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Eighteenth Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1966 British Columbia. Legislative Assembly 1967

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 PROVINCE OF BRITISH COLUMBIA
HOSPITAL INSURANCE ACT
Eighteenth Annual Report
British Columbia
Hospital Insurance Service
IANUARY 1 TO DECEMBER 31
1966
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1967
  Victoria, B.C., January 24, 1967.
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 Eighteenth Annual Report of
the British Columbia Hospital Insurance Service covering the calendar year 1966.
WESLEY DREWETT BLACK,
Minister of Health Services and Hospital Insurance.
 British Columbia Hospital Insurance Service,
Victoria, B.C., January 24, 1967.
The Honourable Wesley Drewett Black,
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 1966.
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 Wesley Drewett Black, Minister of Health Services
and Hospital Insurance.
(Appointed December 12, 1966.)
The Honourable Eric Martin, Minister of Health Services and Hospital Insurance.
(Retired December 12, 1966.)
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.
C. F. Ballam, M.D., Medical Consultant.
A. W. E. Pitkethley, Esq., Manager, Hospital Construction and Planning Division.
N. S. Wallace, C.G.A., Manager, Hospital Finance Division.
J. Bainbridge, Manager, Hospital Consultation and Inspection Division.
K. G. Wiper, Esq., Administrative Officer.
D. S. Thomson, B.A., Director, Research Division.
  CONTENTS
Page
General Introduction  9
British Columbia General Hospitals (Comparisons of Growth)  11
The Hospital Insurance Act  13
The Hospital Act  13
Persons Entitled to or Excluded from the Benefits under the Hospital Insurance
Act  13
Entitled to Benefits  13
Excluded from Benefits  14
Hospital Benefits Available in British Columbia  14
In-patient Benefits  14
Emergency Services and Minor Surgery  15
Application for Hospital Insurance Benefits  15
The Hospital Rate Board and Methods of Payment to Hospitals  15
The B.C.H.I.S. Planning Group  16
Organization and Administration  16
Assistant Deputy Minister  17
Hospital Finance Division  17
Hospital Accounting  18
Hospital Claims  19
Hospital Construction and Planning Division  20
Hospital Projects Completed during 1966  22
Hospital Projects under Construction at Year-end  23
Projects in Advanced Stages of Planning  24
Additional Projects Approved and in Various Planning Stages  24
Director of Hospital Consultation, Development, and Research  25
Hospital Consultation and Inspection Division  25
Research Division  29
Medical Consultation Division  29
Administrative Officer  30
Eligibility Representatives' Section  31
Third Party Liability Section  32
General Office  32
Public Information  3 3
Approved Hospitals  34
Public Hospitals  34
Outpost Hospitals  35
Federal Hospitals  35
Private Hospitals (Providing General Hospital Services)  35
Rehabilitation, Chronic, and Convalescent Hospitals  35
Extended-care Hospitals  3 5
7
 O 8 BRITISH COLUMBIA
Pace
Statistical Data r  3 5
Table 1a.—Patients Separated (Discharged or Died) and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public Hospitals Only, 1949-66 (Excluding Federal, Private, and
Out-of-Province Hospitalization) (Including Rehabilitation Hospitals) 37
Table 1b.—Total Patient-days and Proportion Covered by the British Columbia Hospital Insurance Service, British Columbia Public Hospitals
Only, 1949-66 (Excluding Federal, Private, and Out-of-Province
Hospitalization) (Including Rehabilitation Hospitals)  38
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,
1949-66 (Including Rehabilitation Hospitals)  39
Table 2b.—Summary of the Number of B.C.H.I.S. In-patients (Including
Rehabilitation Patients) and Short-stay Patients, 1949-66  40
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 1966 (Including Rehabilitation Hospitals)  40
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 1966 (Including Rehabilitation Hospitals)  41
Charts  41
I.—Percentage Distribution of Days of Care by Major Diagnostic Groups,
1965  42
II.—Percentage Age Distribution of Male and Female Hospital Cases and
Days of Care, 1965  43
III.—Percentage Distribution of Hospital Cases by Type of Clinical Service,
1965  44
IV.—Percentage Distribution of Hospital Days by Type of Clinical Service,
1965 .  45
V.—Average Length of Stay of Cases in Hospitals in British Columbia by
Major Diagnostic Groups, 1965 (Excluding Newborns)  46
Hospitalization by Major Diagnostic Categories, 1965  47
Statement of Receipts and Disbursements for the Fiscal Year Ended March 31,
1966  50
 Eighteenth Annual Report of the
British Columbia Hospital Insurance Service
GENERAL INTRODUCTION
Donald M. Cox, F.A.C.H.A., Deputy Minister of Hospital Insurance
Residents of British Columbia had expressed considerable interest in some form
of universal hospital coverage many years prior to the start of the British Columbia
Hospital Insurance Service. On January 1, 1949, the Provincial plan came into
operation with four major objectives in mind: First, to protect the residents of the
Province against the financial burden associated with hospitalization; second, to
provide the hospitals of the Province with a steady source of income; third, to help
hospitals establish and maintain high standards of patient care; and, fourth, to assist
communities in providing adequate hospital facilities. During the 18 years the plan
has been in operation, the vast majority of families throughout the Province have
benefited directly in the payment of hospital accounts, and remarkable progress has
been made in the development of hospital facilities and services. Daily payments
to hospitals in 1949 amounted to $50,000; in the current fiscal year an estimated
$90,000,000 will be paid on behalf of hospitalized residents, a daily average of
$246,500. A further measure of progress is evident in the construction of fine new
buildings, the expansion of hospital services, and the extension of coverage. In
1966 hospital construction continued to keep pace with the tremendous programme
of building that took place in British Columbia during the preceding years from 1949
to 1965. During that period over 140 major building projects were completed,
involving approximately 7,450 new beds as well as such vital service facilities as
new emergency, laboratory, and radiological departments, nurses' training-schools,
and laundry buildings. The cost of construction in this vast undertaking amounted
to over $95,500,000, of which the Provincial Government provided grants exceeding
$45,500,000. This past year new hospitals were opened at Richmond and 100 Mile
House; additions, renovations, and the completion of unfinished areas took place
at Prince George, Fort St. John, Rossland, Castlegar, Tofino, and Victoria's Royal
Jubilee Hospital; nurses' residences were built at Grand Forks, 100 Mile House, and
Williams Lake, and a small addition was made to the nurses' residence at Tofino.
A medical intensive-care unit was completed at St. Paul's Hospital, Vancouver, and
an addition was made to the boiler plant at the Royal Jubilee Hospital, Victoria.
At the year-end over 1,000 new beds were under construction throughout the Province, representing construction costs exceeding $25,000,000, and major projects in
the advanced stages of planning represented a further investment of close to
$57,000,000.
Changes in policy that took place during the year included increased benefits
for in-patient hospital care provided outside British Columbia. Effective February
25, 1966, the Provincial Government extended the period of hospital coverage provided by the Hospital Insurance Service to qualified residents who are temporarily
absent from the Province to six months from the date of departure, and extended
the maximum length of stay in an approved out-of-Province hospital to six months.
In cases of urgent medical necessity these time limits may be extended for an addi-
 O 10 BRITISH COLUMBIA
tional period of up to six months by the Lieutenant-Governor in Council. In addition to these extensions, the maximum rate of payment for hospital care outside
Canada was increased from $12 a day for adults to $25, and from $4 a day for
newborn infants to $7.
A further change during the year with respect to hospital benefits was the
extension of coverage to include out-patient cancer therapy in the facilities operated
by the British Columbia Cancer Institute in Vancouver and at the Royal Jubilee
Hospital in Victoria.
In November the Minister of Health Services and Hospital Insurance advised
the acute-care hospitals of the Province that arrangements had been completed for
the free P.K.U. testing of all newborn infants. The Minister stated that infants
found to be suffering from phenylketonuria would be provided with lophenolac
(a low phenylalanine milk substitute) through the out-patient clinic of The Woodlands School in New Westminster.
Throughout the year helpful advice and guidance were provided by the medical
profession, and 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 co-operation they extended us. Other professions, including the Registered Nurses' Association (British Columbia Division) and the Architectural Institute of British Columbia, were most generous also in the assistance they
made available to our branch.
I should like to express my sincere appreciation once again to the staff of the
Hospital Insurance Service for the conscientious manner in which they carried out
their varied duties and responsibilities during this past year.
Finally, I should like, on behalf of the staff of the British Columbia Hospital
Insurance Service, to pay tribute to the accomplishments of Mr. Eric Martin during
his term of office as Minister from August 1, 1952, to December 12, 1966, and to
his great and absorbing interest in the hospital needs of the people of British Columbia.
Reports submitted by the various divisions on work undertaken during 1966
appear under " Organization and Administration " commencing on page 16.
 HOSPITAL INSURANCE SERVICE,  1966
B.C.H.I.S. Payments to Hospitals for In-patient Care
(Including federal and Contract Hospitals)
o
11
85
80
75
70
65
60
55
50
45
J 40
S35
30
25
20
85
80
75
70
65
60
55
50
45
40   1
o
3
35   •»
30
25
20
15
19
49                1951                            1954                            1957                           1960                            1963                      1966
Hospitals' Growth Rate
(Excluding Federal and Contract Hospitals)
440
420
400
380
360
340
320
30O
280
260
240
220
200
180
160
140
120
100
80
60
40
20
0
n
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00
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19
48                          1951                             1954                           1957                           1960                             1963                          19
(es
56
t.)
 O 12
BRITISH COLUMBIA
Total Full-time Staff and Average Number of Patients
(Adults and Children) per Day
17"
^^ y
11
V
tIENT=(A^
, PER PAY      _
6
*****><*%
5
4
17
16
15
14
13
12
"    f
10    |
9
8
7
6
5
4
1966
(est.)
Gross Salaries and Wages and Other Operating Expenses
*&j/
^
&   X
a
,^ll>
<***»*%
<SJ*        ^000.
/^
.tft«fc*
2   30
1966
(est.)
"'Including approximately $3,000,000 in staff fringe benefits
 HOSPITAL INSURANCE SERVICE,  1966
O  13
THE HOSPITAL INSURANCE ACT
This is the Statute which authorizes British Columbia's hospital insurance plan,
and under which the British Columbia Hospital Insurance Service is established.
The main provisions of this Act and the regulations 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 period of six months if they are admitted
to an approved hospital within the first six months following their departure from the Province. These periods may be extended for an additional
period of up to six months by the Lieutenant-Governor in Council.
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 the
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 (a) small public hospitals, most
of which are operated in remote areas by industrial concerns primarily for
their employees, and (b) licensed nursing homes which are not under
B.C.H.I.S. coverage.
(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
 O 14
BRITISH COLUMBIA
hospital care is a medical necessity, and if he establishes 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 brief period 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
(b) A qualified person who leaves British Columbia temporarily and fails to
return and re-establish residence within 12 months; or
(c) A qualified person who leaves British Columbia and who establishes residence elsewhere; or
(d) An inmate of a Federal penitentiary; or
(e) A resident who receives hospital treatment provided under the Workmen's
Compensation Act, or a war veteran who receives treatment for a pensionable disability; or
(/) 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 and consular officials of other countries.
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.)
 HOSPITAL INSURANCE SERVICE,  1966
O  15
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.)
THE HOSPITAL RATE BOARD AND METHODS OF
PAYMENT TO HOSPITAL
The Hospital Rate Board, appointed by Order in Council, is composed of the
Assistant Deputy Minister of Hospital Insurance (Chairman), the Director of Hospital Consultation, Development, and Research (Vice-Chairman), and 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.
 O 16 BRITISH COLUMBIA
Approximately 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.
THE B.C.H.I.S. PLANNING GROUP
This group was formed in December, 1965, to co-ordinate and expedite the
planning of hospital facilities. The Planning Group's functions are to review research reports on hospital bed needs, review submissions from hospitals for increases
in beds or services, consider other problems related to the orderly planning and
provision of facilities and services to meet the needs of the Province, and consider
other matters referred to it by the Deputy Minister. The Planning Group is responsible for making recommendations on these matters to the Deputy Minister.
The regular members are Director, Hospital Consultation, Development, and
Research (Chairman); Assistant Deputy Minister (Vice-Chairman); Medical Consultant; Manager, Hospital Construction and Planning Division; Director, Research
Division; and Assistant to the Manager, Hospital Construction and Planning Division (Secretary).
The Planning Group has averaged one meeting a week during the year. Five
of the meetings were with delegations from hospitals about the future needs of
those hospitals. Individual members on the Planning Group act as liaison members
between the Service and several local hospital planning groups.
During the year the group considered 12 new research reports on area needs
and reviewed approximately the same number of reports prepared previously but
which were brought up to date by the Research Division with new projections for
the future.
Following recommendations by the Planning Group to the Deputy Minister,
10 new hospitals were approved in principle by the Minister. Eight of these will
replace existing hospitals and two will be established in communities which have not
had hospitals. Similarly, 16 expansions of existing hospitals were approved in
principle by the Minister.
Altogether, approximately 1,000 replacement and new beds are involved in
the approvals arising from these recommendations.
Apart from consideration of specific hospital units, the group reviewed subjects of general importance to hospital development in the Province. Some of these
were: Patterns of development to meet extended hospital care needs; psychiatric
units in general hospitals; hospital care in isolated areas of the Province; regional
services, such as cardiac units, chronic renal failure units, cancer treatment; and
regional laundries. Other matters receiving consideration were the impact of regional districts on hospital planning, out-patient and day-care facilities, and priorities
for planning and research.
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
 HOSPITAL INSURANCE SERVICE,  1966
O 17
Mental Health Services. During the year the Honourable Eric Martin, Minister of
the Department since 1952, retired because of failing health, and on December 12,
1966, the portfolio came under the jurisdiction of the Honourable Wesley D. Black.
The administrative head of the Hospital Insurance Service is Mr. Donald M. Cox,
F.A.C.H.A., Deputy Minister of Hospital Insurance.
The following reports provide a brief outline of the work carried out during
1966 by the various divisions and offices which comprise the administrative structure
of this branch.
Assistant Deputy Minister
W. J. Lyle, F.C.I.S.
The Assistant Deputy Minister is responsible for the operation of the Hospital
Finance Division and the Hospital Construction and Planning Division, and for the
administration of the Service in the absence of the Deputy Minister. He is Chairman
of the Hospital Rate Board (see page 15), Vice-Chairman of the Hospital Planning
Group (see page 16), and a member of the following committees: Advsiory Committee on Hospital Insurance and Diagnostic Services (a committee appointed by
the Federal Government to advise on the administration of the Hospital Insurance
and Diagnostic Services Act), the Radiological Advisory Council, and the British
Columbia Hospitals' Association Liaison Committee. In addition, the Assistant
Deputy Minister attended numerous meetings during the year, including seminars
on " Hospital Construction Costs " and " Health Resources Fund," both of which
were held in Ottawa.
A summary of the activities of the two Divisions for which the Assistant Deputy
Minister is responsible follows.
Hospital Finance Division
N. S. Wallace, C.G.A., Manager
Hospital accounting and the 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, which
are authorized up to one-third of the approved cost. In 1966, after a review of
approximately 4,100 applications received from hospitals, grants of approximately
$1,150,000 were approved on movable and fixed technical equipment costing
$3,400,000.
As a means of assisting hospital employees to maintain high working standards,
the Hospital Insurance Service provided $51,000 during the year to enable 460
hospital employees to attend or participate in short-term training programmes. This
is additional to the long-term educational 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 Division Manager continued to perform duties as a member and Secretary
of the Hospital Rate Board.
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.
2
 O 18 BRITISH COLUMBIA
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 othei" 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.
Mr. N. S. Wallace, C.G.A., was appointed Manager of the Hospital Finance
Division at the beginning of the year, and Mr. A. D. MacKenzie, C.A., was
appointed Supervisor of Hospital Accounting.
Hospital Accounting
A. D. MacKenzie, C.A., Supervisor
The work of the Hospital Accounting Section falls into two main categories:
(a) the detailed inspection, in the field, of the financial records of the hospitals
for purposes of verification of annual and other financial statements and (b) the
assembly of relevant information, and preparation of tabulations and other data,
for use by the Hospital Rate Board in its reviews of hospitals' annual operating and
pre-construction estimates. In carrying out the inspection duties, visits were
made at least once during 1966 to 88 public general hospitals and five rehabilitation
hospitals, the individual visits extending from three days to four weeks. In addition,
five extended-care hospitals were visited to assist in establishing systems and a
uniform code of accounts. The gross expenditures approved by the Hospital Rate
Board for public general, rehabilitation, and extended-care hospitals for the year
1966 amounted to $93,600,000.
Other functions performed by the Hospital Accounting staff include:—
(a) The tabulation of monthly statistical and financial reports from hospitals,
and the correlating of these with the approved budgets.
(b) The calculation of the semi-monthly cash advances to be made to hospitals.
(c) Checking and amending annual financial and statistical reports prepared
by hospitals for the Dominion Bureau of Statistics and the Department of
National Health and Welfare.
(d) The provision, on request, of accounting assistance and instruction to
smaller public hospitals in the Province.
(e) The carrying-out of accounting reviews and cost studies of nursing homes,
upon the request of the Social Welfare Department, for welfare payment
purposes.
(/) The auditing of accounts of hospital construction projects, to determine
the amount of construction grants payable by the Province.
During 1966, construction projects involving expenditure of $6,900,000 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.
 HOSPITAL INSURANCE SERVICE,  1966
O 19
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.
Staff resignations created four vacancies during the year. Difficulty was
encountered in obtaining qualified personnel; however, by the year-end the normal
complement of four clerical staff and 10 inspectors had been restored.
Hospital Claims
W. J. Wade, Supervisor
The staff of Hospital Claims is responsible for processing the Admission/
Separation Records (accounts), which hospitals submit for each patient, and
approving for payment all acceptable claims.
During 1966 more hospitals providing extended care were placed on a
quarterly billing basis, which resulted in a substantial increase in the number of
patients' accounts.
A system of preparing and mailing individual statements of account paid on
behalf of patients was put into operation during March. Since then, many questions
have been answered in relation to them and favourable comments received. Three
I.B.M. Selectric typewriters, using continuous forms, and a Burster were purchased
for this work, the insertion into envelopes and sealing being done on the machines of
the Superannuation Branch of the Provincial Secretary's Department.
Two newly constructed acute hospitals which opened during the year (Richmond and 100 Mile House) were instructed in claims procedures. The production
for the year from all sources was up to 1,500 accounts per working-day for inpatients and over 600 emergency service or minor surgery account forms.
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 Representatives.
Advice and assistance were given to hospital admitting staffs on the proper
method of obtaining and recording the patient's residence information and employment history.
In order to further assist the admitting staff in many hospitals, meetings were
attended by the Supervisor and Assistant Supervisor at Victoria, Vancouver, Kamloops, Nelson, Dawson Creek, and Prince George.
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 550 queries per month on accounting matters were addressed
to British Columbia hospitals.
Preliminary figures for 1966 show that more than 363,000 accounts (excluding
out of Province) were processed. For comparison the figures for 1965 were 362,000
processed.
 O 20
BRITISH COLUMBIA
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 30,000 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 1966 a total of over 3,480
accounts, amounting to an estimated $754,000, 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, Azores,
Bahamas, Brazil, Balboa (Canal Zone), Denmark, England, France, Holland, Israel,
Italy, Ireland, Japan, Mexico, New Zealand, The Philippines, Switzerland, Thailand,
Wales, and West Germany. 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 4,600 documents and letters
daily, an increase of 200 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 primary responsibilities of this Division may be summarized as follows:—
(1) Working with hospital boards of management and hospital construction
planning committees in the development of programmes for the construction of new hospital facilities, additions to and renovations of existing
hospitals, and residence accommodation for hospital personnel.
(2) Providing consultative services to hospitals planning projects and recommending such programmes for approval.
(3) Processing and recommending for approval applications for Provincial
grant assistance toward capital improvement and renovation projects.
The Division also initiates applications for Federal construction grants,
and processes and submits claims for payment.
' Special emphasis is given to the need for the development of written programmes
for proposed construction projects. Hospitals are assisted by this Division in the
preparation of such programmes which provide architects and their engineering
consultants with basic planning criteria for the logical development of plans.
A great deal of time is spent in reviewing plans of proposed building projects.
Special attention is given to the interrelationship of the various departments of the
hospital building to ensure a layout arrangement that can provide a high standard of
patient care, efficient and economical operation, and adequate service and clinical
facilities. In planning hospital facilities, attention is also given to the need and
method for future expansion.
During the year, 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
 HOSPITAL INSURANCE SERVICE,  1966
O 21
operation. Some of the elements included in designs for mechanical systems for new
hospital buildings that reflect this approach were heat-recovery systems, air recirculation, and zoned heating and ventilating controls. Liaison was also maintained
with the Hospitals Committee of the Architectural Institute of British Columbia.
The function of this Committee is to review and endeavour to resolve problems
arising out of hospital construction projects which affect members of the Architectural Institute. Hospital boards are provided with a complete consultative planning
service through this Division and through the co-operation of Health Branch personnel, members of the medical and nursing profession, and 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 maintained
liaison with the Faculty of Medicine of the University of British Columbia.
During the year, meetings were held with individual specialist consultants in
the field of physical medicine and rehabilitation in the interest of developing planning criteria for extended hospital care facilities.
Through the co-operation of the Provincial Department of Labour, the Office
of the Inspector of Factories provided a consultative service to the British Columbia
Hospital Insurance Service on proposals for elevators and dumb-waiter installations
in hospitals. A programme of instruction to hospital maintenance personnel regarding practical routine preventive maintenance procedures for elevating devices, including elevator and dumb-waiter installations, was conducted by the Inspector of
Elevators through the co-operation of the Chief Inspector of Factories throughout
the Province. Seminars were held at the Royal Jubilee Hospital, Victoria; St.
Mary's Hospital, New Westminster; the Vancouver General Hospital; Kootenay
Lake General Hospital, Nelson; and Prince George Regional Hospital. Some 90
hospital staff members attended these seminars.
Continuing benefit was derived from the co-operation of the Public Works
Department by assigning architects to this Division. With the additional architectural assistance available, it has been possible to prepare detailed sketch-plans in
support of layouts representing the Division's recommended approach to planning
problems. It has been found advantageous to follow this procedure on small complex projects, where it is easier to develop detailed sketches than to embark on a
lengthy time-consuming review. During the year the staff of the Division was augmented by the appointment of a consultant in engineering design and maintenance.
During 1966 the Manager of the Division, as well as the architects and engineer
attached to his staff, made a number of inspectional visits to hospitals throughout
the Province.
The Manager acted as one of the B.C.H.I.S. liaison representatives to the
Vancouver General Hospital Survey Co-ordinating Committee. In April, 1966, he
participated in a two-day seminar on " Hospital Construction Costs " held by the
Department of National Health and Welfare in Ottawa. The purpose of the seminar
was to assess the effect on hospital operating costs of proposed hospital construction
standards and to evaluate recommended standards in relation to actual need. In
June, 1966, the Division Manager attended the Western Canada Hospital Institute
at Calgary, Alta. At a meeting on September 24, 1966, of the Okanagan Regional
Hospital Council at Kelowna, he acted as moderator in a panel discussion, "Are
Operating Rooms as Presently Being Constructed and Designed Already Obsolete—
What of the Future? "
 O 22 BRITISH COLUMBIA
(a) Hospital Projects Completed during 1966
Richmond General Hospital, Richmond.—The new 132-bed hospital at Richmond was officially opened by the Honourable Eric Martin, Minister of Health
Services and Hospital Insurance, during a ceremony held at the hospital on February
27, 1966. The new hospital is a six-story reinforced-concrete building with provision for 132 beds plus semi-finished areas for further 22 beds. The building is
structurally designed to accommodate three additional floors to the nursing unit
section. This is the first hospital in Western Canada to use a new concept of the
mechanical distribution of supplies, involving the use of a specially designed tray-
veyor system.
Boundary Hospital, Grand Forks—Nurses' Residence.—On March 1, 1966,
the new staff residence at the Grand Forks hospital came into operation. The building is a frame construction and provides accommodation for eight members of the
hospital staff, including a suite for the Director of Nursing.
Mater Misericordice Hospital, Rossland.—The new administration wing at the
hospital was brought into service in the spring of 1966. Following this the necessary
renovation work, including improvements for emergency services, in the existing
hospital got under way.
Royal Jubilee Hospital, Victoria.—The second floor of the West Wing of the
Royal Jubilee Hospital, which had previously been left in a partially finished condition, was completed early in 1966. The nursing unit provides accommodation for
31 beds. The major portion of the work associated with completing the construction
of this nursing unit was done by the hospital's maintenance staff. Renovations were
also completed to other nursing units, and the boiler plant was expanded.
Tofino General Hospital, Tofino.—The construction of an addition to the
nurses' residence at the Tofino hospital provided suitable lounge facilities and permitted the existing lounge to be converted to accommodation for two additional
nurses. The project was completed early in 1966. This additional accommodation
for nurses replaces the temporary accommodation that was lost when a separate
small cottage on the hospital grounds was destroyed by fire on August 8, 1964.
Royal Columbian Hospital, New Westminster.—On May 19, 1966, the Royal
Annex Building at the Royal Columbian Hospital was taken over and occupied by
the laboratory staff. The building, formerly used as a student nurses' residence, has
been renovated to provide over 10,000 square feet for the laboratory department.
The use of the building for laboratories is a temporary measure, pending construction
of permanent facilities at a future date.
Castlegar and District Hospital, Castlegar.—Ten additional beds came into
service at the Castlegar and District Hospital in July, 1966. The construction of
the additions for these beds was approved as a temporary measure to meet a need
resulting from the influx of workers to hydro-development projects. The space in
which the 10 beds are accommodated will, at a later date, revert to alternative use
when the proposed major expansion project at the hospital is complete.
100 Mile District General Hospital, 100 Mile House.—On July 15, 1966, the
Minister of Health Services and Hospital Insurance officially opened the new hospital at 100 Mile House. The 31-bed hospital is a single-story reinforced-concrete
structure with a basement, part of which is unfinished. In addition, a separate residence to accommodate eight staff has been built near the hospital.
Cariboo Memorial Hospital, Williams Lake—Nurses' Residence.—The Minister, on July 22, 1966, officiated at opening ceremonies for the new 18-bed staff
residence at the Williams Lake hospital. The residence is a two-story frame-
constructed building on a reinforced-concrete foundation and provides accommoda-
 HOSPITAL INSURANCE SERVICE,  1966
O 23
tion for 18 persons in single bedrooms. The building includes a living-room and a
sitting-room as well as space for a future recreation-room in the basement.
Prince George Regional Hospital, Prince George.—Construction of the fifth-
floor addition and the fourth-floor extension, to provide a net gain of 77 beds, was
completed, and these additional beds came into operation during the summer and
fall of 1966. The hospital now has a rated capacity of 242 adult and children's beds.
This project represents the first step in a series of expansion proposals for the Prince
George hospital.
Providence Hospital, Fort St. John.—An unfinished area was completed in
October to provide an additional 9 beds.
St. Paul's Hospital, Vancouver.—Renovation of an area to provide an intensive-
care unit of 20 beds was completed toward the end of the year.
(b) Hospital Projects under Construction at Year-end
Cowichan District Hospital, Duncan.—Construction of a new hospital building
to replace the existing facility. The new building will initially provide 127 beds and
will contain semi-finished areas for 19 further beds, plus a fourth floor in "shell"
construction. The project also includes the construction of an extended hospital
care unit of 40 beds.
St. Joseph's General Hospital, Comox.—Construction of a new hospital is well
under way. The new building will replace the old existing structure, with the exception of the 1938 wing. The new acute unit will have 74 beds plus a top floor to be
left unfinished initially which will provide approximately 54 beds in the future. The
1938 wing, following renovation, will provide approximately 45 beds for extended
hospital care patients.
Vernon Jubilee Hospital.—Construction of a 27-bed addition plus extended-
care unit of 60 beds and alteration and expansion of the existing hospital building.
Summerland General Hospital.—Construction of a new 28-bed hospital.
Cranbrook and District Hospital.—Construction of a new hospital of 75 beds
plus 15 beds to be left unfinished initially and construction of a 34-bed extended
hospital care unit.
Royal Inland Hospital, Kamloops.—Renovations to the older sections of the
hospital to improve services as well as redistribute the beds to provide a more efficient
and economical layout.
Lions Gate Hospital, North Vancouver.—Completion of the sixth and seventh
floors to provide 138 additional acute beds and the completion of the fourth floor
of the old hospital building for 21 psychiatric beds; also renovations to the kitchen,
operating-room, and central supply-room.
St. Mary's Hospital, New Westminster.—Additions and alterations to the hospital to provide 85 beds, a new physiotherapy department, and improvements to other
areas such as the kitchen, cafeteria, admitting, medical records, and administrative.
Peace Arch District Hospital, White Rock.—Construction of a new hospital of
106 acute beds, with 2 beds unfinished and a top floor in " shell" form which can
provide 42 beds in the future. Later the existing hospital will be renovated for a
42-bed extended hospital care unit.
Health Sciences Centre, University of British Columbia—Psychiatric Unit.-—
Construction has begun on the first stage, consisting of 60 psychiatric beds. The
psychiatric unit will eventually contain, in addition to the beds, extensive research
and teaching areas.
Maple Ridge Hospital, Haney.—Construction of a nursing unit on the third
floor for 50 beds, 6 of which will remain unfinished initially. Also additions are
being constructed at the ground- and first-floor levels for physical medicine, laboratory, and emergency departments.
 O 24 BRITISH COLUMBIA
Royal Jubilee Hospital, Victoria.—Addition to the boiler-house and installation
of two new boilers.
Queen Charlotte Islands General Hospital.—Construction of a 7-bed pediatric
addition and renovations.
(c) Projects in Advanced Stages of Planning and for Which Working Drawings
Are Completed or in Process of Preparation
Matsqui-Sumas-Abbotsford General Hospital.—Expansion  and renovation.
Campbell River and District General Hospital.—Addition for extended hospital care.
Creston Valley Hospital.—Expansion and renovation.
Kelowna General Hospital.—Expansion and renovation.
Prince George Regional Hospital.—Expansion of services.
Nanaimo Regional General Hospital.—Completion of top floor.
Pouce Coupe Community Hospital.—Addition and renovations.
Surrey Memorial Hospital.—Addition and renovations.
Mills Memorial Hospital, Terrace.—Expansion project.
Health Sciences Centre, University of British Columbia.—New hospital facility
(not including psychiatric unit, Stage I, presently under construction.)
(d) Additional Projects Approved and in Various Planning Stages in 1966
Lady Minto Hospital, Ashcroft.—Replacement.
R. W. Large Memorial Hospital, Bella Bella.—Replacement.
Burnaby General Hospital.—Expansion programme.
Burns Lake and District Hospital.—Additions and renovations.
Campbell River and District General Hospital.—Expansion for acute care.
Chetwynd Hospital.—New facility.
Chilliwack General Hospital.-—Expansion for extended care, activation and
psychiatric beds.
St. Joseph's General Hospital, Comox.—Conversion of 1938 wing for extended
hospital care.
Cowichan District Hospital, Duncan.—Extended hospital care unit.
Enderby and District Memorial Hospital.—Renovations.
Fort St. James Hospital.—New facility.
Fraser Canyon Hospital, Hope.—Expansion and renovations.
Windermere District Hospital, Invermere.—Expansion.
Victorian Hospital, Kaslo.—Construction of 10-bed hospital.
Lillooet District Hospital.—Expansion and renovations.
Langley Memorial Hospital, Murrayville.—Conversion of old hospital for activation and extended care.
Royal Columbian Hospital, New Westminster.—Expansion and renovations.
Lions Gate Hospital, North Vancouver.—Expansion of services.
Ocean Falls General Hospital.—Replacement.
St. Martin's Hospital, Oliver.—Replacement.
Penticton Hospital.—Expansion and renovations.
West Coast General Hospital, Port Alberni.—Completion of space, plus renovations and additions.
Powell River General Hospital.—Expansion for extended hospital care unit.
Prince George Regional Hospital.—Expansion programme.
Prince Rupert General Hospital.—Replacement.
Jewish Home for the Aged, Vancouver.—Proposed extended hospital care unit.
 HOSPITAL INSURANCE SERVICE,  1966
O 25
Queen Victoria Hospital, Revelstoke.—Replacement.
Shuswap Lake General Hospital, Salmon Arm.—Expansion.
Bulkley Valley District Hospital, Smithers.—Addition.
Squamish General Hospital.—Renovations and improvements.
Trail-Tadanac Hospital, Trail.—Additions, renovations, and nurses' residence.
Vancouver General Hospital.—Replacements and additions.
British Columbia Cancer Institute, Vancouver.—Radiotherapy extension.
British Columbia Red Cross Centre, Vancouver.—Red Cross blood transfusion
depot, donor clinic, and headquarters.
Children's Hospital, Vancouver.—Replacement.
Holy Family Hospital, Vancouver.—New 70-bed activation unit and renovation of existing building for extended care.
Mount St. Joseph's Hospital, Vancouver.—New acute unit and renovation of
existing hospital for extended care.
St. Paul's Hospital, Vancouver.—Renovation and expansion programme.
St. Vincent's Hospital, Vancouver.—Expansion programme.
G. F. Strong Rehabilitation Centre.—Addition and renovations.
St. John Hospital, Vanderhoof.—Replacement.
Royal Jubilee Hospital, Victoria.—Renovations plus expansion for laboratory
and expansion for nurses' training-school.
St. Joseph's Hospital, Victoria.—Expansion and renovations.
Cariboo Memorial Hospital, Williams Lake.—Completion of unfinished areas.
Director of Hospital Consultation, Development, and Research
J. W. Mainguy, M.H.A.
The Director is responsible for the operation of both the Hospital Consultation
and Inspection Division and the Research Division, and is Assistant Chief Inspector
of Hospitals under the Hospital Act, the Chief Inspector being the Deputy Minister.
The Director is responsible for the administration of the Service in the absence of
the Deputy and the Assistant Deputy Minister. He is Chairman of the Hospital
Planning Group and Vice-Chairman of the Hospital Rate Board. The work undertaken during the year in connection with these activities is outlined on pages 16
and 15 respectively. He represents the Service on a number of committees of
Government and community agencies, including the Co-ordinating Committee on
Paramedical Training of the British Columbia Institute of Technology, Burnaby;
the Liaison Committee between the Service and the British Columbia Hospitals'
Association; the Education Committee of the British Columbia Hospitals' Association; and the Victoria and District Hospital Planning Board.
Reports of the activities undertaken by the two Divisions responsible to the
Director during the year follow.
Hospital Consultation and Inspection Division
J. Bainbridge, Manager
This Division provides consultative services 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 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.
 Major Hosp
and ui
j
(Fore
Richmond, Gn
gar, 100 Mile H
Victoria (Roya
UNi
Duncan, Como
Kamloops, Noi
Queen Charlol
Mary's), Vane
Centre
COMOX
(Architect:   Gardiner, Thornton, Gathe & Associates, Vancouver.)
 s Completed
ruction
>
nd23.)
(, Tofino, Castle-
, Prince George,
tminster (Royal
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and, Cranbrook,
te Rock, Haney,
Vestminster (St.
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ubilee).
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Duncan
Paul D. Smith, Vancouver.)
(Architect:   Townley, Matheson, Kelly, Humphrey & Ritchie, Vancouver.)
 O 28 BRITISH COLUMBIA
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. 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 check 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 Provincial 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, eight regional pathology services in eight
areas of British Columbia have been approved, and all are in operation.
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.
In co-operation with the Director of Emergency Health Services, the planning
of locations for advanced-treatment centres and 200-bed emergency hospitals was
undertaken. A staff member served on the Provincial Hospital Disaster Plan Review Committee, along with representatives from the Health Branch and Provincial
Civil Defence.
The Division also represented the British Columbia Hospital Insurance 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 co-operated with the Hospitals Committee of the British
Columbia Medical Association. At the request of a hospital in which an unusually
difficult situation had arisen, the Manager of this Division and the Medical Consultant were appointed to an advisory team made up of members of the British
Columbia Hospitals' Association, the College of Physicians and Surgeons of British
Columbia, and the British Columbia Medical Association, which was asked by the
hospital's board of management to survey and report on the situation. A member
of the Division's staff is Vice-Chairman of the British Columbia Council of Practical Nurses, the body responsible for the licensing of practical nurses in accordance
with the Practical Nurses Act.
During the year the Division assisted the Hospital Construction and Planning
Division, in co-operation with the Factories Inspection Branch of the Department
of Labour, in organizing a series of one-day workshops on " Preventive Maintenance for Elevators " in various centres throughout the Province.
A Council of Hospitals with Schools of Nursing was set up during the year,
with a member of this Division acting as B.C.H.I.S. representative.
During the year, 200 visits of a consultative and inspectional nature were made
to private hospitals providing nursing-home care. At the year-end there were 71
private hospitals, providing a total accommodation of 3,252 beds. There were
three private acute hospitals with a total capacity of 45 beds and 10 bassinets. No
person may serve as a superintendent of a private hospital without the approval of
the Chief Inspector of Hospitals. The Registered Nurses' Association of British
Columbia has continued to screen the credentials of all graduate nurses who wish
to work in private hospitals.
 HOSPITAL INSURANCE SERVICE,  1966 O 29
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 require alternative care 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 115 cases were dealt with under this arrangement
in 1966.
During the year Miss B. Dunford and Miss P. Hrehirchek joined the Division
as nursing consultants. Miss Hrehirchek left to get married in September and was
replaced by Mrs. C. Bailey. Miss J. Groves transferred from the Health Branch to
become the B.C.H.I.S. dietary consultant. Mr. E. C. Luscombe joined the Division
as a hospital consultant in July.
Research Division
D. S. Thomson, B.A., Director
Each year the Research Division carries out a number of studies relating to
hospitalization and morbidity in British Columbia. While some of the projects
are of an annual nature, the Division is engaged in the continuing study of hospital
bed requirements in the Province. This study involves individual bed need surveys
of specific areas of the Province, and in 1966 approximately 12 such surveys were
completed.
The Division derives most of its statistical information from the Admission/
Separation records submitted by the hospitals for each in-patient. The data used
is key-punched by the Hospital Claims Section of this Service and then transferred
to magnetic tape by the Data Processing Division of the Department of Industrial
Development, Trade, and Commerce, which prepares the required tabulations.
To aid in the calculation of bed needs, each year the Division prepares population estimates, broken down by age-group and race, for each of the more than 80
districts in the Province.
The Research Division also prepares for publication a number of annual bulletins, the most important of these being the " Statistics of Hospital Cases Discharged
in 1965." In addition to the morbidity tables proposed by the Federal Advisory
Committee on Hospital Insurance and Diagnostic Services, this bulletin also contains an analysis of hospitalization in British Columbia by race, age, geographic
location, major diagnostic group, and type of service, and a new section which was
added in 1966 showing trends in hospitalization. Other bulletins include " Statistics
of Hospitalized Accident Cases " and " Statistical Table Pertaining to Hospitalization in the Metropolitan Vancouver Area." In addition to these, a number of tables
and charts known collectively as " Hospital Indicators " were prepared and circulated to hospitals, to enable them to assess their own performance and to provide
comparative statistics which are not available elsewhere.
A survey of morbidity trends in British Columbia since 1961 was undertaken
during the year, and was still being developed at the year-end.
A number of special requests involving statistical information concerned with
hospitalization or morbidity were also handled.
Mr. P. Pallan, B.Sc, was appointed Research Officer in May, 1966, to fill the
vacancy created by the resignation some months earlier of Mr. E. Weekley.
Medical Consultation Division
C. F. Ballam, M.D., Medical Consultant
The Admission/Separation Form for each patient admitted to a hospital, either
in British Columbia or elsewhere, who claims eligibility for Hospital Insurance
 O 30 BRITISH COLUMBIA
Service coverage, is assessed with regard to its medical aspects by this Division.
This review includes coding according to the " International Classification of
Diseases, Adapted for Indexing Hospital Records by Diseases and Operations,"
and is a function which requires the professional knowledge and training of the
medical coders. The competence and accuracy applied to this work will be reflected
in the statistical end-product. These statistical data are basic to planning decisions
for expanding or developing hospital facilities generally, and special departments in
certain hospitals in particular. Other functions of the review include bed usage,
identifying special-area requirements by reason of geographical or industrial development, and assessing complicated individual cases when required. The Chief
Supervisor of Medical Coders has rendered valuable service in this Division and has,
in addition, commenced giving consultative services to hospitals concerning medical
records and related matters.
Extended-care hospital coverage, introduced in December, 1965, increased the
tasks of this Division. Assessment and review of individual patient applications
created a work load of major proportions. Direct consultation and assistance to the
extended-care hospitals was needed, as they adopted new programmes and accepted
a changing and increased load of patient care. In addition, quarterly reviews of all
extended-care patients by direct reassessment in the hospitals were undertaken, with
two accomplishments in mind: (1) a medical audit, to ensure patients were or continued to be medically qualified; (2) to review and assist the hospital in implementing a treatment programme which would result in the patient receiving the best
possible care under the new programme.
The Medical Consultant has, in addition to supervision of the foregoing, visited
during the past 10 months 21 hospitals and, in addition, attended meetings of many
special disease groups and societies and health agencies. Liaison with the British
Columbia Medical Association, the British Columbia College of Physicians and
Surgeons, and the British Columbia Hospitals' Association continues, and has enabled joint action being taken on special problems involving individual hospitals.
This team approach, involving the Medical Consultant and an Inspector from the
Hospital Consultation and Inspection Division, together with the other agencies
above, has had a very busy year. The machinery to deal with such problems has
been forged; the next logical step would be to consider and set up the administrative
inspection services needed to anticipate problems, so that the consultation machinery
could be put to work early.
The Medical Consultant gives advice to the Service on proposed additions to
or extension of medical services in hospitals. This advice extends to equipment and
design as well as to the introduction or development of new diagnostic and treatment
services. Where unique need requires it, he turns for ancillary consultative advice
to the resources of the Health Branch and Mental Health Services, as well as to
specialist individuals and groups in the profession. He also participates in the postgraduate continuing medical education programmes in order that the British
Columbia Hospital Insurance Service's medical consultation reflects current and
pertinent professional knowledge.
In December, 1966, Dr. D. G. Adams was appointed Assistant Medical Consultant to the Service. He will help cope with the expanding professional commitments of this Division.
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
 HOSPITAL INSURANCE SERVICE,  1966
O 31
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. 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.
The Administrative Officer works closely with the Department of Municipal
Affairs, the Chief Electoral Officer, and the Water Resources Branch in making
arrangements for money votes to be held in municipalities, hospital improvement
districts, and regional districts for the purpose of raising the local communities'
shares of the cost of approved hospital construction, expansion, or renovation
projects.
In collaboration with the Hospital Consultation and Inspection Division, the
Administrative Officer processes, for approval under section 14 of the Hospital Act,
transfers of private hospital property and transfers of shares in the capital stock of
private hospital corporations. In addition, close liaison is maintained with the Land
Registry Office to ensure that the property records of both general hospitals and
private hospitals are suitably endorsed to ensure that land transfers are not made
until they are approved under sections 14 (2) and 41 (1) (c) of the Hospital Act.
As in previous years, considerable time was spent in 1966 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 is the Personnel Officer for the British Columbia
Hospital Insurance Service. He is also responsible for the over-all supervision of
the Third Party Liability and the Eligibility Sections, and during the year the
General Office was placed under the Administrative Officer's jurisdiction.
Eligibility Representatives' Section
P. A. Bacon
In order to ensure that only qualified British Columbia residents receive
hospital insurance benefits, the staff of the Eligibility Section review the Applications
for Benefits made by, or on behalf of, persons admitted to hospital. A detailed check
is made of all doubtful applications, resulting in the rejection of a considerable
number of claims for hospital insurance benefits made by unqualified persons.
Numerous inquiries from the general public with regard to eligibility matters are
dealt with by personal interview, telephone, and correspondence.
Eligibility Representatives visit hospitals on a regular schedule to see that the
B.C.H.I.S. eligibility procedures are being properly carried out. The Representatives
also assist in the training of hospital admitting personnel to deal with problems
connected with the admission of patients to hospitals and the determination of their
status under the Hospital Insurance Act. This training assistance is provided by
means of visits to hospitals and by regional meetings. During 1966, regional meetings were held in Vancouver, Kamloops, Nelson, Prince George, Dawson Creek,
and Campbell River.
This Section keeps the great majority of employers in British Columbia supplied
with certificates on which an employee's length of employment can be certified.
 O 32 BRITISH COLUMBIA
The Representatives 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.
Close liaison is maintained with the British Columbia Medical Plan, and
Eligibility Representatives supply Medical Plan applications and information to the
general public in many communities throughout the Province. Regional representatives are located in Prince George, Kamloops, Nelson, and Kelowna, as well as
in Vancouver and Victoria.
Third Party Liability Section
J. W. Brayshaw
The hospitalization reports that are completed by hospitals for every patient
admitted with accidental injuries are processed by the Third Party Liability Section.
This Section also handles the arrangements under which the British Columbia
Hospital Insurance Service receives reimbursement from public liability insurance
companies and self-insured corporations for hospital expenses paid by this Service
on behalf of accident victims. The Senior Eligibility Representative 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.
General Office
C. R. Leighton
Supervision of expenditure and internal accounting continue as the primary
responsibilities of this office. This involves all administrative accounting, preparation
of financial statements, maintaining payroll and personnel records, and responsibility
for all equipment, furniture, and supplies. The preparation of Departmental estimates is also a continuing responsibility which is carried out annually in consultation
with the Division Managers.
As in the previous year, this office continues to assist the Hospital Construction
and Planning Division in processing applications for Provincial Government grants
in connection with hospital renovations and alterations. During the past year this
responsibility has been broadened to include processing applications being made for
Federal Government grants for hospital alterations and renovations.
The British Columbia Safety Council annual conference was once again
attended by the General Office Supervisor in his capacity as Departmental Safety
Officer. The Safety Committee of the British Columbia Hospital Insurance Service
produced a safe-driving poster for use during the Christmas season which was
distributed throughout the Civil Service and was also used by the British Columbia
Safety Council. The British Columbia Hospital Insurance Service once again earned
a British Columbia Safety Council award, and in December a silver certificate for
327,522 consecutive man-hours of accident-free work was awarded by the Premier,
the Honourable W. A. C. Bennett.
A change in internal administration made during the year requires the General
Office to report to the Administrative Officer instead of the Assistant Deputy
Minister.
 HOSPITAL INSURANCE SERVICE,  1966 O 33
Public Information
R. H. Thompson
This office is responsible for the continuing development of public information
activities and concerns itself with three main areas of responsibility, which are the
general public, hospitals, and in-service duties. The following is a summary of the
work undertaken during 1966: Revision of the pamphlet "At Your Service," which
is supplied to hospitals for distribution to patients and their visitors, was completed
during the year, with the assistance of the Administrators' Division of the British
Columbia Hospitals' Association. It is expected that the revised pamphlet will be
printed early in the new year. At the request of the British Columbia Hospitals'
Association, a start was made on the preparation of material for a hospital trustee
orientation kit. The project has been proposed as a joint B.C.H.A.-B.C.H.I.S.
undertaking. The " General Information " pamphlet was revised and printed, and
copies were forwarded to business and industry, civic organizations, Government
Agents, welcome-wagon agencies, and other sources who regularly contact new
residents. The pamphlet contains information regarding residential requirements,
types of coverage, hospital benefits, and other items of general interest.
An educational display outlining the progress made by hospitals and the
development of the British Columbia Hospital Insurance Service over the years was
prepared for the British Columbia Hospitals' Association annual conference, held
in Vancouver in October, and a brochure was prepared in conjunction with the
display, containing related information and data. Assistance was also given in
up-dating the B.C.H.I.S. material in the Department's exhibit located in the British
Columbia Building on the grounds of the Pacific National Exhibition. This exhibit
is open to the public throughout the year and is viewed by thousands of visitors.
The purchase of a 35-mm. camera early in the year facilitated the development
of a photographic file of the interiors and exteriors of public hospitals. The photographs are taken by B.C.H.I.S. personnel while on field trips, and, in 1966, 27
hospitals were photographed for future reference by the various Divisions. As a
service to hospitals and to offset the cost of purchasing films, a motion-picture library
is maintained for the free use of hospitals for in-service training. Approximately
200 individual screenings of these films were made by hospitals during the year.
A film titled " Fire and Explosion Hazards from Flammable Anaesthetics" was
purchased during the year, bringing to 15 the number of films available to hospitals.
In July the Public Information Officer made a tour of 13 Interior hospitals, at
which time various public information activities were discussed with the hospital
administrators. Regular editions of the B.C.H.I.S. Bulletin were published during
the year, and copies were sent to all public general hospitals and nursing homes. The
Bulletin is an administrative aid used to clarify policy and procedural changes for
hospital personnel. It also features articles of general interest dealing with such
subjects as safety, medical records, nursing care, and so on. Several press releases
on hospital construction and the awarding of Government grants were issued, and
articles were written for the Government News and national publications. Other
duties included the summarizing of reports for the information of the Deputy Minister, maintaining the newspaper files, handling correspondence, and the preparation
and editing of the Eighteenth Annual Report.
 O 34
BRITISH COLUMBIA
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.
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-Natal District Hospital, Michel.
Mills Memorial Hospital, Terrace.
Mission Memorial Hospital, Mission City.
Mount St. Joseph's Hospital, Vancouver.
Nanaimo Regional General Hospital, Nanaimo.
Nicola Valley General Hospital, Merritt.
Ocean Falls General Hospital, Ocean Falls.
100 Mile District General Hospital, 100 Mile
House.
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.
Richmond General Hospital, Richmond.
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.
 HOSPITAL INSURANCE SERVICE,  1966
O 35
Outpost Hospitals
Red Cross Outpost Nursing Station, Alexis
Creek.
Red Cross Outpost Nursing Station, Atlin.
Red Cross Outpost Nursing Station, Bamfield.
Red Cross Outpost Nursing Station, Blue
River.
Red Cross Outpost Nursing Station, Edge-
wood.
Red Cross Outpost Nursing Station, Hudson
Hope (ceased to operate on January 15,
1966).
Red Cross Outpost Nursing Station, Kyuquot.
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 (ceased
to operate on November 30, 1966).
R.C.A.F. Station Hospital, Holberg.
Licensed Private Hospitals
Industrial Hospitals in Remote Areas with Which the Province Has Entered into an
Agreement Requiring Them to Furnish the General Hospital Services Provided
under the Hospital Insurance Act.
Bralorne Private Hospital, Bralorne.
Cassiar Asbestos Corporation Private Hospital, Cassiar.
Gold Quartz Hospital, Wells.
Medical-Dental  Hospital  Unit,   Vancouver
(ceased to operate on September 30, 1966).
Port Alice Private Hospital, Port Alice.
Other
Hollywood Hospital Ltd., New Westminster (licensed under the Mental Health Act).
Rehabilitation, Chronic, and Convalescent Hospitals
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.
Sunny Hill Hospital for Children, Vancouver.
Veterans' Hospital, Victoria.
(A number of the larger public hospitals also have rehabilitation units.)
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.
Veterans' Hospital, Victoria (extended-care
unit).
Shaughnessy Hospital, Vancouver (extended-
care unit).
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 1966 there were 90 public general hospitals
approved to accept B.C.H.I.S. patients. In addition, care was provided in eight
outpost hospitals, six Federal hospitals, five contract hospitals, five public rehabilitation hospitals, and one rehabilitation hospital operated by the Provincial Govern-
 O 36 BRITISH COLUMBIA
ment. Hospital insurance coverage for patients in non-profit extended-care hospitals
and units commenced December 1, 1965. At the year-end there were 12 hospitals
providing extended care. Data for the year 1966 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 298,821 B.C.H.I.S. adult and children patients
were separated (discharged) from British Columbia hospitals in 1966, an increase
of 12,022 or 4.2 per cent over 1965. This table also shows that 95.0 per cent of the
total patients separated (discharged) from British Columbia public hospitals were
covered by hospital insurance, compared to 95.2 in 1964 and 95.0 in 1965. Table
1b indicates in 1966 that the British Columbia Hospital Insurance Service paid
public hospitals in British Columbia for 2,860,750 days of care for adults and children, an increase of 113,518 days or 4.2 per cent over 1965.
As shown in Table 2a, the average length of stay of British Columbia adult and
children patients in public hospitals during 1966 was 9.57 days, and the days of care
per thousand population were 1,773. For comparison purposes, the data for
extended-care hospitals is not included in the above observations, but it should be
noted an additional 151 days of care per thousand population were provided for
these patients.
 HOSPITAL INSURANCE SERVICE,  1966
O 37
Table 1a. — Patients Separated (Discharged or Died) and Proportion
Covered by British Columbia Hospital Insurance Service, British
Columbia Public Hospitals Only, 1949-66 (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
301,510
313,957
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
33,555
32,375
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
335,065
346,332
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
286,799
298,821
84.9
84.0
82.9
81.9
84.2
91.7
92.2
91.6
91.5
93.7
95.5
95.6
95.7
95.5
95.3
95.2
95.1
95.2
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
31,863
30,634
93.8
91.4
89.2
87.3
90.6
92.2
95.0
94.5
93.5
96.5
98.6
98.4
98.3
96.8
96.4
95.8
95.0
94 0
164,808
1950
168,902
1951 	
174,288
1952                                  	
179,359
1953 	
196,997
1954
219,196
1955	
231,289
1956	
241,467
1957  	
1958	
244,448
259,091
1959	
273,263
1960  .
288,634
1961	
297,511
1962 	
301,160
1963                          	
308,475
1964	
19651	
312,219
318,662
19662                          	
329,455
86.2
Percentage of total, patients separated—
1949  	
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	
	
	
	
94.1
1959 	
95.9
1960	
	
96 0
1961  .....
96.0
1962    	
	
95.7
1963...	
	
95 4
1964   _
-
95.2
19651
95.0
19662
	
95 0
i Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to October 31, 1966.
 O 38
BRITISH COLUMBIA
Table 1b.—Total Patient-days and Proportion Covered by British Columt.
bia Hospital Insurance Service, British Columbia Public Hospitals
Only, 1949-66 (Excluding Federal, Private, and Out-of-Province
Hospitalization) (Including Rehabilitation Hospitals).
Total Hospitalized in Public
Hospitals
Adults
and
Children
Newborn
Total
Covered by B.C.H.I.S.
Adults
and
Children
Newborn
Total
Patient-days—
1949	
1950	
1951 _
1952	
1953	
1954 _..
1955...._	
1956	
1957  _
1958	
1959 	
1960	
1961  _
1962 	
1963	
1964....	
19651-
19662.
Percentage of total, patient-days-
1949	
1950 	
1951  	
1952  _ 	
1953    	
1954   	
1955— 	
1956   9.
1957  	
1958	
1959  	
1960 _...   	
1961 -_   	
1962  	
1963. 	
1964	
19651-
19662.
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
2,820,122
2,895,476
3,006,504
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
245,756
235,595
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
3,081,101
3,141,232
3,242,098
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
2,747,232
2,860,750
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
94.7
94.0
95.0
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
230,096
219,728
93.8
90.8
87.7
85.8
89.5
94.5
93.3
93.1
92.6
95.1
96.7
96.7
96.1
96.1
95.4
94.6
93.0
93.0
I 1,631,231
1,669,922
1,654,993
1,754,134
1,909,978
2,168,410
2,217,679
2,259,106
2,299,415
2,402,287
2,514,998
2,692,996
2,777,387
2,837,109
2,889,407
2,916,989
2,977,328
3,080,478
86.0
84.4
82.3
82.3
84.4
90.8
91.4
91.3
91.3
93.6
94.7
95.1
95.3
95.1
94.8
94.7
94.0
95.0
1 Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to October 31, 1966.
 HOSPITAL INSURANCE SERVICE,  1966
O 39
Table 2a.—Patients Separated, Total Patient-days, 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, 1949-66.
Total
(Excluding
Extended Care)
B.C. Public
Hospitals
Other B.C. Hospitals,
Including Federal
and Private
Institutions
Outside B.C.
Extended-
Adults
and
Children
Newborn
Adults
and
Children
Newborn
Adults
and
Children
Newborn
Adults
and
Children
Newborn
Hospitals
(Including
Federal)
Patients separated—
1949	
149,280
154,643
159,739
164,379
180,149
199,974
209,999
219,218
221,585
236,770
251,393
264,120
273,293
278,021
286,753
293,144
301,522
313,524
1,498,121
1,564,222
1,551,954
1,663,149
1,814,344
2,046,087
2,100,386
2,141,445
2,188,765
2,332,502
2,474,974
2,650,129
2,756,665
2,789,355
2,850,559
2,905,544
2,985,092
3,101,916
10.03
10.11
9.71
10.12
10.07
10.23
10.00
9.77
9.88
9.85
9.85
10.03
10.09
10.03
9.94
9.91
9.90
9.89
24,989
24,336
24,587
25,492
28,381
29,761
32,035
33,783
35,813
37,924
39,257
39,488
37,968
36,942
36,326
34,652
32,240
30,958
203,197
196,333
190,948
187,923
200,738
215,507
215,980
221,022
228,875
238,112
244,615
244,480
233,794
266,351
260,771
249,827
232,438
221,823
8.13
8.07
7.76
7.37
7.07
7.24
6.74
6.54
6.39
6.28
6.23
6.19
6.16
7.21
7.18
7.21
7.21
7.17
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
286,799
298,821
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
2,747,232
2,860,750
10.21
10.19
9.77
10.17
10.13
10.30
10.04
9.80
9.91
9.77
9.69
9.82
9.80
9.72
9.65
9.60
9.57
9.57
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
31,863
30,634
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
230,096
219,728
8.14
8.07
7.77
7.36
7.08
7.24
6.74
6.55
6.38
6.27
6.23
6.19
6.15
7.22
7.18
7.22
7.22
7.17
7,093
7,617
7,308
7,431
8,173
7,602
8,313
9,473
10,023
12,506
13,908
11,557
10,361
10,226
10,895
11,605
11,417
11,378
45,960
65,326
62,771
68,892
75,518
66,960
75,599
79,428
93,980
141,925
173,343
169,401
182,690
183,042
187,714
199,164
205,488
205,916
6.48
8.58
8.59
9.27
9.24
8.81
9.09
8.38
9.39
11.35
12.46
14.66
17.63
17.90
17.23
17.16
18.00
18.10
151
173
171
161
229
199
361
457
668
665
514
241
151
157
169
149
114
99
1,146
1,288
1,155
974
1,353
1,251
2,271
2,740
4,299
4,113
2,818
1,417
878
850
1,018
878
619
520
7.59
7.44
6.75
6.05
5.91
6.29
6.29
6.00
6.44
6.19
5.48
5.88
5.81
5.41
6.02
5.89
5.43
5.25
2,019
2,067
2,315
2,612
2,809
2,659
1,912
2,050
2,077
2,218
2,702
2,909
2,979
3,140
3,261
3,516
3,306
3,325
21,515
22,281
22,081
24,283
25,948
24,304
19,622
20,163
18,449
20,680
26,504
28,889
27,631
32,679
31,174
36,204
32,372
35,250
10.66
10.78
9.54
9.29
9.24
9.14
10.26
9.84
8.88
9.45
9.81
9.93
9.27
10.41
9.56
10.30
9.79
10.60
198
220
244
308
322
79
159
159
182
214
263
267
259
280
279
307
263
225
1,466
1,738
1,902
2,789
2,285
669
1,195
1,030
1,497
1,609
1,926
1,906
1,873
2,026
2,017
2,136
1,723
1,575
7.40
7.90
7.79
9.06
7.10
8.47
7.52
6.48
8.23
7.51
7.32
7.14
7.23
7.24
7.23
6.96
I    6.55
1950  .
1951
1952	
1953	
1954	
1955	
1956	
1957	
1958	
1959	
1960	
1961 	
1962	
	
1963	
1964	
19651 	
19662	
Patient-days—
1949	
1950 	
1951 	
1952 	
1953	
1954
656
1955              -   -
1956	
1957...	
1958 	
	
1959	
1960 	
1961-  _
	
1962 - -
1963            	
1964  	
19651	
19662	
Average    days    of
stay—
1949 	
1950	
1951    	
283,250
1952
1953
1954 . 	
1955 	
1956	
1957
=
1958	
1959..  	
1960	
1961	
1962	
1963	
1964 	
19651—	
"..     ~
19662 _	
7.00
4,317.84
i Amended as per final reports from hospitals.
2 Estimated, based on hospital reports to October 31, 1966. 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 1,799; 1966, 1,773. (1954
and subsequent years are based on total population. Because the armed forces, Royal Canadian Mounted Police,
and some other groups are not insured under the Provincial plan, the actual incidence of days would be somewhat higher than shown.) In addition, estimated patient-days per thousand population for extended care
amounted to 151.   Population figures are revised according to latest census figures.
 O 40
BRITISH COLUMBIA
Table 2b.—Summary of the Number of B.C.H.I.S. In-patients (Including
Extended Hospital Care Patients) and Short-stay Patients, 1949-66
Total Adults,
Children, and
Newborn
In-patients
Estimated
Number of
Emergency and
Minor-surgery
Patientsi
Total
Receiving
Benefits
1949
174,269
178,979
184,326
189,871
208,530
229,735
242,034
253,001
257,398
274,694
290,650
303,608
311,261
314,963
323,079
327,796
333,762
345,138
29,000
44,502
47,656
46,767
52,582
63,621
70,533
76,375
83,530
91,883
100,292
107,312
121,000
128,000
135,000
141,000
160,000
175,000
1
203,269
1«*50
223,481
1951
231,982
1952	
236,638
1953
2161,112
1<Md
1955
293,356
312,587
1*956
329,376
1957
1958             ...
1959
I960
340,928
366,577
390,942
410,920
1961         .   .
19S?
432,261
442,963
1963
1964 _  	
10652
458,079
468,796
493,762
19663    ...    	
520,138
Totals
4,743,094
1,674,073
6,417,167
i Years 1962 to 1966 estimated.
2 Amended as per final reports received from hospitals.
3 Estimated, based on hospital reports to October 31, 1966.
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 1966 x (Excluding
Extended-care Hospitals).
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Patients separated—
Adults and children	
298.821
106,050
92,074
56,846
34,936
8,915
Newborn  	
30,634
9,198
10,750
7,203
2,710
773
Patient-days—
Adults and children	
2,860,750
1,207,650
792,479
524,913
270,450
65,268
Newborn 	
219,728
73,348
74,356
50,168
17,160
4,696
Average days of stay—
Adults and children	
9.57
11.39
8.61
9.23
7.74
7.32
Newborn	
7.17
7.97
6.92
6.96
6.33
6.08
i Estimated, based on hospital reports to October 31, 1966.
 HOSPITAL INSURANCE SERVICE,  1966
O 41
Table 4.—Percentage Distribution of Patients Separated and Patient-
days for B.CH.I.S. Patients Only, in British Columbia Public Hospitals, Grouped According to Bed Capacity, Year 19661 (Excluding
Extended-care Hospitals).
Bed Capacity
■
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Patients separated—•
Adults and children
Newborn	
Patient-days—
Adults and children
Newborn  	
Per Cent
100.00
100.00
100.00
100.00
Per Cent
35.49
30.02
42.21
33.38
Per Cent
30.81
35.09
27.70
33.84
Per Cent
19.02
23.51
18.35
22.83
Per Cent
11.69
8.85
9.45
7.81
Per Cent
2.99
2.53
2.29
2.14
i Estimated, based on hospital reports to October 31, 1966.
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 47 to 49 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
1965 " and " Statistics of Hospitalized Accident Cases, 1965," available from the
Research Division.
 O 42
BRITISH COLUMBIA
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 O 46
BRITISH COLUMBIA
Chart V.—Average Length of Stay of Cases* in Hospitals in British
Columbia, by Major Diagnostic Groups in Descending Order, 1965
(Excluding Newborns).
Diseases of the circulatory system
Neoplasms
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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Allergic, endocrine system,
metabolic, and nutritional diseases
Mental, psychoneurotic, and
personality disorders
Injuries and adverse effects
Certain diseases of early infancy
Diseases of the skin and
cellular tissue
PROVINCIAL AVERAGE
LENGTH OF STAY
Diseases of the digestive system
Diseases of the genito-urinary
system
Supplementary classification for
special admissions
Diseases of the respiratory system
Deliveries and complications of
pregnancy, childbirth, and the
puerperium
Symptoms, senility, and ill-
defined conditions
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£o
 O 50 BRITISH COLUMBIA
STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE
FISCAL YEAR ENDED MARCH 31, 1966
Administration—
Salaries  ,        $544,375.00
Temporary assistance  16,651.00
$561,026.00
Office expense  37,489.00
Travelling expense  30,678.00
Office furniture and equipment  11,041.00
Printing and publications  2,054.00
Tabulating and rentals  2,385.00
Motor-vehicles and accessories  1,651.00
incidentals ana contingencies	
Technical surveys	
1,0/3.uu
19,429.00
Less contingencies and adjustments	
$667,378.00
31,770.00
Payments to hospitals—
Claims 	
$635,608.00
76,128,175.00
Vancouver General Hospital re out-patients (Hospital
ance Act. sec. 17 (31 (a)) 	
Insur-
484,746.00
i
Less—
Collections, third-party liability	
$76,612,921.00
405,182.00
($40,573,279)
Chargeable to Government of Canada
and miscellaneous receipts ($154) .
$76,207,739.00
40,573,433.00
Grants in aid of construction of hospitals
$35,634,306.00
3,790,757.00
Total 	
$40,060,671.00
C. F. SW/
Deputy Comptr
ost Excellent Majesty
olumbia.
Certified correct in accordance with Public Accounts.
lNNELL,
oiler-General.
Printed by A. Sutton, Printer to the Queen's M
in right of the Province of British C
1967
700-966-8070
  

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