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Seventeenth Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1965 British Columbia. Legislative Assembly 1966

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Full Text

 PROVINCE OF BRITISH COLUMBIA
HOSPITAL INSURANCE ACT
Seventeenth Annual Report
British Columbia Hospital
Insurance Service
JANUARY 1 TO DECEMBER 31
1965
Printed by A. Sutton, Printer to the Queen's Most Excellent Majestj
in right of the Province of British Columbia.
1966
  Victoria, B.C., January 27, 1966.
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 Seventeenth Annual Report of
the British Columbia Hospital Insurance Service covering the calendar year 1965.
ERIC MARTIN,
Minister of Health Services and Hospital Insurance.
 British Columbia Hospital Insurance Service,
Victoria, B.C., January 27, 1966.
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 1965.
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., Assistant Deputy Minister of Hospital Insurance.
J. W. Mainguy, M.H.A., Director of Hospital Consultation, Development,
and Research.
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 Consulant.
K. G. Wiper, Esq., Administrative Officer.
D. S. Thomson, B.A., Director, Research Division.
  CONTENTS
General Introduction
British Columbia General Hospitals (Comparisons of Growth).
Extended Hospital Care Programme	
The Hospital Insurance Act	
The Hospital Act	
Persons Entitled to or Excluded from the Benefits under the Hospital Insurance
Act	
Entitled to Benefits	
Excluded from Benefits	
Hospital Benefits Available in British Columbia.
In-patient Benefits	
Emergency Services and Minor Surgery	
Application for Hospital Insurance Benefits	
The Hospital Rate Board and Methods of Payment to Hospitals.
Organization and Administration	
Hospital Finance Division	
Hospital Accounting	
Hospital Claims	
Hospital Construction and Planning Division	
Hospital Projects Completed during 1965	
Hospital Projects under Construction at Year-end.
Projects in Advanced Stages of Planning	
Page
. 9
. 11
. 13
. 14
. 15
15
15
15
16
16
16
16
17
17
18
18
19
21
23
24
24
Additional Projects Developed through Various Planning Stages  25
Hospital Consultation and Inspection Division.
Research Division	
Medical Consultation Division	
Administrative Officer	
Third Party Liability Section	
Eligibility Inspectors' Section	
Public Information	
General Office	
Approved Hospitals.
Public Hospitals....
Outpost Hospitals
Federal Hospitals..
Private Hospitals (Providing General Hospital Services)
Rehabilitation, Chronic, and Convalescent Hospitals	
Extended Care Hospitals	
28
29
30
31
31
31
32
33
33
33
34
34
34
35
35
 R 8 BRITISH COLUMBIA
Pace
Statistical Data  35
Table 1a.—Patients Separated (Discharged or Died) and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public Hospitals Only, 1949-65 (Excluding Federal, Private, and
Out-of-Province Hospitalization) (Including Rehabilitation Hospitals)  36
Table 1b.—Total Patient-days and Proportion Covered by the British Columbia Hospital Insurance Service, British Columbia Public Hospitals
Only, 1949-65 (Excluding Federal, Private, and Out-of-Province
Hospitalization)  (Including Rehabilitation Hospitals)  37
Table 2a.—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,
1949-65 (Including Rehabilitation Hospitals)  38
Table 2b.—Summary of the Number of B.C.H.I.S. In-patients (Including
Rehabilitation Patients) and Short-stay Patients, 1949-65  39
Table 3.—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 1965 (Including Rehabilitation Hospitals)  39
Table 4.—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 1965 (Including Rehabilitation Hospitals)  40
Charts  40
I.—Percentage Distribution of Days of Care by Major Diagnostic Groups,
1964,__7.._ _---  41
II.—Percentage Age Distribution of Male and Female Hospital Cases and
Days of Care, 1964  42
III.—Percentage Distribution of Hospital Cases by Type of Clinical Service,
1964  43
IV.—Percentage Distribution of Hospital Days by Type of Clinical Service,
1964  44
V.—Average Length of Stay of Cases in Hospitals in British Columbia by
Major Diagnostic Groups, 1964 (Excluding Newborns)  45
Hospitalization by Major Diagnostic Categories, 1964  45
Statement of Receipts and Disbursements for the Fiscal Year Ended March 31,
1965  49
 Seventeenth Annual Report of the British Columbia
Hospital Insurance Service
GENERAL INTRODUCTION
Donald M. Cox, F.A.C.H.A., Deputy Minister of Hospital Insurance
December 31, 1965, marked the completion of 17 years of operation of the
British Columbia Hospital Insurance Service. During that period there has been
continuous progress made in the development of hospitals and hospital services
throughout the Province. This has been made possible through the combined
efforts of government, hospitals, organizations, and individuals, whose efforts have
ensured that good and efficient hospital services are made available to the residents
of the Province. Such progress is evident in the fine new hospital buildings and
additions constructed throughout British Columbia, in the establishment of regional
laboratory services, in the numerous improvements made in hospital services, and
in the extension of hospital insurance coverage. One of the highlights of the year
was the announcement by the Provincial Government of the commencement
December 1, 1965, of the Extended Hospital Care Programme, whereby benefits
are provided to medically eligible patients in non-profit extended-care hospitals
or units at a cost of $1 a day to the patient (for more details see page 13).
In 1965 payments made by the Hospital Insurance Service to the hospitals
of the Province were at an all-time high. It is estimated that in the current fiscal
year $73,500,000 will be paid to hospitals, an average of $200,000 each day as
compared with daily payments of $50,000 in 1949, the first year of operation.
The vast programme of hospital construction that has been under way throughout the length and breadth of British Columbia for more than a decade continued
without let-up. During the past year 11 major hospital building projects were
completed in British Columbia, at a total estimated cost of $10,000,000. Provincial Government grants toward the construction costs were slightly less than
$5,000,000. New hospitals were completed at Murrayville and Mission City; a
major addition was built at Kamloops; renovations were made to the former North
Vancouver General Hospital; a new physiotherapy department was added to the
Gorge Road Hospital, Victoria, and a new emergency department to the Royal
Columbian Hospital, New Westminster; Phase 2 of a major expansion programme
was completed at St. Joseph's Hospital, Victoria, as were an addition and renovations at Ladysmith, unfinished space at Campbell River, and a small addition at
Tofino.    These completed building programmes resulted in 432 new beds.
In addition, at the year-end 10 major hospital projects were under construction
throughout the Province, involving 457 beds and estimated costs of $11,300,000,
and projects in the advanced stages of planning included another 1,800 beds and
buildings costs of over $50,000,000. This record of achievement is a tribute to
those private individuals throughout the Province who give so freely of their time
to direct, as trustees, the hospital affairs of their community. The fact that so
many communities have developed modern hospital facilities is indicative of the
dedication of the trustees and the support they enjoy.
 R  10 BRITISH COLUMBIA
I should like to express to the British Columbia Hospitals' Association our
appreciation of the Association's invitation to our Service to designate senior staff
members as liaison representatives to various Association committees. It is helpful
to this Service to have an opportunity to work with the Association and to participate
in studies carried out by its committees, and I am sure that the availability of our
staff assists the Association in its studies and deliberations. We look forward to
an extension of the working relationship between the Association and our Service.
Throughout the year the medical profession continued to provide most helpful
advice and guidance. I should like to thank the College of Physicians and Surgeons,
the Canadian Medical Association (British Columbia Division), and the medical
profession in general for the assistance so willingly rendered. Other professions
also, including the Registered Nurses' Association (British Columbia Division)
and the Architectural Institute of British Columbia, were generous in the assistance
they made available to the Service. This expression of co-operation on the part
of these professional bodies is very much appreciated by myself and other B.C.H.I.S.
senior personnel.
During the year it was necessary to strengthen the administrative structure of
the Hospital Insurance Service in order to meet increasing responsibilities. Effective
April 1, 1965, Mr. W. J. Lyle was appointed Assistant Deputy Minister of Hospital
Insurance and Mr. J. W. Mainguy was appointed Director of Hospital Consultation,
Development, and Research (see " Organization and Administration," page 17, for
details).
Finally, I should like to express my sincere appreciation to the staff of the
Hospital Insurance Service for the whole-hearted and conscientious manner in
which they carried out their duties and responsibilities during this past year.
Reports prepared by the various divisions on work undertaken during 1965
appear under " Organization and Administration."
 HOSPITAL INSURANCE SERVICE,  1965
R 11
BRITISH COLUMBIA GENERAL HOSPITALS (COMPARISONS
OF GROWTH)
B.C.H.I.S. Payments to Hospitals
70
60
55
50
45
§40
I
S 35
30
25
20
15
75
70
65
60
55
50
45
40 g
o
35 "
30
25
20
15
1951
1957
1960
1963 1964 1965
(est.)
Percentage
400
380
Hospitals' Growth Rate
280
260
240
220
200
180
160
140
120
100
80
60
40
20
oei
,.-n*»
6*__^
^
.
„•*<-
7
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5TAP
*
PA
r/_r/V7
PAY.
.__9T(0*___.
1948
1951
Percentage Increase over 1948
Total gross expenditure (excluding depreciation)
Staff (full-time equivalent)  .	
Patient-days (adults and children)
Population 	
1%3   1964   1965
(est.)
Per Cent
... 388
... 146
...    91
...    64
 R  12 BRITISH COLUMBIA
Total Full-time Staff and Average Number of Patients
(Adults and Children) per Day
13
__««            __^
11
cat-1- t          i
•3 10
toT^,
d
§    0
6
8
7
6
■Atty^Zf*
AVC««-ff     />
IC   ^   PAV«iT*_
5
4
15
14
13
12
10 I
1963 1964 1965
(est.)
Gross Salaries and Wages and Other Operating Expenses*
*iPt
cs^sS
.     5
A""      __»
Q*1''^
yS^
.   ore*
50
25
1951
1963    1964 1965
(est.)
* Including approximately $2,100,000 in staff.fringe benefits.
 HOSPITAL INSURANCE SERVICE,  1965 R 13
EXTENDED HOSPITAL CARE PROGRAMME (COMMENCED
DECEMBER 1, 1965)
Since 1960 British Columbia hospital insurance benefits have been provided to
patients in activation/rehabilitation hospitals or units. To be eligible for treatment
in this kind of hospital, the patient must be judged medically capable of improvement
to a point where he can be discharged, either to his own home or to some lower
level of care, within a reasonable period of time. This programme has been most
successful in the treatment not only of younger persons who have become handicapped through accidental injury or illness, but also in restoring to maximum function
older people who have suffered from strokes, fractures, and other geriatric afflictions.
In November, 1965, the Minister of Health Services and Hospital Insurance announced that hospital insurance benefits were to be extended to patients in a lower
level of care with effect from December 1st. The programme will extend to all
suitable hospitals operated by non-profit organizations, and the first group which
came under coverage from December 1st consists of Mount St. Mary Hospital, Victoria (excluding top floor); Priory Hospital, Victoria; Mount St. Joseph's Hospital,
Vancouver (top floor only); Pearson Hospital, Vancouver (excluding TB. patients); Menno Hospital, Abbotsford; Valleyhaven Hospital, Chilliwack; and
Mount St. Francis Hospital, Nelson.
Some areas of the Shaughnessy Hospital, Vancouver, and of the Veterans'
Hospital, Victoria, together with the Vancouver General Hospital Annex, are being
considered for inclusion under coverage in the immediate future. There is a possibility that part of the Mary Moore Hospital, Cobble Hill, will also be covered for
the time being. In addition to these existing hospitals, approvals-in-principle have
been given for the construction of units of this kind in conjunction with acute facilities. These approvals have been given in Cranbrook, Port Alberni, Powell River,
Nanaimo, Duncan, Trail, Campbell River, Pouce Coupe, Surrey, Langley, Penticton,
Kelowna, Greater Vancouver, White Rock, Vernon, and Chilliwack.
Facilities participating in this programme will be known as extended-care
hospitals or units, and to be medically eligible for coverage a patient must require,
by reason of physical illness or disability, skilled nursing services available 24 hours
a day and continuing medical supervision. An eligible patient will usually be unable
to walk or use a wheelchair without assistance, and be completely or substantially
unable to care for himself; that is, he will need the help of trained staff in washing
and bathing, in using a toilet, bedpan, or urinal, and in getting into and out of bed.
He may also be unable to feed himself or move independently in bed. A patient
who can walk without assistance or who can get into and out of a wheelchair and
operate it independently will not be eligible unless the treatment he needs necessitates the continuing availability of a graduate nurse. In other words, the functional
ability of the patient is of paramount importance in determining medical eligibility,
although diagnosis, medications, and treatment must, of course, be taken into
account.
Eligibility will be reassessed while the patient is in hospital at intervals of
three months, but coverage will be continuous for as long as the patient needs this
kind of care. A patient who does not require admission to a mental health facility
but is suffering from mental deterioration will be eligible under this programme,
provided he also suffers from the physical disabilities described above. Persons
who are physically able to take care of themselves but suffer from some mental
degeneration will not necessarily be eligible.
 R 14 BRITISH COLUMBIA
From earlier surveys of patients in nursing-home type facilities it appears that
a varying proportion of patients would be eligible for coverage in non-profit
extended-care hospitals or units, but in total approximately 60 per cent are expected
to meet the medical criteria.
Residential eligibility under the programme remains as it is for patients in
acute hospitals, and a dollar-a-day charge will be payable by the patient or by an
agency on his behalf.
It is hoped that arrangements will be made by the designated extended-care
hospitals to engage the consultative services of a physiotherapist and (or) occupational therapist. Although qualified personnel are in short supply, it should be
possible in most cases to make arrangements for a physiotherapist to visit the
extended-care hospital at regular intervals to assess, in conjunction with the attending physician, each patient's capacity for some kind of maintenance activity programme, and also for the purpose of instructing the staff in the techniques necessary
to maintain elderly patients at a reasonable level of function to slow up the process
of deterioration. Each extended-care hospital will be designating a suitable member
of the staff to be in charge of its activity programme and to arrange for in-service
education in this field.
Liaison will be necessary between hospitals and the local office of the Department of Social Welfare, or city social service, and with the Medical Health Officer
to obtain help in assessing the social circumstances of patients for whom admission
is requested, and to obtain home nursing and other domestic services where there
is likely to be a delay in admitting the patient.
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 rehabilitative and extended hospital 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
entitled 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.
 HOSPITAL INSURANCE SERVICE,  1965 R  15
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. This category includes small general hospitals, most of
which are operated in remote areas by industrial concerns primarily for
their employees.
(3) Rehabilitation, chronic, and convalescent hospitals—these are non-profit
hospitals approved under Part III of the Hospital Act, primarily for the
treatment of persons who will benefit from intensive rehabilitative and
extended hospital 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
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.
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
(fc) 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
 R 16 BRITISH COLUMBIA
(_i) 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.
(Note.—Private or semi-private rooms cost more to maintain than standard
wards, and the patient is required to pay extra for such accommodation if it is requested by or on behalf of the patient.)
Emergency Services and Minor Surgery
The following services and treatments 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.
A beneficiary is required to pay $2 for each visit to the hospital for the services,
etc., it has provided, and the remainder of the cost is paid by the British Columbia
Hospital Insurance Service.   However, if the patient received treatment from a physician while at the hospital, he is responsible for paying the doctor, as such charges
are not payable by the British Columbia Hospital Insurance Service.    Non-beneficiaries are required to pay the full charge for the hospital services and treatment
received.
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 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.)
 HOSPITAL INSURANCE SERVICE,  1965 R  17
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.
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.
ORGANIZATION AND ADMINISTRATION
The British Columbia Hospital Insurance Service is a branch of the Department of Health Services and Hospital Insurance, the other branches being Health,
and Mental Health Services. The administrative head of the Hospital Insurance
Service is Mr. Donald M. Cox, F.A.C.H.A., Deputy Minister of Hospital Insurance.
In March of 1965 Mr. Cox announced the appointment of Mr. W. J. Lyle as
Assistant Deputy Minister, with jurisdiction over the Hospital Finance Division
and the Hospital Construction and Planning Division, and Mr. J. W. Mainguy as
Director of Hospital Consultation, Development, and Research, with jurisdiction
over the Hospital Consultation and Inspection Division and the Research Division.
The appointments became effective April 1, 1965. Mr. Lyle has been Manager of
the Hospital Finance Division since June, 1948, and Mr. Mainguy has been Manager
of the Hospital Consultation and Inspection Division since July, 1949. In making
the announcement in March, Mr. Cox said, " With the Provincial Government's
planned extension of nursing-home coverage in facilities operated by public hospitals
and other non-profit organizations, there will be a resulting increase in the adminis-
2
 R 18 BRITISH COLUMBIA
trative responsibilities of the Hospital Insurance Service. The appointment of these
two senior officials to new positions is assurance to hospitals of the Province that
B.C.H.I.S. will continue to provide every assistance in the maintenance of high-
standard patient-care."
The following reports give a brief outline of the work carried out during 1965
by the various divisions and offices which comprise the administrative structure of
this Branch.
Assistant Deputy Minister
W. J. Lyle, F.C.I.S.
Hospital Finance Division
(During the year Mr. W. J. Lyle was appointed as Assistant Deputy Minister
but continued in the interim to serve as Manager of the Hospital Finance Division.)
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 1965, after a review of over 4,000 applications received
from hospitals, it approved grants of approximately $1,200,000 on movable and
fixed technical equipment, costing $3,500,000. The Assistant Deputy Minister,
during 1965, attended a meeting in Ottawa of the Advisory Committee on Hospital
Insurance and Diagnostic Services, which is the advisory body to the Minister of
National Health and Welfare. He also acted on a sub-committee on finance and
accounting, which is responsible for studying and making recommendations relative
to the sharing of certain costs under the Federal-Provincial agreement.
As a means of assisting hospital employees to maintain high working standards,
the Hospital Insurance Service provided $19,200 during the year to enable 235
hospital employees to attend, or participate in short-term training programmes.
This is additional to the long-term educational and training courses sponsored for
certain hospital employees through Federal assistance.
Close liaison was continued with 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 Assistant Deputy Minister 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 related
equipment by public hospitals. He also participated in the planning for the implementation of the Extended Hospital Care Programme.
Mr. N. S. Wallace, C.G.A., was appointed as supervisor of hospital accounting
during the year to replace Mr. J. Butcher, who found it necessary to resign for health
reasons.
Hospital Accounting
N. S. Wallace, C.G.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 1965 to 88 public general
hospitals and five public rehabilitation hospitals, the individual visits extending from
three days to four weeks.   The gross expenditures of these public general and reha-
 HOSPITAL INSURANCE SERVICE,  1965 R  19
bilitation hospitals, as approved by the Hospital Rate Board, for the year 1965
amounted to $80,500,000.
Other functions performed by the Hospital Accounting staff include:—
(_.) 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 1965, construction projects involving expenditures of $6,000,000 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.
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.
During the year three vacancies on the establishment for hospital accounting
inspectors were filled, making a total of 10 inspectors on staff at the year-end.
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
 R 20 BRITISH COLUMBIA
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. The year 1965 required increased production as approximately 1,450
claims and an average of over 550 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 in order to meet the increasing volume and complexity of handling claims (which included an increase in
rehabilitation cases), a new accounting procedure for patients undergoing the continuing dialysis treatments for renal failure, and a procedure for the processing of
extended hospital care accounts.
Discussions with the Bureau of Statistics were continued regarding efficient
use of the I.B.M. electronic data-processing equipment.
A brief outline of the work and duties performed by the various units of
Hospital Claims follows:—
The staff of Admission Control 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 the discrepancies
are referred back to the hospital or the Eligibility Inspectors.
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 at Nelson, Terrace, Smithers,
Vancouver, and Victoria.
The Accounts Payment staff 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, the Department of Veterans Affairs, or other Provinces and Territories.
During the year over 500 queries per month on accounting matters were addressed
to British Columbia hospitals.
Preliminary figures for 1965 show that over 362,000 accounts (excluding
out-of-Province) were processed. For comparison the figures for 1964 were
343,878 processed.
The staff of Social Welfare Records continues to maintain the alphabetical
file of all health services identification cards issued to welfare recipients in this
Province. Over 21,300 hospital accounts incurred by welfare recipients were
checked to this file to determine eligibility for hospital benefits.
The Voucher and Key-punch staff are responsible for batching and vouchering
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 used to tabulate
remittance listings of payments due to hospitals and morbidity statistics for the
Research Division.
The out-of-Province personnel handle 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 1965 a total of over
3,500 accounts, amounting to an estimated $600,000, 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;  England;   France;   Holland;   Italy;   Ireland;   Jamaica;   Japan;   Kenya;
 HOSPITAL INSURANCE SERVICE,  1965 R 21
Mexico; The Netherlands; Portugal; Switzerland; East and West Germany. Correspondence arising from all out-of-Province accounts totalled 14,449 letters and
forms.
This Section also compiles up-to-date hospital rate schedules for every approved hospital in Canada.
The Filing and Mail Unit sorted and filed over 4,400 documents and letters
daily, an increase of 300 daily over last year.
No further microfilming was undertaken; the annual storage of documents
was continued.
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 in the planning of 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 consulting engineers 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. Twenty-six
applications for approval of Federal construction grants toward major
construction and renovation projects were prepared and submitted during
1965.
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 of future expansion in conjunction with the logical and best use of the
hospital-site. During the year approximately 160 sets of plans were received by
the Division. These drawings covered many phases of planning, including small-
scale schematic drawings, preliminary sketch drawings, large-scale detail drawings,
and final working drawings.
Liaison was maintained with the mechanical engineering profession, 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 reflect this approach include heat-recovery systems, air recirculation,
and zoned heating and ventilating controls. Continuing benefit was derived through
the co-operation of the Public Works Department by assigning two architects to
this Division. With this architectural assistance available, it has been possible in
certain selected cases to prepare detailed sketch plans in support of layouts representing the Division's recommended approach to planning problems.    It has been
 R 22 BRITISH COLUMBIA
found advantageous to follow this procedure on some small projects where it is
easier to develop detailed sketches than to embark on lengthy time-consuming review procedures. Under such circumstances the usual portion of architectural fees
relating to sketch drawings would not be charged by the hospital's architect, whose
responsibilities would include the preparation of working drawings and supervision
during construction. The architects on the Division's staff were also able to make
some trips during the year to hospitals, to achieve on-site evaluation of problems
relating to planning projects.
Liaison was also maintained with the Hospitals Committee of the Architectural
Institute of British Columbia. The function of this Committee was to review and
endeavour to resolve problems arising out of hospital construction projects which
affect members of the Architectural Institute. Both members of the architectural
profession working for the Division are members of the Hospital Committee and
attend meetings on a regular basis.
The provision of a complete consultative planning service to hospital boards
and their planning committees is made possible through the co-operation of Health
Branch personnel, members of the medical and nursing professions, and the various
divisions of the British Columbia Hospital Insurance Service. The Provincial
Health Branch renders assistance through the Division of Public Health Engineering, the Technical Supervisor of Clinical Laboratory Services, the Technical Supervisor of Radiology, and the Provincial public health officers. The Construction
and Planning Division also maintains liaison with the Canadian Medical Association
(British Columbia Division) and with the Faculty of Medicine of the University of
British Columbia. Proposed layouts for physical medicine departments were reviewed by the Director, School of Rehabilitation Medicine, Faculty of Medicine,
University of British Columbia. Through the co-operation of the Provincial Department of Labour, arrangements were concluded whereby the Office of the Inspector
of Factories provides a consultative service to the British Columbia Hospital
Insurance Service on proposals for elevators and dumb-waiter installations in
hospitals.
During 1965 the Manager of the Division made a number of inspectional visits
to hospitals throughout the Province.
On April 23, 1965, the Manager addressed an administrators' forum held in
the auditorium of St. Paul's Hospital, Vancouver. The topic under discussion was
" Regional Planning."
The Manager of the Division acted as one of the liaison representatives for
the British Columbia Hospital Insurance Service on the Instructional Resources
Committee of the University of British Columbia Health Sciences Centre. The
function of this Committee is to study advanced designs of large and small group
teaching areas, with particular emphasis on the adaption of new communication
media such as closed-circuit television and computer-based learning resources.
The Manager also acted as one of the B.C.H.I.S. liaison representatives to the
Vancouver General Hospital Survey Co-ordinating Committee. The object of the
survey is the preparation of a master plan for the present and future role of the
Vancouver General Hospital in the community, and recommendations for the implementation of this role in order to provide maximum benefit to the community within
the defined bed limits of the hospital.
The Architectural Institute of British Columbia, through the Hospitals Committee, held a seminar on November 4, 1965, to discuss the topic " Continuing
Care." The Manager of the Hospital Construction and Planning Division spoke on
" Design Principles for Continuing Care Facilities."
 HOSPITAL INSURANCE SERVICE,  1965 R 23
(a) Hospital Projects Completed during 1965
St. Joseph's Hospital, Victoria.—Phase 2 of the expansion programme for this
hospital was substantially completed by September, 1965. Phase 2 included construction of an addition for a new linen service department and morgue, dietary
department renovation, a new electrical distribution system, renovations and improvements to the administration areas and the emergency department, applying
brick facing to the exterior wall surfaces of the hospital buildings, plus additions to
the sisters' quarters.
Royal Inland Hospital, Kamloops.—Governor-General Georges Vanier officially opened the new wing at a ceremony held on June 12, 1965. The new eight-
story wing provides facilities for 186 active treatment beds. A new laundry is located
in the basement of the addition, a dietary department plus dining areas is included
on the first floor, service departments including the laboratory, X-ray, and emergency are located on the second floor, the fourth floor is devoted to operating-room
facilities, while the remaining floors provide bed accommodation. The new wing is
scheduled to come into use gradually, and by the end of 1965 was in partial use.
Menno Private Hospital, Abbotsford.—On June 25, 1965, the Honourable
W. K. Kiernan, Minister of Recreation and Conservation, officially opened the new
addition to the hospital. The addition adds 39 beds to the hospital's capacity, and
the project included relocation of the kitchen.
Mission Memorial Hospital, Mission City.—The Minister of Health Services
and Hospital Insurance officiated at the opening of the new hospital on October 24,
1965. The new building is of reinforced-concrete construction, providing an initial
capacity of 54 active treatment beds. A partial third floor has been left unfinished
so that an additional 24 beds can be made available when required in the future.
Royal Columbian Hospital, New Westminster.—A new addition to house the
emergency department was opened officially by the Honourable Eric Martin during
a brief ceremony September 28, 1965. The two-story addition provides accommodation for 24 emergency, recovery, and treatment beds, and also contains emergency
operating facilities, a new admitting department and ambulance entrance.
Lions Gate Hospital, North Vancouver.—The Minister of Health Services and
Hospital Insurance participated in the official opening ceremonies on January 23,
1965, of the conversion of the former North Vancouver General Hospital to rehabilitative and psychiatric care. The first three floors of the four-story building now
provide accommodation for a 24-bed activation unit and a 19-bed psychiatric unit.
Tofino General Hospital, Tofino.—In March, 1965, a 4-bed addition to the
hospital was completed. The addition contains space for 2 additional beds when
required in future.
Langley Memorial Hospital, Murrayville.—On February 21,1965, the Minister
of Health Services and Hospital Insurance officially opened the new 81-bed hospital
at Murrayville. The hospital is a four-story building of reinforced concrete, built
in the form of a " T." In addition to the 81 beds, the new hospital has a semifinished area for 24 beds, as well as a top floor in " shell " construction that will be
able to accommodate 37 beds when required, giving a total potential capacity of
142 beds.
Ladysmith and District General Hospital.—The work on the new addition to
the hospital which provided space for 13 beds plus an unfinished area was substantially completed and occupied by the year-end.
Gorge Road Hospital, Victoria.—Lieutenant-Governor G. R. Pearkes officially
opened the new physical medicine addition on October 27, 1965.    Named the F. E.
 R 24 BRITISH COLUMBIA
Winslow Memorial Wing, it is a one-story building of frame and concrete-block
construction with wood laminated beams. Its numerous treatment facilities include
an occupational-therapy room, a prosthetics room, a gymnasium, passive- and
active-treatment rooms, and a hydrotherapy pool.
Campbell River and District General Hospital, Campbell River.—Completion
of unfinished areas plus renovations to provide 12 beds. This project was completed during the latter part of 1965 and includes the completion of areas for beds
as well as the installation of a pediatric nursing station, provision of additional storage space, completion of a treatment-room, and improvements to up-patients' rooms.
St. John Hospital, Vanderhoof.—Renovations carried out at this hospital were
substantially completed in June, 1965. The renovations were made on the first
floor of the hospital building in order to increase the bed accommodation. The
revised bed capacity is 44, or a net gain of 14 beds.
Trail-Tadanac Hospital, Trail.—Renovations were completed on the fourth
floor of the hospital to produce 10 beds.
(b) Hospital Projects under Construction at Year-end
Richmond General Hospital, Richmond. — Construction of a new hospital
facility to provide 132 finished beds, plus 22 beds in unfinished areas.
Cowichan District Hospital, Duncan.—Construction of new hospital building
to replace the existing facility. The new building will provide initially 127 beds and
will contain semi-finished areas for 19 further beds, plus a fourth floor in " shell "
construction.
St. Joseph's General Hospital, Comox.—Construction of a new hospital. The
new building will replace the old ex;sting structure, with the exception of the 1938
wing. The new unit will have 74 beds completed, plus a top floor which will provide
approximately 54 beds in future.
100 Mile District General Hospital, 100 Mile House.—Construction of a new
hospital facility of 31 beds, plus 8-bed nurses' residence.
Mater Misericordiae Hospital, Rossland.—Construction of an addition for
administration, plus renovations to provide improved emergency services, etc.
Boundary Hospital, Grand Forks.—Construction of 8-bed nurses' residence.
Cariboo Memorial Hospital, Williams Lake.—Construction of 18-bed nurses'
residence.
•    Prince George Regional Hospital, Prince George.—Construction of fifth-floor
addition and fourth-floor extension to provide 78 beds.
Royal Jubilee Hospital, Victoria.—Completion of 31 beds, plus renovation of
nursing units.   A project is also under way at this hospital to expand the boiler plant.
Tofino General Hospital, Tofino.—Renovations to nurses' residence.
Royal Columbian Hospital, New Westminster.—Alterations to provide laboratory department.
(c)  Projects in Advanced Stages of Planning and for Which Working Drawings
Are Completed or Are in Process of Preparation
Vernon Jubilee Hospital, Vernon.—Additions and renovations.
Summerland General Hospital, West Summerland.—New hospital.
Cranbrook and District Hospital, Cranbrook.—New hospital.
Castlegar and District Hospital, Castlegar.—Additions and renovations.
 HOSPITAL INSURANCE SERVICE,  1965 R 25
Royal Inland Hospital, Kamloops.—Renovations.
St. Mary's Hospital, New Westminster.—Additions and renovations.
Peace Arch District Hospital, White Rock.—Addition to hospital.
Maple Ridge Hospital, Haney.—Additions and renovations.
Health Sciences Centre, University of British Columbia.—New hospital facility.
(_.) Additional Projects Developed through Various Planning Stages in 1965
Prince Rupert General Hospital.—New hospital.
Kelowna General Hospital.—Additions and renovations.
Creston Valley Hospital.—Addition and renovations.
Vancouver General Hospital.—Replacements and additions.
Bulkley Valley District Hospital, Smithers.—Addition.
Trail-Tadanac Hospital.—Addition and renovations.
Holy Family Hospital, Vancouver.—Addition and renovations.
Ocean Falls General Hospital.—Replacement.
Pouce Coupe Community Hospital.—Addition for extended-care facilities.
Queen Victoria Hospital, Revelstoke.—Replacement.
G. F. Strong Rehabilitation Centre, Vancouver.—Addition and renovations.
Children's Hospital, Vancouver.—New facility.
Surrey Memorial Hospital.—Addition and renovations.
Royal Columbian Hospital, New Westminster.—Expansion programme.
West Coast General Hospital, Port Alberni.—Completion of space plus renovations and additions.
Squamish General Hospital.—Renovations and improvements.
Mills Memorial Hospital, Terrace.—Expansion.
Royal Jubilee Hospital, Victoria.—Expansion for laboratory and expansion of
nurses' training-school.
Powell River General Hospital.—Expansion for extended-care facilities.
Nanaimo Regional General Hospital.—Expansion.
King's Daughters' Hospital, Duncan.—Extended-care unit.
Campbell River and District General Hospital.—Extended-care unit.
Penticton Hospital, Penticton.—Expansion and renovations.
Matsqui-Sumas-Abbotsford General Hospital, Abbotsford.—Expansion programme.
Lady Minto Hospital, Ashcroft.—New hospital.
Burnaby General Hospital, Burnaby.—Expansion programme.
Chilliwack General Hospital, Chilliwack.—Expansion for extended-care and
activation beds.
Victorian Hospital, Kaslo.—Construction of 10-bed hospital.
Lions Gate Hospital, North Vancouver.—Completion of unfinished space.
Vancouver Jewish Home for the Aged.—Extended-care unit.
St. Vincent's Hospital, Vancouver.—Expansion programme.
St. Paul's Hospital, Vancouver.—Renovations programme.
St. Joseph's General Hospital, Comox.—Renovations of 1938 wing.
 Major Hospii
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Vernon, Cranbn
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 R 28 BRITISH COLUMBIA
Director of Hospital Consultation, Development, and Research
J. W. Mainguy, M.H.A.
Hospital Consultation and Inspection Division
(During the year Mr. J. W. Mainguy was appointed as Director of Hospital
Consultation, Development, and Research, but continued in the interim as Manager
of the Hospital Consultation and Inspection Division.)
This Division provides a consultative service to both public and private hospitals in all aspects of an administrative and operational nature. The Division is also
responsible for the licensing and inspection of private hospitals, including 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 type care, most
of which are privately owned and operated for profit.
The Division is represented on the Rate Board and works with the Hospital
Finance Division in analysing hospital estimates, including pre-construction estimates
for planned building projects. In conjunction with the Administrative Officer, hospital by-laws are reviewed 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 which meet prescribed standards of care and
management.
Working with the Provincial Fire Marshal and other safety officers, the staff of
the Division checked hospital standards of safety and fire-prevention measures.
A Division member served 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 selection of equipment, and the training of laboratory technologists. On the
advice of the Advisory Council, seven regional pathology services in seven areas of
the Province have been approved, and all are in operation. At the year-end the
Council had completed the review of the proposed establishment of an eighth regional service.
The Division frequently works in conjunction with the Health Branch, particularly with the Medical Health Officers, the Technical Supervisor of Clinical Laboratory Services, and the Technical Supervisor of Radiology, who also visit hospitals
to provide assistance. The Health Branch Nutrition Consultant also assisted the
Division in giving advice on dietary problems to both public and private hospitals.
In co-operation with the Director of Emergency Health Services, and Provincial Civil Defence authorities, another in a series of hospital disaster institutes was
held during the year. A staff member served on the Provincial Hospital Disaster
Plan Review Committee, along with representatives from the Health Branch and
Provincial Civil Defence.
Division members also represented the Service on the Welfare Institutions
Board and provided liaison with committees of the Registered Nurses' Association
and the British Columbia Hospitals' Association. The Division has actively cooperated with the Hospitals Committee of the Canadian Medical Association (British Columbia Division). One of the Consultant-Inspectors is vice-chairman of the
British Columbia Council of Licensed Practical Nurses, the body responsible for
the licensing of practical nurses in accordance with the Practical Nurses Act, which
was implemented during the year. At the request of the hospital board, a member
of the Division provided part-time administrative assistance to a regional hospital
over a period of several months while it was without the services of an administrator.
 HOSPITAL INSURANCE SERVICE,  1965
R 29
The Division was also represented on the faculty of the administrators' forum
held in Vancouver in April, at an architectural institute in November, and assisted
in a study of the advantages of establishing a regional laundry service in the Lower
Mainland.
Members of the Division devoted considerable time to the preparatory work
connected with the introduction of the Extended Hospital Care Programme (see
page 13 for details), and have been in contact with the hospitals involved to assist
them with the changes brought about by the new plan.
During the year, 145 visits of a consultative and inspection nature were made
to private hospitals providing nursing-home care. This figure does not include visits
related to the construction of new private hospitals. In 1964, licences were issued
to the following newly constructed private hospitals: Carlsbad Private Hospital,
Vancouver, 47 beds; Parkridge Private Hospital, Hammond, 54 beds; Oakherst
Private Hospital, Vancouver, 75 beds; Aberdeen Private Hospital, Vancouver, 75
beds; Carlton Private Hospital, Burnaby, 75 beds; Mount Paul Private Hospital,
North Kamloops, 75 beds. At the end of November there were 78 licensed private
hospitals (nursing homes) providing a total of 3,695 beds. With the start of the
Extended Hospital Care Programme, several non-profit facilities, previously licensed
under Part II of the Hospital Act, were designated under Part III as of December 1st.
Five private acute hospitals were under licence, with a total of 91 beds. Four
of these hospitals 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. The Registered
Nurses' Association has continued to assist the Division in screening the credentials
of prospective 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 homes because their needs
are beyond what could be provided in their own homes. This service is provided
only on the request of an acute hospital, and 107 cases were dealt with under this
arrangement during the year.
Research Division
D. S. Thomson, B A., Director
The primary functions of the Research Division are;.—
(1) To undertake studies of hospitalization and economic growth in different
parts of the Province and from these studies forecast the bed requirements
in the areas concerned.
(2) To compile and maintain statistics of hospitalization data.
(3) To analyse the patterns and trends of morbidity in the Province as a whole
and to make comparisons with other Provinces.
During the year, bed requirement studies were carried out in various parts of
the Province. In addition, statistical information and forecasts of hospital bed needs
were prepared for other areas, although full surveys were not undertaken.
The Division prepared a number of publications in 1965, including the annual
bulletins " Statistics of Hospital Cases Discharged " and " Statistics of Hospitalized
Accident Cases." The fourth edition of "An Alphabetical Listing of Place Names
in British Columbia " was also prepared and issued.
A statistical report of patient movements in the Metropolitan Vancouver area
was prepared and circulated among the hospitals concerned.
J
 R 30 BRITISH COLUMBIA
A series of relevant statistics of individual hospitals was circulated to all acute-
care hospitals. The issue of these " hospital indicators " is designed to give each
institution the benefit of comparative statistics which would not otherwise be available to them.
As in previous years, card-punching was done by the Hospital Claims Section
of the Hospital Finance Division of this Service, and the mechanical tabulation of
data used by this Division was done by the Data Processing Division of the Department of Industrial Development, Trade, and Commerce.
Mr. W. D. Burrowes, B.A., transferred from his position as Director of the
Division, December 31, 1964, to accept an appointment as Assistant Director of
the Vital Statistics Division of the Health Branch. He was replaced by Mr. D. S.
Thomson, B.A., who assumed the position April 1, 1965. Mr. E. Weekley, B.Sc,
Research Officer, resigned in November, 1965, to proceed on an extended trip, and
it is expected that a replacement will be appointed early in the new year.
Medical Consultation Division
W. A. Fraser, O.B.E., E.D., M.D., CM., F.A.C.S., Medical Consultant
The work of assessing hospital Admission/Separation forms for medical eligibility for Hospital Insurance Service coverage, and of coding discharge diagnoses, is
a continuing and rewarding procedure of this Division. A high degree of accuracy is
required and the constant pressure on the medical coders is noticeable, especially
when absence due to illness occurs.
The adoption of the International Classification of Diseases, Adapted for
Indexing Hospital Records by Diseases and Operations, continues to be of great
value, and it is anticipated that more detailed statistical studies will result from the
data being tabulated and compiled.
In September, 1965, a visit to two hospitals in the Interior was made by a
medical team from the British Columbia Medical Association, along with the Medical Consultant and a Hospital Inspector from the British Columbia Hospital
Insurance Service. The purpose of the visit was to review the record of hospitalization and length of stay sufficiently to determine whether the existing beds are being
used to best advantage; to look into the referral of patients to hospitals elsewhere
and referral of patients into the area for hospitalization; and to assess whether the
increasing demand for hospital facilities is caused entirely by medical needs.
Commencing in July, 1961, and continuing to date, there have been seven
similar medical-team visits to various hospitals in the Province. These team visits
have proven of great value to British Columbia Hospital Insurance Service, the
medical profession, and the hospital concerned. It has been suggested that hospital
appraisal by a team from the Canadian Medical Association and the Hospital Insurance Service be carried out each year on a planned basis.
The Chief Supervisor of Medical Coders of this Division has, during this past
year, successfully completed a course in a school for medical record librarians.
With this additional valuable training, she will be able to provide a consultative
service to hospitals in the Province. In addition to providing assistance through
correspondence with the hospitals, an actual visiting plan will be adopted at the
beginning of each year. This is necessary to maintain liaison between the Medical
Consultation Division and the record departments in the various hospitals within the
Province.
 hospital insurance service, 1965 r 31
Administrative Officer
K. G. Wiper
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 interpretation and 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 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, the Chief Electoral Officer of the Provincial Secretary's Department, and the Department of Municipal Affairs, 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 1965 there were 36 hospital improvement districts in operation.
As in previous years, considerable time was spent in 1965 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 and other Provinces at meetings held in Ottawa and Victoria.
The Administrative Officer was appointed as Personnel Officer for the British
Columbia Hospital Insurance Service early in 1965. He 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 received 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
 R 32 BRITISH COLUMBIA
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.
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. Trie 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.
Public Information
R. H. Thompson
In the continuing development of public information activities, there are three
main areas of responsibility. These concern themselves with the hospitals of the
Province, the general public, and in-service duties. The following is a summary of
the work undertaken by this office during 1965.
At the request of the British Columbia Hospitals' Association, a poster was
developed for use in the admitting office and reception areas of hospitals. It outlined B.C.H.I.S. benefits and clarified the additional charges for private and semi-
private accommodation. The poster was printed in colour, and copies were forwarded to all general hospitals.
The pamphlet "A Public Relations Guide for Hospitals," originally prepared
by this office in 1959, was reprinted during the year, and at the year-end two other
pamphlets were being revised. These were the " General Information " pamphlet,
intended primarily for new residents of the Province, and "At Your Service," which
is supplied to hospitals for distribution to their patients and visitors.
More than 150 individual screenings were made by hospitals of films on loan
from the Service's 16-mm. library. Two films dealing with work simplification
were purchased during the year. A third film in this management series and a
film on the subject of the nurse-patient relationship in psychiatric care were on order
in December. This will make a total of fourteen 16-mm. sound films available to
hospitals for in-service training.
An educational display was prepared for use during the British Columbia
Hospitals' Association annual conference, held in September in Vancouver. Assistance was also provided in renovating the Departmental display in the British
Columbia Building on the grounds of the Pacific National Exhibition.
Following the announcement in the Legislature in February by the Minister
of Health Services and Hospital Insurance of the Government's proposed coverage
for nursing-home type care, an explanatory advertisement was placed in the majority
of the Province's newspapers in order that all communities would be advised and
could give consideration to the development of the necessary facilities. When the
Extended Hospital Care Programme commenced on December 1st, a copy of the
Minister's statement outlining the new programme was sent to all hospital administrators, board chairmen, and trustees; to all medical doctors in the Province; and
to the news media.
 HOSPITAL INSURANCE SERVICE,  1965
R 33
Regular editions of the B.C.H.I.S. Bulletin were published during the year, with
copies sent to all general hospitals and nursing homes. The Bulletin is an administrative aid used to clarify policy and procedural changes for hospital personnel.
It also features items of general interest dealing with such subjects as safety, laundry
management, accreditation, and so on. Several press releases on hospital construction and the awarding of Government grants were prepared, and articles written
for national journals and the British Columbia Government News. Other duties
included the summarizing of reports, maintaining the newspaper and photographic
files, correspondence, and the preparation and editing of the Seventeenth Annual
Report.
General Office
C. R. Leighton
The main area of responsibility of the General Office is internal accounting
and supervision of expenditure. This includes administrative accounting, maintaining payroll and personnel records, and assuming responsibility for all supplies,
furniture, and equipment. One of the major functions is the preparation of
Departmental estimates, which is done each year in conjunction with the Division
managers.
Another function of this office is to keep abreast of modern developments in
office methods and machinery with a view to possible automation where economically feasible. In this connection the Supervisor attended several demonstrations
of office equipment and machinery.
Owing to the increasing work volume in the Hospital Construction and Planning Division, the General Office is now providing assistance in processing applications and grants in connection with alterations and renovations to hospitals. This
assistance has succeeded in increasing the speed of dealing with the applications and
related grants.
The Supervisor, in his capacity of Safety Officer, attended the British Columbia
Safety Council convention in Vancouver last March. Much of value was learned
at this convention, particularly in the field of safety as related to the care of the
elderly. The Branch once again earned a British Columbia Safety Council award
for a further 11 months of accident-free operation. A bronze certificate was awarded
by the Premier to the Department at a ceremony which took place in the Parliament
Buildings on December 11th.
APPROVED HOSPITALS
Public Hospitals
Armstrong and Spallumcheen Hospital, Armstrong.
Arrow Lakes Hospital, Nakusp.
Bella Coola General Hospital, Bella Coola.
Boundary Hospital, Grand Forks.
British Columbia Cancer Institute, Vancouver.
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.
G. R. Baker Memorial Hospital, Quesnel.
 R 34
BRITISH COLUMBIA
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 Misericordiae Hospital, Rossland.
Matsqui, Sumas, and Abbotsford General
Hospital, Abbotsford.
Michel Hospital, Michel.
Mills Memorial Hospital, Terrace.
Mission Memorial Hospital, Mission City.
Mount St. loseph's Hospital, Vancouver.
Nanaimo Regional General Hospital, Nanaimo.
Nicola Valley General Hospital, Merritt.
Ocean Falls General Hospital, Ocean Falls.
Peace Arch District Hospital, White Rock.
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, New Westminster.
St. Mary's Hospital, Sechelt.
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.
Stewart General Hospital, Stewart.
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.
Windermere District Hospital, Invermere.
Wrinch Memorial Hospital, Hazelton.
Red Cross Outpost Nursing Station
Creek.
Red Cross Outpost Nursing Station, Atlin.
Red Cross Outpost Nursing Station, Bam-
field.
Red Cross Outpost Nursing Station, Blue
River.
Red Cross Outpost Nursing Station, Edge-
wood.
Outpost Hospitals
Alexis
Red Cross Outpost Nursing Station, Hudson
Hope.
Red Cross Outpost Nursing Station, Kyu-
quot.
Red Cross Outpost Nursing Station, Masset.
Red Cross Outpost Nursing Station, Wad-
hams.
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.
Licensed Private Hospitals
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,  1965
Rehabilitation, Chronic, and Convalescent Hospitals
R 35
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.
Sunny Hill Hospital for Children, Vancouver.
Extended-care Hospitals
Mount St. Mary Hospital, Victoria (excluding top floor).
Mount St. Francis Hospital, Nelson.
Mount St. Joseph's Hospital, Vancouver (top
floor).
Menno Hospital, Abbotsford.
Priory Hospital, Colwood (24-bed unit).
Pearson Hospital, Vancouver (excluding facilities for tuberculosis patients).
Valleyhaven Hospital, Chilliwack.
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 1965 there were 88 public general hospitals approved to accept B.C.H.I.S. patients. In addition, care was provided in nine outpost
hospitals, six Federal hospitals, five contract hospitals, five public rehabilitation
hospitals, and one rehabilitation hospital operated by the Provincial Government.
In addition, rehabilitation care was also provided in a considerable number of
public general hospitals and in two Federal hospitals. Hospital insurance coverage
for patients in non-profit extended-care hospitals and units commenced December
1, 1965. Six hospitals and one hospital operated by the Provincial Government
were designated for this type of care. Data for the year 1965 have been estimated
from reports submitted by hospitals to October 31st, and are subject to minor
revision when actual figures for the year are submitted.
Table 1a shows that a total of 286,360 B.C.H.I.S. adult and children patients
were separated (discharged) from British Columbia hospitals in 1965, an increase
of 8,337 or 3.0 per cent over 1964. This table also shows that 95.1 per cent of
the total patients separated from British Columbia public hospitals were covered
by hospital insurance, compared to 95.4 in 1963 and 95.2 in 1964. Table 1b
indicates in 1965 that the British Columbia Hospital Insurance Service paid public
hospitals in British Columbia 2,741,576 days of care for adults and children, an
increase of 71,400 days or 2.6 per cent over 1964.
As shown in Table 2a, the average length of stay of British Columbia adult
and children patients in public hospitals during 1965 was 9.57 days, and the days
of care per 1,000 population was 1,800. The continuing high incidence of patient-
days per 1,000 population is a reflection of the number of hospital beds available,
resulting from an increasing number of hospital beds being constructed.
Statistical data for extended-care coverage is not available for 1965.
 R 36
BRITISH COLUMBIA
Table Ia. — Patients Separated (Discharged or Died) and Proportion
Covered by British Columbia Hospital Insurance Service, British
Columbia Public Hospitals Only, 1949-65 (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 	
164,964
172,645
181,160
188,355
200,893
206,992
216,743
227,359
228,917
236,859
245,766
261,128
271,609
277,073
285,998
292,119
301,035
26,272
26,205
27,096
28,675
30,712
31,984
33,190
35,118
37,376
38,374
39,039
39,599
38,226
37,697
37,231
35,688
34,079
191,236
198,850
208,256
217,030
231,605
238,976
249,933
262,477
266,293
275,233
284,805
300,727
309,835
314,770
323,229
327,807
335,114
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
272,597
278,023
286,360
84.9
84.0
82.9
81.9
84.2
91.7
92.2
91.6
91.5
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
35,878
34,196
32,392
93.8
91.4
89.2
87.3
90.6
92.2
95.0
94.5
93.5
164,808
1950
168,902
1951
174,288
195?
179,359
1951
196,997
1954                                           	
219,196
1955	
1956  	
231,289
241,467
1957
244,448
1958             .           	
259,091
1959
273,263
IQfiO
288,634
1961
297,511
196?
301,160
1963	
308,475
312,219
19641        	
19652                               ....   j_         ,   ,
318,752
Percentage of total, patients separated—
1949
86.2
1950 -	
84.9
1951 ..   ..
83.7
1952    .
82.6
1953
	
85.1
1954
91.7
1955
	
92.5
1956
92.0
1957                              ...              	
91.8
1958
 —
93.7      1      96.5    1       94.1
1959
95.5
95.6
95.7
95.5
95.3
95.2
95.1
98.6
98.4
98.3
96.8
96.4
95.8
95.0
95.9
IQfifl
96.0
1961
	
96.0
1962
 	
95.7
1963	
	
95.4
10fi4l
95.2
1«fi52                   ,              |                             i         ■    I
	
	
95.1
i Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to October 31, 1965.
 HOSPITAL INSURANCE SERVICE,  1965
R 37
Table Ib.—Total Patient-days and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public Hospitals
Only, 1949-65 (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
Patient-days—
1940
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
2,778,668
2,-20,1212
2,896,370
213,874
212,979
214,285
214,701
220,208
226,031
227,674
233,402
240,872
244,429
248,074
249,273
240,207
274,032
270,298
260,979
246,819
1,896,070
1,979,659
2,009,723
2,131,187
2,261,823
2,388,033
2,426,537
2,473,048
2,518,439
2,567,225
2,655,208
2,830,315
2,915,609
2,982,369
3,048,966
I 3,081,101
1 3,143489
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
2,631,671
2,670,176
2,741,576
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
04.7
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
257,736
246,813
231,002
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
05 4
1,631,231
1950
1,669,922
1951
1,654,993
195?
1,754,134
1953
1,909,978
1054
2,168,410
1955
2,217,679
1956	
1057
2,259,106
2,299,415
1958
2,402,287
1959
2,514,998
1960
2,692,996
1961
2,777,387
1962                             ....                              	
1963	
19641 	
19652                            	
2,837,109
2,889,407
1 2,916,989
1 2,972,578
86.0
Percentage of total, patient-days—
1040
1950
84.4
1051
	
82.3
1952    ,
82.3
1953
	
	
	
84.4
1954
90.8
1955
	
	
91.4
1956
91.3
1957
91.3
1058
93.6
1959
94.7
1960
95.1
1961
95.3
1962
95.1
1963	
04.8
19641  _	
04 6     '        04 7
1965»	
	
-
94.6       !       93.6     '        94.6
i Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to October 31, lj965.
 R 38                                                    BRITISH COLUMBIA
Table 2a.—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 Popula
tion, 1949-65 (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                        .  _
149,280
24,989
24,336
140,168
24,640
23,943
7,093
7,617
151
2,019
198
1950
154,643
144,959
173
2,067
220
1051
159,739
24,587
25,492
28,381
150,116
24,172
25,023
7,308
171
2,315
2,612
244
1057
164,379
154,336
7,431
161
308
1051
180,149
169,167
27,830
8,173
229
2,809
322
1954    .
199,974
29,761
189,713
29,483
7,602
199
2,659
79
1955	
209,999
32,035
199,774
31,515
8,313
361
1,912
159
1956   	
219,218
33,783
208,293
33,174
9,473
457
2,050
159
1957       _	
221,585
35,813
209,485
34,963
10,023
668
2,077
182
1958  	
236,770
37,924
222,046
37,045
12,506
665
2,218
214
1959	
251,393
39,257
234,783
38,480
13,908
514
2,702
263
1960	
264,120
39,488
249,654
38,980
11,557
241
2,909
267
1961
273,293
37,968
259,953
37,558
10,361
151
2,979
259
1962  	
278,021
36,942
264,655
36,505
10,226
157
3,140
280
1963-.	
286,753
36,326
272,597
35,878
10,895
169
3,261
279
19641   	
293,144
34,652
278,023
34,196
11,605
149
3,516
307
19652. 	
300,700
32,795
286,360       32,392
11,115
123
3,225
280
Patient-days—
1949	
1,498,121
203,197
1,430,646
200,585
45,960
1,146
21,515
1,466
1950	
1,564,222
196,333
1,476,615
193,307
65,326
1,288
22,281
1,738
1951
1,551,954
190,948
1,467,102
187,891
62,771
1,155
22,081
1,902
1952	
1,663,149
187,923
1,569,974
184,160
68,892
974
24,283
2,789
1953	
1,814,344
200,738
1,712,878
197,100
75,518
1,353
25,948
2,285
1954
2,046,087
215,507
215,980
1,954,823
2,005,165
213,587
212,514
66,960
75,599
1,251
2,271
24,304
19,622
669
1,195
1955	
2,100,386
1956	
2,141,445
221,022
2,041,854
217,252
79,428
2,740
20,163
1,030
1957 	
2,188,765
228,875
2,076,336
223,079
93,980
4,299
18,449
1,497
1958	
2,332,502
238,112
2,169,897
232,390
141,925
4,113
20,680
1,609
1959	
2.474,974
244,615
2,275,127
239,871
173,343
2,818
26,504
1,926
1960	
2,650,129
244,480
2,451,839
241,157
169,401
1,417
28,889
1,906
10(51
2,756,665
233,794
2,546,344
231,043
182,690
878
27,631
1,873
1962	
2,789,355
266,351
2,573,634
263,475
183,042
850
32,679
2,026
1963  	
2,850,559
260,771
2,631,671
257,736
187,714
1,018
31,174
2,017
19641	
2,905,544
249,827
2,670,176
246,813
199,164
878
36,204
2,136
19652. 	
2,968,876
233,282
2,741,576
231,002
195,300
630
32,000
1,650
Average days of stay—
1949   .	
10.03
8.13
10.21
8.14
6.48
7.59
10.66
7.40
1950
10.11
9.71
10.12
8.07
7.76
7.37
10.19
9.77
10.17
8.07
7.77
7.36
8.58
8.59
9.27
7.44
6.75
6.05
10.78
9.54
9.29
7.90
7.79
9.06
1951 	
1952	
1953 _    ..
10.07
7.07
10.13
7.08
9.24
5.91
9.24
7.10
1954	
10.23
7.24
10.30
7.24
8.81
6.29
9.14
8.47
1955.. 	
10.00
6.74
10.04
6.74
9.09
6.29
10.26
7.52
1956     	
9.77
9.88
6.54
6.39
9.80
9.91
6.55
6.38
8.38
9.39
6.00
6.44
9.84
8.88
6.48
8.23
1957    -.-...   	
1958	
9.85
6.28
9.77
6.27
11.35
6.19
9.45
7.51
1959 	
9.85
6.23
9.69
6.23
12.46
5.48
9.81
7.32
1960	
10.03
6.19
9.82
6.19
14.66
5.88
9.93
7.14
1961
10.09
6.16
9.80
6.15
17.63
5.81
9.27
7.23
1962	
10.03
7.21
9.72
7.22
17.90
5.41
10.41
7.24
1963	
9.94
7.18
9.65
7.18
17.23
6.02
9.56
7.23
1964L. , 	
9.91
7.21
9.60
7.22
17.16
5.89
10.30
6.96
19652	
9.87     |      7.11
9.57
7.13
17.57
5.12
9.92
5.89
i Amended as per final reports from hospitals.
2 Estimated, based on hospital reports to October 31, 1965.    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, 1,835;  1964, 1,815;  1965, 1,800.
(1954 and subsequent
years are based on total population.   Because the armed forces, Royal Canadian Mounted P<
>lice, and some other
groups are not insured under the Provincial plan, the actual incidence of days would be s<
jmewhat higher than
shown.)   Population figure
s are revise
_ accordin
g to latest (
ensus figu
res.
 HOSPITAL INSURANCE SERVICE,  1965
R 39
Table 2b.—Summary of the Number of B.C.H.I.S. In-patients (Including
Rehabilitation Patients) and Short-stay Patients, 1949-65
Total Adults,
Children, and
Newborn
In-patients
Estimated
Number of
Emergency and
Minor-surgery
Patientsi
Total
Receiving
Benefits
1049
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
323,079
327,796
333,495
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
141,000
150,000
203,269
1950
1051
223,481
231,982
105?.
236,638
1053
261,112
1954
293,356
1055
312,587
1956
329,376
1957
340,928
1958
366,577
1959
390,942
I960
410,920
10K1
432,261
1962
442,963
1963
458,079
19642
468,796
19653
483,495
Totals	
4.397.689           1        1.489.073
5,886,762
i Years 1962 to 1965 estimated.
2 Amended as per final reports received from hospitals.
3 Estimated, based on hospital reports to October 31,1965.
Table 3.—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 19651 (Including
Rehabilitation Hospitals).
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Patients separated—
Adults and children	
286,360
32,392     i
2,741,576
231,002
9,57
7.13
103,594
9,590
1,203,070
78,127
11.61
8.15
85,999
11,393
723,773
76,472
8.42
6.71
54,839
7,639
497,137
52,219
9.07
6 84
32,770
2,911
249,508
18,441
7.61
6 33
9,15.
859
Patient-days—
Adults and children
Newborn	
Average days of stay—
Adults and children
68,086
5,743
7.43
6 69
1 Estimated, based on hospital reports to October 31, 1965.
 R 40
BRITISH COLUMBIA
Table 4.—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 19651 (Including
Rehabilitation Hospitals).
Bed Capacity
Total
250 and
Over
1O0 to 249
50 to 99
25 to 49
Under 25
Patients separated—-
Adults and children
Per Cent
100.00
100.00
100.00
100.00
Per Cent
36.18
29.61
43.93
33.82
Per Cent
30.03
35.17
26.43
33.10
Per Cent
19.15
23.58
18.04
22.61
Per Cent
M .44
8.99
9.11
7.98
Per Cent
3.20
2.65
Patient-days—
Adults and children
Newborn	
2.49
2.49
i Estimated, based on hospital reports to October 31, 1965.
CHARTS
The statistical data shown in the following charts prepared by the Research
Division are derived from Admission/Separation forms submitted to the British
Columbia Hospital Insurance Service.
The major diagnostic categories used for the table on pages 46 to 48 are more
detailed than the diagnostic groups shown on the charts. Both lists are based
on the International Classification of Diseases, Adapted, prepared by the Public
Health Service of the United States Department of Health, Education, and Welfare.
Readers who are interested in more detailed statistics of hospitalization in
this Province may wish to refer to " Statistics of Hospital Cases Discharged during
1964" and "Statistics of Hospitalized Accident Cases, 1964."
 HOSPITAL INSURANCE SERVICE,  1965
R 41
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 HOSPITAL INSURANCE SERVICE,  1965
R 45
Infective and parasitic diseases
Certain diseases of early infancy
Allergic, endocrine system,
metabolic, and nutritional diseases
Mental, psychoneurotic, and
personality disorders
Injuries and adverse
effects
PROVINCIAL AVERAGE
LENGTH OF STAY
Diseases of the digestive system
Diseases of the skin
and cellular tissue
Diseases of the genito-urinary
system
Diseases of the respiratory system
Deliveries and complications of
pregnancy, childbirth, and the
puerperium
Symptoms, senility, and ill—
defined conditions
Supplementary classification for
special admissions
* Including rehabilitative care
Chart V.—Average Length of Stay of Cases* in Hospitals in British Columbia,
by Major Diagnostic Groups in Descending Order, 1964
(Excluding Newborns)
Neoplasms
Diseases of the circulatory system
Diseases of the bones and
organs of movement
Diseases of the blood and
blood-forming organs
Diseases of the nervous system
and sense organs
Congenital malformations
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 HOSPITAL INSURANCE SERVICE,  1965 R 49
STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE
FISCAL YEAR ENDED MARCH 31, 1965
Administration—
Salaries         $490,113
Temporary assistance  5,303
$495,416
Office expense  33,820
Travelling expense  29,593
Office furniture and equipment  3,007
Printing and publications  1,017
Tabulating and rentals  2,484
Motor-vehicles and accessories  1,767
Incidentals and contingencies  4,250
Construction—consulting fees
Technical surveys  6,676
$578,030
Less transfer, Vote 128 (b)—Salary adjustments  23,568
Payments to hospitals—
Claims   $68,533,484
Vancouver General Hospital re out-patients (Hospital Insurance Act, sec. 17 (3) (a))  322,512
$554,462
$68,855,996
Less collections, third-party liability  417,450
$68,438,536
Less—
Chargeable to Government of Canada $35,857,435
Miscellaneous receipts     394
 35,857,829
32,580,707
Grants in aid of construction of hospitals       3,724,756
Total    $36,859,925
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1966
810-1165-7636
 

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