PROVINCE OF BRITISH COLUMBIA
HOSPITAL INSURANCE ACT
Twentieth Annual Report
British Columbia
Hospital Insurance Service
JANUARY 1 TO DECEMBER 31
1968
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1969
Victoria, British Columbia, January 23, 1969.
To Colonel the Honourable John R. Nicholson, P.C, O.B.E., Q.C., LL.D.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned has the honour to present the Twentieth Annual Report of
the British Columbia Hospital Insurance Service covering the calendar year 1968.
RALPH R. LOFFMARK,
Minister of Health Services and Hospital Insurance.
British Columbia Hospital Insurance Service,
Victoria, British Columbia, January 23, 1969.
The Honourable Ralph R. Loffmark,
Minister of Health Services and Hospital Insurance,
Parliament Buildings, Victoria, British Columbia.
Sir,—-I have the honour to present herewith the Report of the British Columbia
Hospital Insurance Service covering the calendar year 1968.
DONALD M. COX, F.A.C.H.A.,
Deputy Minister of Hospital Insurance.
The Honourable Ralph R. Loffmark,
Minister of Health Services
and Hospital Insurance.
Mr. Donald M. Cox, F.A.C.H.A.,
Deputy Minister of
Hospital Insurance.
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CONTENTS
Page
Organization Chart 8
General Introduction 11
20 Years in Review 12
Major Policy Developments, 1949-68 13
British Columbia Regional Hospital Districts Act 14
British Columbia Regional Hospital Districts Financing Authority Act 15
The B.C.H.I.S. Planning Group 15
British Columbia General Hospitals (Comparisons of Growth) 16
The Hospital Insurance Act 18
The Hospital Act 19
Persons Entitled to or Excluded from the Benefits under the Hospital Insurance
Act 19
Entitled to Benefits 19
Excluded from Benefits 20
Hospital Benefits Available in British Columbia 20
In-patient Benefits 20
Emergency Services and Minor Surgery 20
Application for Hospital Insurance Benefits 21
The Hospital Rate Board and Methods of Payment to Hospitals 21
Organization and Administration 21
Assistant Deputy Minister 22
Hospital Finance Division 22
Hospital Accounting 23
Hospital Claims 24
Hospital Construction and Planning Division 27
Hospital Projects Completed during 1968 28
Hospital Projects under Construction at Year-end 32
Projects in Advanced Stages of Planning 32
Additional Projects Approved and in Various Planning Stages 33
Director of Hospital Consultation, Development, and Research 34
Hospital Consultation and Inspection Division 34
Research Division 36
Medical Consultation Division 37
Administrative Officer 39
Eligibility Representatives' Section 40
Third Party Liability Section 40
General Office 40
Public Information 41
9
2
M 10 BRITISH COLUMBIA
Page
Approved Hospitals 42
Public Hospitals 42
Outpost Hospitals 43
Federal Hospitals 43
Private Hospitals (Providing General Hospital Services) 43
Rehabilitation, Chronic, and Convalescent Hospitals 43
Extended Care Hospitals 43
Statistical Data. 43
Table 1a.—Patients Separated (Discharged or Died) and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public Hospitals Only, 1949-68 (Excluding Federal, Private, and
Out-of-Province Hospitalization) (Including Rehabilitation Hospitals) 45
Table 1b.—Total Patient-days and Proportion Covered by the British Columbia Hospital Insurance Service, British Columbia Public Hospitals
Only, 1949-68 (Excluding Federal, Private, and Out-of-Province
Hospitalization) (Including Rehabilitation Hospitals) 46
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,
1949-68 (Including Rehabilitation Hospitals) 47
Table 2b.—Summary of the Number of B.C.H.I.S. In-patients (Including
Rehabilitation Patients) and Short-stay Patients, 1949-68 48
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 1968 (Excluding
Extended Care Hospitals) 48
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 1968 (Excluding Extended
Care Hospitals) 49
Charts 49
I.—Percentage Distribution of Days of Care by Major Diagnostic Groups,
1967 50
II.—Percentage Age Distribution of Male and Female Hospital Cases and
Days of Care, 1967 51
III.—Percentage Distribution of Hospital Cases by Type of Clinical Service,
1967 52
IV.—Percentage Distribution of Hospital Days by Type of Clinical Service,
1967 53
V.—Average Length of Stay of Cases in Hospitals in British Columbia by
Major Diagnostic Groups, 1967 (Excluding Newborns) 54
Hospitalization by Major Diagnostic Categories, 1967 55
Statement of Receipts and Disbursements for the Fiscal Year Ended March 31,
1968 59
Twentieth Annual Report of the
British Columbia Hospital Insurance Service
GENERAL INTRODUCTION
Donald M. Cox, F.A.C.H.A., Deputy Minister of Hospital Insurance
January 1, 1969, will mark a significant date in the development of one of
British Columbia's most successful programmes of social service, as it will represent
the 20th anniversary of the British Columbia Hospital Insurance Service. The article
" 20 Years in Review," which follows these introductory comments, outlines briefly
the development of the Service.
The tremendous programme of hospital construction which has been under way
throughout the length and breadth of the Province for many years (see photographs
on pages 30 and 31) continued through 1968 without let-up.
Major projects completed in 1968 involved a total of 660 new beds, of which
282 were for extended hospital care accommodation, as well as the improvement
and expansion of diagnostic and treatment services. Included in those communities
which saw the completion of hospital construction and renovation programmes
in 1968 were White Rock, Cranbrook, Fort St. John, Campbell River, Grand Forks,
Murrayville, Powell River, Richmond, Enderby, Vernon, Comox, Pouce Coupe,
Prince George, Vancouver, and Victoria. In addition to these completed projects,
hospital construction programmes were under way at the year-end in the following
centres: Quesnel, Abbotsford, Castlegar, Creston, Kelowna, Port Alberni, Revelstoke, Terrace, Surrey, New Westminster, Trail, and Vancouver. Provincial Government approvals-in-principle and approvals to plan had been given to the boards
of management of over 45 hospitals.
The regional hospital district programme, introduced by the Provincial Government in 1967 through enactment of the Regional Hospital Districts Act and the
Regional Hospital Districts Financing Authority Act, has met with a great deal of
success. During 1968 five regional hospital districts were incorporated, making
a total of 28 regional hospital districts throughout British Columbia.
Payments to hospitals have continued to increase each year, and in the 1968/69
fiscal year an estimated $137,000,000 will be paid by the British Columbia Hospital
Insurance Service to the hospitals of the Province toward expenses incurred by
residents.
In February, 1968, day-care surgical services for out-patients were provided
as an extension of the coverage offered through the Hospital Insurance Service.
Medical advances in recent years, particularly in the field of anaesthesia, have made it
possible for a number of surgical procedures to be carried out without requiring the
patient to be admitted as an in-patient. The provision of this additional benefit,
for which the beneficiary is required to pay only $2, has proven to be extremely
satisfactory. Based on the assumption that day-care surgical-service patients would
usually be in hospital for two days had they been admitted as in-patients, a total of
23,000 patient-days would have been utilized in the 10 months that the new benefits
have been in use. In other words, the introduction of these services has saved the
equivalent of 95 to 100 in-patient beds, based on 80 per cent occupancy.
11
M 12 BRITISH COLUMBIA
In December, 1968, benefits were extended to include, on an out-patient basis,
those patients attending psychiatric clinics in British Columbia hospitals to be
designated by the Minister of Health Services and Hospital Insurance. The patient
would be required to pay $1 a day for the services. This extension of coverage is
expected to free more hospital beds in psychiatric units for acutely ill in-patients by
allowing those who still require care to be discharged earlier than was previously
possible.
I should like to once again express our appreciation for the advice and guidance
extended the Hospital Insurance Service by members of the medical profession.
We are very appreciative of the assistance rendered by the College of Physicians and
Surgeons and by the Canadian Medical Association (British Columbia Division).
The laboratory and radiological advisory councils continued to be of inestimable
value in assisting hospitals to improve the laboratory and radiological services, and
in advising the Service regarding the approval of Provincial grants-in-aid for the
purchase of major hospital equipment.
The British Columbia Hospitals Association continued to render very valuable
advice to the Service. The liaison committee with the association, inaugurated in
1966, has been an effective channel of communication between the Service and
the association, and the resulting improvements in co-operation have made the
committee a very worth-while development.
In December our Branch was honoured by the Prime Minister when he presented us with a silver-on-gold safety award from the British Columbia Safety
Council for 792,217 accident-free man-hours of operation.
Reports submitted by the various divisions which comprise the administrative
structure of our Branch appear under " Organization and Administration," commencing on page 21.
20 YEARS IN REVIEW
On December 31, 1968, the British Columbia Hospital Insurance Service completed its 20th year of operation. British Columbia's programme of insured hospital
coverage had four main objectives when the plan came into being on January 1,
1949: 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 regular source of income; third, to assist hospitals in developing and maintaining high standards of patient-care; and, finally, to assist communities in providing adequate hospital facilities. During the 20 years since the commencement of
the programme, continuous and vital progress has taken place in the provision of
expanded facilities and improved hospital services throughout the Province. This
progress in the hospital field was brought about through the combined efforts of
government, hospitals, professional and community organizations, and individuals
whose contributions have ensured that the residents of British Columbia have
efficient hospital services at their disposal. It is of interest to note that from January 1, 1949, to December 31, 1968, approximately 1 billion 4V2 million dollars
has been paid by the Provincial Government, through the British Columbia Hospital
Insurance Service, to the hospitals of the Province toward hospital expenses incurred
by residents. This represents the sum of about $500 for each man, woman, and child
living in British Columbia at the present time. While the average hospital bill
paid by the Hospital Insurance Service is now approximately $350, individual bills
have exceeded $25,000 when an urgent medical need for active treatment care was
required over a period of many months. In addition to the financial assistance
provided to residents incurring hospital care, the Provincial Government has also
provided grants of over $68,000,000 toward the construction costs of major hospital
projects, and an estimated $20,000,000 toward the purchase of hospital equipment
HOSPITAL INSURANCE SERVICE, 1968 M 13
and furnishings. British Columbia's accelerated programme of hospital construction
has produced over 9,000 beds, in addition to new diagnostic and treatment areas,
emergency departments, laboratory facilities, laundry buildings, and schools of
nursing.
These expenditures represent a total payment to British Columbia hospitals of
over 1 billion 92 million dollars during the 20 years of hospital insurance coverage.
The value of the hospital insurance programme as measured in dollars represents only one yardstick of accomplishment, and although the protection of residents
of the Province from the crippling cost of hospital bills and the provision of financial
assistance in the development of adequate facilities are most important, they are
no more vital than the progress made in improved standards of patient-care. These
improvements may be illustrated by studying the advances made in the quality and
quantity of services provided by the Province's general hospitals. Prior to hospital
insurance, many hospitals were unable to provide their patients with adequate
services, primarily because of the tremendous cost of equipping departments and
employing professional personnel. Through the combined efforts of hospitals and
professional organizations, together with the financial and advisory services offered
by the Provincial Government, the quality of hospital care in British Columbia has
been progressively improved over the years.
It is significant to note that during the past 20 years the total gross expenditure
by public general hospitals in British Columbia has increased from $16,000,000
to $134,000,000. During the same period total numbers of staff employed in
hospitals have increased 191 per cent to 18,900, total patient-days by 110 per cent to
3,100,000, and the Province's population by 84 per cent to approximately 2,000,000.
Changing concepts in medical care brought about the need for additional provisions within the framework of the British Columbia plan and, as a result, rehabilitation and activation care benefits were introduced in September, 1960, and extended
hospital care in December, 1965. Further evidence of the Province's willingness to
provide its residents with all-inclusive coverage was the introduction of out-patient
cancer therapy benefits available at facilities in Vancouver and Victoria in 1967,
and the provision of day-care surgical services in February, 1968, and out-patient
psychiatric services in designated hospitals in December, 1968.
With increasing activity throughout the Province in connection with the planning of hospital expansion and renovation programmes, and with continuing vigilance
on the part of hospital administration, medical and nursing staffs, it is apparent that
the residents of British Columbia will continue to enjoy high standards of hospital
care for many years to come.
Major Policy Developments, 1949-1968
Premium Payment Plan, 1949-1954
From January 1, 1949, to March 31, 1954, the major portion of revenue for
the Hospital Insurance Service was derived from compulsory premium payment.
During the first year, annual premiums were levied on the basis of $15 for a single
person, $24 for a person with one dependent, and $30 for a person with two or more
dependents. Premiums were remitted through monthly payroll deduction or by
direct payments, levied twice a year. At one time over 5,000 firms were registered
for monthly payroll deductions.
It became apparent that the premium method of providing funds for the hospital
insurance programme was not satisfactory, due in part to the fact that some 20 per
cent of the Province's labour force changed employment frequently or was seasonally
employed. There was a marked resistance to compulsory registration requirements
M 14 BRITISH COLUMBIA
for insurance coverage from many people who were self-employed. At the time
the premium plan terminated in March, 1954, annual premiums were $27 for a
single person and $39 for a head of family.
One Year's Residence for Coverage, 1954-1958
Effective April 1, 1954, the collection of premiums was discontinued. Entitlement to hospital insurance benefits became contingent upon the completion of 12
months' permanent residency in British Columbia. The operation of the Hospital
Insurance Service is financed from funds voted annually by the Legislature.
Federal-Provincial Plan, luly 1,1958
July 1, 1958, marked the start of the Federal-Provincial hospital insurance plan,
and British Columbia was among the first of the Provinces to become a participating
member as of that date. Under this programme each Province is responsible for the
development, administration, and operation of its own hospital insurance plan.
Provided the Province meets the minimum requirements set forth in the Federal Act
and regulations, the Federal Government shares certain stipulated costs. The cost-
sharing formula for Federal payments is on the basis of 25 per cent of the Provincial
per capita cost plus 25 per cent of the Canadian per capita cost for hospital care.
With the introduction of the Federal-Provincial plan, the length of permanent residency required to establish entitlement to coverage was reduced from the existing
12 months to three consecutive months. Through reciprocal arrangements with
other Provinces, three months' out-of-Province benefits plus reasonable travel time
are provided to residents moving within Canada.
Rehabilitation and Activation Care, September 1, 1960
On this date British Columbia expanded its programme to include rehabilitation
in approved hospitals. In-patient care is provided to patients who no longer require
the intensive diagnostic and treatment services of an acute-care hospital, and who,
in the opinion of medical authorities, will benefit from rehabilitation treatment
services to the extent that they may return to their homes.
Extended Hospital Care, December 1, 1965
A further expansion of the British Columbia plan extended benefits to those
patients in approved facilities operated by public hospitals or other non-profit
agencies for whom skilled nursing care on a 24-hour-a-day basis and continuing
medical supervision is shown to be required.
Regional Hospital Districts, March, 1967
The Provincial Legislature, in March, 1967, made provision for the division
of the Province into 29 large districts to enable regional planning, development, and
financing of hospital projects to be carried out under a revised formula which
increased the financial assistance provided by the Provincial Government toward
capital costs (see " British Columbia Regional Hospital Districts Act " below).
BRITISH COLUMBIA REGIONAL HOSPITAL DISTRICTS ACT
The Act provides for the division of the Province into large districts to enable
regional planning, development, and financing of hospital projects to be carried out
under a revised formula, which provides increased financial assistance from the
Provincial Government toward the capital cost of hospital projects. The Province
was divided into 29 areas, and 28 of them had been incorporated as regional hospital
districts by the end of 1968.
HOSPITAL INSURANCE SERVICE, 1968 M 15
As is the case with school construction, each regional hospital district will, subject to the requirements of the Act, be able to pass money by-laws authorizing
debentures to be issued covering the total cost of one or more hospital projects.
When approval has been obtained from the Minister of Health Services and Hospital
Insurance, the district will be able to raise any funds immediately required by
temporary bank borrowing on a uniform basis. The Regional Hospital Districts
Financing Authority (see below) will in due course issue and sell its own debentures
in the amount required, which may cover a number of district debenture issues.
At that time the districts will then be able to sell then debentures to the Authority.
Following this a district can repay any sum which has been temporarily borrowed.
Each year the Provincial Government will pay through the Hospital Insurance
Service its share of the amortization cost in accordance with section 22 of the Act.
Each district will in turn raise, by taxation, the remainder of the annual amortization
cost required to retire its debentures which are held by the Authority.
Under the new formula the Province pays annually to each district 60 per cent
of the net cost of amortizing the district's borrowings for an approved hospital
project, after deduction of Federal Government capital grants and items which are
the district's responsibility, such as provision of working funds for hospital operation,
etc. If a 4-mill tax levy by the district is inadequate to discharge its responsibility
in regard to annual charges on old debt for hospital projects, as well as the remaining
40 per cent of the charges on the new debt resulting from a hospital project, the
Province will provide 80 per cent of the funds required in excess of the 4-mill levy.
The affairs of each regional hospital district are managed by a board comprised
of the same representatives of the municipalities and unorganized areas who comprise the board of the regional district (incorporated under the Municipal Act),
which will have the same boundaries as the regional hospital district. The board
of the regional hospital district will be responsible for co-ordinating the requests for
funds from hospitals within the district, and for presenting money by-laws to the
taxpayers in respect of either single projects or an over-all programme of hospital
projects for the district.
A hospital society or corporation is not compelled to seek financing under this
new Act. In situations where the community's share of the cost can be, or has
already been, raised by other means, a Provincial Government grant under the
old 50-per-cent formula can be applied for under the procedure which was applicable up to this time.
BRITISH COLUMBIA REGIONAL HOSPITAL DISTRICTS
FINANCING AUTHORITY ACT
This Act establishes a Provincial Government authority similar to the one set up
a few years ago to assist school districts in financing their projects. The functions
of the Authority are referred to briefly in the second paragraph of the preceding
commentary regarding the Regional Hospital Districts Act.
B.C.H.I.S. PLANNING GROUP
This group was formed in December, 1965, to co-ordinate and expedite the
planning for hospital facilities. The Planning Group's functions are to review
research reports on hospital bed needs, study 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 to
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.
(Continued on page 18.)
M 16
BRITISH COLUMBIA
British Columbia General Hospitals Comparison
of Growth
B.C.H.I.S. Payments to Hospitals for In-patient Care
{Including Federal and Contract Hospitals)
1966 1967 1968
(Est.)
Total Full-time Staff and Average Number of Patients
(Adults and Children) per Day
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14
13
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14
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1966 1967 1968
(Est.)
HOSPITAL INSURANCE SERVICE, 1968
Gross Salaries and Wages and Other Operating Expenses
M 17
r«s
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£t4SV.=
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.
1966 1967 1968
(Est.)
♦Including approximately $4,000,000 in staff fringe benefits
Hospitals' Growth Rate (Public General Hospitals, Excluding
Federal and Contract Hospitals, Etc.)
1948
1968 (Est.)
Per Cent
Increase
Total gross expenditure (excluding depreciation).
Staff (full-time equivalent)..
Total patient-days (adult and child)..
Population of British Columbia...
$16,081,000
6,500
1,476,000
1,082,000
$134,000,000
18,900
3,100,000
1,994,000
800
191
110
84
M 18 BRITISH COLUMBIA
The regular members are as follows: Director, Hospital Consultation, Development, and Research (Chairman); Assistant Deputy Minister (Vice-Chairman);
Medical Consultant; Manager, Hospital Construction and Planning Division; Director, Research Division; Manager, Hospital Consultation and Inspection Division.
The Planning Group held 30 meetings during the year. Some of these were
meetings with hospitals or other agencies, such as the Hospitals Committee of the
British Columbia Medical Association and the Regional Medical Director and staff
from the Pacific Region, Department of National Health and Welfare. Individual
members on the Planning Group have acted as liaison members between the Service
and several local hospital planning groups.
During the year two sub-committees were set up under the Planning Group
to undertake specific tasks. The first of these was to develop a design programme
for extended care hospitals. Drafts of this programme had been completed at the
year-end and were reviewed with a committee of the Architectural Institute of
British Columbia. The object of the programme is to speed the planning of extended
care units, with particular emphasis at the start on the larger units required for metropolitan areas. The second sub-committee was appointed to examine the feasibility
of new types of facility for provision of health services in smaller communities.
After these studies have been completed, the sub-committee will add a second function: that of examining and recommending on the way in which certain services
can best be distributed in a region.
Action was taken on four new reports by the Research Division involving eight
hospitals. Teams from Planning Group visited three of the four regional districts
to discuss the projections and planning problems. In addition to the new reports,
several previous reports were brought up to date and reviewed. The Victoria district
hospital study prepared by outside consultants was analysed.
In connection with the above reviews, approval was given for preliminary planning of over 750 beds, the majority of these being for extended hospital care. These
approvals for planning were in addition to those outstanding in the previous year.
Apart from the activities previously mentioned, the group concerned itself with
other planning matters; for example, an examination with the Mental Health Branch
of the integration of mental health facilities with general hospitals.
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.
HOSPITAL INSURANCE SERVICE, 1968 M 19
(3) The wide range of in-patient benefits, together with the emergency outpatient, minor surgery, and day-care surgical 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
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.
M 20 BRITISH COLUMBIA
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
(f) 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.)
Emergency Services, Minor Surgery, and Day-care Surgical Services
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.
Day-care surgical services are available to patients who require operating-room
or other specialized treatment facilities, but who would be discharged within 24 hours.
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.
HOSPITAL INSURANCE SERVICE, 1968 M 21
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 patients 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); 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.
Approximately 96 per cent of all hospital accounts incurred in British Columbia
are the responsibility of the British Columbia Hospital Insurance Service. Cash
advances to hospitals are made on a semi-monthly basis, so that hospitals are not
required to wait for payment until patients' accounts are submitted and processed
by the British Columbia Hospital Insurance Service. Qualified patients are charged
$1 per day, which is deductible when calculating payments to hospitals from the
Service. Non-qualifying residents are charged the hospitals' established per diem
rates, which are all-inclusive; that is, the daily rate covers the cost of all the regular
hospital services, such as X-ray, laboratory, operating-room, etc., provided to
patients, in addition to bed, board, and nursing care.
ORGANIZATION AND ADMINISTRATION
The British Columbia Hospital Insurance Service is a branch of the Department
of Health Services and Hospital Insurance, the other branches being Health, and
Mental Health Services. The administrative head of the Hospital Insurance Service
is Mr. Donald M. Cox, F.A.C.H.A., Deputy Minister of Hospital Insurance.
M 22 BRITISH COLUMBIA
The following reports provide a brief outline of the work carried out during
1968 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 21), Chairman of the Special Services
Committee, Vice-Chairman of the B.C.H.I.S. Planning Group (see page 15), and
a member of the following committees: Advisory 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 Sub-committee on Finance, the Radiological Advisory Council, and the British
Columbia Hospitals' Association Liaison Committee.
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.
At the 1967 Session of the Legislature, two Acts were passed which changed
the method of financing hospital capital projects—the Regional Hospital Districts
Act and the British Columbia Regional Hospital Districts Financing Authority Act.
The Finance Division is responsible for reviewing the annual budgets prepared by
each regional hospital district as required by the legislation, and works closely with
the Hospital Financing Authority and the regional hospital districts in the financing
of hospital capital projects and repayment of debentures. During 1968 the Finance
Division assisted the regional hospital districts in debenture sales to the British
Columbia Regional Hospital Districts Financing Authority amounting to $19,936,-
000 and provided capital grants of approximately $575,000 toward the repayment
of principal and interest on capital borrowings of the regional hospital districts.
The Finance Division is also responsible for the approval of grants to assist
hospitals in the purchase of equipment. In 1968, after a review of approximately
5,000 applications received from hospitals, grants of approximately $1,800,000 were
approved on movable and fixed technical equipment costing $5,500,000.
As a means of assisting hospital employees to maintain high working standards,
the Hospital Insurance Service provided over $100,000 during the year to enable
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 and as a member of the Sub-committee on Hospital
Finance and Accounting (a sub-committee appointed by the Federal Government
to advise on the administration of the Hospital Insurance and Diagnostic Services
Act).
HOSPITAL INSURANCE SERVICE, 1968 M 23
Experience during the first few years' operation of the British Columbia Hospital Insurance Service indicated that operating costs required serious consideration
when planning new hospitals and additions to existing hospitals. In order to ensure
that plans for new hospitals or hospital additions are prepared with economical
and efficient operation in mind, a system of pre-construction operating budgets
is used.
The procedure requires a hospital to prepare an estimate of staff and other
costs, based upon a reasonable occupancy for the new area. These estimates are
submitted to the British Columbia Hospital Insurance Service and are reviewed by
the Hospital Rate Board in the same manner as normal operating estimates. It is
essential that the estimated operating costs of the new hospital, or new addition,
compare favourably with other hospitals actually in operation. Where the hospital's
pre-construction operating estimates do not indicate a reasonable operating cost,
it is necessary for the hospital board to revise its construction plans to ensure
efficient and economical operation. Once a satisfactory pre-construction operating
estimate has been agreed upon by the hospital officials and the British Columbia
Hospital Insurance Service, the hospital board is required to provide written guarantees relative to the projected operating cost. It is considered that this method of
approaching the operating picture for proposed hospital facilities ensures more
satisfactory planning, efficient use of hospital personnel, and an economical
operation.
Hospital Accounting
H. G. Benjamin, C.G.A., Supervisor
The work of the Hospital Accounting Section falls into three main categories:
(a) the detailed inspection, in the field, of the financial records of the hospital for
purposes of verification of annual and other financial statements; (b) the assembly
of relevant information and preparation of tabulations and other data, for the use
of the Hospital Rate Board in its review of the hospital's annual operating and pre-
construction estimates; and (c) the assembly of information and preparation of
data for the Deputy Minister in the review of the annual budgets of regional hospital
districts. Work in category (c) is a result of the passage of the Regional Hospital
Districts Act at the 1967 sitting of the Legislature. In carrying out the inspection
duties in 1968, visits were made at least once to each of 101 public general, rehabilitation, and extended care hospitals. The gross expenditures approved by the Hospital Rate Board for public general, rehabilitation, and extended care hospitals for
the year 1968 amounted to $131,000,000.
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.
M 24 BRITISH COLUMBIA
The Annual Report on Hospital Statistics, issued by the Department of Health
Services and Hospital Insurance and covering the administration of the Hospital
Act for the preceding year, is prepared by this office.
During 1968, construction projects involving expenditure of $2,430,000 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.
During the year a number of experienced accounting inspectors left the Service,
and difficulties were encountered in obtaining suitable replacements, resulting in
a delay in the audit of construction projects and annual inspectional visits to
hospitals.
Hospital Claims Section
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. Assistance is provided to hospitals by the
Section in the proper method of submitting the individual accounts. This is
accomplished by correspondence, telephone, and personal visits. During the year
the supervisor visited hospitals in the Vancouver Island and Lower Mainland areas.
Day-care surgical service procedures, inaugurated in February, 1968, required
a new set of forms and procedures. These were planned in close consultation with
the Medical Consultant's staff and the Director of Research. The information
obtained on the new form is transferred to a statistical I.B.M. card for eventual
processing by the Data Processing Centre. These accounts were in excess of 11,000
for the period of March 1 to December 31, 1968.
The filing, accounting, and review of the quarterly billing for extended care
hospital patients continued to increase in volume as new units were added to hospitals or new hospitals added to the programme. The number of different procedures
required also increased because of changes to the welfare regulations regarding
extended-care patients, and the change in registering all welfare recipients with the
British Columbia Medical Plan.
Research and adjustments to accounts, due primarily to changes of responsibility, showed an increase in volume.
Accounts processed were in excess of 1,600 per working-day for in-patients,
and over 800 emergency-service or minor-surgery account forms were handled per
working-day. Discussions with the Data Processing Centre were held regarding the
efficient use of the I.B.M. electronic data-processing equipment. These included
discussions on the designing of the key-punch card in relation to the day-care surgical
accounts, out-of-Province accounts, and special surveys.
A brief outline of the work and duties performed by the various offices of the
Hospital Claims Section 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; during the year over
7,200 had to be returned to hospitals because they were incomplete or unacceptable.
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 in the co-operation between the British Columbia
Hospital Insurance Service and hospitals, the supervisor of Admission Control
visited hospitals in the Lower Mainland area and on Vancouver Island for discussions of the procedures being used for verification of the residence of patients.
HOSPITAL INSURANCE SERVICE, 1968
M 25
The Accounts Payment staff pre-audits the charges made to the British Columbia Hospital Insurance Service, and ensures that all information shown on each
claim is completed so that it can be coded for statistical purposes, and that it is
charged to the correct agency, such as to the British Columbia Hospital Insurance
Service, Workmen's Compensation Board, the Department of Veterans Affairs, or
other Provinces and Territories. During the year over 650 queries per month on
such accounting matters were addressed to British Columbia hospitals.
Preliminary figures for 1968 show that more than 390,000 accounts (excluding
out-of-Province) were processed. For comparison the figures for 1967 were
382,157 processed.
The staff of Social Welfare Records continued to maintain the alphabetical file
of all health services identification cards issued to welfare recipients in this Province.
Over 38,000 hospital accounts incurred by welfare recipients were checked to this
file to determine eligibility for hospital benefits.
The new procedures which followed the Department of Social Welfare changes
necessitated extra work in locating cards which were recorded differently subsequent
to November 1st while a change-over period existed from July 1st to November 1st.
The new system required a new file to accommodate some 65,000 forms, with
changes being received daily from welfare offices in British Columbia.
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 for morbidity statistics for the
Research Division. New procedures included the new out-of-Province account
cards and the day-care surgical services account cards.
The Out-of-Province personnel process 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 1968 over 4,400 accounts, amounting to an estimated $1,000,000, were 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; Austria, Australia,
Belgium, British Honduras, British West Indies, England, France, Grand Canary
Islands, Greece, Holland, Hong Kong, Hungary, Iran, Israel, Italy, Japan, Mexico,
New Zealand, Norway, Phillipines, Portugal, Scotland, South America, Spain,
Sweden, Switzerland, Tahiti, Trinidad, and West Germany.
Correspondence to accomplish the procedures amounted to over 17,000 letters
for the year. This office also compiles up-to-date hospital rate schedules for every
approved hospital in Canada. Commencing January 1, 1968, all accounts were
coded for statistical purposes and an I.B.M. card punched for each account.
The Filing and Mail Unit sorted and filed over 5,500 documents and letters
daily, an increase of 500 over last year. The filing system was expanded and new
procedures instituted, in order to accommodate the increase. A survey was completed in order to assess the possibility of installing open-shelf files to replace the
older cabinet files.
M 26
BRITISH COLUMBIA
Many factors contribute to increasing hospital costs. These include the
need for complex diagnostic and
operating-room equipment, specialized dietetics, and professional personnel on 24-hour duty. This is a
photograph of the biochemistry laboratory in the new diagnostic
laboratory building at St. Paul's
Hospital, Vancouver (1962).
4
3
Adequate provision for psychiatric care in general
hospitals is part of the modern patient-care concept.
This is the patients' lounging area, overlooking an
enclosed landscaped patio, in the Bay Pavilion of the
Royal Jubilee Hospital, Victoria.
In addition to the new hospitals
constructed during the past 20
years (see pages 30 and 31),
several major projects not involving patient beds have also
been built. These have included
new diagnostic and treatment
areas, laboratories, emergency
departments, laundry buildings,
and nurses' residences and
training-schools.
Modern lecture facilities are an
important feature of the new 195-
bed nurses' residence and training-
school at the Royal Columbian
Hospital, opened in May, 1962.
It is one of six nurses' training-
schools in British Columbia.
HOSPITAL INSURANCE SERVICE, 1968 M 27
Hospital Construction and Planning Division
The primary responsibilities of this Division may be summarized as follows:—
(1) Working with hospital boards of management and hospital construction
and planning committees in the development of programmes for the
construction of new hospital facilities, and additions to and renovations
of existing hospitals.
(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,
both at the sketch-plan stage and the working-drawing stage. Drawings and the
architectural programme, which evolves from the hospital's functional programme,
are reviewed with the various professions either existing in the Consultation,
Finance, or Medical Consultation Divisions, or allied organizations such as the
Radiology Advisory Council and the Laboratory Advisory Council.
Reviews are made with several objectives, but basically the intent is to ensure
that, in terms of the construction funds available, the greatest benefit will obtain
and that funds are distributed in an equitable fashion. Thus remarks are made
including consideration on alternate solutions which may produce a better plan for
the same amount of money, on items which are felt might have an unwarranted
influence on operating costs, and on items which are felt to be not in keeping with
the philosophy of the lower initial cost consistent with good service and acceptable
standards. Such remarks may be supported by alternate suggestions.
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
operation. Some of the elements included in designs for mechanical systems for
new hospital buildings that reflect this approach included air recirculation and
zoned heating and ventilating controls.
The criteria for installation of heat recovery systems has now been completely
reviewed in line with changes in interest rates on capital funds. Reduced application of air-conditioning systems has been included in new projects in recognition of
the need to provide over-all comfort and environmental levels within hospitals consistent with acceptable capital and operating costs.
Satisfactory mechanical plant operation in hospitals will be considerably
assisted by virtue of a new approach in the compilation of maintenance manuals
which will also incorporate a system of planned preventive maintenance. Such
schemes are being incorporated with the design stage of hospital projects. Consultative advice is given to hospitals as well as other departments of the Hospital
Insurance Service in the fields of plant operation and equipment selection.
Liaison was 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. An architect on the Division's staff
is a member of this committee.
M 28 BRITISH COLUMBIA
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 professions, 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, and the Technical Supervisor of Radiology. 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.
Continuing benefit was derived from the co-operation of the Department of
Public Works by assigning architects to this Division. With this architectural
assistance it has been possible to prepare, in a number of cases, sketch-plans in
support of layouts representing the Service's recommended approach to planning
problems.
During 1968 the architects and engineer attached to the Division made a number of inspectional visits to hospitals throughout the Province, and one visit was
made to several hospitals in the Toronto area.
The Division provided architectural and engineering representation on the
sub-committee of the B.C.H.I.S. Planning Group which had the responsibility of
developing a programme for design of 150-bed extended care hospitals. This subcommittee will remain active during the compilation, by an architectural team, of
drawings and descriptions of all the components of a model extended care hospital.
At the end of March, Mr. A. W. E. Pitkethley, Manager of the Construction
Division for 19 years, retired and was replaced by Mr. John G. Glenwright, formerly
of the Consultation Division, who filled the position until October, at which time
he resigned to become the administrator of the Matsqui-Sumas-Abbotsford General
Hospital. The position of Manager of the Division at the time of writing this report
had not been filled. Mr. O. B. Padden, who was attached to the Division as a senior
architect for approximately 10 years, left the Service in June to take up private
practice.
(a) Hospital Projects Completed during 1968
Campbell River and District General Hospital, Campbell River.—A new wing
for extended-care patients was opened at this hospital on July 13, 1968. The unit
contains 25 beds plus unfinished space for 15 more beds.
St. Joseph's General Hospital, Comox.—The final stage of expansion programme at the Comox hospital was completed when a 45-bed extended-care unit
was officially opened on September 7, 1968, in a renovated wing of the old hospital.
This unit is connected to the new acute hospital, completed last year, from which it
will receive services.
Cranbrook and District Hospital, Cranbrook.—On August 31, 1968, the Honourable Ralph R. Loffmark, Minister of Health Services and Hospital Insurance,
opened the new hospital complex at Cranbrook, consisting of a new acute hospital
of 75 beds, plus space for 15 additional beds when required in the future, and a wing
for 35 extended-care beds.
Enderby and District Memorial Hospital, Enderby.—A construction programme consisting of additions and renovations to this hospital, including an increase
of 3 beds, was finished in November of this year.
Providence Hospital, Fort St. John.—A further 15 beds were completed and
brought into service this year, bringing the total capacity of the hospital up to 100
beds.
HOSPITAL INSURANCE SERVICE, 1968 M 29
Royal Inland Hospital, Kamloops.—Renovations were carried out to provide
a 3-bed renal-failure unit.
Langley Memorial Hospital, Murrayville.—The old hospital building at this
hospital was renovated to accommodate 40 extended-care and 10 activation patients.
This unit was officially opened on February 11, 1968.
Royal Columbian Hospital, New Westminster.—A project to increase and improve the electrical service to the Royal Columbian Hospital was completed by the
year-end.
Pouce Coupe Community Hospital, Pouce Coupe.—The Honourable Donald L.
Brothers opened a 26-bed extended-care unit at this hospital on October 26, 1968.
The construction programme also included the expansion of the kitchen, administrative area, etc., and renovations to the existing hospital.
Powell River General Hospital, Powell River.—On July 5, 1968, an addition
and alterations project was officially opened by the Honourable Ralph R. Loffmark
at Powell River. The programme resulted in a 26-bed extended-care unit, with space
for 8 future beds and a new and enlarged emergency department and kitchen, cafeteria, etc.
Prince George Regional Hospital, Prince George. — The services expansion
project, consisting of additions and renovations to provide enlarged laboratory,
radiological and emergency departments, etc., was completed at this hospital.
Mills Memorial Hospital, Terrace.—This hospital has added a new floor containing patients' beds over an existing first-floor service area, and an addition at the
main-floor level accommodating new emergency and physiotherapy and occupational-therapy departments and an enlarged laboratory and X-ray department. The
new area, including a 4-bed intensive-care unit, was ready for patients in December,
although the project, including renovations, is not to be officially opened until January, 1969. When the programme is finished, the hospital will have a capacity of
87 acute beds.
British Columbia Cancer Institute, Vancouver.—An addition to the building to
provide further radiotherapy facilities was completed this year.
Louis Brier Hospital, Vancouver.—The Jewish Home for the Aged of British
Columbia Society has completed the construction of a combined extended-care unit
of 60 beds and 50-bed boarding home. The two units share lounge, physiotherapy
and occupational therapy, administrative, kitchen, and laundry facilities.
St. Paul's Hospital, Vancouver.—A major renovation programme, begun in
1966, was finished this year. The projects involved the dietary department, four
elevators, a medical intensive-care unit, new sisters' quarters, premature nursery and
special-care unit for children, the extension of the recovery room, provision of an
isotope laboratory and X-ray special-procedures room, as well as other extensive
renovations in the basement and on the main floor.
Vancouver General Hospital, Vancouver.—The Honourable Wesley D. Black
opened the 12-bed renal-failure unit at this hospital on May 1, 1968.
Vernon Jubilee Hospital, Vernon.—A programme of extensive alterations, as
well as additions, including a 60-bed extended-care wing, was completed and officially opened by the Minister of Health Services and Hospital Insurance, the Honourable Ralph R. Loffmark, on June 20, 1968. The hospital now has a total of 117
acute beds, including an 11-bed psychiatric unit, a new surgical suite and kitchen,
and enlarged emergency, X-ray, laboratory, and physiotherapy departments.
1949
1952
51
■ ■ .
* '
Fernie.
Burnaby.
1958
These photographs ar
pitals which have bet
past 20 years. Thf
grants-in-aid amountii
total costs
1953
1954
■IIII1IKS
(IIf1111 f!
[■IIIHJ
iiumiiimi
III!
Abbotsford.
iff!
■ ■ ■
'-—*.%—- "v _. Pjg.
Vancouver (St. Vincent's).
1959
als
the over 50 new hos-
Columbia during the
rnment has provided
68,000,000 toward the
onstruction.
ItlCljl
Vancouver (Centennial Building,
Vancouver General Hospital).
1963
Fort St. John.
Nanaimo.
1968
Comox.
M 32 BRITISH COLUMBIA
Peace Arch District Hospital, White Rock.—The new acute hospital at White
Rock was opened by the Honourable Ralph R. Loffmark on July 4, 1968. The
new building contains 106 acute beds and diagnostic, treatment, and service departments. The adjoining old hospital building was subsequently renovated to provide
42 extended-care beds.
St. Joseph's Hospital, Victoria.—During the year extensive alterations, including electrical and mechanical revisions, were carried out to improve the radiological
department.
Royal Jubilee Hospital, Victoria. — A 4-bed coronary unit was brought into
operation in March this year.
(b) Projects under Construction at Year-end
Matsqui-Sumas-Abbotsford General Hospital, Abbotsford.—Construction of
an addition to increase the bed capacity to a total of 109 beds, plus 12 unfinished
initially, and renovations to the existing hospital.
Castlegar and District Hospital, Castlegar.—Construction of additions and
renovations to provide a total of 60 acute beds.
Creston Valley Hospital, Creston.—Construction of an addition and renovations to existing areas to provide a total of 44 acute beds, plus 8 unfinished.
Kelowna General Hospital, Kelowna.—Construction of new acute block of
153 beds and enlarged service departments.
Lillooet District Hospital, Lillooet.—Temporary prefabricated addition to provide 12 paediatric beds.
Royal Columbian Hospital, New Westminster.—Renovation work to provide a
4-bed trauma unit in the emergency department.
West Coast General Hospital, Port Alberni.—Completion of top floor and
additional construction which will increase the hospital's capacity to 139 acute beds
and 30 extended hospital care beds. The project includes renovations of existing
areas and construction of additions to provide enlarged service departments.
Princeton General Hospital, Princeton.—New 25-bed acute hospital.
G. R. Baker Memorial Hospital, Quesnel.—Completion of 22 beds and renovations.
Queen Victoria Hospital, Revelstoke.—Construction of new 50-bed hospital
with space for 10 more beds.
Surrey Memorial Hospital, Surrey.—Construction of new additions to provide
a further 150 finished beds and 108 unfinished, plus renovation of the existing
hospital.
Trail-Tadanac Hospital, Trail.—Two separate projects are currently under
way—one to provide a regional laboratory and 24-bed psychiatric unit and the
other a 50-bed extended hospital care unit.
Canadian Red Cross Society, British Columbia-Yukon Division, Vancouver.—
New facilities for its blood transfusion service.
Children's Hospital, Vancouver.—Metabolic investigation unit.
Royal Jubilee Hospital, Victoria.—Major laboratory addition and renovation.
(c) Projects in Advanced Stages of Planning
Lady Minto Hospital, Ashcroft.—Replacement.
Burnaby General Hospital, Burnaby.—Expansion and renovation programme.
Burns Lake and District Hospital, Burns Lake.—Additions and renovations.
Chetwynd and District Hospital, Chetwynd.—New facility of 30 beds.
Chilliwack General Hospital, Chilliwack.—Additions and renovations.
HOSPITAL INSURANCE SERVICE, 1968 M 33
Fort St. James Hospital, Fort St. James.—New facility of, 25 beds.
Fraser Canyon Hospital, Hope.—Expansion and renovations.
Victorian Hospital, Kaslo.—Replacement.
Kelowna General Hospital, Kelowna.—Extended-care unit and renovations.
Nanaimo Regional General Hospital, Nanaimo.—Additions and renovations.
Royal Columbian Hospital, New Westminster.—Additions and renovations.
Lions Gate Hospital, North Vancouver.—Extended-care unit.
Penticton Hospital, Penticton.—Expansion, renovations, and extended-care
unit.
Prince Rupert General Hospital, Prince Rupert.—Replacement.
Shuswap Lake General Hospital, Salmon Arm.—Expansion.
St. Mary's Hospital, Sechelt.—Expansion programme and extended-care unit.
Surrey Memorial Hospital, Surrey.—Extended-care unit.
Vancouver General Hospital, Vancouver.—Extended-care unit and Willow
Pavilion renovations, also construction of haemodialysis training unit.
St. Paul's Hospital, Vancouver.—Renovation and expansion programme.
Health Sciences Centre, University of British Columbia, Vancouver.—New
hospital facility (Stage III).
St. John Hospital, Vanderhoof.—Replacement.
Windermere District Hospital, Invermere.—Expansion.
(d) Additional Projects Approved and in Various Planning Stages in 1968
R. W. Large Memorial Hospital, Bella Bella.—Replacement.
Campbell River and District General Hospital, Campbell River.—Expansion
of acute hospital.
St. Joseph General Hospital, Dawson Creek.—Expansion.
Cowichan District Hospital, Duncan.—Extended-care unit.
Fernie Memorial Hospital, Fernie.—New hospital to serve Fernie and Michel
areas.
Golden and District General Hospital, Golden.—Expansion and 4-bed extended-care unit.
Boundary Hospital, Grand Forks.—Completion of 5 acute beds and provision
of 14 extended-care beds.
Wrinch Memorial Hospital, Hazelton.—Replacement of acute hospital plus 7
extended-care beds.
Royal Inland Hospital, Kamloops.—Expansion, including extended-care unit,
psychiatric and activation/rehabilitation beds.
Lillooet District Hospital, Lillooet.—Expansion of acute beds plus approval
to plan 6 extended-care beds.
Arrow Lakes Hospital, Nakusp.—New hospital to serve Nakusp and New
Denver.
Lions Gate Hospital, North Vancouver.—Expansion of services.
Ocean Falls General Hospital, Ocean Falls.—Replacement.
St. Martin's Hospital, Oliver.—Replacement.
Richmond General Hospital, Richmond.—Extended-care unit.
Bulkley Valley District Hospital, Smithers.—Expansion.
Squamish General Hospital, Squamish.—Renovations and improvements.
Prince George Regional Hospital, Prince George.—Expansion programme.
Children's Hospital, Vancouver.—Replacement.
Holy Family Hospital, Vancouver.—New activation unit and renovation of
existing building for extended care.
M 34
BRITISH COLUMBIA
Mount St. Joseph Hospital, Vancouver.—New acute unit and renovation of
existing hospital for extended care.
St. Vincent's Hospital, Vancouver.—Expansion and renovations and extended-
care unit.
G. F. Strong Rehabilitation Centre, Vancouver.—Expansion.
Vancouver General Hospital, Vancouver.—New activation/rehabilitation unit.
Priory Hospital, Victoria.—Extended-care unit.
Royal Jubilee Hospital, Victoria.—Renovations.
St. Joseph's Hospital, Victoria.—Expansion.
Cariboo Memorial Hospital, Williams Lake.—Expansion.
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 Assistant Deputy Minister. He is Chairman of the B.C.H.I.S. Planning Group and Vice-Chairman of the Hospital Rate Board. The work undertaken
during the year in connection with these activities is outlined in pages 15 and 21
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;
and the Sub-committee on Quality of Care and Research, Ottawa.
Reports of the activities undertaken by the two Divisions responsible to the
Director follow.
Hospital Consultation and Inspection Division
J. Bainbridge, Manager
This Division provides public and private hospitals with consultative services
in all matters of hospital operation and administration. It is responsible for an
inspectional programme to ensure basic standards are met, and for the licensing of
private hospitals regardless of the type of care given. Its staff is composed of
administrative, nursing, dietary, and management engineering consultants.
The Division co-operates with all other divisions of the Service in achieving
aims of mutual interest and responsibility. It is accountable for the analysis and
subsequent recommendations for approved staffing patterns resulting from hospital
estimates, both annual and otherwise, and the Manager is a member of the Hospital
Rate Board. Staff members also participate in the planning function of British
Columbia Hospital Insurance Service, including the review of the operational implications of construction projects and the setting of standards. Sketch-plans are
analysed and assessed in conjunction with the Hospital Construction and Planning
Division. The Division represents the Service on a large number of councils, committees, and working parties associated with hospitals and the health field, and
works with Federal, Provincial, and municipal representatives on related matters.
During 1968, 109 staff visits were made to acute, rehabilitation, chronic, convalescent, and extended care hospitals. In addition, 160 visits by nursing and other
staff consultants were made to private hospitals giving nursing-home care.
(Continued on page 36.)
HOSPITAL INSURANCE SERVICE, 1968
M 35
A nursing consultant from the staff
of the British Columbia Hospital
Insurance Service is photographed
during a routine hospital inspection.
This is one of several professional
counselling services available to the
hospitals of the Province.
.*«!%
This standard (public) ward is typical of the accommodation available
in British Columbia's modern hospitals. A 4-bed ward designed for
the patient's comfort and convenience, it features reading-lamps, individual lockers, and a nurses' call
system.
Nurses' residence and training-school of the
Royal Inland Hospital, Kamloops (1964).
M 36 BRITISH COLUMBIA
The Division's management engineering unit was expanded during the latter
part of the year with the addition of three new members, and has been functioning
at maximum capacity in response to numerous requests from hospitals for studies
on a wide variety of subjects. These included studies on hospital organizational
structure, dining arrangements in an extended care hospital, medical records departments and records storage, waste-disposal systems, central sterilizing systems,
materials-handling, and the layout of a hospital's X-ray and laboratory services.
Members of the unit have also taken part in hospital educational seminars to stimulate the use of work simplification in hospitals. A library of reference material is
currently being assembled.
Personnel of the Division attended a variety of educational sessions during the
year, as a necessary means of keeping abreast of changing concepts and techniques
in the hospital field.
During 1968 Mr. J. G. Glenwright, administrative consultant, left the Division
to become Manager of the Hospital Construction and Planning Division. Messrs.
D. Giles and E. Zulkowski, administrative consultants; L. Mann, J. Reeve and
F. Lohner, management engineering consultants; and Miss J. DesJardins, nursing
consultant, all joined the staff of the Division during the year.
The Division continues to process an increasing number of requests for
statistical information pertaining to morbidity data and hospitalization experience.
Research Division
D. S. Thomson, B.A., Director
The Research Division is responsible for compiling and maintaining statistical
data relating to hospitalization and morbidity in British Columbia. The Admission-
Separation Records submitted by the hospitals for each in-patient serve as the major
source of reference in deriving statistical information. The data used are keypunched 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 prints out the required tabulations.
The hospital data are used extensively in the bed requirement studies that the
Division carries out each year, and are also made available to independent consultants engaged in similar studies. These studies, which become the basis of hospital
planning decisions, have become increasingly important as the newly formed regional
hospital districts become active in hospital planning. To aid in these studies, the
Research Division makes an annual review of economic and population growth and
prepares population estimates for the Province's school districts. School districts
also serve as convenient planning areas for bed studies, and by grouping these districts together to correspond with the regional hospital district areas, it is possible
to gather relevant hospital data.
The Division is responsible for the publication of several annual bulletins
which have, over the years, been useful to various research groups and agencies
throughout the Province and Canada. " Statistics of Hospital Cases Discharged in
1967 " includes 10 standard morbidity tables as suggested by the Federal Advisory
Committee on Hospital Insurance and Diagnostic Services, along with an analysis
of the Province's hospitalization experience by race, age, geographical location,
major diagnostic group, and type of service. " Statistics of Hospitalized Accident
Cases " provides a broad analytical coverage of hospitalized accidents by circumstance, type of accident, and by nature of injury. Another bulletin prepared and
issued by the Division was an Alphabetical Listing of Place-names in British Columbia with Geographical Code. In addition, a number of statistical tables entitled
HOSPITAL INSURANCE SERVICE, 1968 M 37
" Hospital Indicators " were circulated to all hospitals. These indicators allow the
individual hospital to focus attention on its own performance as well as making a
comparison with hospitals of a similar size-group. A further series of reports produced by this Division involved an analysis of patient-flow patterns within five of
the larger regional hospital districts.
In connection with the 10 standard morbidity tables approved in 1961, a
working party was convened in Ottawa, February 12 to 16, 1968, at the request of
the Advisory Committee on Hospital Insurance, to review hospital morbidity statistics. The working party, which included the Director of the Research Division,
developed proposals for uniform reporting of hospital morbidity data.
As the field of hospital development takes on an increasing and more complex
role in the provision of health care, a continuing study is being made of the assessment of hospital bed needs. With the co-operation of several hospitals regarding
the utilization of their records, a waiting-list study was undertaken and completed
during the year. A Province-wide study is presently being carried out to determine
the over-all bed needs by school district and by regional hospital district to serve
as a planning guide for future hospital programmes. Now in its final stage of completion, it is concerned with the patient movement among the regional hospital
districts and among the major referral centres within the Province. Its object is
to define these patterns of movement and, along with population projections, to
ascertain the bed need requirements to a future date.
The Division continues to process an increasing number of requests for statistical information pertaining to morbidity data and hospitalization experience.
In November, 1968, Mr. D. Belton, B.Sc, joined the staff as a research officer,
filling the position previously held by Mr. P. Pallan, who enrolled in a programme
of hospital administration and is on an educational leave of absence.
Medical Consultation Division
C. F. Ballam, M.D., Medical Consultant
The Admission-Separation Record for each patient admitted to a hospital
either in British Columbia or while out of Province 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 medical coders. The competence and accuracy applied
to this work is reflected in the statistical end-product, and to ensure a continuing
high standard all coders at the British Columbia Hospital Insurance Service are
graduate nurses. These statistical data are basic to planning decisions for expanding or developing hospital facilities generally and special departments in certain
hospitals in particular. In addition, this coded information is utilized by the
Research Division of the British Columbia Hospital Insurance Service and the
Dominion Bureau of Statistics for the publication of hospital morbidity and mortality data. 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 Medical Record Consultant visited 20 hospitals during the year. On
these visits, medical record department problems are identified, and assistance and
advice are offered with a view to encouraging a high standard of medical recordkeeping, in accordance with the guidelines laid down by the Canadian Council on
Hospital Accreditation. The needs of the British Columbia Hospital Insurance
Service for statistical and research studies are also clarified with the hospital medical
M 38 BRITISH COLUMBIA
record personnel. Membership and participation on the Perinatal Morbidity and
Mortality Study Committee of British Columbia and the Education Committee of
the British Columbia Association of Medical Record Librarians is maintained,
ensuring further liaison with hospital medical record personnel.
In co-operation with such bodies as the Faculty of Medicine of the University
of British Columbia, the College of Physicians and Surgeons of British Columbia,
and other departments of government, special medical research projects have been
a part of the work of this Division. These studies have been greatly benefited by
legislation making the data of such studies privileged information and not subject
to litigation.
Extended care hospital coverage was introduced in December, 1965, and
greatly increased the tasks of the Medical Consultation Division. The assessment
and review of individual patients' applications continue to provide an increasing
work load. A quarterly review of all extended care hospitals is undertaken, with
two purposes—(1) a medical audit, to ensure patients continue to be medically
qualified for this benefit, and (2) for the purpose of reviewing and assisting in the
treatment programme provided by the hospital—in order that the care which the
patient receives is commensurate with current thinking in the management of
chronically disabled individuals. The Medical Consultation Division has the
assistance of qualified consultants in physical medicine to bring the weight of their
specialized knowledge to this programme. Several new extended-care units were
opened during the year, increasing the application review load, but additionally demanding professional consultation to implement treatment programmes in these new
units.
Dr. D. G. Adams, Assistant Medical Consultant, has major administrative
supervisory responsibility for the Coding Division and the survey and review projects previously mentioned. In addition, administration of the medical aspects of
the extended-care programme is under his supervision. Management of the day-today problems which arise in the administration of these matters enables Dr. Adams
to participate with the Medical Consultant in the preparation of policy recommendations to the Deputy Minister, with the anticipation that Service policy can be
adjusted to meet current hospital conditions and needs.
In February, 1968, day-care surgical services were approved as a hospital insurance benefit. Legislation has therefore been adopted to accommodate an altering
pattern of medical practice. This form of practice has improved the utilization of
our health facilities, and the Medical Consultant continues to advise the Service in
its planning for an expanded role in ambulatory patient-care. In a similar fashion
to the in-patient admission records, all day-care surgical services records are assessed
and coded according to the International Classification of Diseases, so that these data
may be tabulated and the subject of statistical review.
The Medical Consultant, while maintaining responsibility for the foregoing,
also ensures active liaison through visits to hospitals, special disease groups, societies,
and health agencies. Liaison with the British Columbia Medical Association, and
active participation on its Hospitals Committee and the Advisory Sub-committee
for Chronic Renal Failure, continued during the year. New committees to consider
radioisotope facilities and intensive coronary-care services were set up by the British
Columbia Medical Association at our request, and both Medical Consultants participate directly with these advisory bodies.
The encouragement of hospitals to achieve accreditation standards imposes
certain pressures to conform to the requirements of accreditation, and when these
pressures produce problems for the medical staff of the hospital, the Medical
Consultant is able, with the assistance of the Hospital Consultation and Inspec-
HOSPITAL INSURANCE SERVICE, 1968 M 39
tion Division, to render assistance. The Medical Consultant gives advice to this
Service on the proposed addition or extension of medical services in hospitals. It
follows that new treatment services require additional equipment, and today not only
must the traditional hospital departments be supplied with modified equipment, but
new technology in the bio-medical sciences is introducing new diagnostic and treatment services, often demanding equipment which was unheard of 5 to 10 years ago.
There is a constant and rising demand to keep abreast of the change in medicine and
to call upon ancillary consultative advice from specially talented individuals, as well
as organized technical groups from the profession. The resources of other Government departments—namely, the Health Branch and Mental Health Services—are
utilized where problems are related to these special fields, and particularly where
the treatment services being made available in acute general hospitals must be complementary to those services being provided through Health Branch and mental
health agencies; additionally, of course, the Social Welfare Department is similarly
involved.
The Medical Consultant and the Assistant Medical Consultant participate in
the postgraduate continuing medical education programmes sponsored through the
university and the British Columbia and local medical societies, as well as special
and pertinent continuing medical education seminars or courses offered outside
British Columbia.
Administrative Officer
K. G. Wiper
The Administrative Officer is responsible for the drafting of legislation, regulations, and Orders in Council for the British Columbia Hospital Insurance Service.
In the performance of these duties, a close working relationship exists between this
office and the Attorney-General's Department.
Hospital societies may apply to the Administrative Officer for assistance in
connection with the drafting of hospital constitutions and by-laws, and their interpretation and application. 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.
Under the Regional Hospital Districts Act, described earlier in this Report, the
Administrative Officer has worked closely with the officials of other departments
and of the various districts in establishing regional hospital districts, arranging for
money by-laws, temporary borrowing, and related matters.
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 so 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 1968 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 General Office and the Third Party Liability and the Eligibility Sections.
M 40 BRITISH COLUMBIA
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
British Columbia Hospital Insurance Service 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.
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.
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
The supervision of internal administrative accounting, purchasing, payroll, and
supplies continued to be the main function of the General Office.
The preparation of annual Departmental estimates is also a responsibility of
this office, and this is done in consultation with Division Managers.
The General Office provided assistance to the Construction and Planning Division in processing grants toward hospital alterations and renovations, and also provided periodic stenographic services to various other offices during the year.
HOSPITAL INSURANCE SERVICE, 1968 M 41
The Supervisor, in his capacity of Safety Officer, prepared a number of circulars for hospitals dealing with various aspects of hospital safety. These circulars
were prepared in conjunction with the Hospital Consultation and Inspection Division. Articles dealing with hospital safety are prepared for each issue of the British
Columbia Hospital Insurance Service " Bulletin."
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 1968.
With increased activity on the part of hospitals in developing in-service training programmes, considerable effort was made during the year to augment the
audio-visual aids available to hospitals from the British Columbia Hospital Insurance
Service film library. Staff consultants viewed 18 motion-picture films on various
subjects, and two filmstrip series which dealt with long-term care and hospital housekeeping. As a result of these screenings, both filmstrip series were purchased, as
well as two 16-mm. films on the subjects of management engineering and hospital
fire safety. Growing interest on the part of hospitals in audio-visual presentations
was shown in the increased use made of the film library in 1968, when an estimated
3,500 hospital staff viewed 178 separate film presentations. The availability of
these films on a loan basis makes it unnecessary, in many instances, for hospitals
to purchase their own films for in-service training.
Revision of the British Columbia Hospital Insurance Service Manual on
Policy, Organization and Procedures was continued, and several replacement pages
were printed, together with a revised 25-page index. Approximately 150 pages
of the original 270-page manual have now been replaced, and 29 pages have been
added.
Minor revisions were made to the B.C.H.I.S. exhibit at the British Columbia
Building at the Pacific National Exhibition. It is anticipated that the entire Departmental display will require major renovations in the near future in order to make it
as attractive and interesting as possible.
The " General Information " pamphlet was again revised and reprinted, and
early in the new year copies will be forwarded to civic organizations, business and
industry, Government Agents, and " Welcome Wagon " representatives.
The volume of press releases issued during the year increased considerably,
as efforts were made to ensure that the public, through the news media, was kept
aware of various hospital construction programmes, Governmental policy changes,
and other items of public interest.
Regular editions of the B.C.H.I.S. Bulletin were published during the year for
distribution to all public hospitals and licensed private hospitals. The B.C.H.I.S.
Bulletin is an administrative aid used to clarify policy and procedural changes for
hospital personnel as well as publishing articles of general interest.
January 1, 1969, will mark the 20th anniversary of the British Columbia
Hospital Insurance Service, and a publicity programme to commemorate the event
included the development of a display for public exhibition, and preparation of
special material for distribution to the news media.
Other duties included the drafting of speeches, the summarizing of reports for
the information of the Deputy Minister, maintaining the newspaper and hospital
photograph files, replying to general correspondence, and the preparation and
editing of the 20th Annual Report.
M 42
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.
Cowichan District Hospital, Duncan.
Cranbrook and District Hospital, Cranbrook.
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.
Kitimat General Hospital, Kitimat.
Kootenay Lake General Hospital, Nelson.
Lady Minto Hospital, Ashcroft.
Lady Minto Gulf Islands Hospital, Ganges.
Ladysmith and District General Hospital,
Lady smith.
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 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.
* Ceased operation September 14, 1968, and replaced by Cranbrook and District Hospital, Cranbrook.
HOSPITAL INSURANCE SERVICE, 1968
Outpost Hospitals
Red Cross Outpost Nursing Station, Alexis
Creek.
Red Cross Outpost Nursing Station, Atlin.
Red Cross Outpost Nursing Station, Bam-
field.
Red Cross Outpost Nursing Station, Blue
River.
M 43
Edge-
Red Cross Outpost Nursing Station,
wood.
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.
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. Port Alice Private Hospital, Port Alice.
Cassiar Asbestos Corporation Private Hos- Tasu Hospital, Tasu Sound, Queen Char-
pital, Cassiar. lotte Islands.
Mica Creek Private Hospital, Mica Creek.
Other
Hollywood Hospital Ltd., New Westminster (licensed under the Mental Health Act).
Rehabilitation, Chronic, and Convalescent Hospitals
Berkeley Private Hospital, White Rock.*
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.)
* Became part of Peace Arch District Hospital,
November 27, 1968.
Extended Care Hospitals
Mount St. Mary Hospital, Victoria (excluding top floor).
Mount St. Francis Hospital, Nelson.
Mount St. Joseph Hospital, Vancouver (top
floor).
Menno Hospital, Abbotsford.
Priory Hospital, Colwood (24-bed unit and
71-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).
The Louis Brier Hospital, Vancouver.*
* Opened December 22, 1968.
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 1968 there were 90 public general hospitals approved
to accept British Columbia Hospital Insurance Service patients. Care was also
M 44 BRITISH COLUMBIA
provided in eight outpost hospitals, five Federal hospitals, seven contract hospitals,
five public rehabilitation hospitals, and one rehabilitation hospital operated by the
Provincial Government. Hospital insurance coverage for patients in non-profit
extended care hospitals and units commenced December 1, 1965. At the end
of 1968 there were 20 hospitals providing extended care. Data for the year 1968
had 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 328,433 British Columbia Hospital Insurance
Service adult and children patients were separated (discharged) from British Columbia hospitals in 1968, an increase of 16,715 or 5.3 per cent over 1967. This table
also shows that 95.7 per cent of the total patients separated (discharged) from
British Columbia public hospitals were covered by hospital insurance, compared
to 95.2 in 1966 and 95.3 in 1967. Table 1b indicates in 1968 that the British
Columbia Hospital Insurance Service paid public hospitals in British Columbia
for 3,099,840 days of care for adults and children, an increase of 153,840 days or
5.2 per cent over 1967.
As shown in Table 2a, the average length of stay of British Columbia adult
and children patients in public hospitals during 1968 was 9.44 days, and the days
of care per thousand population were 1,771. For comparison purposes, the data
for extended care hospitals is not included in the above observations, but it should
be noted that an additional 202 days of care per thousand population were provided
for these patients.
Table 2b, under " Minor Surgery Patients," includes an estimated 11,500 daycare surgery patients from March 1, 1968. An additional estimated 30,000 outpatient cancer treatments were covered by the British Columbia Hospital Insurance
Service, which are not included in this table.
HOSPITAL INSURANCE SERVICE, 1968
M 45
Table 1a. — Patients Separated (Discharged or Died) and Proportion
Covered by British Columbia Hospital Insurance Service, British
Columbia Public Hospitals Only, 1949-68 (Excluding Federal,
Private, and Out-of-Province Hospitalization) (Including Rehabilitation Hospitals).
Total Hospitalized
Hospitals
in Public
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
314,585
326,793
342,602
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
32,488
32,014
32,786
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
347,073
358,807
375,388
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
299,518
311,718
328,433
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
95.4
95.9
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
30,814
30,377
30,841
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
94.8
94.9
94.1
164,808
1950
168,902
1951
174,288
195?.
179,359
1953
196,997
1954
219,196
1955
231,289
1956
241,467
1957
244,448
1958
259,091
1959 -
1960
273,263
288,634
1961-... - .
1962
297,511
301,160
1963.
308,475
1964
1965
312,219
318,662
1966
330,332
19671
19682..
Percentage of total, patients separated—
1949
342,095
359,724
86.2
1950
84.9
1951
83.7
1952
82.6
1953
85.1
1954
91.7
1955
92.5
1956
92.0
1957
91.8
1958
94.1
1959 ...
95.9
1960
96.0
1961 ..
96.0
1962...
95.7
1963
95.4
1964
95.2
1965. ...
95.0
1966
95.2
19671 ___
95.3
19682
95.7
1 Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to October 31, 1968.
M 46
BRITISH COLUMBIA
Table 1b.—Total Patient-days and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public Hospitals
Only, 1949-68 (Excluding Federal, Private, and Out-of-Province
Hospitalization) (Including Rehabilitation Hospitals).
Total Hospitalized in Public
Hospitals
Covered by B.C.H.I.S.
Adults
and
Children
Newborn
Total
Adults
and
Children
Newborn
Total
Patient-days—
194Q
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
3,008,632
3,093,372
3,246,340
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
235,796
239,972
242,047
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
3,244,428
3,333,344
3,488,387
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
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
1,631,231
19SO
1,669,922
19S1
1,654,993
19 V?
1,754,134
1953 - - _
19S4
1,909,978
2,168,410
19SS
2,217,679
1956
1957 - -
2,259,106
2,299,415
19<!R
2,402,287
1959
2,514,998
10fiO
2,692,996
1961
2,777,387
19fi?
2,837,109
19M
2,889,407
19fi4
2,916,989
1965
2.747.232 1 230.096
2,977,328
1966
19671 -
19682
Percentage of total, patient-days—
1940
2,861,260
2,946,000
3,099,840
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
95.1
95.2
95.5
220,270
222,543
222,867
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
93.4
92.7
92.1
3,081,530
3,168,543
3,322,707
86.0
19S0
84.4
19S1
82.3
19S?
82.3
1953
84.4
1954
90.8
19ss
91.4
19S6
91.3
19<i7
91.3
1958
93.6
1959
94.7
I960
95.1
1961
95.3
1962 -
95.1
1963
94.8
1964
.
94.7
1965
94.0
1966
95.0
19671.-
95.0
19682 _
95.3
i Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to October 31, 1968.
HOSPITAL INSURANCE SERVICE, 1968
M 47
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, 1949-68.
Total
(Excluding
Extended Care)
Adults
and
Children
Newborn
B.C. Public
Hospitals
Adults
and
Children
Newborn
Other B.C. Hospitals,
Including Federal
and Private
Adults
and
Children
Newborn
Institutions
Outside B.C.
Adults
and
Children
Newborn
Extended
Care
Hospitals
(Including
Federal)
Patients separated-
1949.
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965-
1966
19671-
19682
Patient-days—
1949
1950 --
1951
1952
1953
1954
1955 -
1956
1957 -
1958
1959
1960
1961
1962
1963
1964
1965
1966
19671
19fiS2
Average days
stay—
1949
of
1950
1951
1952 -
1953
1954
1955 -
1956 -
1957
1958
1959
1960
1961 ~- -
1962 -
1963 --
1964
1965
1966
19671 -
19682
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
314,391
325,861
342,081
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
3,110,701
3,189,212
3,330,213
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
9.79
9.74
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
31,152
30,804
31,216
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
222,475
225,479
225,157
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
7.14
7.32
7.21
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 I
278,023 |
286,799 |
299,518 |
311,718 |
328,433
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
2,861,260
2.946,000
3,099,840
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
9.55
9.45
9.44
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
30,814
30,377
30,841
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
220,270
222,543
222,867
8.14
8.07
7.77
7.36
7.08
7.24
6.74
6.55
6.38
6.27
6.23
6.19
6.15
7.22
7.18
7.22
7.22
7.15
7.32
7.23
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
11,459
9,436
9,048
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 |
212,413 |
195,564 1
184,373
6.48 j
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 |
18.53 |
20.72 |
20.38 j
151
173
171
161
229
199
361
457
668
665
514
241
151
157
169
149
114
101
83
75
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
541
451
390
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
5.36
5.43
5.20
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
3,414
4,707
4,600
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
37,028
47,648
46,000
10.66
10.78
9.54
9.29
9.24
9.14
10.26
9.84
8.88
9.45
9.81
9.93
9.27
10.41
9.56
10.30
9.79
10.84
10.12
10.00
198
220
244
308
322
79
159
159
182
214
263
267
259
280
279
307
263
237
344
300
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
I 2,026
I 2,017
| 2,136
j 1,723
1 1,664
1 2,485
1,900
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
6.55
7.02
7.22
6.33
699
873
904
305,940
358,675
405,174
437.68
410.85
448.20
1 2 Footnotes at bottom of page 48.
M 48
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, 1949-68
Total Adults,
Children, and
Newborn
In-patients
Estimated
Number of
Emergency and
Minor-surgery
Patientsi
Total
Receiving
Benefits
1949
1950 ...
1951
1952 '
1953
1954
1955
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
346,242
357,538
374,201
29,000
44,502
47,656
46,767
52,582
63,621
70,553
76,375
83,530
91,883
100,292
107,312
121,000
128,000
135,000
141,000
160,000
175,000
195,000
210.000
203,269
223,481
231,9812
236,63®
261,112
293,356
312,5*7
19S6
329,376
1957
340,928
1958
1959
1960
1961
1967.
366,577
390,942
410,920
432,261
442,963
1963
1964 .
458,079
468,796
493 762
1965
1966
19672 ,-
19683 __ _ _
521,242
552,538
584.701
Totals
5,475,937
7 079 07"! I 7.ssl;nio
1 Years 1962 to 1968 estimated, includes day-care surgery.
2 Amended as per final reports received from hospitals.
s Estimated, based on hospital reports to October 31, 1968.
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 19681 (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
Average days of stay—
Adults and children.....
Newborn...
328,433
30,841
3,099,840
222,867
9.44
7.23
143,424
12,273
1,521,915
95,718
10.61
7.80
83,854
8,660
714,445
60,105
8.52
6.94
56,224
6,672
517,125
46,037
9.20
6.90
35,258
2,593
269,570
16,546
7.65
6.38
9,673
643
76,785
4,461
7.93
6.94
1 Estimated, based on hospital reports to October 31, 1968.
Footnotes to Table 2a
i Amended as per final reports from hospitals.
2 Estimated, based on hospital reports to October 31, 1968. 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, 1,779; 1967,
1,754; 1968, 1,771. (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 184 in 1967 and 202 in 1968. Population figures are revised according
to latest census figures.
HOSPITAL INSURANCE SERVICE, 1968
M 49
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 1968x (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
Per Cent
100.00
100.00
100.00
100.00
Per Cent
43.67
39.80
49.10
42.95
Per Cent
25.53
28.08
23.05
26.97
Per Cent
17.12
21.63
16.68
20.66
Per Cent
10.73
8.41
8.69
7.42
Per Cent
2.95
2.08
2.48
2.00
1 Estimated, based on hospital reports to October 31, 1968.
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 55 to 58 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 1967 "
and " Statistics of Hospitalized Accident Cases, 1967," available from the Research
Division.
M 50
BRITISH COLUMBIA
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M 53
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M 54
BRITISH COLUMBIA
Chart V.—Average Length of Stay of Cases* in Hospitals in British
Columbia, by Major Diagnostic Groups in Descending Order, 1967
(Excluding Newborns).
Diseases of the circulatory system 1/^
Neoplasms
Diseases of the bones and
organs of movement
Diseases of the blood and
blood-forming organs
Certain diseases of early infancy
Diseases of the nervous system
and sense organs
Congenital malformations
Mental, psychoneurotic, and
personality disorders
Allergic, endocrine system,
metabolic, and nutritional diseases
Infective and parasitic diseases
Injuries and adverse effects
PROVINCIAL AVERAGE
LENGTH OF STAY
Diseases of the digestive system
Diseases of the skin and
cellular tissue
Diseases of the genito-urinary
system
Diseases of the respiratory system
Deliveries and complications of
pregnancy, childbirth, and the
puerperium
Symptoms, senility, and ill-
defined conditions
Supplementary classification for
special admissions
* Including rehabilitative care.
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HOSPITAL INSURANCE SERVICE, 1968 M 59
STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE
FISCAL YEAR ENDED MARCH 31, 1968
Administration—
Salaries $717,689.00
Temporary assistance 4,445.00
$722,134.00
Office expense 50,184.00
Travelling expense 37,077.00
Office furniture and equipment 10,055.00
Printing and publications 1,539.00
Tabulating and rentals 2,365.00
Motor-vehicles and accessories 2,489.00
Incidentals and contingencies 1,075.00
Construction and consultation fees 29.00
Technical surveys 22,049.00
$848,996.00
Less transfer, Vote 128 (b)—Salary Adjustments 41,508.00
$807,488.00
Payments to hospitals 108,805,134.00
Grants in aid of construction 6,050,375.00
Total $115,662,997.00
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1969
730-968-7473
BC Sessional Papers
Twentieth Annual Report British Columbia Hospital Insurance Service JANUARY1 TO DECEMBER 31 1968 British Columbia. Legislative Assembly [1969]
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