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 3 00 O 3 E» o OS a t> o ^ & ^ 9V ,c&' i> or 4i AtS' CAT? Sttf tot rt ©K*9 ¥ s>- VO?1 jjjtfios 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 ION and, Cranbrook, te Rock, Haney, Vestminster (St. Health Sciences ubilee). (^rci7. eCf; %i **'ti, «oc "ll Ce*. 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 in ^o OS ^H „ </> PL, D V) O rt a w < o 1—1 P * H CO 0 z o 3 p Pi o h < 2 >< ( 33 rt * M w rt Q 2 O o o PC| Z o 3 og Z >* w < u P ft o P z z o ' ' H 3 P9 2 H CO P cfl < m 3 < 5 z « rt w H rt < as O HOSPITAL INSURANCE SERVICE, 1966 O 43 in 33 PS < U ft o 00 < P Q Z < oo ft oo < o -3 <S H P. oo O w ►J < 33 Q Z < 33 < ft o z o H P m 5 H 33 o 33 o < H Z B3 U Pi 33 P. H rt < as O .5-° *o o <D o :=3 O SS -O X+J rt U O E £ iy n fl-9 ih <a O a> co 5 O ty •J3«w ia 9 fis Eg O-Tl . us£ 6^ ceo agg CJ V o ~ ^ '-j _c ~ 0-cl ra i_ 1—1 0- xsjf B'S'o 3 ., 3 O CJ A * i:-1 HOSPITAL INSURANCE SERVICE, 1966 O 45 o SS. ££ SR ,:\—\°o"• o"^ w ■" ^ W +J — -a j rt < —. p 3 3 1 1 I > 33 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 Infective and parasitic diseases 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 iiiiiiiiiiiiiiiiiiiiiimiimi -> miiiiiiiiiiiiiiiiiimm i/iiiiiiiiiiiiiiiiiiiiiiiiiiim ■>•• §/////////////////////////////////, ll/lll/llll/lll/l/lll/ll/llll/lim Wlllllllillllllllillillillilllllli mmmm ■« iiiiiiiiiiiiiiiiiiiiiiiiiiiiih, mmmmm»-w/i//i/////////i/M m/iiiiiiiiiiiiiii/ii/im mmmm, wiiiiiiiiii/iiii/iiiiin, ■" mm/mm///, !««»".'«•!«« '////////////////////////•>■•'////////////////////////////, W////////////////7'*////////////////////////////, iiiiiiiiiiii/iiiiimiiiiiiiii/ii/ii/iiiiiiiiiiiih wiiiiiiiiiiiimmmiiiiiimmi, wam»msssssm Wllllllllllli-WIIIIIIIIIIIIIIIIIIIIIIIII, Wllllllllll-lllllllllllllllllllllllll illinium,"iiiin/iim Wll/llll >-> lll/ll/ll/llllli, W/lllh-'lllllll/ll/lllll, 'iiiiiii - m/m "' Including rehabilitative care. HOSPITAL INSURANCE SERVICE, 1966 O 47 oo Z O a 33 z O z Q P >-) U X m •. / >n vo tn 33 3 O a 33 H < u H oo 0 Z o < rt o < CQ z o H < N < H ft 00 O X <0 o rt.G >« «5 ^i ^ ^ cj ^ "^ oir5'*ioinvcvOTi;'Hrvivo<omrj wodo'odaJdoddociddoddo'N oo O to © © © • ' © © _©* OmrHrnO rHooo0'o<noooodoooo*o©Or-i <p ©' «riddpdddddriHwd ro^^r^^^©^^©#r^^vor^T^c^ooo\spi- r^ve^^r-QinoovprSoc^oooo^^ci^Dt--a" ■co cn vdc^OvC^Pvvp'r^vornro^mcJt-- Q hcOinpifnific>oor-n'Or^inftti(00*0*rt C-" co" ©" t-» ©" ^ ■*?■ Tf^vD^oTt^cf,,*'^oo>oooov' ^ t-i ,_| ,-, ^ ^^h^h^^^h Hrl VO in vo r- IS Ov © Vi ( oo y? ?v to 0O >-( fl ! .inoort ' imrlh« t?SP^^Q5<?v;g-<yc$iO£vO£vpr^©£'5rOv:!fr ffimiOO'?rtt^v5loOMlrj'*'-'QO^i5\MOfirf| GGrSrC^V}tnfor^cA-^SO^&0%-*t-tricAtr~Os'<tT-' 0O v£> r- © r^ VOOO* oo rn cA-^t^cArriCi^-^^-^-ViCA 0\(XiS0<Os0r-<QS0srriS0&S0 f~-f<0\ooc^iC~ViViCicAcAC^ z < a u co 0\ co 2? 17 S3 © 0v oo TO S3 oo sOrt't oo 2 © co ^ vo t— 9 in „l © © © t-i t-i »-t ^ H HinO\ © o vO °7\ £ 7.7 "Si 11 JD rt < _-, +3 £ i *a .T3 *j i 1 § Is* i .s •" "i '•§11 <U ra j —• 3 g fi 3 rt 9 y c| O 3 0 fl M-£ 5ts * s ooooooo SS 3 £> 3 = -H > 8 "3 3 o B.3 -| o o - 8 o segseggESse-ge , o. p, ft ooo fl fl c g c c rt rt rt rt rt rt «j i_i C fl fl fl fl fl- •Grtrtrtrtrt'rtrtrt 0) o o o o ^ (U W O CJ fl fl C C G rt c fl C fl •§ ' cd rt rt rt g C G C C u 60 M bD DC W rt rt ra rt j? •n <c u a. c p " g rt F ft O u rt to 3 c *o o "rt ca ft G O a o o H G SO T3 G G rt G rt JD ;G G 0 > fl * G U s a g •c c CJ rt «_■ u q> •c fibromyom neoplasm o neoplasm ( co >^ co U fl 'G O c u 't H 2 c > c E •Ou c P E5 u •G cii oh H. i» ; S ¥ 0) 'fl fl:'2 u'i - Srt P cc P3 G bi < c c C ■O -G ' o ja *j co aj ■r1 <u w _r 0<C S«2 vi G oj O O 13 OOO >^ >. w (A co 'J5 A'^r4tn'^f"ni7vDc-~ooo\0'-iMcnTtv-)vpr--oo <?JS O 48 BRITISH COLUMBIA s •S a o U tn Z « O « 33 Z o z Q 13 t-3 O X B «o VO CO 33 5 o a 33 H < rt o < CQ Z o H ►J < H ft. oo O G O 00 (A 1- ©•TiTj-oi©0\votsmovcicsi'oH",,tOvoc> *- o- f>» co co ■"* tOOvt OO ^- «0 © "d- Ov i> ■* i>rn-O'-i>H^ciV0r-(OHrt0OOO-O,t'-'fHrtfMO(S 0«-i*ri©i-i©©cSi-<ooo©©f-« s 0 s CJ) rt G U ^fOOvcoiri^coco,^©r~i^OVOcoin©c»Tl-vOT-iir)VOiricvJl»rt vOfirHTj-h- TtolOvolfNcoOvr-m OJ rt in^do'M^og'dmwdoHo'o'o^^o*MN^H^rtH OHrid^dd'-'Movdo'dw Ih CJ ft. u ©,^©t^vOc^coc»c^vOt^^co©©vDT-icOt-it--icocovor^r^'^' VOvoOv ^" «n cS©T-^'^"VO00<SI'^"© *" an ^ d w « t^ f* ^' w r^ ^ n ri vh oo vi m* \d ^' io rn oo t^t^co©"vor^©*roo\odrt©ovov > flM «J! vO^r^O\in*^©co©^.r^i>-rJco^^c^ri-©^vpV0<S©ci0Tfr Or-OO'-iO'ft'oQr-ooiflt-w rtr~or^'?^vaw[^«ir^--ifsr-'tOOrtr<iT}'*h.*i>Qt> cort\0ifl0rtoo"d,6oyrir-r~0 rt^rnMO^-vOr^r^^^rtC^rtrfcor^inrOfJr^ONrtm^i c?sr~-f>lTl-,*voc-->r)Oo*-ii-iincooo °o >-.« o-'OOr-,vo«r-i3\Owoor-^inrHffiin"^Oirif-^i>o\QOn co©r~fN,**OT-ioO'rfr~-CslcO'-,co rViOv-^-T-.cofoOv — astt<ScofO—'t-it-<oco tS wrt m S r- i-icom»-icor-l*-ic»co'''+i-«.£Sf5l''* «o p r>l CO •—" CO ri CO (S c>^inMinh-«r^rtHrnOhwmm^Ti-(SNrHH*J'OcfiO vo«-«i-«rJiOT+oocor-'-iocOco© vOcodOHioNO^^^^gr^oo^i/inar^f-Nrtoorrirtr"- co^,*©lAi>'500\av«)r-(oooiOvo c^©vo©r-Tfc^©vo©r>i^OvOvr^«n&i*r^cNvoco<3NO«)r-- 6^©^c5csicocooNvoooo6t--cJOo in • U vOTfcs-— ^Tj-mr-iocorNrtfsl—' HONinHHiflo^OPiTj' ,-»■*!• vp .-. m --i in co oo rMCS'* i-i fN" •»**-« «s co ts (— CO OV d in t~- © to co in vo J ^ 1 00'st©Ov©\oooovo<M;'*frT>vo t* 't r- vi m m M r- r- "n ci mcort co r-- co r^ ■"* *£ v> OscriVisDG0Os*£>T-icArn'y*in v£> T cs r- oo Ov © rj oo cn ^ *j m *C eooot^coov © © Z Q cOcococococo^^^^'^^J-©'-|,*l"l/lln'H"'^''^",o©,^,'Ol'^,n inmSn©>-ic-linin>nvO'n©vo^o IJ-JJJJi' 1 SP *© -S J. J I 1*? 1 11 J 11-r-P-r-J.I-ri©-- ooinooooooooo^'trn^ooooO'VirtOOO co©ou-)Vnm©**o\©©vOfNco coco^-vOr-c3s©©cScoTj-w-i vO - r- t-~ co c5\ © —< co cO -^J- -^- in vp oo oo co Ov Ov O© cocococococoTj-^'^-Tt^-^l- t£ rs "<t ■** ■**■"<* >n in in vo in in m m mm^mih vO vo j. SB 1 - O "3" / VO —i U ■* fo © co in v5 ■a G « -3 CJ rt 6 O s OJ o J3 •3 E V IH o co fl rt J3 a OJ OJ > (fl a V co •3 rt CJ 3 OJ aj *o O G 00 rt « = ci 6 £ 4 > Cfl 1 Li OJ 2 .a 2 Ih CC rt EL OJ t/ ■fl x _> "to C CJ <D ft CJ E i •3 C rt OJ 00 rt OJ > rt 5 ■a 5 1 E 3 z ° 5 Si G 3 "H a 3 b w u c c rt .c rt d> aj Q c " .22 t: s^g 5? "£ c cotg o ca § **2 S ■> (fl B > £ j- rt Ih > B a c 0 Q X, o c/ a E ■3 c rt rt a. E 4 [/ i> > C cc 5 (. 'c CJ *j rt « P 'fl <" *. £ S p G oo S ■o — * rt S 5 o ° u o i 5^ tH OJ •B o ■o G rt OJ co rt OJ ■a IH <U rt 'C * i o rt 3 1 CJ aj c o X D o £ c £ s a a > Cfl t C 0 fl c In '3 u 0 ca CJ E i > Cfl > C a '— 'o (0 9 a. E C t ,2 c > c 1 tH 'c i s ■a c 0 e 0 c > E a, « > ca > Ih 2 2 c Cfl CJ O Cfl a: £ CJ a > CJ > j CJ CI - t 3 a c t- 0 c fl 3 Cfl •a G a •B OJ & oj 'O •o | a "3 II c a OJ O •a O *3 3 C ■a rt c .2 ■si u > C 0 G 1 O -3 _o C t l a 0 C 8 j s| Oh U 3 g a> £ .2 S 3-3 0 3 "•a ■a c 3 « rt .2: C aj 1- 1 c 4 c^ rt 4 a '•B (H 4 X 0 ■a 0 4 u o fl n fl -3 C cc OJ •a -3 rt 0 01 E a I .1 OJ 51 X o cfl S a > > u C i 0 'c 4J CJ V "5 c k- JO B E c S E a > Ci c £ 2 Cfl & s a 3 tH 0 y c_(rtga>cjoj^2o'oiJ<i>«i- 0GGrtrtrt„GC^5rtOc tflCJcHfljajajcogfljajjvoj.jHt: 8 | <g .a JUS 8.S U£ S.3 « « C 03 o U B A ca u*. s -a "Z^ «H!.aSj'BaB*l ^ .5 a .2 b s "3 «H S o .-. -a rt""o3oco oi-"?-^ •Gu,'H5erti~'GtiGV- Ih^ CO Ih H m Jfl OJ P«.P t-S J3 _oj jC Mr a g* 3 g M ° O I aj « *s - £ 8 3"E 1 3 § !E c c c &5 8 .Si! S 2 1 OJ O fl g>5QQQs*<OEQ>ffi So g<t P.CC ao20P06<:aoouu«o2ZAuo ^Mco'Winvd^r^co'ov^Trtr^co^in^vo't^co'c^©^^^^^ vivor-oof>Q-<NArn^invO DmrnrnrnmWrnrnm^^^Tt^TfU^TtTtTtviirWvi^in .riinininin^ovovOi—lvovovOvo > > > >< X HOSPITAL INSURANCE SERVICE, 1966 O 49 vO h vo © -st Ov r-i © © ih O © C^c^'ovoin--;opooQ-in©Tt;'-H rt rj; co coooov © -* oo t>j rt co tN (^ On CO h 6 in H d h O rn Vl N h* (S i-l *i ©" © h vi cJ T-i T-i © to" ri r-I ©" © tN © O © 3\ fN Qv f- rt t— © ©"©'© tH *^ >co©t—'-|t-ov.QCJt-~ovr- lT-io\i-H©T-i©©tp*w©i-i CO co Ov Ov cN co c- co vo cN co m ©oooprHT-iincN'n'-'f-cNco-H vd^'covDov-^^cor^^oo'intN tN Ov 0> oo QHMH i c~- co r- © - © " ©' ri i cn rt in <©'©■-* ■n in ■>■ r- m Vi co rt ii co vi r- rs ts © O m *n © vO ■—■ VQ m ro fN rt" — vo •* © Ov © © ! ^ 0v<£© OV VO ri oq co co CO t*" f> fN m ov oo co co r> -i Ov r^- <N r- P- l> f- r^ co tN fN tN <N rt *n co CO Ov co Ov ~'^ 00 (^ Ti ;u 1-1 r; IN ~©t>TH©hT^O0Ov rt vo invNoofN'^ffO ©" o' h in © m §23 r- co t-i r- -3- >n tN O © m * C- SC ^t v "ncororj- vocoo©© th rt Ov vo . i fN r- vOvo>n m m tN vo © <n rt rt <N oocoootN _ . 1 io 66 M ■* i in m tN cnvdcs© oo vi vj vi ft voovobtN invOOvritN^cOOOinincoOvco^ -* rt r- iS oo oo Ov in cS t-< cN © r- <n co o int-^toooi/T in fN <N -^ co" cN in co" to" ininvo rt n rt t>T co~ rf rH rt © fN t oCco" © tn VO rH rt vo rn —i rs co to „ vq vo vO vo vO rt rsT r- Ov ov \0 vO vO vp _T m © © 3 vp VO VO oo Ov vp oo vo ov r~- 5S . © vO © r- oo ov c vo Ov 0\ Ov ^O co F © v> F r^rT-rrinr-fv^-t^rT- iflunioov l> Ov Ov 3v rp r~ r- Ov ©tSfN co-3-ininSb vpoodoo ^ o t> r- r- <N c6 t> rH VP §5 Q S3 <3 fN co oo <XS oo oo sslg'i oo oo otj 50 56 as;* rN ts o <o E 3 2 § ° I "1 ft ^ OJ o £ i n « a g "9 5 rt oj H G o S*2 <§ a G O O HH 33 rt to vi ZZ « 3 G ft tn aj ,2 to M O G <+-i M 4) O ft g Cfl T-> OJ rt ^ co G 0 rt ■£o2 I rt oj S > -3 ^ O C Ih Ih O 43 4> Cfl Jfl DQO •5 "-I a o S co ° 5 > o G « fl O o G <W ft'lH ° g 8 ■a 3 ;> tn rt .H c t« Q, "w "fi B 2 Bob s 3 & u SOOT) 8Is | "S 'S "cs u Iiii !,» O S : " a > > 9 I I 3 §1 o is*- ' 3 M g :g3« •O-S 3 3 3 5 3 M rt n'-o 3 •So | 3 lA g w o e tH M o a o „ SB 1.1 i 3.2 3 ■ ■a s 8 a a a rt 3 o te 3 & - u 3 3 .M O-Oih qqO 2«o 2<3o . co , . 3 -S & « Jt_'^ N 3 1 ^J I -■ f—\ If** Wl oo o> s c r- i> M c 5"2 „ rt ra - -2 G rt G % "T >3 Og^>v 33 E « -5 go § & ^ w rt 1 r: rt o - ' S^? T3 <G ni OJ H't t! ^ a O 3 « ttH S w U rt-3 8'C •3Sa-S7 rt oj ra « b0"3 -* S 8 .s £ oo (j rt (jq uSuS > > rt .- "J > t ll§"S fell's »| MS S 6«-S ■SE o ^ — 3 ~ 0 B * ooo 4> 4> 4) S^6 £2 (it £ B. on CJ Ih a O .-7 -SbO£ > C x x .9 5 i co .2 J 8 fl (-1 .-- rt oS,5 r?«fi M rt J> o g-3 &f s &s i 0 5 Xi ** HcJS 3 u « ■Sss S j3 it ■s > •o'S rt u. £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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Eighteenth Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1966 British Columbia. Legislative Assembly [1967]
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Title | Eighteenth Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1966 |
Alternate Title | HOSPITAL INSURANCE SERVICE, 1966 |
Creator |
British Columbia. Legislative Assembly |
Publisher | Victoria, BC : Government Printer |
Date Issued | [1967] |
Genre |
Legislative proceedings |
Type |
Text |
FileFormat | application/pdf |
Language | English |
Identifier | J110.L5 S7 1967_V02_09_O1_O50 |
Collection |
Sessional Papers of the Province of British Columbia |
Source | Original Format: Legislative Assembly of British Columbia. Library. Sessional Papers of the Province of British Columbia |
Date Available | 2018-03-09 |
Provider | Vancouver : University of British Columbia Library |
Rights | Images provided for research and reference use only. For permission to publish, copy or otherwise distribute these images please contact the Legislative Library of British Columbia |
CatalogueRecord | http://resolve.library.ubc.ca/cgi-bin/catsearch?bid=1198198 |
DOI | 10.14288/1.0364209 |
AggregatedSourceRepository | CONTENTdm |
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