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Fifteenth Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1963 British Columbia. Legislative Assembly 1964

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 PROVINCE OF BRITISH COLUMBIA
HOSPITAL INSURANCE ACT
Fifteenth Annual Report
British Columbia Hospital
Insurance Service
JANUARY 1  TO DECEMBER 31
1963
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1964
  Victoria, B.C., January 23, 1964.
To Major-General the Honourable George Randolph Pearkes,
V.C., P.C., 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 Fifteenth Annual Report of the
British Columbia Hospital Insurance Service covering the calendar year 1963.
ERIC MARTIN,
Minister of Health Services and Hospital Insurance.
 British Columbia Hospital Insurance Service,
Victoria, B.C., January 23, 1964.
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 1963.
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.
W. J. Lyle, F.C.I.S., Manager, Hospital Finance Division.
J. W. Mainguy, M.H.A., Manager, Hospital Consultation and Inspection Division.
A. W. E. Pitkethley, Esq., Manager, Hospital Construction and Planning Division.
W. A. Fraser, O.B.E., E.D., M.D., CM., F.A.C.S., Medical Consultant.
K. G. Wiper, Esq., Administrative Officer.
W. D. Burrowes, B.A., Director, Research Division.
  CONTENTS
9
General Introduction      	
British Columbia General Hospitals (Comparisons of Growth)  1 I
The Hospital Insurance Act  13
The Hospital Act  13
Persons Entitled to or Excluded from the Benefits under the Hospital Insurance
Act  13
Entitled to Benefits  13
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
The Hospital Rate Board and Methods of Payment to Hospitals  15
Organization Chart  17
Organization and Administration    18
Hospital Finance Division   18
Hospital Accounting  1.8
Hospital Claims  20
Hospital Construction and Planning Division  21
Hospital Projects Completed during 1963  24
Hospital Projects under Construction at Year-end  25
Projects in Advanced Stages of Planning  26
Additional Projects Developed through Various Planning Stages     26
Hospital Consultation and Inspection Division  27
Medical Consultation Division  29
Administrative Officer  29
Third Party Liability Section  30
Eligibility Inspectors' Section  30
Research Division  31
Public Information  32
General Office  33
Hospitals as Defined under the Hospital Insurance Act  33
Public Hospitals  3 3
Outpost Hospitals  34
Federal Hospitals  34
Private Hospitals (Providing General Hospital Services)  35
Rehabilitation, Chronic, and Convalescent Hospitals  35
Statistical Data  35
Table I.—Patients Separated (Discharged or Died), Total Patient-days
and Proportion Covered by British Columbia Hospital Insurance
Service, British Columbia Public Hospitals Only, 1949-63 (Excluding
Federal, Private, and Out-of-Province Hospitalization)  36
Table IIa.—Patients Separated, Total Days' Stay, and Average Length of
Stay According to Type and Location of Hospital for B.C.H.I.S.
Patients Only, and Days of Care per Thousand of Covered Population, 1949-63 (Including Rehabilitation Hospitals)  37
 H 8 BRITISH COLUMBIA
Pace
Statistical Data—Continued
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients (Including
Rehabilitation Patients) and Short-stay Patients, 1949-63  38
Table III.—Patients Separated, 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 1963  38
Table IV.—Percentage Distribution of Patients Separated and Patient-days
for B.C.H.I.S. Patients Only, in British Columbia Public Hospitals,
Grouped According to Bed Capacity, Year 1963  38
Charts  39
I.—Percentage Distribution of Days of Care by Major Diagnostic Groups,
1962  40
II.—Percentage Age Distribution of Male and Female Hospital Cases and
Days of Care, 1962  41
III.—Percentage Distribution of Hospital Cases by Type of Clinical Service,
1962  42
IV.—Percentage Distribution of Hospital-days by Type of Clinical Service,
1962  43
V.—Average Length of Stay of Cases in Acute-care Hospitals in British
Columbia by Major Diagnostic Groups, 1962 (Excluding Newborns)  44
Hospitalization by Diagnoses According to the Canadian List of Diseases
and Causes of Death, 1962  45
Statement of Receipts and Disbursements for the Fiscal Year Ended March 31,
1963  48
 Fifteenth Annual Report of the British Columbia
Hospital Insurance Service
GENERAL INTRODUCTION
Donald M. Cox, F.A.C.H.A., Deputy Minister of Hospital Insurance
On December 31, 1963, the British Columbia Hospital Insurance Service completed its 15th year of service to the residents and hospitals of the Province. It
continued to ensure that good and efficient standards of hospital services were maintained, and payments to hospitals were at their highest level since the start of the
programme. During the current fiscal year the British Columbia Hospital Insurance
Service will pay over $63,000,000 toward hospital expenses incurred by British
Columbia residents, the equivalent of approximately $38 for each man, woman, and
child living in the Province today. It is of interest to note that early in November
the payment of a hospital account brought the amount paid in claims to the $500,-
000,000 mark since January 1, 1949. At the year-end an estimated $510,000,000
in hospital bills will have been paid by the British Columbia Hospital Insurance
Service in its 15 years of operation. Daily payments to British Columbia hospitals
have increased from an average of $50,000 in 1949 to approximately $170,000
in 1963.
The extensive programme of hospital construction, which has been under way
throughout the Province for the past decade, continued without let-up, and the
number of projects still on the planning boards would indicate that numerous areas
will continue to witness the start of new construction for many months to come.
During the year 13 major projects were completed, involving 551 beds and gross
construction costs of over $9,000,000. These included new hospitals at Nanaimo,
McBride, and Grand Forks; new additions at Powell River and the Royal Jubilee at
Victoria; new staff residences at Queen Charlotte City, Salmon Arm, and Terrace;
and completion of a top floor at Prince George. Major hospital projects still under
construction as the year drew to a close involved 600 beds and total costs of over
$11,500,000. In addition to construct'on grants-in-aid, representing 50 per cent of
the approved costs, the Provincial Government also pays one-third the costs of
equipment and furnishings. A detailed summary of hospital construction appears
elsewhere in this Report.
The continued advice of the medical profession was of great assistance to the
British Columbia Hospital Insurance Service during the past year. The progressive
development of the rehabilitation programme was the subject of extensive medical
study, and advice was given also on many other medical matters affecting the operation of the Service. By arrangement, inquiries are directed to the executive director
of the Canadian Medical Association (British Columbia Division), and referred by
him to the appropriate committees or sub-committees. I should like to record my
appreciation of the assistance rendered by the Canadian Medical Association (British Columbia Division), the College of Physicians and Surgeons of British Columbia, and by the medical profession generally.
9
 H   10 BRITISH  COLUMBIA
The work of the Laboratory Advisory Council and the Radiological Advisory
Council continues to be a tremendous help and strength in the programme of assisting hospitals in the improvement of their laboratory and radiological services, and in
advising on requests relative to grants in aid of purchases of major equipment.
In October the Minister announced the Government's decision to utilize the
available beds in Pearson Hospital, Vancouver, for the use of Provincial Infirmary
patients. The Infirmary staff is now proceeding with a review and transfer of the
patients involved.
The British Columbia Hospital Insurance Service was again invited by the
executive of the British Columbia Hospitals' Association to exhibit a display during
the association's annual conference, held in the Hotel Vancouver in October. Some
of the charts appearing in this display are reproduced on the following pages.
Reports prepared by the various divisions on work undertaken during 1963
appear under " Organization and Administration."
L
 HOSPITAL INSURANCE SERVICE, 1963
H   11
1949
B.C.H.I.S. Payments to Hospitals
60
55
50
45
o 40
S 35
.0
25
20
15
1951
1954
1957
1960
65
55
50
30
25
20
196.1
(est.)
Percentage
340
320
280
260
240
220
200
180
160
140
120
100
80
60
40
20
Hospitals' Growth Rate
.0*
6* ^
>05»
r^
7
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F
PA
Tr£NT
PAYi
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.l.fiiTtON^
1948
1951
1954
1957
1960
1963
(est.)
Percentage Increase over 1948
Per Cent
Total gross expenditure (excluding depreciation)  328
Staff (full-time equivalent)  129
Patient-days (adults and children)     86
Population     57
 H  12
BRITISH COLUMBIA
Total Full-time Staff and Average Number of Patients
(Adults and Children) per Day
15
14
13
12
11
■o 10
c
n
3
9 9
H
8
7
6
5
4
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ill--
TOT^
rf * C^^Jii
.,   pATtertT-i
15
14
13
12
11
M
10 _r
c
p
9 5
8
7
6
5
1948
1954
1960
1963
(est.)
Gross Salaries and Wages and Other Operating Expenses*
55
50
45
40
m     35
Q
O
1   30
25
10
1948
1951
^s
W^
?*>/
,     5
G*05   .^
,;  fxff^
yS^
1954
1957
1960
55
40
35
25
20
15
1963
(est.)
* Including approximately $2,000,000 in staff fringe benefits.
 HOSPITAL INSURANCE SERVICE,  1963 H 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 is entitled to
benefits under the Act.
(2) Approved hospitals are paid an all-inclusive per diem rate for medically
necessary in-patient care rendered to qualified British Columbia residents
who are suffering from an acute illness or injury, and those who require
active convalescent and rehabilitative care. 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 wide range of in-patient benefits and the emergency out-patient and
minor surgery services, provided under the Act, are described on the
following pages.
(4) Qualified persons who are temporarily absent from British Columbia are
entided to certain benefits for a maximum period of three months, if they
are admitted to an approved hospital within 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 primarily 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.
(b) 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, primarly for the
treatment of persons who will benefit from intensive rehabilitative care.
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 the provision of
 H  14 BRITISH COLUMBIA
hospital care is a medical necessity, and if he proves to the satisfaction of the Deputy
Minister of Hospital Insurance that he qualifies under one of the following
categories:—
(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 temporarily and
returns after an absence of less than 12 months and resumes residence
within the Province; or
(c) He is living within the Province and is a dependent of a resident of the
Province.
During the three-month residence qualification period, a person is permitted to
be temporarily absent from British Columbia for a total of one month without incurring 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 other Provinces.
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 12 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 under the Statutes 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 necessary nursing
services, a beneficiary may receive any of the other services available in the hospital,
which may include:—
Laboratory and X-ray services.
Drugs, biologicals, and related preparations (with a few exceptions).
Use of operating-room and caseroom facilities.
Use of anaesthetic equipment, supplies, and routine surgical supplies.
Use of radiotherapy and physiotherapy facilities where available.
Other approved services rendered by employees of the hospital.
 HOSPITAL INSURANCE SERVICE,  1963 H  15
(Note.—Private or semi-private rooms cost more to maintain than standard
wards, and a patient is required to pay extra for such accommodation, except under
special circumstances.)
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 within 24 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, and the remainder of the
cost is paid by the British Columbia Hospital Insurance Service.    However, if the
patient received treatment from a private physician, he is responsible for paying the
doctor's services, as such charges are not payable by the British Columbia 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
in 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 satisfactorily
established.   (See Eligibility Section.)
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 1,
1951, provides for a review of hospitals' estimates by the Rate Board. Under the
firm-budget procedure, hospitals are required to operate within their approved
budgets, with the exception of fluctuation in days' treatment and other similar items.
They are further advised that deficits incurred through expenditures in excess of the
approved budget will not be met by the Provincial Government. The value of variable supplies used in patient-care has been established. 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.
 H  16
BRITISH COLUMBIA
Over 95 per cent of all hospital accounts incurred in British Columbia are the
responsibility of the British Columbia Hospital Insurance Service. Cash advances
to hospitals are made on a semi-monthly basis, so that hospitals are not required to
wait for payment until patients' accounts are submitted and processed by the British
Columbia Hospital Insurance Service. Qualified patients are charged $1 per day,
which is deductible when calculating payments to hospitals from the Service.
Non-qualifying 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, 1963
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 H 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 during 1963
by the various divisions and offices which comprise the administrative structure of
the Branch.
Hospital Finance Division
W. J. Lyle, F.C.I.S., Manager
Hospital accounting and payment of hospital claims are the two main functions
of the Hospital Finance Division. The Division is also responsible for the approval
of equipment grants, and in 1963, after a review of 3,500 applications received from
hospitals, it paid grants of $550,000 on equipment costing approximately $1,700,-
000. During 1963 the Division Manager attended three meetings in Ottawa of the
Advisory Council on Hospital Insurance and Diagnostic Services, which is the
advisory body to the Minister of National Health and Welfare. The Manager also
acted on a sub-committee on finance and accounting which was given the task of
studying and making recommendations relative to the sharing of certain costs under
the Federal-Provincial Agreement.
At the end of 1963 the employees of all public hospitals in British Columbia,
except one, were covered under the Municipal Superannuation Act. Additional
employees became eligible from April 1, 1963, as a result of an amendment to the
Municipal Superannuation Act, which changed the maximum retirement age for
females from 60 to 65 years. Close liaison was continued between the Division
Manager and the Commissioner of Municipal Superannuation in respect to the
application of the Act to hospital personnel, and the postponement of retirement for
certain employees who reach maximum retirement age.
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 the purchase of equipment by
public hospitals. He also participated in meetings of the Advisory Committee on
Medical Radiography, which was appointed to assist in the development plans for
the new Institute of Technology being constructed in Burnaby.
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 work of the Hospital Accounting Section falls into two main categories:
(a) the detailed inspection, in the field, of the financial records of the hospitals for
purposes of verification of annual and other financial statements, and (b) the
assembly of relevant information and preparation of tabulations and other data for
use by the Hospital Rate Board in its reviews of hospitals' estimates. In carrying
out the inspection duties, visits were made at least once during 1963 to 87 public
general hospitals and four public rehabilitation hospitals, the individual visits extending from three days to four weeks. The gross expenditures of these public general
and rehabilitation hospitals, as approved by the Hospital Rate Board, for the year
1963, amounted to $68,000,000.
 HOSPITAL INSURANCE SERVICE, 1963
H 19
Other functions performed by the Hospital Accounting staff include:—
(a) The tabulation of monthly statistical and financial reports from hospitals,
and the correlating of these with the approved budgets.
(b) The calculation 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 provision, on request, of accounting assistance and instruction to
smaller public hospitals in the Province.
(e) The carrying-out of accounting reviews and cost studies of nursing homes,
upon the request of the Social Welfare Department, for welfare payment
purposes.
(/) The auditing of accounts of hospital-construction projects, to determine
the amount of construction grants payable by the Province.
During 1963, construction projects, involving expenditures of $6,400,000,
were audited and the required statements prepared for the Federal Government, in
order that Federal construction grants could be claimed on behalf of the hospitals.
Experience during the first few years' operation of the British Columbia
Hospital Insurance Service indicated that operating costs required serious consideration when planning new hospitals and additions to existing hospitals. In order to
ensure that 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 board is 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 shares in the costs of in-patient care in this
Province, monthly payments are made to the Province by Ottawa, based on advances
to hospitals made by the Province during the previous month. These payments 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 hospital's
records have been inspected by accountants from this Section and approved by
Federal Treasury auditors. Compilation of the necesary data required by the
Federal authorities for purposes of the final settlement is highly complex, and involves a considerable amount of detailed work before agreement on the amount
shareable in respect of each financial year is reached.
 H 20 BRITISH COLUMBIA
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
The Hospital Claims Section is responsible for processing Admission/Separation 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, by the patient, or
other agency. 1963 was another year of active production; approximately 1,350
claims and an average of over 460 emergency-service or minor-surgery account
forms were processed during each working-day.
In addition to the normal processing of hospital claims, the planning and reviewing of procedures was continued during the year. This was necessary in order
to devise methods of meeting the increasing volume and complexity of handling
claims. Several pages of the B.C.H.I.S. manual were revised, and some forms were
modified to bring them up to date. Discussions with the Bureau of Statistics, when
planning the use of the new I.B.M. electronic data-processing machine, resulted in
an improvement in the listing of the account cards.
A brief outline of the work and duties performed by the various sections of
Hospital Claims 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 the Eligibility Inspectors. Over 5,000 hospital
claims, or some 1.4 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 obtaining and recording the patient's residence information and employment history. This was carried out by correspondence, by actual
visit to the hospital, or by attendance at hospital regional meetings.
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 other Provinces and Territories. During the year an average of 500 queries per month on accounting matters
were addressed to British Columbia hospitals. In 1963 a total of 318,804 accounts
was paid, compared to 311,543 in 1962 and 308,023 in 1961.
The Social Welfare Records Section continues to maintain the alphabetical
file of all Health Services Identification Cards issued to welfare recipients in this
Province. Over 27,600 hospital accounts incurred by welfare recipients were
checked to this file to determine eligibility for hospital benefits. This file is also
used by the Department of Social Welfare as a source of information. During the
year, Health Services Identification Card duplicates were received for new recipients
of social welfare in British Columbia, which increased the number of cards filed to
over 85,000.
The Voucher and Key-punch Sections are responsible for batching and voucher-
ing 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.
 HOSPITAL INSURANCE SERVICE,  1963
H 21
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 1963 a total of 3,364
accounts, amounting to $538,275, was paid on behalf of qualified residents who
were hospitalized in the other Provinces and Territories of Canada and the continental United States, including Alaska and Hawaii; Australia; Austria; Bermuda;
China; Denmark; England; Finland; France; Holland; Italy; Ireland; Jamaica;
Korea; Mexico; New Caledonia Island; New Zealand; Portugal; Scotland; Spain;
Sweden; and West Germany. Correspondence arising from all out-of-Province
accounts totalled 14,800 letters and forms.
This Section also compiles up-to-date hospital rate schedules for every
approved hospital in Canada.
The Filing Section sorted and filed an average of 3,950 documents and letters
daily, an increase of 50 daily over last year. During the year all 1962 hospital
accounts were microfilmed by the Central Microfilm Bureau; 597,292 documents
were photographed on 19,900 feet of film. In addition, the out-of-province " paid "
and " rejected " accounts and general correspondence were microfilmed, totalling
31,378 documents on 1,100 feet of film. This annual microfilming effects a con-
s'derable saving in office space, which would normally be taken up with 70 filing-
cabinets for documents.
Hospital Construction and Planning Division
A. W. E. Pitkethley, Manager
The main functions of this Division can be briefly described as follows: —
(1) Providing hospital boards of management, their architects and planning
committees, with a full consultative service on planning hospital-
construction projects, which include new hospital facilities, additions to
and renovations of existing hospitals, as well as residence accommodation
for hospital personnel.
Special emphasis is given to the need for the development of written
programmes for proposed construction projects. Hospitals are assisted
by this Division in the preparation of such programmes, which provide
architects and their engineering consultants with basic planning criteria
for the logical development of plans.
(2) Provincial grants-in-aid toward construction, renovations, and building
improvements are processed and recommended for payment by this
Division. The Division also initiates applications for Federal construction grants, and processes and submits claims for payment.
The Manager of the Hospital Construction and Planning Division serves as
secretary of the Advisory Board of Management of the Provincial Infirmaries, and
is responsible for general administrative supervision.
A great deal of time is spent in reviewing plans of proposed building projects.
Special attention is given to the interrelationship of the various departments of the
hospital building, to ensure a layout arrangement that can provide a high standard
of patient-care, efficient and economical operation, and adequate service and clinical
facilities. In planning hospital facilities, attention is also given to the need and
method for future expansion. Liaison was maintained with the mechanical engineering profession, and meetings were held with representatives, in recognition of
the need to design high-quality mechanical systems that would make a maximum
contribution toward an efficient and economical hospital operation. Some of the
elements included in designs for mechanical systems for new hospital buildings that
 H 22 BRITISH COLUMBIA
reflect this approach include heat recovery systems, air recirculation, variable-speed
motors for air-systems fans, and zoned heating and ventilating controls, including
automatic clock control systems. Hospital boards are provided with a complete
consultative planning service through this Division and through the co-operation of
Health Branch personnel, members of the medical and nursing profession, and other
divisions of the British Columbia Hospital Insurance Service. The Provincial Health
Branch renders assistance through the Division of Public Health Engineering, the
Nutrition Consultant, the Technical Supervisor of Clinical Laboratory Services, and
Technical Supervisor of Radiology, and the Provincial Public Health Officers.
Hospital plans are also referred for review and comment by the Chief of the Hospital
Design Division, Department of National Health and Welfare, Ottawa. The Construction and Planning Division maintained liaison with the Canadian Medical
Association (British Columbia Division) and the Faculty of Medicine of the University of British Columbia.
During the year the Division continued to benefit through the co-operation of
the Public Works Department, which assigned an architect on a full-time basis.
The Manager of this Division continued to serve on two working parties established under the chairmanship of the Chief of the Hospital Design Division, Ottawa.
One working party studied accommodation problems of hospitals for the chronically
ill, with a view to the development of construction standards for this type of hospital,
and the other studied the revision and expansion of the general hospital construction
standards, originally published in 1948.
During the year, liaison was also maintained with the Hospital Committee of
the Architectural Institute of British Columbia. The function of this Committee is
to review and endeavour to resolve problems arising out of hospital-construction
projects which affect members of the Architectural Institute.
The Manager of the Hospital Construction and Planning Division was a member of a panel at the British Columbia Hospitals' Association conference at Vancouver on October 24, 1963. The topic under discussion was "A Specific Approach
for Regional Planning."
 HOSPITAL INSURANCE SERVICE,  1963
MAJOR HOSPITAL PROJECTS, 1963
H 23
Boundary Hospital, Grand Forks
This new 30-bed hospital was opened by the Minister of
Health Services and Hospital Insurance on August 26,
1963.
(For details on the hospital-construction programme,
please refer to pages 21 to 27.)
PROJECTS COMPLETED
Nanaimo:   New  160-bed hospital.
McBride: New 21-bed hospital.
Powell River: New additions.
Grand Forks: New 30-bed hospital.
Victoria (Royal Jubilee): New
195-bed addition plus 20-bed addition to psychiatric unit.
Prince George: Completion of 28
beds.
Terrace: Completion of 10 beds
plus 7-bed addition to staff residence.
New Westminster (Royal Columbian): New two-story laundry
and maintenance building.
Vancouver (St. Paul's): New emergency department facilities.
Also new staff residences at Salmon
Arm, Queen Charlotte City, and
Burns Lake.
PROJECTS UNDER CONSTRUCTION AT YEAR-END
Mission: New 54-bed hospital.
Murrayville: New 81-bed hospital.
Kamloops:  New 152-bed addition and 107-
bed nurses' residence and training-school.
Merritt: New 37-bed hospital.
Fort Nelson: New 33-bed hospital.
Vernon: New laundry and boiler plant.
Quesnel: New addition.
Sechelt: New 35-bed hospital.
Dawson  Creek:   Completion  of  unfinished
areas.
PROJECTS
IN ADVANCED STAGES
OF PLANNING
Duncan: New 125-bed hospital.
North Vancouver: Renovation of
old hospital building.
Tofino: New addition.
New Westminster (Royal Columbian): New emergency department.
■J?*
(Architects:  Gardiner, Thornton, Gathe & Associates, Vancouver.)
Holy Family Hospital, Vancouver
This proposed addition to the Holy Family Hospital is
one of 30 projects at various stages of planning, other
than advanced.
 H 24 BRITISH COLUMBIA
(a) Hospital Projects Completed during 1963
Nanaimo Regional General Hospital.—The new 160-bed hospital at Nanaimo
was officially opened by the Minister on January 6, 1963. The new building, which
has provision for easy expansion in the form of unfinished areas, replaces the old
110-bed hospital building which was constructed in 1929 and added to in 1942.
The new building, which is of reinforced-concrete construction, is designed in the
form of a " T." The top of the " T " provides five floors of nursing units, which
have been structurally designed to take additional floors in future.
Royal Jubilee Hospital, Victoria.—The Minister of Health Services and Hospital Insurance officially opened the 20-bed addition to the psychiatric unit on
January 18, 1963. The net gain in beds amounted to 18, which brought the total
psychiatric beds at the hospital to 42 beds. The addition features a central courtyard and has adequate provision for ambulatory patients.
McBride and District Hospital.—An official opening ceremony was performed
by the Minister for the new 21-bed hospital at McBride on April 21, 1963. The
project also included a residence to accommodate 10 hospital personnel. Due to
peculiar subsoil conditions in the McBride district, it was essential to engineer the
hospital on a " floating " concrete foundation. The building is constructed as a
single story. The new hospital replaces the old hospital building, which was originally a dwelling, taken over for a hospital by the Village of McBride in 1932.
Royal Jubilee Hospital, Victoria.—Construction of the new south and west
wings. His Honour the Lieutenant-Governor George R. Pearkes officiated at the
opening ceremonies on June 22, 1963. The new wings provide a total of 195 beds,
31 of which remain unfinished and can be readily brought into service when required
in the future. The radiotherapy and rad'Ography departments are located on the
main floor of the new wings.   The top floor is devoted to new surgeries.
Powell River General Hospital.—The Minister officially opened the additions
to the Powell River General Hospital on Friday, July 5, 1963. The new additions
include nursing units, an extended administration department, a new laundry, new
physiotherapy department, laboratory, and morgue, as well as centralized locker
facilities. Thirty-eight new beds are included in the project, and are located in a
four-story addition constructed at the front of the existing building. The new
accommodation replaces beds that were formerly in overcrowded areas throughout
the existing building. In conjunction with the additions, extensive renovations have
also been completed in the existing buildings.
Boundary Hospital, Grand Forks.—On August 26, 1963, the Minister officially
opened the new hospital at Grand Forks, which provides 30 active-treatment beds
and 6 bassinets. The buildings is a single-story reinforced-concrete structure with
partial basement.   It replaces the old hospital which was built in 1914.
Prince George Regional Hospital.—Early in 1963, 28 additional beds were
brought into service. These beds are located in areas in the existing building which
were originally left in a semi-finished state when the hospital build:ng was constructed. Space for a further 12 beds was later fin"shed and brought into service
late in the year.
Mills Memorial Hospital, Terrace.—Ten additional beds were brought into
operation at Terrace. These beds are located in areas which were originally left in
a semi-finished state when the new hospital building was constructed in 1961.
Addition to Staff Residence: A 7-bed addition to the staff residence at Terrace was
completed this year; this addition brings the capacity of the residence at Terrace to
a total of 17 beds for hospital personnel.
 HOSPITAL INSURANCE SERVICE, 1963
H 25
Shuswap Lake General Hospital, Salmon Arm—Nurses' Residence.—A new
7-bed residence at Salmon Arm was completed this year. Accommodation is self-
contained in single and double suites.
Queen Charlotte Islands General Hospital—Staff Residence.—A new 15-bed
residence at Queen Charlotte City was opened in May, 1963. This is a two-story
frame building which replaces the inadequate accommodation located in the basement of the hospital.
■ Royal Columbian Hospital, New Westminster—Laundry and Maintenance
Building.—In December, 1963, the new laundry and maintenance building came
into operation. The building is two stories of reinforced-concrete construction, and
is connected to the main building by a tunnel.
Burns Lake and District Hospital—Nurses' Residence.—On June 5, 1963, the
new 15-bed residence at Burns Lake was completed. The building is of frame construction and has accommodation for 15 nurses in single rooms, including a suite
for the matron.  The building has a combined lounge and recreation room.
St. Paul's Hospital, Vancouver—New Emergency Department Facilities were
completed early in 1963. The project involves an area of approximately 6,500
square feet, which was renovated to be used effectively and economically as an
emergency department.
(b)  Hospital Projects under Construction at Year-end
Mission Memorial Hospital.—New hospital of 54 beds, with an unfinished area
which w'll provide an additional 24 beds when required at a future date.
Lan°ley Memorial Hospital, Murravville—New 81-bed Hospital.—The four-
story building of reinforced concrete with initial accommodation for 81 beds will
have unfinished areas for 24 additional beds, and the fourth floor will be partially
completed to provide for 37 beds at a future date, for a total of 61 beds to be left
unfinished.
Royal Inland Hospital, Kamloops — Addition and Nurses' Residence and
Training-school.—The new hospital addition will have 152 beds and will contain
a new laundry, kitchen, X-ray department, laboratory, and emergency department,
as well as operating theatres. The eighth floor of the new win*, will be initially left
in an unfinished state. This floor will provide approximately 34 beds when required
in the future. The residence and training-school will have 107 student-nurses' beds
and a suite for the resident supervisor. When the new addition is complete, the 1911
wing of 43 beds will be demolished.
N'cola Valley General Hospital, Merritt.—The new 3 7-bed reinforced-concrete
two-story hospital will replace the existing hospital, which was constructed in 1911.
Space for 8 unfinished beds will be left in the building for use when required in the
future. A separate frame nurses' residence is being constructed, wh;ch will accommodate 7 hospital staff.
Fort Nelson General Hospital.—New 3 3-bed hospital capable of expansion to
60 beds. There is residence accommodation included in the hospital building for 8
nurses. This new building will replace the existing hospital, which was formerly a
first-a:d station leased from the Department of Transport.
Vernon Jubilee Hospital.—Construction of an addition to provide a new laundry and boiler plant. This is the first phase in an expansion programme planned for
the hospital.
 H 26 BRITISH COLUMBIA
G. R. Baker Memorial Hospital, Quesnel.—Additions to the existing building
to provide 36 beds plus unfinished space for 22 future beds. The additions also
include space for 3 labour beds, an enlarged emergency department, an enlarged
laboratory, plus physiotherapy department, pharmacy stores, general storage, etc.
The construction is of reinforced concrete steel stud and plaster walls and terrazzo
floors.
Sunshine Coast Hospital, Sechelt.—The construction of a new 35-bed hospital.
The building will be of reinforced-concrete construction, single story with partial
basement, structurally designed to take an additional story at a future date. The
new hospital at Sechelt will replace the existing St. Mary's Hospital at Garden Bay.
St. Joseph General Hospital, Dawson Creek.—Completion of areas on the top
floor of the hospital which will provide accommodation to bring the capacity of the
hospital up to a total of 100 beds. The hospital presently is listed for a capacity of
71 beds.
(c) Projects in Advanced Stages of Planning and for Which Working Drawings and
Specifications Are Completed or Are in Process of Preparation
Cowichan District Hospital, Duncan.—Construction of a new 125-bed hospital.
Royal Columbian Hospital, New Westminster.—Working drawings are under
way for the new emergency department addition.
Lions Gate Hospital, North Vancouver.—Renovation of old hospital building
to provide accommodation for " activation " and psychiatric beds.
Tofino General Hospital.—Construction of an addition to contain 6 additional
beds, 2 of which will be left unfinished.
(d)  Additional Projects Developed through Various Planning Stages in 1963
Ladysmith and District General Hospital:  Addition and renovations.
Vernon Jubilee Hospital:  Additions and renovations.
St. Joseph's Hospital, Comox:  Replacement.
100 Mile House: New facility.
Prince Rupert General Hospital:  Addition and alterations.
Richmond General Hospital: New facility.
Gorge Road Hospital, Victoria:  Addition.
Kelowna General Hospital:  Additions and renovations.
Creston Valley Hospital:  Addition and improvements.
Medical Sciences Centre, University of British Columbia:  New hospital.
St. Vincent's Hospital, Vancouver:  Additions and renovations.
Vancouver General Hospital: Replacement or renovation of Willow Pavilion
and replacement of Laurel Pavilion.
White Rock District Hospital: Addition.
Cariboo Memorial Hospital, Williams Lake: Nurses' residence.
Boundary Hospital, Grand Forks: Nurses' residence.
Bulkley Valley District Hospital, Smithers:  Addition.
Trail-Tadanac Hospital: Laboratory addition and renovations.
Summerland General Hospital: New hospital.
Holy Family Hospital, Vancouver:  Addition.
Cranbrook: New hospital.
Maple Ridge Hospital, Haney: Expansion programme.
Nanaimo Regional General Hospital: Long-term care programme under consideration.
Ocean Falls General Hospital: Replacement.
Pouce Coupe Community Hospital: Addition for nursing home.
 HOSPITAL INSURANCE SERVICE,  1963
H 27
Queen Victoria Hospital, Revelstoke: Replacement.
Mater Misericordiae, Rossland:  Addition.
G. F. Strong Rehabilitation Centre, Vancouver:   Addition and renovations.
Children's Hospital, Vancouver: Planning only.
St. John Hospital, Vanderhoof:  Addition.
Surrey Memorial Hospital, North Surrey: Expansion programme.
Hospital Consultation and Inspection Division
J. W. Mainguy, M.H.A., Manager
The work of this Division is concerned with both public and private hospitals.
A consultative service is provided to all hospitals on problems of administration and
operation in all aspects of management. The Division is also responsible for the
licensing and inspection of private hospitals, includ:ng both private acute hospitals
(all but one of which are operated in remote areas of the Province by industrial
companies) and private hospitals giving nursing-home care to the aged sick. Most
of the latter kind are privately owned and operated for profit.
The Division works with the Finance Division in analysing and reviewing hospital estimates, including pre-construction estimates for projects being planned, and
the manager is a member of the Hospital Rate Board. Hospital society by-laws are
reviewed with the Administrative Officer and advice is given to hospitals on setting
up suitable medical staff by-laws, rules, and regulations. Hospitals are encouraged
to work toward accreditation by the Canadian Council on Hospital Accreditation,
which gives recognition to those hospitals that meet prescribed standards of care
and management. During 1963 the consultants in the Division made 47 visits to
public hospitals, most visits requiring from one to three days or more in the hospital,
and sometimes needing more than one member of the staff.
Working with the Provincial Fire Marshal, the Inspector of Electrical Energy
of the Department of Public Works, and the Inspector of Elevators, Department of
Labour, the staff of the Division checked hospital standards of safety and fire
precautions.
The Division Manager continued to serve as the B.C.H.I.S. representative on
the Laboratory Advisory Council, which advises the Government on the development of laboratory services in public hospitals, including the setting-up of regional
pathology services, the appropriate selection of equipment, and the training of
laboratory technologists. With the advice of the Council, approval in principle was
given during the year to the establishment of a regional pathology service in the
north-east region.   Seven regional services have now been approved.
As in previous years, the Division worked in conjunction with Health Branch
personnel on many matters. Contact was maintained with the Medical Health
Officers, and with the Technical Supervisor of Clinical Laboratory Services and the
Technical Supervisor of Radiology, of the Health Branch, who also visit hospitals
to provide advice and assistance in respect to the work of these two departments.
The Health Branch Nutrition Consultant assisted the Division in providing advice
on dietary problems in public and private hospitals.
During the year this Division co-operated with the Director of Emergency
Health Services and Provincial Civil Defence authorities in organizing two hospital
disaster institutes—one at Kelowna for hospitals in the Okanagan District and one
at Victoria for hospitals on Vancouver Island. These were two-day institutes attended by the administrator, director of nursing, and a medical staff representative
from each hospital in the district. The purpose of the institutes was to encourage
each hospital to prepare a written plan for dealing with an emergency where it might
be faced with a large influx of casualties resulting from a local disaster.   This Divi-
 H 28 BRITISH COLUMBIA
sion was represented on the Provincial Hospital Disaster Plan Review Committee,
along with members from the Health Branch and the Provincial Civil Defence. This
Committee is charged with reviewing disaster plans submitted by hospitals and approving them for the issue of the Federal disaster supply kits, which are issued to all
hospitals with an approved disaster plan.
The Manager of the Division, in addition to being a member of the Working
Party on Hospital Standards, was also appointed to the Sub-committee on Quality
of Care, Research, and Statistics, both of which committees met in Ottawa during
the year.
The Division continues to maintain liaison with such groups as the Registered
Nurses' Association and the British Columbia Hospitals' Association.
During the year, 107 visits for consultation and inspection were made to private
hospitals. This figure does not include visits made during the construction of new
private hospitals.
The following changes took place in the private hospital field:—
Richmond Private Hospital, Richmond:   Increased capacity from 55 to
75 beds.
Royal Oak Private Hospital, Saanich:   Increased capacity from 30 to
42 beds.
Athlone Private Hospital, Vancouver: Hospital closed (18-bed capacity).
North Shore Private Hospital, North Vancouver: Increased capacity from
26 to 57 beds.
Braddan Private Hospital, Vancouver:   New hospital of 44 beds (old
hospital of 18 beds closed in 1962).
Kensington Private Hospital, Vancouver: New hospital of 74 beds.
Glengarry Private Hospital, Victoria: New hospital of 75 beds.
Willowhaven Private Hospital, Nelson:   Increased capacity from 27 to
52 beds.
These changes brought the total number of private hospital nursing-home beds
in the Province to 2,710, an increase of 263 beds over 1962.   Altogether there are
now 67 hospitals of this kind operating in the Province today.
As mentioned in previous Annual Reports, the conversion of buildings such as
dwelling-houses to private hospitals is not permitted unless they meet the construction standards for new private hospitals. At the year-end there were six hospitals
under construction, involving a total of 450 beds. One hundred and forty persons
or groups approached the Division with detailed inquiries into the requirements for
obtaining a licence to operate a private hospital.
The number of beds in private acute hospitals remained at 76 beds in five
hospitals, four of which are operated by industrial concerns.
Under the Hospital Act no person may act as superintendent of a private hospital without the approval of the Chief Inspector of Hospitals. In this regard the
Registered Nurses' Association assisted the Division in screening the credentials of
prospective private hospital superintendents.
An associated responsibility of the Division is to arrange for the placement, by
the Social Welfare Department, of welfare patients who no longer need to remain in
acute general hospitals, but must be admitted to nursing-home facilities because
their needs are beyond what can be given in their own homes. The Division is
involved only when service is requested by the acute hospital. In 1963 social welfare offices placed 135 cases under this arrangement.
 HOSPITAL INSURANCE SERVICE, 1963 H 29
Medical Consultation Division
W. A. Fraser, O.B.E., E.D., M.D., CM., F.A.C.S., Medical Consultant
The processing of all Admission-Separation Records for medical eligibility,
length of stay, and assuring correct discharge diagnoses for statistical purposes continued to be a steadily mounting task of this Division.
It is essential to ensure the accuracy and adequacy of the separation diagnoses and operations for medical coding based on the Manual of the International
Classification of Diseases, Injuries, and Causes of Death. These data are secured
for medical research projects and comparative studies on hospital utilization.
Considerable interest continues to be shown in studies on tonsillectomies and ade-
noidectomies, dental extractions, maternal and newborn morbidity, foetal deaths, and
accidents, in relation to incidence, causes, and effects, and hospital costs involved.
This year a special study on perinatal mortality in part'cular reference to accredited
hospitals was undertaken.
To maintain the quality of these data, the outside source—that is, the hospital
record department—is visited by the Supervisor and the Medical Consultant as
often as possible to assist hospital personnel on mutual problems.
The Chief Supervisor of this Division attended the Fourth International Congress on Medical Records at Chicago. At this meeting very informative and interesting papers by key men presented a picture of collaborative studies and medical
research projects now being conducted in the United States. Stress was laid on
the need for comparative hospital morbidity studies on an international basis, preferably by electronic processing and retrieval of medical data for speed and accuracy.
This is in keeping with the rapid progress in the field of medical science.
Trends toward out-patient care to include diagnostic follow-up, rehabilitation,
and home care, in view of high costs of hospital construction and maintenance and
staffing, are on the upward. This is true for the mentally ill as well as the physically
incapacitated.
Conferences in Regina and Vancouver for the Canadian Association of Medical Record Librarians and the British Columbia Association of Medical Record
Librarians respectively were also attended.
During the year Dr. Brock Fahrni, Associate Professor, Faculty of Medicine,
School of Rehabilitation Medicine, University of British Columbia, and adviser to
the British Columbia Hospital Insurance Service, prepared two interesting and
widely studied reports titled " Some Observations on Acute' Hospitalization " and
" Principles Relating to Continuing ' Chronic' Care," which were submitted to this
Division for study.
An estimated 92,400 patient-days were covered under the rehabilitation and
activation care plan, an increase of approximately 44 per cent over 1961, the first
full year of operation.
Administrative Officer
K. G. Wiper
The office of the Administrative Officer is responsible for the drafting of legislation, regulations, and Orders in Council for the British Columbia Hospital Insurance Service. In the performance of these duties a close working relationship exists
between this office and the Attorney-General's Department.
Hospital societies may apply to the Administrative Officer for assistance in
connection with the drafting of hospital constitutions and by-laws, and their application. This work is carried out in conjunction with the Hospital Consultation and
Inspection Division.   Changes in hospital by-laws are reviewed by this office prior
 H 30 BRITISH COLUMBIA
to their submission for Government approval as required under the Hospital Act.
A set of model by-laws has been developed for use by hospitals as a guide in making
revisions.
Collaborating with the Water Rights Service of the Department of Lands,
Forests, and Water Resources and the Chief Electoral Officer of the Provincial Secretary's Department, the Administrative Officer provides guidance to committees in
unorganized territory which are establishing hospital improvement districts. Such
districts are necessary for the raising of funds by money by-laws, in areas outside
cities or municipalities, for the construction of new hospital facilities or the improvement of existing buildings. At the end of 1963 there were 33 hospital improvement
districts in operation and a number of others in the process of formation. Material
which describes the procedure required for the establishment of a hospital improvement district is available upon request.
As in previous years, considerable time was spent in 1963 on matters related
to the Federal-Provincial hospital insurance arrangements. Methods of streamlining administrative procedures and improving liaison were discussed with officials
of the Federal Government at meetings held in Ottawa and Victoria.
The Administrative Officer is also responsible for the over-all supervision of
the Third Party Liability and Eligibility Sections.
Third Party Liability Section
J. W. Brayshaw
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, Mr. H. E.
Drab, 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 Inspectors' Section
P. A. Bacon
In order to ensure that only qualified British Columbia residents receive hospital insurance benefits, the staff of the Eligibility Section reviews all applications
for benefits made by, or on behalf of, persons admitted to hospital. A detailed check
is made of all doubtful applications, resulting in the rejection of a considerable
number of claims for hospital insurance benefits made by unqualified persons.
Numerous inquiries from the general public with regard to eligibility matters were
dealt with by personal interview, telephone, and correspondence.
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 hospital admitting staff members. In this regard, regional meetings are held in a number of centres for the purpose of holding panel
discussions with hospital personnel, to deal with problems connected with the admission of patients to hospitals, and their status under the Hospital Insurance Act.
 HOSPITAL INSURANCE SERVICE, 1963
H 31
This Section has provided the great majority of employers in British Columbia
with a supply of certificates on which an employee's length of employment can be
certified. 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.
Research Division
W. D. Burrowes, B.A., Director
The functions of the Division are:—
(1) To compile and maintain a body of statistics derived from the processing
of Admission-Separation Records, and from other sources, showing the
pattern of hospitalization in the individual hospitals and school districts,
and to make special compilations as required by other divisions of this
Service and by other agencies:
(2) To maintain a continuous study of the population and economic growth
of all parts of the Province so as to advise the Deputy Minister of
the need for new construction of hospital beds, by type of service, in
each area:
(3) To analyse the patterns and trends of morbidity in the Province as a
whole as revealed by statistics derived from Admission-Separation Records and other sources, and to study these data in comparison to corresponding data for other Provinces.
During the year, bed-requirement studies were undertaken and reports submitted for the districts of Haney, Ucluelet-Tofino, Tahsis-Zeballos, Prince George,
and Prince Rupert. Studies of other localities were in progress at the end of the
year. Statistical information and forecasts of hospital bed needs were given for
other areas for which full surveys were not required.
Research into the methodology of estimating bed requirements in different
services continued during the year.
As in past years, the preparation of punch cards from Admission-Separation
forms was undertaken by the Hospital Claims Section of the Hospital Finance
Division of this Service, and the mechanical tabulation of data from these cards was
carried out by the Mechanical Tabulation Unit of the Department of Industrial
Development, Trade, and Commerce. The preparation of annual statistics of morbidity for 1962 was delayed because of the time required to install and adjust an
I.B.M. 1401 electronic computer by the Mechanical Tabulation Unit. It is anticipated that improved timing and increased scope of tabulation will be possible in
future from the use of the new machme. The annual bulletin entitled " Statistics of
Hospital Cases Discharged in 1962 " was completed at the end of the year, and was
enlarged by inclusion of tables showing the regional pattern of hospitalization.
With the collaboration of the Bureau of Economics and Statistics, estimates of
the 1961 population of each school district in the Province, classified by age-group,
sex, and race, were prepared from the detailed census data for enumeration areas,
supplied by the Dominion Bureau of Statistics. In preparing these estimates, the
number and age distribution of Indians on reserves were not derived from the 1961
Census data, but were synthesized from the most reliable information available on
the population of Indian reserves and bands. In this work the co-operation of the
Indian Agents in this Province and the Department of Indian Affairs was invaluable.
The annual bulletin "Statistics of Hospital Accidents in 1962," prepared by
the Division, was issued in November. This edition was enlarged by the inclusion,
for the first time, of a series of regional tables.   A detailed classification of out-
 H 32 BRITISH COLUMBIA
patient emergency accident cases treated in British Columbia hospitals in 1963 was
carried out during the year, and the results will be reflected in the annual bulletin of
accident statistics for that year.
In order that hospitals might have the benefit of comparative statistics prepared
in this office, approval was obtained to commence a series of annual circulars to
hospitals giving statistics of their own operations and of comparable groups of hospitals, in terms of well-known hospital indicators. Indicators for the year 1961
were issued in June, 1963, and the corresponding statistics for 1962 were circulated
in December.
A bulletin of "Current Demographic Trends in British Columbia" was prepared for the benefit of persons concerned with the future demands for hospital beds
in the Province as a whole and in specific areas.
Miss B. Morrison, B.A., M.S., Statistics Research Officer, resigned in September, 1963, and was replaced by Mr. E. Weekley, B.Sc.
Public Information
R. H. Thompson
The three main areas of responsibility in the continuing development of public
information activities include hospitals, the general public, and in-service. The
following is a summary of the work undertaken during 1963.
A new " General Information " pamphlet was produced and made available to
hospitals, industry, "welcome wagon" hostesses, Government Agents, and other
interested organizations. The pamphlet outlines the residential requirements for
hospital insurance coverage, the benefits provided, the hospital services not covered,
and other items of general interest. A stencilled pamphlet entitled "A Welcome to
New Employees " was also prepared, for in-service use to assist in the orientation
of new staff members.
During the year four new 16-mm. films were added to the film library, which is
used extensively by hospitals as part of their in-service training programmes. These
were " I Dress the Wound," whxh portrays proper post-operative techniques and
procedures; "Position of Trust," illustrating the responsibilities of members of the
boards of management; " They Called It Fireproof," dealing with fire prevention
within a hospital; and " The Role of Nursing in Infection Control."
With the co-operation of the offices concerned, several pages of the B.C.H.I.S.
Manual of Policy, Procedures, and Organization were revised, and replacements
distributed to all hospitals. In some instances entire chapters were affected, as a
result of amendments introduced since the Manual was issued in October, 1959.
To keep the public aware of various developments in the Provincial plan and
the hospital field, numerous press releases were issued during the year. These dealt
with the payment of hospital accounts, the grant-in-aid programme for hospital construction, the awarding of contracts, and the opening of new hospitals. Feature
articles were written for the British Columbia Government News and national hospital magazines, and revised material on the Service was prepared for city directories, civic pamphlets, and the booklet " Invitation to Industry," which is issued by
the Department of Industrial Development, Trade, and Commerce. Through the
co-operation of the Photographic Branch of the Department of Recreation and Conservation, numerous photographs were taken of the new hospitals opened during
the year.
At the request of the executive of the British Columbia Hospitals' Association,
a display was developed for use at its annual conference, held in Vancouver in
October.   Assistance was also given in the preparation of a Departmental display
 HOSPITAL INSURANCE SERVICE, 1963
H 33
appearing in the Victoria Industrial and Agricultural Exhibition in May, in the
Kinsman Fall Fair held in Esquimalt in September, and in alterations made to the
Departmental exhibit in the British Columbia Building on the grounds of the Pacific
National Exhibition.
Regular editions of the B.C.H.I.S. Bulletin were prepared and distributed to
over 90 public hospitals and 60 private hospitals. The Bulletin is an administrative
aid used to outline policy and procedural changes. The contents also include condensations of published articles dealing with subjects of interest to hospitals, such
as safety, laundry management, and geriatric nursing.
In November the Public Information Officer was asked to co-ordinate the
coverage by news representatives at the Vancouver Island Hospital Disaster Institute, jointly sponsored by Provincial emergency health services and the civil defence
organization, and held in Victoria.
Other duties included the summarizing of reports, replying to all letters of
general inquiry, maintaining the newspaper-clipping file, and editing and preparing
the Fifteenth Annual Report.
General Office
C. R. Leighton
The supervision of expenditure continues to be the main function of the
General Office. Administrative accounting, personnel, payroll, supplies, infirmary
accounting supervision, and assistance in the preparation of estimates are also
included in General Office responsibilities.
The Supervisor continued as Safety Officer, and it is gratifying to report that
during the year the Branch won a Safety Council Bronze Award for nine months of
accident-free operation.
Due to a decreasing volume in the number of teletype messages being sent to
Vancouver and the availability of direct telephone-line service, it was decided to
cancel the teletype service. The saving in teletype rental charges of $212 per month
was used to offset the cost of acquiring a photostat copying machine.
This office continues to act as a liaison between the Mount St. Mary authorities
and the Infirmary Superintendent.
The change-over from monthly to bi-monthly payment of Government employees' salaries was effected in October. Stenographic assistance was given to
various offices during the year, including the typing of all correspondence, stencils,
pamphlet drafts, and articles prepared by the Public Information Office.
HOSPITALS AS DEFINED UNDER THE HOSPITAL INSURANCE ACT
Part I
Hospitals defined as such under section 2 of the Hospital Act:—
(a)  Public Hospitals
Armstrong and Spallumcheen Hospital, Armstrong.
Arrow Lakes Hospital, Nakusp.
Bella Coola General Hospital, Bella Coola.
Boundary Hospital, Grand Forks.
Bulkley Valley District Hospital, Smithers.
Burnaby General Hospital, Burnaby.
Burns Lake and District Hospital, Burns
Lake.
Campbell River and District General Hospital, Campbell River.
Cariboo Memorial Hospital, Williams Lake.
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.
 H  34
BRITISH COLUMBIA
G. R. Baker Memorial Hospital, Quesnel.
Golden and District General Hospital.
Golden.
Grace Hospital, Vancouver.
Kelowna General Hospital, Kelowna.
Kimberley and District Hospital, 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.
Lions Gate Hospital, North Vancouver.
McBride and District Hospital, McBride.
Maple Ridge Hospital, Haney.
Mater Misericordia; Hospital, Rossland.
Matsqui, Sumas, and Abbotsford General
Hospital, Abbotsford.
Michel Hospital, Michel.
Mills Memorial Hospital, Terrace.
Mission Memorial Hospital, Mission City.
Mount St. Joseph's Hospital, Vancouver.
Nanaimo Regional General Hospital, Nanaimo.
Nicola Valley General Hospital, Merritt.
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.
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.
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.
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, Bamfield.
Red Cross Outpost Nursing Station, Blue
River.
Red Cross Outpost Nursing Station, Edge-
wood.
Red Cross Outpost Nursing Station, Hudson
Hope.
Red Cross Outpost Nursing Station, Kyuquot.
Red Cross Outpost Nursing Station, Masset.
Stewart General Hospital, Stewart.
(c) Federal Hospitals
Veterans' Hospital, Victoria.
Shaughnessy Hospital, Vancouver.
Coqualeetza Indian Hospital, Sardis.
Miller Bay Indian Hospital, Prince Rupert.
Nanaimo Indian Hospital, Nanaimo.
R.C.A.F. Station Hospital, Holberg.
Part II
Private hospitals which are defined as such under section 7 of the Hospital
Act, and with which the Province has entered into an agreement requiring the
hospital to furnish the general hospital  services  provided  under the Hospital
Insurance Act:—
Bralorne Private Hospital, Bralorne.
Cassiar Asbestos Corporation Private  Hospital, Cassiar.
Gold Quartz Hospital, Wells.
Hollywood Hospital Ltd., New Westminster.
Medical-Dental Hospital Unit, Vancouver.
Port Alice Private Hospital, Port Alice.
 r
HOSPITAL INSURANCE SERVICE, 1963
Part 111
H 35
Rehabilitation, chronic, and convalescent hospitals, as defined under section
25 of the Hospital Act:—
G. F. Strong Rehabilitation Centre, Vancouver.
The Gorge Road Hospital, Victoria.
Holy Family Hospital, Vancouver.
Pearson Hospital (Poliomyelitis Pavilion),
Vancouver.
Queen   Alexandra   Solarium   for   Crippled
Children, Victoria.
Shaughnessy Hospital, Vancouver.
Veterans' Hospital, Victoria.
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. In 1963 there were 87 public general hospitals approved to accept B.C.H.I.S. patients, the same number as in 1962. In addition,
care was provided in eight outpost hospitals, six Federal hospitals, and five private
hospitals. Also approved as of September 1, 1960, were four public rehabilitation
hospitals, one Provincial rehabilitation hospital, and rehabilitation-care areas in
two Federal hospitals which also provide general hospital care. Data for the year
1963 have been estimated from reports submitted by hospitals to October 31st and
are subject to revision when actual figures for the year are submitted.
Table I shows that a total of 271,911 B.C.H.I.S. adults and children patients
were separated (discharged or died) from British Columbia hospitals in 1963, an
increase of 7,256 or 2.7 per cent over the previous year. This table also shows that
95.5 per cent of the total patients separated from British Columbia hospitals in 1963
were covered by hospital insurance, compared to 96 per cent in 1961 and 95.7 per
cent in 1962. The second part of the table indicates in 1963 that the British Columbia Hospital Insurance Service paid public hospitals in British Columbia for
2,624,026 days of care for adults and children, an increase of 50,392 days or 2 per
cent over 1962.
As shown in Table IIa, the average length of stay of B.C.H.I.S. adult and
children patients in British Columbia public hospitals during 1963 was 9.65 days.
The days of care per thousand population decreased from 1,841 in 1962 to 1,830
in 1963, but this incidence of care is a reflection of the number of hospital beds
resulting from the continued hospital-construction programme of recent years.
 H 36                                                    BRITISH COLUMBIA
Table I.—Patients Separated (Discharged or Died), Total Patient-days
and Proportion Covered by British Columbia Hospital Insurance
Service, British Columbia Public Hospitals Only, 1949-63 (Excluding
Federal, Private, and Out-of-Province Hospitalization)  (Including
Rehabilitation Hospitals).
Total Hospitalized in Public
Hospitals
Covered by B.C.H.I.S.
Adults
and
Children
Newborn
Total
Adults
and
Children
Newborn
Total
Patients separated—
1949 -
1950      	
164,964
172.645
26,272
26.205
191,236
198.850
140,168
144,959
150,116
154,336
169,167
189.713
199,774
208,293
209,485
222,046
234,783
249,654
259,953
264,655
271,911
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
2,451.839
2,546,344
2,573,634
2,624,026
84.9
84.0
82.9
81.9
84.2
91.7
92.2
91.6
91.5
93.7
95.5
95.6
95.7
95.5
95.3
85 0
83.6
81.7
81.9
83.9
90.4
91.2
91.2
91.2
93.4
94.5
95.0
95.2
95.0
94.7
24.640
23,943
24,172
25,023
27,830
29,483
31,515
33,174
34,963
37,045
38,480
38,980
37,558
36,505
36,472
200,585
193,307
187.891
184,160
197,100
213,587
212,514
217,252
223,079
232,390
239,871
241,157
231,043
263,475
258,867
93.8
91.4
89.2
87.3
90.6
92.2
95.0
94.5
93.5
96.5
98.6
98.4
98.3
96.8
96.4
93.8
90.8
87.7
85.8
89.5
94.5
93.3
93.1
92.6
95.1
96.7
96.7
96.1
96.1
95.5
164,808
168,902
174,288
179,359
196.997
219,196
231,289
241,467
244.448
259.091
273.263
288,634
297,511
301,160
308,383
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
2,692.996
2,777,387
2,837.109
2,882,893
86.2
84.9
83.7
82.6
85.1
91.7
92.5
92.0
91.8
94.1
9*\°
96.0
96.0
95.7
95.5
86.0
84.4
82.3
82.3
84.4
90.8
91.4
91.3
91.3
93.6
94.7
95.1
95.3
95.1
94.8
1951     	
181,160  |    27,096 |     208,256
188.355   I     28.675   I      217.030
1952	
1953   _	
1954    	
1955   _._.
200,893
206,992
216,743
227,359
228,917
236.859
245,766
261,128
271,609
277,073
285,213
1,682,196
1,766,680
1,795,438
1,916,486
2,041,615
2,162,002
2,198,863
2.239,646
2,277,567
2,322,796
2,407,134
2,581,042
2,675,402
2,708,337
2,771,188
30,712  |     231,605
31,984 |     238,976
33,190  |     249,933
35,118  |     262,477
37,376 1     266,293
38.374  |     275,233
39,039 |     284,805
39,599  [     300,727
38,226 j     309,835
37,697  |     314,770
37.849   1      323.062
1956	
1957...             	
1958
1959     	
1960 _ 	
1961....	
19621 _  	
19632 	
Patient-days—
1949                                               _.
213,874
212,979
214,285
214,701
220,208
226,031
227,674
233,402
240.872
1,896,070
1,979,659
2,009,723
2,131,187
2,261,823
2,388,033
2,426,537
2,473,048
2.518.439
1950    	
1951  ...   _  ...
1952 _     	
1953   	
1954....,  _ - -
1955   __ ..... _   ...
1956    __	
1957 	
1958  _  	
244,429 | 2,567.225
248,074 | 2,655,208
249,273  j 2,830,315
240,207   |  2,915,609
274,032 I 2,982,369
271,186 | 3.042,374
1959 _ 	
1960     	
1961   ._    ..
19621 	
1963 2 	
Percentage of total, patients separated—
1949         	
1950  	
1951   _  	
	
1952 	
1953          	
1954 	
	
1955 	
1956	
1957 	
1958	
	
1959 	
1960	
	
	
1961 _	
19621 _	
	
19632  _.   ._	
Percentage of total, patient-days—
1949                                                      	
	
1950
1951
1952
	
1953
1954
1955
	
1956
1957.
1958	
1959	
1960	
1961	
	
	
19621...
	
19632	
	
i Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to October 31, 1963.
 HOSPITAL INSURANCE SERVICE,  1963
H 37
Table IIa.—Patients Separated, Total Days' Stay, and Average Length of
Stay According to Type and Location of Hospital for B.C.H.I.S.
Patients Only, and Days of Care per Thousand of Covered Population, 1949-63 (Including Rehabilitation Hospitals).
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 separated—
1949.. _ _         	
1950
149,280
154,643
159,739
164,379
180,149
199,974
209,999
219,218
221,585
236,770
251,393
264,120
273,293
278,021
285,366
1,498,121
1,564,222
1.551.954
1,663,149
1,814,344
2.046,087
7.100,386
2,141,445
2,188,765
2,332,502
. .4-M.974
2,650,129
2,756,665
2,789,355
2,838,881
10.03
10.11
9.71
10.12
10.07
10.23
10.00
9.77
9.88
9.85
9.85
10.03
10.09
10.03
9.95
24,989
24,336
24,587
25,492
28,381
29,761
32,035
33,783
35,813
37,924
39,257
39,488
37,968
36,942
36,913
203,197
196,333
190,948
187,923
200,738
215,507
215,980
221,022
228,875
238,112
244.615
244,480
233,794
266,351
261,727
8.13
8.07
7.76
7.37
7.07
7.24
6.74
6.54
6.39
6.28
6.23
6.19
6.16
7.21
7.09
140,168
144,959
150,116
154,336
169,167
189,713
199,774
208,293
209,485
222,046
234.783
249,654
259,953
264,655
271,911
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
2,451,839
2,546,344
2,573,634
2,624,026
10.21
10.19
9.77
10.17
10.13
10.30
10.04
9.80
9.91
9.77
0.69
9.82
9.80
9.72
9.65
24,640
23,943
24,172
25,023
27,830
29,483
31,515
33,174
34,963
37,045
38,480
38,980
37,558
36,505
36,472
200,585
193,307
187,891
184,160
197,100
213,587
212,514
217,252
223,079
232,390
239,871
241,157
231,043
263,475
258,867
8.14
8.07
7.77
7.36
7.08
7.24
6.74
6.55
6.38
6.27
6.23
6.19
6.15
7.22
7.10
7,093
7,617
7,308
7,431
8,173
7,602
8,313
9,473
10,023
12,506
13,908
11,557
10,361
10,226
10,255
45,960
65,326
62,771
68,892
75,518
66,960
75,599
79,428
93,980
141,925
173,343
169,401
182,690
183,042
183,855
6.48
8.58
8.59
9.27
9.24
8.81
9.09
8.38
9.39
11.35
12.46
14.66
17.63
17.90
17.93
151
173
171
161
229
199
361
457
668
665
514
241
151
157
166
1,146
1,288
1,155
974
1,353
1,251
2,271
2,740
4,299
4,113
2.818
1,417
878
850
960
7.59
7.44
6.75
6.05
5.91
6.29
6.29
6.00
6.44
6.19
5.48
5.88
5.81
5.41
5.78
2,019
2,067
2,315
2,612
2,809
2,659
1,912
2,050
2,077
2,218
2,702
2,909
2,979
3,140
3,200
21,515
22,281
22,081
24,283
25,948
24,304
19,622
20,163
18,449
20,680
26,504
28,889
27,631
32,679
31,000
10.66
10.78
9.54
9.29
9.24
9.14
10.26
9.84
8.88
9.45
9.81
9.93
9.27
10.41
9.69
198
220
1951 	
1952 	
1953       .
1954.	
244
308
322
79
1955 _	
1956	
1957   ,
159
159
182
1958  	
1959    ..
214
263
1960    	
1961....                	
267
259
19621	
19632.   __ 	
Patient-days—
1949 _	
1950 	
1951    '
1952	
280
275
1,466
1,738
1,902
2,789
1953	
2,285
1954  	
1955	
1956..	
669
1,195
1,030
1957	
1,497
1958 -	
1,609
1959	
1,926
1960 	
1961...
1,906
1,873
19621...  	
19632...... 	
Average days of stay—
1949	
2,026
1,900
7.40
1950                    	
7.90
1951    .               	
7.79
1952- 	
9.06
1953                       	
7.10
1954.	
8.47
1955.  	
1956 	
1957-  	
1958  	
1959	
7.52
6.48
8.23
7.51
7.32
1960 _ - -
1961	
19621  	
19632  _	
7.14
7.23
7.24
6.91
1 Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to October 31, 1963. Estimated patient-days (including newborn
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, 1,804; 1961, 1,806; 1962, 1,841; 1963, 1,830. (1954 and subsequent years based on assumption that total population is covered by British Columbia Hospital Insurance Service. Patient-days include rehabilitation patient-days from September 1, 1960.)    Population figures revised according to latest census figures.
 H 38
BRITISH COLUMBIA
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients (Including
Rehabilitation Patients) and Short-stay Patients, 1949-63
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
303,608
311,261
314,963
322,279
29,000
44,502
47,656
46,767
52,582
63,621
70,553
76,375
83,530
91,883
100,292
107,312
121,000
128,000
135,000
203,269
1950 _    ...
1951 _   _ _ _	
223,481
231,982
1952  _ _ _  	
236,638
1953   ..                      	
261,112
1954 _	
293,356
1955 _   	
1956    	
1957          	
1958...   . _ 	
312,587
329,376
340,928
366,577
1959  _   _
1960 _ -	
1961   — 	
19622     __    	
390,942
410.920
432,261
442.963
19633  __
457,279
Totals   _     _	
3.735,598
1,198,073
4,933,671
i Estimated.
2 Amended as per final reports received from hospitals.
3 Estimated, based on hospital reports to October 31, 1963.
Table III.—Patients Separated, 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 19631 (Including
Rehabilitation Hospitals).
Bed Capacity
Total             250 and
lotal             Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Hospitals
Patients separated—
Adults and children
Newborn. 	
Patient-days—
Adults and children    .
Newborn   ._.
Average days of stay—
Adults and children	
Newborn	
271,911    j      98,326
36,472    [       11,213
i
2,624,026    | 1,166,858
258,867    |      90,803
9.65    |        11.87
7.10    |          8.10
78,816
12,057
674,330
79,689
8.56
6.61
36,491    |      41,168
6,142    |        5,196
347,701    [    308,820
43,852    |      33,363
9.53    [          7.50
7.14    |          6.42
10.411    j        6,699
1,331    j           533
75,093    j      51,224
8.089    !        3,071
7.21    j          7.65
6.08    i          5.76
1 Estimated, based on hospital reports to October 31, 1963.
Table IV.—Percentage Distribution of Patients Separated and Patient-
days for B.C.H.I.S. Patients Only, in British Columbia Public Hospitals, Grouped According to Bed Capacity, Year 19631 (Including
Rehabilitation Hospitals).
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Hospitals
Patients separated—
Adults and children
1
Per Cent   |   Per Cent
100.00            36.16
100.00      I      30.74
Per Cent
28.99
33.06
25.70
30.78
Per Cent
13.42
16.84
13.25
16.94
Per Cent
15.14
14.25
11.77
12.89
Per Cent
3.83
3.65
2.86
3.12
Per Cent
2.46
1.46
Patient-days—
Adults and children —
Newborn 	
100.00
100.00
44.47
35.08
1.95
1.19
i Estimated, based on hospital reports to October 31, 1963.
 HOSPITAL INSURANCE SERVICE,  1963
H 39
CHARTS
The charts on the following pages have been prepared by the Research Division. The statistical data shown in these charts are taken from the annual tabulation
of the information shown on Admission-Separation Records submitted to the British
Columbia Hospital Insurance Service by all hospitals designated as acute. The
charts give a general idea of the relative importance of the various hospital services
(medicaJ, surgical, etc.); they also provide some insight into morbidity in British
Columbia.
It should be noted that the Canadian diagnostic list used for the tables on
pages 45 to 47 is a more detailed listing than the diagnostic groups shown on the
charts. Both lists are based mainly on the International Statistical Classification of
Diseases, Injuries, and Causes of Death, prepared by the World Health Organization (1957 edition).
 H 40
BRITISH COLUMBIA
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Chart V.—Average Length of Stay of Cases in Acute-care Hospitals in
British Columbia, by Major Diagnostic Groups in Descending Order,
1962 (Excluding Newborns).
Neoplasms
Diseases of the circulatory system Tj
Congenital malformations
Diseases of the bones and
organs of movement
Diseases of the blood and
blood-forming organs
Certain diseases of early infancy
Diseases of the nervous system
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violence
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PROVINCIAL AVERAGE
LENGTH OF STAY
Diseases of the genito-urinary
system
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Deliveries and complications of
pregnancy, childbirth, and the
puerperium
Symptoms, senility, and ill-
defined conditions
Supplementary classification for
special admissions
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X
 H 48 BRITISH COLUMBIA
STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE
FISCAL YEAR ENDED MARCH 31, 1963
Administration—
Salaries         $435,443.29
Temporary assistance   1,361.77
$436,805.06
Office expense  35,681.81
Travelling expense   28,664.48
Office furniture and equipment  2,172.77
Printing and publications _____  1,035.83
Tabulating and rentals _  2,070.00
Motor-vehicles and accessories  , ■ 4,244.19
Incidentals and contingencies  929.16
Construction—consulting fees   300.00
Technical surveys—
Travelling expense  $385.00
Other expenses __:_j  9,371.31
  9,756.31
$521,659.61
Less transfer, Vote 132 (b)—salary adjustments 7,142.00
Payments to hospitals—
Claims  .  $58,388,883.03
Vancouver General Hospital re  out-patients
(Hospital Insurance Act, see. 29) ——__-        278,962.92
$58,667,845.95
Less collections, third-party liability  284,338.30
$58,383,507.65
Less—
Chargeable to Government
of Canada   $30,049,147.43
Miscellaneous receipts  1,241.58
     30,050,389.01
$514,517.61
     28,333,118.64
Grants in aid of construction of hospitals       3,566,288.22
Total _-_  $32,413,924.47
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1964
810-1163-1693

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