilitation Centre, Vancou- Queen   Alexandra   Solarium   for   Crippled
ver. Children, Victoria.
The Gorge Road Hospital, Victoria. Shaughnessy Hospital, Vancouver.
Holy Family Hospital, Vancouver. Veterans' Hospital, Victoria.
Pearson  Hospital   (Poliomyelitis  Pavilion),
Vancouver.
 Williams Lake
The new War Memorial Hospital of 70 beds.
(Architects: Thompson, Berwick & Pratt, Vancouver.)
**»
z>
Fort St. John
The new Providence Hospital of 80 beds.
(Architects:   Gardiner, Thornton, Gathe & Associates, Vancouver.)
HOSPITAL PROJECTS
DEVELOPED
TO THE ADVANCED
STAGES OF
PLANNING IN
1960
Also
Fort Nelson: A new hospital.
Terrace: A 10-bed nurses' residence.
Chemainus: A new addition.
Hazelton: A new addition.
New Westminster: A laundry and
maintenance-shop for the Royal
Columbian Hospital.
Victoria: Sixteen additional beds at
the Queen Alexandra Solarium
plus unfinished areas for future
use.
Lytton: A new elevator plus renovations.
|I_J II lilt
II  I  It tl Ira
Vancouver
The new laboratory and laundry addition to
St. Paul's Hospital.
(Architects:   Gardiner, Thornton, Gathe & Associates, Vancouver.)
 HOSPITAL INSURANCE SERVICE,  1960
VV 39
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 British Columbia
Hospital Insurance Service. Eighty-eight public hospitals were approved in 1960
to accept B.C.H.I.S. patients. In addition, care was provided in eight outpost hospitals, six Federal hospitals, and seven private hospitals. Effective September 1st,
1960, five public hospitals and two Federal hospitals were approved for chronic-
care, but data from these hospitals on such care were not available for this Report.
Data for the year 1960 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 a total of 249,841 B.C.H.I.S. adult and children patients
were discharged from British Columbia hospitals in 1960, an increase of 15,058 or
6.4 per cent over the previous year. This table also shows that 95.6 per cent of
the total patients discharged from British Columbia hospitals in 1960 were covered
by hospital insurance, compared to 93.7 in 1958 and 95.5 in 1959. The percentage
continues to reflect the result of the reduction in residence requirements on July 1st,
1958, from twelve months to three months. The second part of Table I indicates
that in 1960 the British Columbia Hospital Insurance Service paid public hospitals
in British Columbia for 2,420,965 days of care for adults and children, an increase
of 145,838 days or 6.4 per cent over 1959.
As is shown in Table Ha, the average length of stay of B.C.H.I.S. adult and
children patients in British Columbia public hospitals during 1960 was 9.69 days,
the same as the preceding year. The increase from 1,724 days of care per thousand
population in 1959 to 1,803 in 1960, as shown on the notation to Table IIa, is due
to an increase in the incidence of hospital admissions, which is largely attributable
to the considerable increase in available hospital beds, resulting from the intensive
construction programme of the past few years.
 W 40
BRITISH COLUMBIA
Table I.—Patients Discharged and Days of Care and Proportion Covered
by British Columbia Hospital Insurance Service, British Columbia
Public Hospitals Only, 1949-60 (Excluding Federal, Private, and Out-
of-Province Hospital Data).
1 Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to November 30th. 1960.
Total Hospitalized
Covered by B.C.H.I.S.
Adults
and
Children
Newborn
Total
Adults
and
Children
Newborn
Total
Patients discharged—
1949 	
1
1
164.964   I    96.779
191.236
198,850
208,256
217,030
231,605
238,976
249,933
262,477
266,293
275,233
284,805
301,077
140,168
144,959
150,116
154,336
169,167
189,713
199,774
208,293
209 405
222,046
234,783
249,841
84.9
84.0
82.9
81.9
84.2
91.7
92.2
91.6
91.5
93.7
95.5
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
2,275,127
2,420,965
85.0
83.6
81.7
81.9
83.9
90.4
91.2
91.2
91.2
93.4
94.5
94.8
24,640
23,943
24,172
25,023
27,830
29,483
31,515
33,174
34,963
37,045
38,480
39,032
93.8
91.4
89.2
87.3
90.6
92.2
95.0
94.5
93.5
96.5
98.6
98.4
200,585
193,307
187,891
184,160
197,100
213,587
212,514
217,252
223,079
232,390
239,871
240,911
93.8
90.8
87.7
85.8
89.5
94.5
93.3
93.1
92.6
95.1
96.7
96.6
164,808
168,902
174,288
179,359
196,997
219,196
231,289
241 467
244,448
259,091
273,263
288,873
86.2
84.9
83.7
82.6
85.1
91.7
92.5
92.0
91.8
94.1
95.9
95.9
1,631,231
1,669,922
1,654,993
1,754,134
1,909,978
2,168,410
2.217,679
2,259,106
2,299,415
2,402,287
2,514,998
2,661,876
86.0
84.4
82.3
82.3
84.4
90.8
91.4
91.3
91.3
93.6
94.7
94.9
1950   -
1951 	
172,645
181,160
188.355
26,205
27,096
.8.675
1952         	
1953       	
200,893  |    30,712
206,992 I    31.984
216,743  I    33,190
227,359 |    35,118
228.917  1    37,376
236,859  |    38,374
245,766 j    39,039
961.411   I     19 ftfifi
1954                                   	
1955                        _.	
1956                                           	
1957                         — 	
1958
19591	
I9602          	
Percentage of total, patients discharged—
1949         	
1950  	
	
1951         	
	
1952     	
1953    . 	
1954    .. 	
....
1955            ...     .   	
	
1956    .   .
.
1957	
1958  	
19591  	
I9602 	
Patient-days—
1949	
1.6"2,196
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
2,407,134
2,554,285
213,874
212.979
214,285
214,701
220,208
226.031
227,674
233,402
240,872
244,429
248,074
249,298
1,896,070
1.979.659
2,009,723
2,131.187
2.261.823
2.3S8.033
2.426.537
2,473,048
2.518.439
2,567.225
2,655,208
2,803,583
1950	
1951    	
1952      	
1953     „   	
1954    	
1955 ...	
1956 -
1957                                                 -        	
1958             	
19591  	
I9602                     	
Percentage of total, patient-days—
1949                        .. .           	
1950                                          	
1951
1952                                                  	
1953 	
1954                                                     	
1955                                                  	
1956                                                 . -    	
	
1957                                                  -
	
1958                                              	
19591                                 	
	
I9602                      	
 r
HOSPITAL INSURANCE SERVICE,  1960
W 41
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, 1949-60.
Total
B.C. Public
Hospitals
Other B.C. Hospitals,
Including Federal
and Private
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
221,585
236,770
251,393
264,653
1,498,121
1,564,222
1,551,954
1,663,149
1,814,344
2,046,087
2,100,386
2,141,445
2.188.765
2,332,502
2,474,974
2,624,197
10.03
10.11
9.71
10.12
10.07
10.23
10.00
9.77
9.88
9.85
9.85
9.92
24,989
24,336
24,587
25,492
28,381
29,761
32,035
33,783
35,813
37,924
39,257
39,514
203,197
196,333
190,948
187,923
200,738
215,507
215,980
221,022
228,875
238,112
244,615
244,184
8.13
8.07
7.76
7.37
7.07
7.24
6.74
6.54
6.39
6.28
6.23
6.18
140,168
144,959
150,116
154,336
169,167
189,713
199,774
208,293
209,485
222,046
234,783
249,841
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
2,275,127
2,420,965
10.21
10.19
9.77
10.17
10.13
10.30
10.04
9.80
9.91
9.77
9.69
9.69
24,640
23,943
24,172
25,023
27,830
29,483
31,515
33,174
34,963
37,045
38,480
39,032
200,585
193,307
187,891
184,160
197,100
213,587
212,514
217,252
223,079
232,390
239,871
240,911
8.14
8.07
7.77
7.36
7.08
7.24
6.74
6.55
6.38
6.27
6.23
6.17
7,093
7,617
7,308
7,431
8,173
7,602
8,313
9,473
10,023
12,506
13,908
11,896
45,960
65,326
62,771
68,892
75,518
66,960
75,599
79,428
93,980
141,925
173,343
173,784
6.48
8.58
8.59
9.27
9.24
8.81
9.09
8.38
9.39
11.35
12.46
14.61
151
173
171
161
229
199
361
457
668
665
514
222
1,146
1,288
1,155
974
1,353
1,251
2,271
2,740
4,299
4,113
2,818
1,334
7.59
7.44
6.75
6.05
5.91
6.29
6.29
6.00
6.44
6.19
5.48
6.01
2,019
2,067
2,315
2,612
2,809
2,659
1,912
2,050
2,077
2,218
2,702
2,916
21,515
22,281
22,081
24,283
25,948
24,304
19,622
20,163
18,449
20,680
26,504
29,448
10.66
10.78
9.54
9.29
9.24
9.14
10.26
9.84
8.88
9.45
9.81
10.10
198
1950 	
1951 	
1952  	
1953  	
1954 	
1955 	
1956 	
1957
220
244
308
322
79
159
159
182
1958                   	
214
19591 	
I9602 _.
Patient-days—
1949           	
263
260
1,466
1950 —
1,738
1951        	
1,902
1952               	
2,789
1953     	
2,285
1954
669
1955                   	
1,195
1956       	
1,030
1957     —	
1,497
1958
1,609
19591	
1,926
I9602     	
1,939
Average days of stay—
1949                             	
7 40
1950  	
7.90
1951  	
7.79
1952     ,   	
9.06
1953
7.10
1954           	
8.47
1955                     	
7.52
1956
6.48
1957  	
8.23
1958  	
7.51
19591                            - .
7.32
I9602 	
7.46
1 Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to November 30th,  1960.
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; 1960, 1,803. (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.
 VV 42
BRITISH COLUMBIA
Table IIb.
-Summary of the Number of B.C.H.I.S. In-patients and
Short-stay Patients, 1949-60
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
290,650
304,167
29,000
44,502
47,656
46,767
52,582
63,621
70,553
76,375
83,530
91,883
100,292
107,312
203,269
223,481
231,982
236 638
1950	
1951       _	
1952
1953     	
261,112
293,356
312,587
329,376
1954..  ..   ....    .
1955	
1956     	
1957       ....           	
340,928
1958. 	
19591  .
366,577
390,942
I9602	
411,479
2,787,654
814,073
3,601,727
1 Amended as per final reports from hospitals.
2 Estimated, based on hospital reports to November 30th, 1960.
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 I960.1
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Hospitals
Patients discharged—
Adults and children	
249,841
39,032
2,420,965
240,911
9.69
6.17
86,023
10,804
1,056,858
72,553
12.29
6.72
77,305
13,781
685,943
81,950
8.87
5.95
32,270
7,048
262,740
43,484
8.14
6.17
36,438
4,994
279,001
29,342
7.66
5.88
10,926
1,606
78,457
9,228
7.18
5.75
6,879
799
Patient-days—
57,966
4,354
Average days of stay—
Adults and children
8.43
5.45
1 Estimated, based on hospital reports to November 30th, 1960.
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 I960.1
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Hospitals
Patients discharged—
Adults and children .
New-born	
Patient-days—
Adults and children-
New-born	
100.00
100.00
100.00
100.00
I
34.44
27.68
43.65
30.12
30.94
35.31
28.33
34.02
12.92
18.06
10.85
18.05
14.58
12.79
11.53
12.18
4.37
4.11
3.24
3.83
2.75
2.05
2.40
1.80
Estimated, based on hospital reports to November 30th. 1960.
 HOSPITAL INSURANCE SERVICE,  1960 W 43
CHARTS
The charts on the following pages have been prepared by the Research Division
from the annual tabulations made for the use of various British Columbia Government agencies. They give a general idea of the relative importance of the various
hospital services (medical, surgical, etc.); they also provide some insight into
morbidity in British Columbia.
It should be noted that the diagnostic groups shown in these charts are those
of the British Columbia list, and not those of the aU-Canadian list used for the table
on pages 50 to 53. In November, 1960, the Working Party of the Sub-committee on
Quality of Care, Research, and Statistics, meeting in Ottawa, adopted a 98-item
list of diseases and causes of death in order to provide uniform morbidity statistics
in all ten Provinces. The Canadian list is based mainly on the International Statistical Classification of Diseases, Injuries, and Causes of Death, prepared by the World
Health Organization (1957 edition).
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Average Length of Stay of Patients in Acute-care Hospitals in British
Columbia by Major Diagnostic Groups (Excluding New-borns), 1959
Diseases of the Circulatory
System
Neoplasms
Congenital Malformations
Diseases of the Bones and
Organs of Movement
Diseases of the Blood and
Blood-forming Organs
Allergic, Endocrine, Metabolic
and Nutritional Diseases
Diseases of the Nervous System
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Infective and Parasitic Diseases
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Early Infancy
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Provincial Average
Length of Stay
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Deliveries and Complications of
Pregnancy, Childbirth and
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Diseases of the Respiratory
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Symptoms, Senility and
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Supplementary Classification
for Special Admissions
15.7
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 HOSPITAL INSURANCE SERVICE,  1960
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rt 2 w h .o u
 W 54 BRITISH COLUMBIA
STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE
FISCAL YEAR ENDED MARCH 3 1st,  1960
Administration—
Salaries         $393,012.37
Temporary assistance  8,037.40
$401,049.77
Office expense  21,821.80
Travelling expense   30,385.21
Office furniture and equipment  1,497.20
Printing and publications  21,218.53
Tabulating and rentals  2,809.70
Motor-vehicles and accessories  2,297.80
Incidentals and contingencies  2,480.50
Construction—consulting fees 	
Technical surveys  1,721.03
$485,281.54
Payments to hospitals—
Claims   $43,553,502.75
Vancouver General Hospital re out-patients
(Hospital Insurance Act,  section  35
(30))   283,415.84
$43,836,918.59
Less collections, third-party liability 195,954.66
43,640,963.93
Grants in aid of construction and equipment of hospitals       4,672,946.94
$48,799,192.41
Less chargeable to Government of Canada.. $20,406,091.56
Less miscellaneous receipts  4,351.83
Less transfer, Vote 138—Salary Revision __ 28,332.00
     20,438,775.39
Total, Vote 177  $28,360,417.02
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1961
460-1260-9009
  

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