PROVINCE OF BRITISH COLUMBIA
HOSPITAL INSURANCE ACT
Nineteenth Annual Report
British Columbia
Hospital Insurance Service
JANUARY 1 TO DECEMBER 31
1967
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1968
Victoria, B.C., January 25, 1968.
To Major-General the Honourable George Randolph Pearkes,
V.C., P.C., C.B., D.S.O., M.C., CD.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned has the honour to present the Nineteenth Annual Report of
the British Columbia Hospital Insurance Service covering the calendar year 1967.
WESLEY DREWETT BLACK,
Minister of Health Services and Hospital Insurance.
British Columbia Hospital Insurance Service,
Victoria, B.C., January 25, 1968.
The Honourable Wesley Drewett Black,
Minister of Health Services and Hospital Insurance,
Parliament Buildings, Victoria, B.C.
Sir,—I have the honour to present herewith the Report of the British Columbia
Hospital Insurance Service covering the calendar year 1967.
D. M. COX, F.A.C.H.A.,
Deputy Minister of Hospital Insurance.
DEPARTMENT OF HEALTH SERVICES AND HOSPITAL INSURANCE
BRITISH COLUMBIA HOSPITAL INSURANCE SERVICE
The Honourable
Wesley D. Black
Minister of
Health Services and
Hospital Insurance
W. J. Lyle
Assistant Deputy
Minister
D.M. Cox
Deputy Minister
of Hospital Insurance
J. W. Mainguy
Director of Hospital
Consultation, Development,
and Research
Dr. C. F. Ballam
Medical Consultant
A. W. E. Pitkethley
Manager,
Hospital Construction
and Planning Division
K. G. Wiper
Administrative Officer
and Personnel Officer
N. S. Wallace
Manager,
Hospital Finance
Division
'J^.S
m -JfV,
J. Bainbridge
Manager,
Hospital Consultation
and Inspection Division
, S. Thomson
Director,
Research Division
Dr. D. S. Adams
Assistant
Medical Consultant
CONTENTS
Page
General Introduction 11
Regional Hospital Districts 12
British Columbia Regional Hospital Districts Financing Authority Act 13
The B.C.H.I.S. Planning Group 13
British Columbia General Hospitals (Comparisons of Growth) 14
The Hospital Insurance Act 16
The Hospital Act 16
Persons Entided to or Excluded from the Benefits under the Hospital Insurance Act 17
Entitled to Benefits 17
Excluded from Benefits 17
Hospital Benefits Available in British Columbia 18
In-patient Benefits 18
Emergency Services and Minor Surgery 18
Application for Hospital Insurance Benefits 18
The Hospital Rate Board and Methods of Payment to Hospitals 18
Organization and Administration 19
Assistant Deputy Minister 19
Hospital Finance Division 20
Hospital Accounting 21
Hospital Claims 21
Hospital Construction and Planning Division 23
Hospital Projects Completed during 1967 24
Hospital Projects under Construction at Year-end 26
Projects in Advanced Stages of Planning 27
Additional Projects Approved and in Various Planning Stages 27
Director of Hospital Consultation, Development, and Research 30
Hospital Consultation and Inspection Division 30
Research Division P 32
Medical Consultation Division 3 2
Administrative Officer 34
Eligibility Representatives' Section 35
Third Party Liability Section 35
General Office 35
Public Information 36
Approved Hospitals 37
Public Hospitals 37
Outpost Hospitals 38
Federal Hospitals 38
Private Hospitals (Providing General Hospital Services) 38
Rehabilitation, Chronic, and Convalescent Hospitals 38
Extended Care Hospitals 38
9
O 10 BRITISH COLUMBIA
Page
Statistical Data 38
Table 1a.—Patients Separated (Discharged or Died) and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public Hospitals Only, 1949-67 (Excluding Federal, Private, and
Out-of-Province Hospitalization) (Including Rehabilitation Hospitals) 40
Table 1b.—Total Patient-days and Proportion Covered by the British Columbia Hospital Insurance Service, British Columbia Public Hospitals
Only, 1949-67 (Excluding Federal, Private, and Out-of-Province
Hospitalization) (Including Rehabilitation Hospitals) 41
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,
1949-67 (Including Rehabilitation Hospitals) 42
Table 2b.—Summary of the Number of B.C.H.I.S. In-patients (Including
Rehabilitation Patients) and Short-stay Patients, 1949-67 43
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 1967 (Excluding
Extended Care Hospitals) 43
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 1967 (Excluding Extended
Care Hospitals) 44
Charts 44
I.—Percentage Distribution of Days of Care by Major Diagnostic Groups,
1966 45
II.—Percentage Age Distribution of Male and Female Hospital Cases and
Days of Care, 1966 46
III.—Percentage Distribution of Hospital Cases by Type of Clinical Service,
1966 47
IV.—Percentage Distribution of Hospital Days by Type of Clinical Service,
1966 48
V.—Average Length of Stay of Cases in Hospitals in British Columbia by
Major Diagnostic Groups, 1966 (Excluding Newborns) 49
Hospitalization by Major Diagnostic Categories, 1966 50
Statement of Receipts and Disbursements for the Fiscal Year Ended March 31,
1967 _-_ 54
L
Nineteenth Annual Report of the
British Columbia Hospital Insurance Service
GENERAL INTRODUCTION
Donald M. Cox, F.A.C.H.A., Deputy Minister of Hospital Insurance
During the 19 years since the commencement of hospital insurance coverage
in British Columbia, continuous and vital development has taken place in the
provision of expanded hospital facilities and improved services throughout the
Province. This progress in the hospital field has been the result of the combined
efforts of government, hospitals, organizations, and individuals, whose contributions ensure that good and efficient hospital services are made available to the
residents of the Province. During the past year, payments to hospitals were at
their highest level since the inception of the Hospital Insurance Service, and the
vast programme of hospital construction which has been evident throughout the
length and breadth of the Province for more than a decade continued at an accelerated pace.
It is estimated that in the current fiscal year $108,000,000 will be paid by the
British Columbia Hospital Insurance Service to the hospitals of the Province toward
hospital expenses incurred by residents. Daily payments to British Columbia hospitals have increased from $50,000 in 1949/50, the first complete fiscal year of
coverage, to $296,000 in 1967/68.
British Columbia's programme of hospital construction, initiated at the community level by public-minded citizens, and stimulated by the provision of generous
financial assistance from the Provincial Government, has produced, since 1949, over
8,500 beds at a total cost in excess of $113,000,000. The Provincial Government
has provided grants estimated at $53,600,000 toward the costs of construction.
During 1967 new hospitals were opened at Duncan, Comox, and Summerland;
additions and renovations were completed at Haney, Kamloops, Nanaimo, North
Vancouver, Prince George, Murrayville, New Westminster (St. Mary's), and Queen
Charlotte City; an intensive-care ward and heart catheterization laboratory were
completed at the Vancouver General Hospital; and a new boiler plant was constructed for the Royal Jubilee Hospital in Victoria. These projects involved a total
of 665 beds, and construction costs were approximately $12,000,000. As the year
drew to a close, some 790 beds were under construction throughout the Province
and over 2,100 beds were in the advanced stages of planning.
The most noteworthy item of progress in the British Columbia Hospital Insurance Service for the year was the establishment of regional hospital districts for
financing hospital construction. The Regional Hospital Districts Act and the
Regional Hospital Districts Financing Authority Act were passed by the Legislature
in March, 1967 (for details see pages 12 and 13).
The Province has been divided into regional hospital district areas, and the
majority of those areas have been incorporated into regional hospital districts by
Letters Patent.
In the Fraser-Burrard Regional Hospital District, the largest district from standpoints of population and numbers of hospitals, the ratepayers approved a $51,-
000,000 by-law on October 4, 1967, by an overwhelming majority to provide funds
for 16 hospitals.
11
O 12 BRITISH COLUMBIA
By the year-end, Government approval had been given for money votes in seven
other regional hospital districts for hospital projects involving a total cost of approximately $31,000,000.
During the year the Hospital Insurance Service continued to receive the advice
and guidance of the medical profession, for which we were most appreciative. I
should like to again record my appreciation of the assistance rendered by the Canadian Medical Association (British Columbia Division), the College of Physicians
and Surgeons, and by the medical profession generally.
The work of the Laboratory and Radiological Advisory Councils was once
again of inestimable value in assisting hospitals to improve their 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 Liaison Committee with the British Columbia Hospitals' Association has
proven very worth while, and several constructive items resulted from meetings held
during the year. As in previous years, members of our senior staff were invited to
attend the Hospitals' Association's annual conference, held in Penticton in October.
We are always grateful for the opportunity the conference presents to meet with representatives of boards of management, administration, and the nursing service from
hospitals throughout the Province. The association marked its 50th anniversary in
1967, and in honour of the occasion the Honourable Wesley D. Black, Minister of
Health Services and Hospital Insurance, presented the British Columbia Hospitals'
Association with an illuminated scroll " in appreciation of the outstanding services
rendered to the hospitals of the Province."
Reports submitted by the various divisions which comprise the administrative
structure of our Branch appear under " Organization and Administration," commencing on page 19 of this Report.
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 23 of these were incorporated as regional hospital
districts during 1967.
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 page 13) 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 their 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 the remainder of the annual amortization cost required
to retire its debentures which are held by the Authority.
HOSPITAL INSURANCE SERVICE, 1967 O 13
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 will be 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 applied up to
this time.
BRITISH COLUMBIA REGIONAL HOSPITAL DISTRICTS FINANCING
AUTHORITY ACT
This new 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, review submissions from hospitals for increases
in beds or services, consider other problems related to the orderly planning and provision of facilities and services to meet the needs of the Province, and 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.
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 33 meetings during the year. Six of the meetings
were with delegations from hospitals about the future needs and long-range planning
problems of those hospitals. Individual members on the Planning Group have acted
as liaison members between the Service and several local hospital planning groups.
During the year the group considered seven new reports compiled by the Research Division on area needs, and in addition reviewed extensions of nine reports
previously prepared which were brought up to date by the Research Division with
new projects for the future. (Continued on page 16.)
O 14
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)
105
100
SO
85
80
70
65
60
50
45
J 40
Is5
30
25
20
15
1957
1967
(est.)
Total Full-time Staff and Average Number of Patients
(Adults and Children) per Day
14
^«& s
11
■8 10
c
a
_>
9 9
ft
8
TTEKTS CA^5
, VV.TH P^Y
6
^^n^1j
5
4
1966 1967
(est.)
HOSPITAL INSURANCE SERVICE, 1967
Gross Salaries and Wages and Other Operating Expenses
O 15
70
65
^v"'
a
0
2 30
.Vs
5$0 >^
25
G1
cS bt _^
20
15
4S» ^^^
,o^*-
5
'''Including approximately 53,500,000 in staff fringe benefits
1967
(est.)
Hospitals' Growth Rate (Public General Hospitals, Excluding
Federal and Contract Hospitals, Etc.)
1948
1967 (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
$107,500,000
18,000
3,100,000
1,947,000
572
177
110
O 16 BRITISH COLUMBIA
Following recommendations by the Planning Group, hospitals were given approval to undertake preliminary planning of over 800 beds. High priority was given
to recommendations for the development of extended hospital care beds. The approvals for planning are in addition to those outstanding in the previous year.
Apart from consideration of specific hospital units, the group also concerned
itself with other subjects of importance to hospital planning in the Province. Some
of these were the new regional hospital districts and their implications; hospital and
other services for children, including those for the physically handicapped, for the
mentally ill, and those needing extended care; out-patient and day-care services;
rehabilitation and activation services in hospitals; and staff residences, as well as
subjects related to the flexible development of hospital structures to meet changes
in patterns of care.
THE HOSPITAL INSURANCE ACT
This is the Statute which authorizes British Columbia's hospital insurance plan,
and under which the British Columbia Hospital Insurance Service is established.
The main provisions of this Act and the regulations may be summarized as follows:—
(1) Generally speaking, every permanent resident who has made his home in
British Columbia for at least three consecutive months is entitled to benefits under the Act.
(2) Approved hospitals are paid an all-inclusive per diem rate for medically
necessary in-patient care rendered to qualified British Columbia residents
who are suffering from an acute illness or injury, and those who require
active convalescent rehabilitative and extended hospital care. The payment made to a hospital by the British Columbia Hospital Insurance Service amounts to $1 less than the per diem rate approved for the particular
hospital, and the patient is responsible for paying the remaining dollar.
The Provincial Government pays the dollar-a-day charge on behalf of
Provincial social welfare recipients.
(3) The wide range of in-patient benefits and the emergency out-patient and
minor surgery services, provided under the Act, are described on the following pages.
(4) Qualified persons who are temporarily absent from British Columbia are
entitled to certain benefits for a period of six months if they are admitted
to an approved hospital within the first six months following their departure from the Province. These periods may be extended for an additional period of up to six months by the Lieutenant-Governor in Council.
THE HOSPITAL ACT
One of the important functions of the British Columbia Hospital Insurance
Service is the administration of the Hospital Act. The Deputy Minister of Hospital
Insurance is also the Chief Inspector of Hospitals for British Columbia under the
Statute.
HOSPITAL INSURANCE SERVICE, 1967
O 17
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.
Excluded from Benefits
Some of the main classes of persons either permanently or temporarily excluded
from benefits are as follows:—
(a) A person who works full or part time in British Columbia but who resides
outside the Province; or
(b) A qualified person who leaves British Columbia temporarily and fails to
return and re-establish residence within 12 months; or
(c) A qualified person who leaves British Columbia and who establishes residence elsewhere; or
(d) An inmate of a Federal penitentiary; or
(e) A resident who receives hospital treatment provided under the Workmen's
Compensation Act, or a war veteran who receives treatment for a pensionable disability; or
(/) Persons entitled to receive hospital treatment under the Statutes of Canada
or any other government; for example, members of the armed forces or
Royal Canadian Mounted Police, and consular officials of other countries.
O 18 BRITISH COLUMBIA
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 anesthetic equipment, supplies, and routine surgical supplies.
Use of radiotherapy and physiotherapy facilities where available.
Other approved services rendered by employees of the hospital.
(Note.—Private or semi-private rooms cost more to maintain than standard
wards, and the patient is required to pay extra for such accommodation if it is requested by or on behalf of the patient.)
Emergency Services and Minor Surgery
The following services and treatments are also provided in British Columbia
public hospitals to beneficiaries who do not require in-patient care:—
Emergency treatment within 24 hours of being accidentally injured.
Operating-room or emergency-room services for minor surgery, including
application and removal of casts.
A beneficiary is required to pay $2 for each visit to the hospital for the services,
etc., it has provided, and the remainder of the cost is paid by the British Columbia
Hospital Insurance Service. However, if the patient received treatment from a physician while at the hospital, he is responsible for paying the doctor, as such charges
are not payable by the British Columbia Hospital Insurance Service. Non-beneficiaries are required to pay the full charge for the hospital services and treatment
received.
APPLICATION FOR HOSPITAL INSURANCE BENEFITS
At the time of admission to hospital, a patient wishing to apply for coverage
under the hospital insurance programme is required to make an Application for
Benefits. The hospital is responsible for verifying the patient's statements regarding
length of residence, etc., to determine if the patient is a qualified resident as defined
in the Hospital Insurance Act and regulations. Payment is then requested by the
hospital from the British Columbia Hospital Insurance Service, which may reject
any account where either the patient's status as a qualified resident or the medical
necessity for his receiving hospital care benefits has not been satisfactorily established.
(See Eligibility Section.)
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.
HOSPITAL INSURANCE SERVICE, 1967 O 19
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 95 per cent of all hospital accounts incurred in British Columbia
are the responsibility of the British Columbia Hospital Insurance Service. Cash
advances to hospitals are made on a semi-monthly basis, so that hospitals are not
required to wait for payment until patients' accounts are submitted and processed
by the British Columbia Hospital Insurance Service. Qualified patients are charged
$1 per day, which is deductible when calculating payments to hospitals from the
Service. Non-qualifying residents are charged the hospitals' established per diem
rates, which are all-inclusive; that is, the daily rate covers the cost of all the regular
hospital services, such as X-ray, laboratory, operating-room, etc., provided to patients, in addition to bed, board, and nursing care.
ORGANIZATION AND ADMINISTRATION
The British Columbia Hospital Insurance Service is a branch of the Department
of Health Services and Hospital Insurance, the other branches being Health, and
Mental Health Services. The administrative head of the Hospital Insurance Service
is Mr. Donald M. Cox, F.A.C.H.A., Deputy Minister of Hospital Insurance.
The following reports provide a brief outline of the work carried out during
1967 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 18), Vice-Chairman of the Hospital Planning
Group (see page 13), 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 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.
L
O 20 BRITISH COLUMBIA
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 will be responsible for reviewing the annual budgets prepared
by each regional hospital district as required by the legislation, and will work closely
with the Hospital Financing Authority and the regional hospital districts in the
financing of hospital capital projects and repayment of debentures.
The Finance Division is also responsible for the approval of grants to assist
hospitals in the purchase of equipment. In 1967, after a review of approximately
4,500 applications received from hospitals, grants of approximately $1,400,000 were
approved on movable and fixed technical equipment costing $4,000,000.
As a means of assisting hospital employees to maintain high working standards,
the Hospital Insurance Service provided $80,000 during the year to enable 750 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).
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 INSURANCE SERVICE, 1967 O 21
Hospital Accounting
A. D. MacKenzie, C.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 additional to that previously done by this section,
as a result of passage of the Regional Hospital Districts Act at the 1967 sitting of
the Legislature. In carrying out the inspection duties in 1967, 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 1967 amounted to
$110,000,000.
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.
During 1967, construction projects involving expenditure of $10,300,000 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.
The Annual Report on Hospital Statistics, issued by the Department of Health
Services and Hospital Insurance and covering the administration of the Hospital Act
for the preceding year, is prepared by this office.
Hospital Claims 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 by the Section to
hospitals in the proper method of submitting the individual accounts, which is accomplished by correspondence, telephone, and personal visits. During the year the
supervisor visited hospitals in the Prince Rupert area, Okanagan, Vancouver, and
Victoria, attending conferences at Terrace and Penticton.
Co-ordination of amendments to the Admission-Separation Record (H.I.A. 18)
was undertaken with the form being redesigned to include certain new statistical
information required by the Medical Consultant and Research Divisions. The new
forms will be used commencing January 1, 1968.
O 22 BRITISH COLUMBIA
The filing, accounting, and review of the quarterly billing for extended care
hospital patients has increased in complexity and volume as new units are 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.
Research and adjustments to accounts, due primarily to changes of responsibility, also showed an increase in volume.
Accounts from all sources were in excess of 1,500 accounts per working-day
for in-patients, and over 800 emergency-service or minor-surgery account forms were
handled per working-day. Discussions with the Bureau of Statistics continued regarding the efficient use of the I.B.M. electronic data-processing equipment. These
included discussions on the redesigning of the key-punch card in relation to the new
requirements for statistics, which will be reflected in the revised application form.
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
5,000 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.
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 600 queries per month on such
accounting matters were addressed to British Columbia hospitals.
Preliminary figures for 1967 show that more than 370,000 accounts (excluding
out of Province) were processed. For comparison the figures for 1966 were
357,221 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 35,000 hospital accounts incurred by welfare recipients were checked to this
file to determine eligibility for hospital benefits.
The Voucher and Key-punch staff are responsible for batching and vouchering
the checked accounts, in order to determine the amounts payable to each hospital,
and for the punching of an I.B.M. card for each account. The cards are punched
daily to record statistical, financial, and medical data, and are used to tabulate
remittance listings of payments due to hospitals and for morbidity statistics for the
Research Division.
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 1967 over 4,700 accounts,
amounting to an estimated $1,173,100, were paid on behalf of qualified residents
who were hospitalized in the other Provinces and Territories of Canada, and the
HOSPITAL INSURANCE SERVICE, 1967 O 23
continental United States, including Alaska and Hawaii; Austria, Australia, Belgium,
British West Indies, Cape of Good Hope, Central America, China, England, France,
Greece, Holland, Hong Kong, Ireland, Italy, Jamaica, Japan, Mexico, New Zealand,
Norway, Scotland, South America, Spain, Sweden, Switzerland, Tahiti, Thailand,
West Germany, and Yugoslavia. This office also compiles up-to-date hospital rate
schedules for every approved hospital in Canada. Plans to commence, in January,
1968, a punch-card record of statistics from out-of-Province accounts were completed, including the designing of a new form and the procedures required to carry
out this work.
The Filing and Mail Unit sorted and filed over 5,000 documents and letters
daily, an increase of 400 over last year. The filing system was expanded and new
procedures instituted, in order to accommodate the quarterly billings for the extended
care hospitals. New methods of routing the documents within the section were
required to accommodate some of the extra flow of work.
Hospital Construction and Planning Division
A. W. E. Pitkethley, Manager
The main functions of this Division can be briefly described as follows:—
(1) Providing hospital boards of management, their architects and planning
committees, with a consultative service in the planning of hospital construction projects, including new hospital facilities and additions to and
renovations of existing hospitals. Special emphasis is given to the need
for the development of written programmes for proposed construction
projects. Hospitals are assisted by this Division in the preparation of
such programmes, which provide architects and their consulting engineers
with basic planning criteria for the logical development of plans.
(2) Provincial grants-in-aid toward construction, renovations, and building
improvements are processed and recommended for payment by this Division. The Division also initiates applications for Federal construction
grants, and processes and submits claims for payment. During 1967, 25
applications for approval of Federal construction grants toward major
construction and renovation projects were prepared and submitted.
The Manager of the Division is a member of the B.C.H.I.S. Planning Group,
which has the responsibility of reviewing and making recommendations to the Deputy
Minister on matters concerning the development of hospital facilities throughout the
Province (seepage 13).
A great deal of time is spent by the Division in reviewing plans of proposed
building projects. Special attention is given to the interrelationship of the various
departments of the hospital building to ensure a layout arrangement that can provide
a high standard of patient-care, efficient and economical operation, and adequate
service and clinical facilities. In planning hospital facilities, attention is also given
to the need and method of future expansion in conjunction with the logical and best
use of the hospital-site. Proposed hospital-sites are approved by this Division, and
direction and guidance are given in site selection. Wherever possible, potential sites
are inspected by a member of the Division. During the year approximately 200 sets
of plans were received by the Division. These drawings covered many phases of
planning, including small-scale schematic drawings, preliminary sketch drawings,
large-scale detail drawings, and final working drawings and specifications, including
the architectural, mechanical, electrical, and plumbing drawings.
O 24 BRITISH COLUMBIA
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 the designs for mechanical systems
for new hospital buildings that reflect this approach include heat recovery systems,
air recirculation and zoned heating ventilating controls, and limited air-conditioning
systems. Consideration was directed toward the cooling by natural means, such as
well, river, or lake water, for air-conditioning systems. Continuing benefit was
derived through the co-operation of the Public Works Department by assigning two
architects to this Division. Detailed reviews of hospital plans were made, involving
some 30 hospital projects through various stages of planning.
Liaison was also maintained with the Hospitals Committee of the Architectural
Institute of British Columbia. The function of this Committee is to review, and
endeavour to resolve, problems arising out of hospital construction projects which
affect members of the Architectural Institute. Both members of the architectural
profession working for the Division are members of the Hospital Committee and
attend meetings on a regular basis.
The provision of a complete consultative planning service to hospital boards
and their planning committees is made possible through the co-operation of Health
Branch personnel, members of the medical and nursing professions, and the various
divisions of the British Columbia Hospital Insurance Service. The Provincial Health
Branch renders assistance through the Division of Public Health Engineering, the
Technical Supervisor of Clinical Laboratory Services, the Technical Supervisor of
Radiology, and the Provincial public health officers. The Division also maintains
liaison with the Canadian Medical Association (British Columbia Division) and
with the Faculty of Medicine of the University of British Columbia. Proposed layouts for physical medicine departments were reviewed by the Director, School of
Rehabilitation Medicine, Faculty of Medicine, University of British Columbia.
Through the co-operation of the Provincial Department of Labour, the office of the
Inspector of Factories provides a consultative service to the British Columbia Hospital Insurance Service on proposals for elevators and dumb-waiter installations in
hospitals.
During 1967 the Manager of the Division, as well as the architects and engineer
attached to his staff, made a number of visits to hospitals to achieve on-site evaluation of problems relating to planning projects, and also to inspect projects which
had been completed.
On June 8th and 9th the Manager of the Division attended a course in " Hospital Hygiene and Infection Control " at the Faculty of Medicine, University of
British Columbia, and gave a talk on " Operating Room Planning." On September
18th and 19th the Manager also attended a " Symposium on the Control of Hazards
in Hospitals," under the joint sponsorship of the National Research Council and
Department of National Health and Welfare, Ottawa.
(a) Hospital Projects Completed during 1967
Summerland General Hospital, Summerland.—The Honourable W. A. C. Bennett opened the new Summerland hospital on June 17, 1967. The new hospital is
a single-story reinforced-concrete building with accommodation for 28 acute-care
beds.
St. Joseph's General Hospital, Comox.—The Honourable Dan Campbell, Acting Minister of Health Services and Hospital Insurance at the time, opened the new
addition to the Comox hospital on June 17, 1967. The new wing is a three-story
HOSPITAL INSURANCE SERVICE, 1967 O 25
reinforced-concrete building containing 74 beds. The third story is in " shell " form
and will provide approximately 54 additional beds when required.
Cowichan District Hospital, Duncan.—On September 15, 1967, the Honourable Wesley Black, Minister of Health Services and Hospital Insurance, opened the
Cowichan District Hospital, which replaces the King's Daughters' Hospital. The
new hospital has 127 finished beds, semi-finished areas for a further 19 beds, and
a fourth floor in " shell" form which could provide an additional 40 beds in the
future. For the first time since commencement of the British Columbia Hospital
Insurance Service, the financing of the local area's share of hospital construction
involved the participation of four separate districts (City of Duncan, Municipality of
North Cowichan, and Lake Cowichan and Koksilah Valley Hospital Improvement
Districts).
Maple Ridge Hospital, Haney.—A third floor containing 50 beds and new
emergency, physical medicine, and laboratory departments at the ground-floor level
were opened on September 9, 1967, by the Honourable Wesley Black. The Haney
hospital now has a total capacity of 106 beds.
Royal Inland Hospital, Kamloops.—Renovations and alterations to older sections of the hospital to improve service departments and to provide new rehabilitation, psychiatric, and intensive-care units were completed in the fall of the year.
Langley Memorial Hospital, Murrayville.—Space for 10 acute beds previously
left in a semi-finished condition was completed and brought into operation.
Nanaimo Regional General Hospital, Nanaimo.—During the latter part of the
year, the sixth floor of the hospital (previously unfinished) was completed to provide
37 additional acute beds.
Saint Mary's Hospital, New Westminster.—The Honourable Grace McCarthy
opened the new additions to this hospital on October 28, 1967. The expansion
programme included 85 additional beds, a new physiotherapy department, an enlarged kitchen and cafeteria, and alterations to admitting, medical records, and administrative areas.
Lions Gate Hospital, North Vancouver.—Further expansion of the new hospital building was completed during the year by the completion of the sixth and seventh
floors for 138 additional acute beds. Alterations to the fourth floor of the older
hospital building provided a further 21 psychiatric beds. In addition, certain renovations to the kitchen and central supply room in the new hospital were carried out
and an additional operating-room finished.
Prince George Regional Hospital, Prince George.—A 24-bed addition to the
nurses' residence was completed at this hospital early in December.
Queen Charlotte Islands General Hospital, Queen Charlotte City.—An addition
for 7 pediatric beds was brought into service at this hospital early in the year. This
addition, together with renovations to the former pediatric ward, resulted in a net
gain of 6 beds.
Vancouver General Hospital, Vancouver.—Three projects were completed during the year to provide an intensive-care unit, heart catheterization and electroencephalograph laboratories, and an in-service education area.
St. Vincent's Hospital, Vancouver.—An underground steam-line to carry steam
from Shaughnessy Hospital to St. Vincent's Hospital was completed in the fall.
Royal Jubilee Hospital, Victoria.—A project to add to the boiler-house, and
the installation of two new boilers, was completed at the Royal Jubilee Hospital
during the year. The additional boiler capacity will serve not only this hospital, but
the Veterans' Hospital and the Lee Avenue mental health facility also.
O 26 BRITISH COLUMBIA
(b) Hospital Projects under Construction at Year-end
Campbell River and District General Hospital, Campbell River.—Addition for
an extended-care unit of 25 unfinished beds, with provision for a further 12 beds.
Castlegar and District Hospital, Castlegar.—Addition of a further story to the
existing hospital to provide 50 beds and renovations to existing building for expanded
service departments.
Cranbrook and District Hospital, Cranbrook.—Construction of new hospital of
75 acute beds, plus 15 to be left unfinished initially, and construction of a 34-bed
extended-care unit.
Enderby and District Memorial Hospital, Enderby.—Addition and renovations
to hospital to provide a net gain of 3 beds.
Kelowna General Hospital, Kelowna.—Major addition to provide a total of
228 acute beds and enlarged service departments.
Langley Memorial Hospital, Murrayville.—Conversion of old hospital building
to provide 40 extended-care and 10 activation beds.
Pouce Coupe.—Addition for an extended-care unit of 26 beds, enlarged dietary
department, etc.
Powell River General Hospital, Powell River.—Addition to the hospital to
provide 26 extended-care beds, unfinished space for a further 8 beds, and enlarged
emergency and dietary departments.
Prince George Regional Hospital, Prince George.—Services expansion project
which consists of an addition and renovations to provide enlarged laboratory, radiological, and emergency departments, etc.
Mills Memorial Hospital, Terrace.—Construction of a wing to provide a net
gain of 21 beds, and new emergency and physiotherapy departments, plus renovations for enlarged radiology and laboratory departments.
British Columbia Cancer Institute, Vancouver.—An addition to the building
to provide increased radiotherapy facilities.
Canadian Red Cross Society, British Columbia-Yukon Division, Vancouver.—
New facilities for its blood transfusion service.
Health Sciences Centre, University of British Columbia, Vancouver.—Psychiatric unit to provide 60 psychiatric beds (Stage I), neurological research and teaching
facilities (Stage II).
St. Paul's Hospital, Vancouver.—A major renovation programme has been continued throughout the year. Renovations to service areas on the main basement
floors were mostly completed, and also the centralization of the dietary facilities.
Work is also under way to renovate four of the hospital's elevators.
Jewish Home for the Aged, Vancouver.—A 60-bed extended-care unit is being
constructed in conjunction with a boarding home. Certain facilities such as the
lounge and service departments will be shared between the two units.
Vancouver General Hospital.—Alterations for renal failure unit of 12 beds.
St. Joseph's Hospital, Victoria.—Alterations to X-ray department.
Royal Jubilee Hospital, Victoria.—Coronary care unit of 4 beds.
Vernon Jubilee Hospital, Vernon.—An addition to the hospital to provide an
extended-care unit of 60 beds and 27 more acute beds.
Peace Arch District Hospital, White Rock.—Construction of a new 106-bed
acute-care hospital adjacent to the existing building, plus 2 unfinished beds and a
fifth floor in " shell " form which can provide 42 beds in the future. The existing
hospital will shordy be renovated for a 42-bed extended-care unit.
In addition, at the year-end, tenders had been received and a contract award
was being considered for the following:—
HOSPITAL INSURANCE SERVICE, 1967 O 27
St. Joseph's General Hospital, Comox.—Renovations and additions to the 1938
wing to provide 45 extended-care beds.
Creston Valley Hospital.—Additions and alterations to provide a total of 44
acute-care beds.
(c) Projects in Advanced Stages of Planning
Matsqui-Sumas-Abbotsford General Hospital, Abbotsford.—Expansion and
renovations.
Burnaby General Hospital, Burnaby.—Expansion and renovations programme.
Burns Lake and District Hospital, Burns Lake.—Additions and renovations.
Chilliwack General Hospital, Chilliwack.—Additions and renovations.
Providence Hospital, Fort St. James.—New facility.
Windermere District Hospital, Invermere.—Additions and renovations.
Nanaimo Regional General Hospital, Nanaimo.—Additions and renovations.
Royal Columbian Hospital, New Westminster.—Up-grading existing services.
Penticton Hospital, Penticton.—Expansion, renovations, and extended-care
unit.
West Coast General Hospital, Port Alberni.—Completion of space plus renovations and additions.
Prince Rupert General Hospital, Prince Rupert.—Replacement.
Princeton General Hospital, Princeton.—Replacement.
Queen Victoria Hospital, Revelstoke.—Replacement.
Surrey Memorial Hospital, North Surrey.—Addition and renovations.
Trail-Tadanac Hospital, Trail.—Extended-care unit, regional laboratory, addition for psychiatric beds, plus renovations.
G. F. Strong Rehabilitation Centre, Vancouver.—Addition and renovations.
Health Sciences Centre, University of British Columbia, Vancouver.—New hospital facility (Stage III).
St. Vincent's Hospital, Vancouver.—Additions and renovations.
St. John Hospital, Vanderhoof.—Replacement.
Royal Jubilee Hospital, Victoria.—Renovations and laboratory expansion.
(d) Additional Projects Approved and in Various Planning Stages in 1967
Lady Minto Hospital, Ashcroft.—Replacement.
R. W. Large Memorial Hospital, Bella Bella.—Replacement.
Campbell River and District General Hospital, Campbell River.—Expansion
for acute care.
Chetwynd and District Hospital, Chetwynd.—New facility.
St. Joseph General Hospital, Dawson Creek.—Expansion of services.
Cowichan District Hospital, Duncan.—Extended-care unit.
Providence Hospital, Fort St. John.—Completion of 15 acute beds.
Golden and District General Hospital.—Expansion programme.
Boundary Hospital, Grand Forks.—Completion of 5 beds.
Wrinch Memorial Hospital, Hazelton.—Replacement.
Fraser Canyon Hospital, Hope.—Expansion and renovations.
Royal Inland Hospital, Kamloops.—Expansion, including extended-care unit.
Victorian Hospital, Kaslo.—Replacement.
Lillooet District Hospital, Lillooet.—Expansion and renovations.
Arrow Lakes Hospital, Nakusp.—New hospital to replace existing hospital at
Nakusp and New Denver.
Royal Columbian Hospital, New Westminster.—Additions.
Major Hospital Projects Completed
or under Construction
during 1967
COMPLETED
Duncan, Comox, Summerland, Haney, Prince George, Queen
Charlotte City, North Vancouver, Victoria (Royal lubilee),
Vancouver (Vancouver General), Murrayville, Nanaimo, New
Westminster (St. Mary's), and Kamloops.
UNDER CONSTRUCTION
White Rock, Vernon, Cranbrook, Campbell River, Enderby,
Castlegar, Terrace, Pouce Coupe, Kelowna, Powell River, Prince
George, Pouce Coupe, Murrayville, Victoria, Vancouver, White
Rock, Comox, and Creston.
(For details see pages 24 to 26.)
New Westminster (St. Mary's) Addition
ii
*f
t'~
'■
(Design consultants: Allen C. Smith & Associates, Vancouver.)
■ ■ ■ ■ ...
Vancouver (U.B.C. Health Sciences Centre)
. :::::::: :;:::;;;
(Architects: Thompson, Berwick, Pratt & Partners, Vancouver.)
Psychiatric Unit, Stages 1 and 2.
Cranbrook
"•••_w •.:.!>
lejohn & Gower, Penticton.)
(Architect: David P. Fairbank.)
O 30 BRITISH COLUMBIA
Lions Gate Hospital, North Vancouver.—Expansion of services and extended-
care unit.
Ocean Falls General Hospital, Ocean Falls.—Replacement.
St. Martin's Hospital, Oliver.—Replacement.
Prince George Regional Hospital, Prince George.—Expansion programme.
Richmond General Hospital, Richmond.—Extended-care unit.
St. Mary's Hospital, Sechelt.—Expansion programme, including extended-care
unit.
Shuswap Lake General Hospital, Salmon Arm.—Expansion.
Bulkley Valley District Hospital, Smithers.—Addition.
Squamish General Hospital, Squamish.—Renovations and improvements.
Children's Hospital, Vancouver.—Replacement.
Holy Family Hospital, Vancouver.—Activation unit and renovation of existing
building for extended care.
Mount St. Joseph's Hospital, Vancouver.—New acute unit and renovation of
existing hospital for extended care.
St. Paul's Hospital, Vancouver.—Renovation and expansion programme.
Vancouver General Hospital, Vancouver.—Replacements and additions, including extended-care unit.
Royal Jubilee Hospital, Victoria.—Renovations.
St. Joseph's Hospital, Victoria.—Expansion programme.
Priory Hospital, Victoria.—Extended-care unit.
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 Hospital 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 13 and 18
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 Victoria District Hospital Planning Board.
The Director served on the Mental Health Committee which was appointed by
the Minister in March to study the mental health services of the Province, and to
make recommendations to the Minister respecting reorganization and future development of these services.
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
HOSPITAL INSURANCE SERVICE, 1967 O 31
private hospitals regardless of the type of care given. Its staff is composed of administrative, nursing, and dietary consultants. One of the administrative consultants
now on staff is a specialist in management engineering.
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 Rate
Board. Its members represent the Service on the Laboratory Advisory Council;
Hospital Disaster Plan Review Committee; Welfare Institutions Board; British
Columbia Council of Practical Nurses; Council of Hospitals with Schools of Nursing; Advisory Committee, Nurse Training Programme, British Columbia Institute
of Technology; Practical Nursing Advisory Committee; British Columbia Nutritional Co-ordinating Committee; Food Services Technicians Advisory Committee,
Vancouver City College; committees of the Registered Nurses' Association of British
Columbia and the British Columbia Hospitals' Association, and the Health Sciences
Centre, University of British Columbia. They also carry out liaison duties with the
Health Branch, Mental Health Branch, Emergency Health Services, Civil Defence
Organization, and other departments and offices of Provincial and municipal government.
An active programme during 1967 resulted in 61 staff visits to acute, rehabilitation, chronic, convalescent, and extended care hospitals, and 161 staff visits to
private hospitals giving nursing-home type care. The majority of these visits were
made by individual consultants of this Division, the remainder by teams consisting
of two consultants (25 visits) or three consultants (nine visits). Every private hospital in the Province giving nursing-home type care was visited at least once during
the year by the nursing consultants. One hundred and thirty-five requests from acute
hospitals for assistance in the placement of patients in lower-care facilities were processed during the year.
Personnel of the Division attended many educational sessions during the year,
as a necessary means of keeping abreast of changing concepts and techniques in the
hospital field.
Papers were presented by staff members at the Canadian Hospital Association
Nursing Unit Administration Course, Vancouver; Victoria Chapter of Practical
Nurses' Association meeting, Victoria; Executive Housekeepers Institute, Victoria;
Nutritional Clinical Session, Victoria; and North Shore Medical Society meeting,
Vancouver.
Studies were also conducted into the following aspects of hospital planning and
management: Preferred type of hospital bed; ratio of self-care beds to other beds;
hospital ward size and patient toilet facilities; determination of the number of operating-rooms required; private-hospital operating costs; programme for development
or reconstruction of small hospitals; management of therapeutic diets (in co-operation with the committee of dieticians from Victoria, B.C.); infant formulary cost
study (in co-operation with the Dietary Consultant, Department of National Health
and Welfare and Richmond General Hospital); nutrient analysis of menus in private hospitals; hot- and cold-food service carts; use of bulk frozen foods for hospital
food service; recommended nursing procedures for controlling the spread of communicable diseases; recommended nursing organization and staffing for extended-
care facilities; and projected need for nursing services by 1985.
Several staff changes took place during 1967. In August Mr. C. C. White,
administrative consultant, left the Service to become Assistant Administrator, St.
O 32 BRITISH COLUMBIA
Vincent's Hospital, Vancouver, and was replaced in September by Mr. P. M. Breel,
from Ingersoll Hospital, Ont. Mr. J. P. B. Langran joined the staff in November
as a management study consultant.
Research Division
D. S. Thomson, B.A., Director
The Research Division is responsible for compiling and maintaining statistical
data relating to hospitalization and morbidity within the Province. Most of the
statistical information is derived from the Admission-Separation Records submitted
by the hospitals for each in-patient. The data used are key-punched by the Hospital
Claims Section of this Service and then transferred to magnetic tape by the Data
Processing Division of the Department of Industrial Development, Trade, and Commerce. The data are essential to the bed requirement studies carried out by the
Division. In addition to a comprehensive analysis of hospitalization data, these
studies also involve economic and population growth projections.
School districts form convenient planning areas for most bed need studies, and
consequently the Division prepares population estimates each year, broken down by
age-group, sex, and race for each of the more than 80 school districts in the Province. The regional hospital districts are composed of groups of school districts,
and consequently projections can readily be applied to these new areas.
In attempting to assess hospital bed requirements more carefully, the Division
carries out special studies. With the co-operation of Surrey Memorial Hospital, a
comparison of maternity-ward occupancy was made with that predicted by a Poisson
Distribution technique. At the year-end a study of waiting lists was being made,
using the records of a number of co-operating hospitals.
The Division also prepares for publication a number of annual bulletins, the
most important of these being the " Statistics of Hospital Cases Discharged in 1966."
This bulletin contains the 10 standard morbidity tables prepared by each Province
as recommended by the Federal Advisory Committee on Hospital Insurance and
Diagnostic Services, as well as an analysis of hospitalization in the Province of British Columbia by race, age, geographical location, major diagnostic group, and type
of service. The bulletin also presents, in graphical form, trends in hospitalization
over the past 10 years. "Statistics of Hospitalized Accident Cases" is another
annual bulletin produced by the Division. This bulletin analyses in detail hospitalized accidents by circumstance, type of accident, and nature of injury.
For the past few years this Division has been preparing statistical tables analysing patient-flow patterns in the metropolitan Vancouver area. As a planning aid
to the new regional hospital districts, five such reports were prepared in 1967 covering the larger regional hospital districts, including that of Fraser-Burrard.
There is a growing demand for morbidity data from research groups both inside
and outside of government, and every attempt is made to provide information for
worth-while projects.
Mr. W. Selwood, B.A., joined the staff in February, 1967, as a research officer,
filling a vacancy created by the resignation of Mrs. H. Thornton.
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
HOSPITAL INSURANCE SERVICE, 1967 O 33
" 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. 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.
Consultative services by the Chief Supervisor of Medical Coders included visits
to 23 hospitals during the year, with particular reference to medical records. In the
capacity of consultant to hospital medical record departments, problems are identified and assistance and advice offered, so that medical records generally, in all British
Columbia hospitals, will be of high quality and thereby contribute toward better
patient-care and more satisfactory statistical information for continuing research
studies.
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, and these studies have been greatly benefited by
the recent legislation which makes 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.
Dr. D. G. Adams, Assistant Medical Consultant, has assumed major administrative supervisory responsibility for the Coding Division and 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-
to-day 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.
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, the Advisory Sub-committee for
Chronic Renal Failure, and representation to special committees on training of paramedical personnel continued during the year. 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
O 34 BRITISH COLUMBIA
staff of the hospital, the Medical Consultant is able, with the assistance of the Hospital Consultation and Inspection 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 relate 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 Welfare Branch 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 to ensure that land transfers are not made
until they are approved under sections 14 (2) and 41 (1) (c) of the Hospital Act.
As in previous years, considerable time was spent in 1967 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.
HOSPITAL INSURANCE SERVICE, 1967 O 35
Eligibility Representatives' Section
P. A. Bacon
In order to ensure that only qualified British Columbia residents receive hospital insurance benefits, the staff of the Eligibility Section review the Applications
for Benefits made by, or on behalf of, persons admitted to hospital. A detailed check
is made of all doubtful applications, resulting in the rejection of a considerable number of claims for hospital insurance benefits made by unqualified persons. Numerous inquiries from the general public with regard to eligibility matters are dealt with
by personal interview, telephone, and correspondence.
Eligibility Representatives visit hospitals on a regular schedule to see that the
B.C.H.I.S. eligibility procedures are being properly carried out. The Representatives also assist in the training of hospital admitting personnel to deal with problems
connected with the admission of patients to hospitals and the determination of their
status under the Hospital Insurance Act. This training assistance is provided by
means of visits to hospitals and by regional meetings.
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
Internal accounting and supervision of expenditure continued as the main
functions of this office. In summary, these responsibilities consist of maintaining
personnel and payroll records, preparation of financial statements, administrative
accounting, and purchasing. Departmental estimates were prepared as usual in
consultation with Division Managers. Continuing assistance to the Hospital Construction and Planning Division was provided in connection with processing grants
toward hospital alterations and renovations.
O 36 BRITISH COLUMBIA
The functions of Departmental Safety Officer were also carried out by the
Supervisor of the General Office. Since the publication of the last Annual Report,
this Department has won a gold and a bronze-on-gold award from the British Columbia Safety Council for 637,000 accident-free man-hours of operation. The
bronze-on-gold award was presented to the Department by the Prime Minister, the
Honourable W. A. C. Bennett, in December.
The Departmental Safety Committee once again prepared safe-driving posters
for use over the Christmas season by the Accident Prevention Division and by the
British Columbia Safety Council. The Committee is also producing a safety news
magazine which is now gaining wide acceptance in the Government Service.
Public Information
R. H. Thompson
This office is responsible for carrying out the public information activities,
in which there are three main areas of responsibility—the general public, approved
hospitals, and in-service duties. The following is a summary of the work undertaken during 1967.
A general outline of the organization of the Service, prepared at the request of
the British Columbia Hospitals' Association, was completed, and 1,000 copies
were supplied to the association for incorporating in its newly developed trustees'
manual. A pamphlet containing statistical data and other information of interest
to the administrative personnel of hospitals was prepared for distribution to delegates attending the British Columbia Hospitals' Association annual conference,
held in Penticton in October.
The " General Information " pamphlet was revised and reprinted, and copies
were distributed to business and industry, civic organizations, Government Agents,
welcome-wagon agencies, hospitals, and other services which come in regular contact
with new residents of the Province.
Several replacement pages were prepared for the B.C.H.I.S. Manual on Policy,
Organization and Procedures, copies of which are held by all approved British
Columbia hospitals. At the year-end a revised Index and Appendix of Hospital
Lists was being developed.
Press releases were issued to the various news media, dealing primarily with
the official openings of new hospitals and other aspects of the Province's vast programme of hospital construction. Regular editions of the B.C.H.I.S. Bulletin were
published during the year for distribution to all public hospitals and nursing homes.
The Bulletin is an administrative aid used to clarify policy and procedural changes.
Films in the B.C.H.I.S. motion-picture library, maintained for the free use of
hospitals for in-service training purposes, were used quite extensively throughout
the year and were seen by an estimated 1,500 hospital staff members.
Assistance was given in up-dating the Departmental exhibit in the British
Columbia Building on the grounds of the Pacific National Exhibition. Government
exhibits are open to the public throughout the year and are viewed by thousands
of visitors.
Other duties included the summarizing of reports for the information of the
Deputy Minister, maintaining the newspaper and hospital photograph files, replying
to general correspondence, writing articles for publication, drafting speech material,
and the preparation and editing of the Nineteenth Annual Report.
HOSPITAL INSURANCE SERVICE, 1967
O 37
APPROVED HOSPITALS
Public Hospitals
Armstrong and Spallumcheen Hospital,
Armstrong.
Arrow Lakes Hospital, Nakusp.
Bella Coola General Hospital, Bella Coola.
Boundary Hospital, Grand Forks.
British Columbia Cancer Institute, Vancouver.
Bulkley Valley District Hospital, Smithers.
Burnaby General Hospital, Burnaby.
Burns Lake and District Hospital, Burns
Lake.
Campbell River and District General Hospital, Campbell River.
Cariboo Memorial Hospital, Williams Lake.
Castlegar and District Hospital, Castlegar.
Chemainus General Hospital, Chemainus.
Children's Hospital, Vancouver.
Chilliwack General Hospital, Chilliwack.
Creston Valley Hospital, Creston.
Cumberland General Hospital, Cumberland.
Enderby and District Memorial Hospital,
Enderby.
Esperanza General Hospital, Esperanza.
Fernie Memorial Hospital, Fernie.
Fort Nelson General Hospital, Fort Nelson.
Fraser Canyon Hospital, Hope.
G. R. Baker Memorial Hospital, Quesnel.
Golden and District General Hospital,
Golden.
Grace Hospital, Vancouver.
Kelowna General Hospital, Kelowna.
Kimberley and District Hospital, Kimberley.
King's Daughters' Hospital, Duncan.
Kitimat General Hospital, Kitimat.
Kootenay Lake General Hospital, Nelson.
Lady Minto Hospital, Ashcroft.
Lady Minto Gulf Islands Hospital, Ganges.
Ladysmith and District General Hospital,
Ladysmith.
Langley Memorial Hospital, Murrayville.
Lillooet District Hospital, Lillooet.
Lions Gate Hospital, North Vancouver.
McBride and District Hospital, McBride.
Maple Ridge Hospital, Haney.
Mater Misericordias Hospital, Rossland.
Matsqui, Sumas, and Abbotsford General
Hospital, Abbotsford.
Michel-Natal District Hospital, Michel.
Mills Memorial Hospital, Terrace.
Mission Memorial Hospital, Mission City.
Mount St. Joseph's Hospital, Vancouver.
Nanaimo Regional General Hospital, Nanaimo.
Nicola Valley General Hospital, Merritt.
Ocean Falls General Hospital, Ocean Falls.
100 Mile District General Hospital 100 Mile
House.
Peace Arch District Hospital, White Rock.
Penticton Hospital, Penticton.
Pouce Coupe Community Hospital, Pouce
Coupe.
Powell River General Hospital, Powell
River.
Prince George Regional Hospital, Prince
George.
Prince Rupert General Hospital, Prince Rupert.
Princeton General Hospital, Princeton.
Providence Hospital, Fort St. John.
Queen Alexandra Solarium for Crippled
Children, Victoria.
Queen Charlotte Islands General Hospital,
Queen Charlotte City.
Queen Victoria Hospital, Revelstoke.
Rest Haven Hospital and Sanitarium, Sidney.
Richmond General Hospital, Richmond.
Royal Columbian Hospital, New Westminster.
Royal Inland Hospital, Kamloops.
Royal Jubilee Hospital, Victoria.
R. W. Large Memorial Hospital, Bella Bella.
St. Bartholomew's Hospital, Lytton.
St. Eugene Hospital, Cranbrook.
St. George's Hospital, Alert Bay.
St. John Hospital, Vanderhoof.
St. Joseph General Hospital, Dawson Creek.
St. Joseph's General Hospital, Comox.
St. Joseph's Hospital, Victoria.
St. Martin's Hospital, Oliver.
St. Mary's Hospital, New Westminster.
St. Mary's Hospital, Sechelt.
St. Paul's Hospital, Vancouver.
St. Vincent's Hospital, Vancouver.
Shuswap Lake General Hospital, The, Salmon Arm.
Slocan Community Hospital, New Denver.
Squamish General Hospital, Squamish.
Stewart General Hospital, Stewart.
Summerland General Hospital, Summerland.
Surrey Memorial Hospital, North Surrey.
Tofino General Hospital, Tofino.
Trail-Tadanac Hospital, Trail.
University Health Service Hospital, University of British Columbia, Vancouver.
Vancouver General Hospital, Vancouver.
Vernon Jubilee Hospital, Vernon.
Victorian Hospital, Kaslo.
West Coast General Hospital, Port Alberni.
Windermere District Hospital, Invermere.
Wrinch Memorial Hospital, Hazelton.
O 38 BRITISH COLUMBIA
Outpost Hospitals
Red Cross Outpost Nursing Station, Alexis Red Cross Outpost Nursing Station, Edge-
Creek, wood.
Red Cross Outpost Nursing Station, Atlin. Red Cross Outpost Nursing Station, Kyuquot.
Red Cross Outpost Nursing Station, Bam- Red Cross Outpost Nursing Station, Masset.
field. Red Cross Outpost Nursing Station, Wad-
Red Cross Outpost Nursing Station, Blue hams.
River.
Federal Hospitals
Veterans' Hospital, Victoria. Miller Bay Indian Hospital, Prince Rupert.
Shaughnessy Hospital, Vancouver. R.C.A.F. Station Hospital, Holberg.
Coqualeetza Indian Hospital, Sardis.
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
G. F. Strong Rehabilitation Centre, Vancou- Queen Alexandra Solarium for Crippled
ver. Children, Victoria.
The Gorge Road Hospital, Victoria. Shaughnessy Hospital, Vancouver.
Holy Family Hospital, Vancouver. Sunny Hill Hospital for Children, Vancou-
Pearson Hospital (Poliomyelitis Pavilion), ver.
Vancouver. Veterans' Hospital, Victoria.
(A number of the larger public hospitals also have rehabilitation units.)
Extended Care Hospitals
Mount St. Mary Hospital, Victoria (exclud- Pearson Hospital, Vancouver (excluding fa-
ing top floor). cilities for tuberculosis patients).
Mount St. Francis Hospital, Nelson. Valleyhaven Hospital, Chilliwack.
Mount St. Joseph's Hospital, Vancouver (top Veterans' Hospital, Victoria (extended-care
floor). unit).
Menno Hospital, Abbotsford. Shaughnessy Hospital, Vancouver (extended-
Priory Hospital, Colwood (24-bed unit and care unit).
71-bed unit).
STATISTICAL DATA
The tables on the following pages represent statistical data compiled by the
Hospital Finance Division. The data deal with the volume of hospital insurance
coverage provided to the people of British Columbia through the British Columbia
Hospital Insurance Service. In 1967 there were 90 public general hospitals approved
to accept B.C.H.I.S. patients. Care was also provided in eight outpost hospitals,
five Federal hospitals, seven contract hospitals, five public rehabilitation hospitals,
HOSPITAL INSURANCE SERVICE, 1967
O 39
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 1967 there were 15 hospitals providing
extended care. Data for the year 1967 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 310,500 B.C.H.I.S. adult and children patients
were separated (discharged) from British Columbia hospitals in 1967, an increase
of 10,982 or 3.7 per cent over 1966. This table also shows that 95.3 per cent of
the total patients separated (discharged) from British Columbia public hospitals
were covered by hospital insurance, compared to 95.0 in 1965 and 95.2 in 1966.
Table 1b indicates in 1967 that the British Columbia Hospital Insurance Service
paid public hospitals in British Columbia for 2,943,700 days of care for adults and
children, an increase of 82,440 days or 2.9 per cent over 1966.
As shown in Table 2a, the average length of stay of British Columbia adult and
children patients in public hospitals during 1967 was 9.48 days, and the days of
care per thousand population were 1,752. For comparison purposes, the data for
extended care hospitals is not included in the above observations, but it should be
noted that an additional 183 days of care per thousand population were provided
for these patients.
O 40
BRITISH COLUMBIA
Table 1a. — Patients Separated (Discharged or Died) and Proportion
Covered by British Columbia Hospital Insurance Service, British
Columbia Public Hospitals Only, 1949-67 (Excluding Federal,
Private, and Out-of-Province Hospitalization) (Including Rehabilitation Hospitals).
Total Hospitalized in Public
Hospitals
Adults
and
Children
Newborn
164,964
26,272
172,645
26,205
181,160
27,096
188,355
28,675
200,893
30,712
206,992
31,984
216,743
33,190
227,359
35,118
228,917
37,376
236,859
38,374
245,766
39,039
261,128
39,599
271,609
38,226
277,073
37,697
285,998
37,231
292,119
35,688
301,510
33,555
314,585
32,488
325,800
32,600
Total
Covered by B.C.H.I.S.
Adults
and
Children
Newborn
Total
Patients separated—
1949
1950
1951
1952 -
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964 -
1965 --.
1966i__
19672..
Percentage of total, patients separated-
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
19661..
19672-
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
358,400
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
310,500
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
95.3
I
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
31,100
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
95.4
164,808
168,902
174,288
179,359
196,997
219,196
231,289
241,467
244,448
259,091
273,263
288,634
297,511
301,160
308,475
312,219
318,662
330,332
341,600
86.2
84.9
83.7
82.6
85.1
91.7
92.5
92.0
91.8
94.1
95.9
96.0
96.0
95.7
95.4
95.2
95.0
95.2
95.3
1 Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to October 31,1967.
HOSPITAL INSURANCE SERVICE, 1967
O 41
Table 1b.—Total Patient-days and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public Hospitals
Only, 1949-67 (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—
1»40
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
3,095,700
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
237,700
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
3,333,400
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
2,943,700
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
95.1
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
221,700
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
93.3
1,631,231
1010
1,669,922
1951
1,654,993
1<«7
1,754,134
1Q<;-.
1,909,978
j 954
2,168,410
1Q«
2,217,679
1956 ...
2,259,106
1957
2,299,415
1<"8
2,402,287
1959
I960
2,514,998
2,692,996
1Qfi1
2,777,387
1962
2,837,109
1963
2,889,407
1964
2,916,989
1965
2,977,328
19661.
19672
3,081,530
3,165,400
86.0
Percentage of total, patient-days—
IQ40
1950
84.4
1951
82.3
1957,
82.3
1953
84.4
1954
90.8
1955 .. . . ..
91.4
1956
91.3
1957
91.3
1958
93.6
1959
__:=
94.7
1960
95.1
1961
95 3
1967,
95.1
1963
94.8
lOfi-L
94.7
1965
94 0
19661
95 0
19672
1 Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to October 31,1967.
O 42
BRITISH COLUMBIA
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, 1949-67.
Total
(Excluding
Extended Care)
B.C. Public
Hospitals
Other B.C. Hospitals,
Including Federal
and Private
Institutions
Outside B.C.
Extended
Care
Hospitals
(Including
Federal)
Adults
and
Children
Newborn
Adults
and
Children
Newborn
Adults
and
Children
Newborn
Adults
and
Children
Newborn
Patients separated—
1949
149,280
154,643
159,739
164,379
180,149
199,974
209,999
219,218
221,585
236,770
251,393
264,120
273,293
278,021
286,753
293,144
301,522
314,391
324,321
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
3,186,415
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
9.82
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
31,500
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
224,210
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
7.12
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
310,500
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
2,943,700
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
9.48
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
31,100
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
221,700
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
7.13
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
9,221
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
196,215
6.48
8.58
8.59
• 9.27
9.24
8.81
9.09
8.38
9.39
11.35
12.46
14.66
17.63
17.90
17.23
17.16
18.00
18.53
21.27
151
173
171
161
229
199
361
457
668
665
514
241
151
157
169
149
114
101
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
360
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
4.80
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
4,600
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
46,500
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
10.11
198
220
244
308
322
79
159
159
182
214
263
267
259
280
279
307
263
237
325
1,466
1,738
1,902
2,789
2,285
669
1,195
1.030
1950
1951
1952
1953
1954
1955
1956
1957
1958
_
1959
1960
1961
1962
1963
1964
1965._
19661
19672
699
Patient-days—
1949
1950
1951-
1952
1953 _
1954
1955
1956
1957
1,497 |
1958
1.609 I
1959
1960
1,926
1,906
1,873
2,026
2,017
2,136
1,723
1961
1962
1963
1964
1965
19661
19672
1,664
2,150
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
6.62
305,940
357,200
Average days of
stay—
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
=
1959
1960
1961
1962
1963
1964
1965
19661--
19672...
437.68
435.08
1 Amended as per final reports from hospitals.
2 Estimated, based on hospital reports to October 31, 1967. 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,
1,752. (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 163 in 1966 and 183 in 1967. Population figures are revised according to latest census
figures.
HOSPITAL INSURANCE SERVICE, 1967
O 43
Table 2b.—Summary of the Number of B.C.H.I.S. In-patients (Including
Extended Hospital Care Patients) and Short-stay Patients, 1949-67
Total Adults,
Children, and
Newborn
In-patients
Estimated
Number of
Emergency and
Minor-surgery
Patientsi
Total
Receiving
Benefits
1949
1950
1951
1957
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
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
203,269
223,481
231,982
236,63®
1953 ...
1954
1955
261,112
293,356
312,5®7
1956
1957-
329,376
340,92®
1958
366,577
1959
1960
390,942
410,920
1961
1962
432,261
442,963
1963
1964
323,079 135,000
327,796 Ml.OOO
333,762 160,000
346,083 175,000
355,821 195,000
455,079
468,796
1965
493,762
19662 _
521,083
19673 _
550,821
Totals —
5.099.860 1.869.073 1 6.968.933
1 Years 1962 to 1967 estimated.
2 Amended as per final reports received from hospitals.
s Estimated, based on hospital reports to October 31,1967.
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 19671 (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—
310,500
31,100
2,943,700
221,700
9.48
7.13
110,500
9,100
1,244,200
71,200
11.26
7.82
100,500
11,650
854,000
80,200
8.50
6.88
53,250
6,700
492,300
47,200
9.25
7.04
36,400
2,900
279,400
18,300
7.68
6.31
9,850
750
73,800
4,800
7.49
6.40
i Estimated, based on hospital reports to October 31,1967.
O 44
BRITISH COLUMBIA
Table 4.—Percentage Distribution of Patients Separated and Patient-
days for B.C.H.I.S. Patients Only, in British Columbia Public Hospitals, Grouped According to Bed Capacity, Year 19671 (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.
Per Cent
100.00
100.00
100.00
100.00
Per Cent
35.59
29.26
42.27
32.12
Per Cent
32.37
37.46
29.01
36.18
Per Cent
17.15
21.54
16.72
21.29
Per Cent
11.72
9.33
9.49
8.25
Per Cent
3.17
2.41
Patient-days—•
Adults and children
2.51
2.16
i Estimated, based on hospital reports to October 31,1967.
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 50 to 53 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 1966 "
and " Statistics of Hospitalized Accident Cases, 1966," available from the Research
Division.
HOSPITAL INSURANCE SERVICE, 1967
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HOSPITAL INSURANCE SERVICE, 1967
O 49
Chart V.—Average Length of Stay of Cases* in Hospitals in British
Columbia, by Major Diagnostic Groups in Descending Order, 1966
(Excluding Newborns).
Diseases of the circulatory system
Diseases of the bones and
organs of movement
Diseases of the blood and
blood-forming organs
Neoplasms
Diseases of the nervous system
and sense organs
Congenital malformations
Allergic, endocrine system,
metabolic, and nutritional diseases
Certain diseases of early infancy
Mental, psychoneurotic, and
personality disorders
Infective and parasitic diseases
Injuries and adverse effects
Diseases of the digestive system
PROVINCIAL AVERAGE
LENGTH OF STAY
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
llllllllllllllllllllllllllllllllllll ■>■> /III/II/IIII/I////I///I/IIIIIIII,
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ifiMi » «■■■_
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* Including rehabilitative care.
O 50
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B
O 54 BRITISH COLUMBIA
STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE
FISCAL YEAR ENDED MARCH 31, 1967
Administration—
Salaries $641,759
Temporary assistance 14,895
$656,654
Office expense 39,967
Travelling expense 40,306
Office furniture and equipment 12,827
Printing and publications 2,370
Tabulating and rentals 2,584
Motor-vehicles and accessories 1,902
Incidentals and contingencies 1,514
Construction and consulting fees 622
Technical surveys 17,592
$776,338
Less transfer, Vote 129 (b)—Salary Adjustments 28,656
$747,682
Payments to hospitals—
Claims $90,949,925
Vancouver General Hospital re out-patients (Hospital Insurance Act, sec. 17 (3) (c)) 284,689
91,234,614
Grants in aid of construction of hospitals 5,738,713
Total $97,721,009
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1968
700-867-7425
BC Sessional Papers
Nineteenth Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1967 British Columbia. Legislative Assembly [1968]
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