PROVINCE OF BRITISH COLUMBIA
HOSPITAL INSURANCE ACT
Twenty-second Annual Report
British Columbia
Hospital Insurance Service
JANUARY 1 TO DECEMBER 31
1970
Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1971
Victoria, British Columbia, January 21, 1971.
To Colonel the Honourable John R. Nicholson, P.C., O.B.E., Q.C, LL.D.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned has the honour to present the Twenty-second Annual Report
of the British Columbia Hospital Insurance Service covering the calendar year 1970.
RALPH R. LOFFMARK
Minister of Health Services and Hospital Insurance
British Columbia Hospital Insurance Service,
Victoria, British Columbia, January 21, 1971.
The Honourable Ralph R. Loffmark,
Minister of Health Services and Hospital Insurance,
Parliament Buildings, Victoria, British Columbia.
Sir—I have the honour to present herewith the Report of the British Columbia
Hospital Insurance Service covering the calendar year 1970.
DONALD M. COX, F.A.C.H.A.
Deputy Minister of Hospital Insurance
The Honourable Ralph R. Loffmark, Minister of Health Services and
Hospital Insurance.
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DEPARTMENT OF HEALTH SERVICES AND
HOSPITAL INSURANCE
BRITISH COLUMBIA HOSPITAL INSURANCE SERVICE
The Honourable Ralph R. Loffmark, Minister of Health Services
and Hospital Insurance.
Senior Administrative Staff
D. M. Cox, F.A.C.H.A., F.C.I., F.C.I.S., Deputy Minister of Hospital Insurance.
W. J. Lyle, F.C.I.S., Assistant Deputy Minister of Hospital Insurance.
J. W. Mainguy, M.H.A., Director of Hospital Consultation, Development, and Research.
D. G. Adams, M.D., CM., Medical Consultant.
N. S. Wallace, C.G.A., Manager, Hospital Finance Division.
K. G. Wiper, Senior Administrative Officer.
P. Breel, Manager, Hospital Consultation and Inspection Division.
Wm. E. Selwood, B.A., Acting Director, Research Division.
J. G. Glenwright, Manager, Hospital Construction and Planning Division.
D. M. N. Longridge, M A., B.Ch., F.R.C.S., Assistant Medical Consultant.
CONTENTS
Page
Organization Chart 8
General Introduction 13
British Columbia Regional Hospital Districts Act 15
British Columbia Regional Hospital Districts Financing Authority Act 16
The Hospital Insurance Act 16
The Hospital Act 16
Persons Entitled 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
Other Benefits 18
Application for Hospital Insurance Benefits 19
The Hospital Rate Board and Methods of Payment to Hospitals 19
BCHIS Planning Group 20
Organization and Administration 21
Assistant Deputy Minister 22
Hospital Finance Division 22
Hospital Accounting 23
Hospital Claims Section 24
Hospital Construction and Planning Division 26
Hospital Projects Completed During 1970 28
Hospital Projects Under Construction at Year-end 29
Projects in Advanced Stages of Planning 30
Additional Projects Approved and in Various Planning Stages in
1970 30
Director of Hospital Consultation, Development, and Research 34
Hospital Consultation and Inspection Division 34
Research Division 35
Medical Consultation Division 36
Administrative Officer 3 8
Eligibility Representatives' Section 3 8
Third-party Liability Section 39
General Office 3 9
Information Office 40
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P 12 BRITISH COLUMBIA
Page
Approved Hospitals 41
Public Hospitals 41
Outpost Hospitals 42
Federal Hospitals 42
Private Hospitals (Providing General Hospital Services) 42
Rehabilitation Hospitals 42
Extended-care Hospitals 42
Statistical Data 43
Table 1a—Patients Separated and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public General Hospitals Only (Excluding Federal, Private, Extended-care, and Out-of-
Province Hospitalization) 45
Table 1b—Total Patient-days and Proportion Covered by British Columbia
Hospital Insurance Service, British Columbia Public General Hospitals Only (Excluding Federal, Private, Extended-care, and Out-of-
Province Hospitalization) 46
Table 2a—Patients Separated, Total Days' Stay, and Average Length of
Stay According to Type and Location of Hospital for BCHIS Patients
Only, and Days of Care per Thousand of Covered Population 47
Table 2b—Summary of the Number of BCHIS In-patients and Outpatients 48
Table 3—Patients Separated, Total Days' Stay, and Average Length of Stay
in British Columbia Public Hospitals for BCHIS Patients Only,
Grouped According to Bed Capacity, Year 1970 (Excluding Extended-care Hospitals) 4 8
Table 4—Percentage Distribution of Patients Separated and Patient-days
for BCHIS Patients Only, in British Columbia Public Hospitals.
Grouped According to Bed Capacity, Year 1970 (Excluding Extended-care Hospitals ) 4 8
Charts 49
I—Percentage Distribution of Days of Care by Major Diagnostic
Groups, 1969 50
II—Percentage Age Distribution of Male and Female Hospital Cases and
Days of Care, 1969 51
III—Percentage Distribution of Hospital Cases by Type of Clinical Service,
1969 52
IV—Percentage Distribution of Hospital Days by Type of Clinical Service,
1969 53
V—Average Length of Stay of Cases in Hospitals in British Columbia by
Major Diagnostic Groups, 1969 (Excluding Newborns) 54
Hospitalization by Major Diagnostic Categories, 1969 (Excluding Newborns) 55
Statement of Receipts and Disbursements for the Fiscal Year Ended March 31,
1970 61
Twenty-second Annual Report of the
British Columbia Hospital Insurance Service
GENERAL INTRODUCTION
Donald M. Cox, F.A.C.H.A., Deputy Minister of Hospital insurance
The British Columbia Hospital Insurance Service
has now completed 22 years of operation. Those
years have been marked by development of hospital
services and hospital insurance protection for the
people of the Province far in excess of anything that
would have been possible without a Government-
operated hospital insurance programme. The information from the divisions of the Service appearing
later in this Report provide a brief summary of what
was accomplished during 1970. The record is a
tribute to the policy direction of the Government and
the efforts of the boards, administration, and staffs of
hospitals; the medical profession; the women's auxiliaries; and the boards of regional hospital districts.
I would be remiss if I did not acknowledge here the skilled and devoted work of the
staff of the British Columbia Hospital Insurance Service. It is my considered
opinion that the staff of the Service is outstanding among fine hospital insurance
service staffs in Canada.
During the year, British Columbia Hospital Insurance Service payments to
hospitals reached an all-time high of an estimated $182,500,000, which is the
equivalent of $84.23 being paid on behalf of each man, women, and child living in
British Columbia at the present time. Hospital insurance daily payments to hospitals amounted to $490,410, as compared to $432,232 in the 1969/70 fiscal year,
an increase of 13.6 per cent.
The report of the Hospital Construction Division describes the continued progress in British Columbia's programme of hospital construction. Unfortunately,
work stoppages delayed seriously a number of essential projects. Building programmes under way at year-end, many due for completion early in 1971, will cost
an estimated $60,442,394, and projects in the advanced stages of planning represent
an additional $33,353,930 in capital expenditure.
The major projects completed during the year involved a total of 589 new beds,
of which 203 were for extended care. In addition, 1,302 beds were under construction at year-end, with 573 for extended care.
Communities which witnessed completion of building programmes, including
major construction, renovations, and alterations in 1970, were Creston, Kamloops,
Kelowna, Murrayville, Princeton, Revelstoke, Surrey, Trail, and Victoria. Centres
in which construction projects are currently under way included Burns Lake, Chetwynd, Chilliwack, Golden, Kelowna, Mackenzie, Nanaimo, North Vancouver, Ocean
Falls, Penticton, Port Alberni, Prince Rupert, Richmond, Salmon Arm, Sechelt, and
Surrey. It is anticipated the majority of these projects will be completed during
1971.
13
P 14 BRITISH COLUMBIA
In 1970, coverage under the Hospital Insurance Service was extended to include
a cytology service as an out-patient benefit. The cytology programme provides a
laboratory service of great value in the early detection of cancer in women. The
service, formerly under the administration of the Vancouver General Hospital, is
now under the supervision of the British Columbia Cancer Institute.
Provision was also made during the year for coverage as an insured benefit of
out-patient and day-care psychiatric services in selected hospitals. Such coverage
provides a tremendous step in the over-all psychiatric-care programme, as it enables
a person to return to his home after receiving treatments instead of remaining in
hospital. These services are a very worth-while benefit to the public and represent a
concept of care considered to provide an efficient way of reducing pressure on inpatient hospital beds.
The hospitals authorized to make available these insured benefits were Vancouver General; Royal Jubilee, Victoria; Lions Gate, North Vancouver; and the
Prince George Regional Hospital. Prior to this the only coverage for psychiatric
out-patient and day-care services was at the pilot project in the Health Sciences
Centre Hospital at the University of British Columbia.
The Government also gave approval for construction of a number of diagnostic
and treatment centres to provide emergency and out-patient services to communities
located at a distance from hospitals and with sufficient population to support a
physician's practice.
In early April, two members of the Australian Medical Association—Dr.
Nicholas Larkins, secretary, and Dr. Lionel Wilson, council member—visited with
British Columbia Hospital Insurance Service officials to inquire in broad terms into
the relationship of the practising medical profession with the hospital service in
British Columbia, and payment for physicians' services under the Canadian system.
They also looked at the organization of hospital accreditation and the whole question
of general practitioner access to hospitals, the role played in hospitals by general
practitioners and the training of these practitioners. Another distinguished visitor
inquiring about our services was William Naylor, Secretary and Chief Administrative
Officer of the Sheffield Regional Hospital Board, Sheffield, England, who came here
in June.
As in previous years, members of our senior staff were invited to attend the
British Columbia Hospitals' Association Convention held in Vancouver in October.
We are always grateful for the opportunity the conference presents to meet with
representatives of the board of management, administrators, and nursing service
from hospitals throughout the Province. In all, 66 meetings were held with hospital
delegations during the three days.
During the year, the audio-visual and stockroom staffs of the Provincial Health
Branch helped us with photography, printing, and films. This has meant a saving to
Hospital Insurance, as otherwise it would have been necessary to have much of the
work done outside.
The assistance of the other departments of the Provincial Government, which
is always so readily available, was of tremendous value to our Service. The close
working relationship that prevails with the Deputy Minister of Health and the
Deputy Minister of Mental Health and their staffs, and the steps taken by the Minister
of Health Services and Hospital Insurance to encourage that relationship, are particularly gratifying. There is an equally good relationship with the Chairman, Medical Services Commission and the staff of the Commission and the British Columbia
Medical Plan.
It gives me great pleasure once again to express my sincere appreciation for
the advice and guidance by the College of Physicians and Surgeons, the British
HOSPITAL INSURANCE SERVICE, 1970
P 15
Columbia Medical Association, the medical profession generally, and for the continuing assistance of the British Columbia Hospitals' Association and the Registered
Nurses' Association of British Columbia.
The work of the Laboratory and Radiological Advisory Councils was again
of inestimable value in assisting hospitals to improve their laboratory and radiological service and in advising the British Columbia Hospital Insurance Service
regarding the approval of Provincial grants-in-aid for the purchase of hospital equipment.
Reports submitted by the various divisions which comprise the administrative
structure of our Branch appear under "Organization and Administration," commencing on page 21.
BRITISH COLUMBIA REGIONAL HOSPITAL DISTRICTS ACT
The Act provides for the division of the Province into large districts to enable
regional planning, development, and financing of hospital projects to be carried out
under a revised formula, which provides increased financial assistance from the
Provincial Government toward the capital cost of hospital projects. The Province
was divided into 29 areas, and 28 of them have been incorporated as regional hospital districts. The district not incorporated is located in an area without hospitals in
the northern part of the Province.
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 next page) 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 long-term debentures to the
Authority. Following this a district can repay any sum which has been temporarily
borrowed.
Each year the Provincial Government will pay through the Hospital Insurance
Service its share of the amortization cost in accordance with section 22 of the Act.
Each district will in turn raise, by taxation, the remainder of the annual amortization
cost required to retire its debentures which are held by the Authority.
Under the new formula the Province pays annually to each district 60 per cent
of the net cost of amortizing the district's borrowings for an approved hospital
project, after deduction of Federal Government capital grants and items which are
the district's responsibility, such as provision of working funds for hospital operation,
etc. If a 4-mill tax levy by the district is inadequate to discharge its responsibility
in regard to annual charges on old debt for hospital projects, as well as the remaining
40 per cent of the charges on the new debt resulting from a hospital project, the
Province will provide 80 per cent of the funds required in excess of the 4-mill levy.
The affairs of each regional hospital district are managed by a board comprised
of the same representatives of the municipalities and unorganized areas who comprise the board of the regional district (incorporated under the Municipal Act)
which has 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.
r
P 16 BRITISH COLUMBIA
A hospital society or corporation is not compelled to seek financing under this
new Act. In situations where the community's share of the cost can be, or has
already been, raised by other means, a Provincial Government grant under the
old 50-per-cent formula can be applied for under the procedure which was applicable up to this time.
BRITISH COLUMBIA REGIONAL HOSPITAL DISTRICTS
FINANCING AUTHORITY ACT
This Act establishes a Provincial Government authority similar to the one set up
a few years ago to assist school districts in financing their projects. The functions
of the Authority are referred to briefly in the second paragraph of the preceding
commentary regarding the Regional Hospital Districts Act.
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 illnes 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, together with out-patient benefits,
which include emergency, minor surgery, day-care surgical, cancer therapy,
psychiatric, cytology, and rehabilitative services, provided under the Act
are described on the following pages.
(4) Qualified persons who are temporarily absent from British Columbia are
entitled to certain benefits for a period of six months if they are admitted
to an approved hospital within the first six months following their departure from the Province. These periods may be extended for an additional period of up to six months by the Lieutenant-Governor in Council.
THE HOSPITAL ACT
One of the important functions of the British Columbia Hospital Insurance
Service is the administration of the Hospital Act. The Deputy Minister of Hospital
Insurance is also the Chief Inspector of Hospitals for British Columbia under the
Statute.
The Hospital Act controls the organization and operation of hospitals, which
are classified as follows:
(1) Public hospitals—nonprofit hospitals caring primarily for acutely ill persons.
HOSPITAL INSURANCE SERVICE, 1970
P 17
(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
BCHIS coverage.
(3) Rehabilitation and extended-care hospitals. These are nonprofit 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.
P 18 BRITISH COLUMBIA
HOSPITAL BENEFITS AVAILABLE IN BRITISH COLUMBIA
In-patient Benefits
In addition to standard-ward accommodation with meals and necesary nursing
services, a beneficiary may receive any of the other services available in the hospital,
which may include:
Laboratory and X-ray services.
Drugs, biologicals, and related preparations (with a few exceptions).
Use of operating-room and caseroom facilities.
Use of anaesthetic equipment, supplies, and routine surgical supplies.
Use of radiotherapy and physiotherapy facilities where available.
Other approved services rendered by employees of the hospital.
(Note.—Private or semiprivate 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.)
Other Benefits
The following services and treatments are also provided in British Columbia
public hospitals to beneficiaries who do not require in-patient care:
Emergency treatment within 24 hours of being accidentally injured.
Operating-room or emergency-room services for minor surgery, including application and removal of casts.
Day-care surgical services are available to patients who require operating-room
or other specialized-treatment facilities, but who would be discharged
within 24 hours.
Out-patient cancer therapy is provided by the branches of the B.C. Cancer
Institute in Vancouver and Victoria.
Day-care and night-care psychiatric services are available to patients who
come to hospital for an organized programme of treatment which requires
that they remain for a minimum of seven hours, but does not necessitate
formal admission as in-patients.
Out-patient psychiatric care is available to patients who come to the hospital
only for a particular psychiatric service. (During 1970 the number of
hospitals authorized to provide day-care and out-patient psychiatric
services as insured benefits was increased.)
A cytology service, formerly handled with grants from the Health Branch,
was transferred to BCHIS during the year. This service provides for
examination by cervical smears for the early detection of cancer in women.
The service is operated by the B.C. Cancer Institute and is universally
available for residents of the Province.
Day-care rehabilitative services at the G. F. Strong Rehabilitation Centre in
Vancouver apply to patients requiring an organized and comprehensive
programme of treatment which would require that they remain at the
centre for at least a half day.
A beneficiary is required to pay a nominal sum for each visit to the hospital for
these services, and the remainder of the cost is paid by the British Columbia Hospital
Insurance Service. Charges for medical services incurred at the hospital are not
payable by the British Columbia Hospital Insurance Service, and nonbeneficiaries
are required to pay the full charge for the hospital services and treatment received.
HOSPITAL INSURANCE SERVICE, 1970 P 19
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 TO HOSPITALS AND METHODS
OF PAYMENT
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 for both in-patient and out-patient benefits.
A system of firm budgets for hospitals, which, with modifications, 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. However, hospitals retain surplus funds earned as a result of keeping
expenditures within the total amount approved. 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.
Policies to be used in the allocation of the total funds provided are approved
by the Government. The Hospital Rate Board reviews the detailed revenue and
expenditure estimates forwarded by each hospital and applies the policies in establishing approved budgets.
Approximately 96 per cent of all hospital accounts incurred in British Columbia are the responsibility of the British Columbia Hospital Insurance Service. Cash
advances to hospitals are made on a semimonthly 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. Nonqualifying 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.
HOSPITAL INSURANCE SERVICE, 1970
P 21
BCHIS PLANNING GROUP
The Planning Group co-ordinates and expedites planning for hospital facilities.
Its functions are to review research reports on hospital bed needs; study submissions
from hospitals and regional hospital districts for increases in beds or services; consider other problems related to 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.
Of the 27 meetings held during the year, six were with outside groups. Detailed
discussions were held with the Advisory Committee of the Greater Vancouver Regional Hospital District regarding a number of programmes and studies initiated
by that district.
There was increased activity by regional hospital districts in planning total
hospital programmes to meet district needs, reflecting a trend evident in 1969. As
recommended by the Planning Group, teams from the Service acted as consultants
to the boards of the East Kootenay, Central Kootenay, and Comox-Strathcona
Regional Hospital Districts to assist them in devising over-all programmes. The
Service was also represented on the directing group of a study of health needs initiated
by the Kitimat-Stikine Regional Hospital District. The Planning Group worked
with other regional hospital districts in developing comprehensive programmes on
which money votes were held.
The future planning of cancer-therapy services in the Province was studied by
a special task committee appointed by the Medical Advisory Committee to the
Service. This followed from discussions in 1969 between Planning Group and the
Hospitals' Committee of the British Columbia Medical Association.
A revised system was set up for reviewing the hospital's functional programmes,
which form the basis for the design of new hospital construction.
The Task Sub-committee which developed the publication Hospitals for Extended Care, a Programme and Design Guide in 1969 was reappointed in 1970 to
restudy the guidelines to ensure construction at the lowest reasonable cost and also
to review the comments which have come in on the original guide from persons and
groups, both inside and outside the Province.
Studies of day-care services and of diagnostic and treatment centres were carried
further. Day-care benefits under the Hospital Insurance Service were expanded as
described elsewhere in this Report.
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
1970 by the various divisions and offices which comprise the administrative structure
of this branch.
P 22
BRITISH COLUMBIA
ASSISTANT DEPUTY MINISTER
W. J. Lyle, F.C.I.S.
The Assistant Deputy Minister is responsible for
the operation of the Hospital Finance Division, 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 19), Vice-Chairman of the
BCHIS Planning Group (see page 21), and a member of the following committees: Advisory Committee
on Hospital Insurance and Diagnostic Services (a
^ committee appointed by the Federal Government to
advise on the administration of the Hospital Insurance and Diagnostic Services Act), the Sub-commit-
*' :M tee on Finance, the Radiological Advisory Council,
and the British Columbia Hospitals' Association Liaison Committee.
During 1970 the Assistant Deputy Minister was appointed by the Department
of National Health and Welfare as liaison officer for British Columbia to work with
the national steering committee on health-care costs.
A summary of the activities of the divisions for which the Assistant Deputy
Minister is responsible follows.
Hospital Finance Division
N. S. WaUace, C.G.A., Manager
Hospital accounting, the payment of hospital
claims, and financing of hospital capital projects are
the three 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 A uthority A ct. The Finance Division is responsible for reviewing the annual budgets
prepared by each regional hospital district as required
by the legislation, and works closely with the Hospital
Financing Authority and the regional hospital districts
in the financing of hospital capital projects and repayment of debentures. During
1970, the Finance Division assisted the regional hospital districts in debenture sales
to the British Columbia Regional Hospital Districts Financing Authority amounting
to $18,500,000, and recommended capital grants of approximately $2,700,000
toward the repayment of principal and interest on capital borrowings of the regional
hospital districts.
The Finance Division is also responsible for the approval of grants to assist
hospitals in the purchase of equipment. In 1970, after a review of approximately
5,500 applications received from hospitals, grants estimated at $2,100,000 were
approved on movable and fixed technical equipment costing $6,500,000.
As a means of assisting hospital employees to maintain high working standards,
the Hospital Insurance Service provided over $135,000 during the year to enable
hospital employees to attend or participate in short-term training programmes. This
HOSPITAL INSURANCE SERVICE, 1970 P 23
was 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 subcommittee 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 Accounting
H. G. Benjamin, C.G.A., Supervisor
The five main functions of the Hospital Accounting Section are as follows:
(a) The assembling of relevant information and preparation of data for the
use of the Hospital Rate Board in its review of hospitals' annual and pre-
construction estimates. During this process estimated revenues and expenditures are examined in detail, and adjustments to estimated amounts
are recommended. The gross expenditure approved by the Hospital Rate
Board for public general, rehabilitation, and extended-care hospitals for
the year 1970 amounted to $183,000,000.
(b) The detailed annual inspecting of each budget-review hospital for purposes of verification of annual and other financial statements. Final settlement with each hospital for that year is based on inspection and review
results.
(c) The assembling of relevant information and preparation of data for the
Deputy Minister in the review of the annual budgets of regional hospital
districts.
(d) The auditing of hospital construction projects, in the field, to determine
the amount shareable by the Province and the regional hospital district.
P 24 BRITISH COLUMBIA
(e) The tabulating of monthly statistical and financial reports from hospitals,
correlating these with approved budgets, and the calculation of semimonthly cash advances to be made to hospitals.
Other functions performed by the Hospital Accounting Section include:
(a) The review and amendment of annual financial and statistical reports
prepared by hospitals for submission to the Dominion Bureau of Statistics
and the Department of National Health and Welfare.
(b) The preparation of monthly and annual claims on the Federal Government
under the Hospital Insurance and Diagnostic Services Act.
(c) The tabulation of temporary borrowing for construction projects by regional hospital districts, and the calculation of the Provincial share to be
paid to the district. The preparation and issue of debentures to replace
short-term borrowing and the calculating of the Provincial share of repayment.
(d) The provision of accounting and financial assistance and instruction to
public hospitals in the Province.
(e) The review of annual operating results and recommendation of year-end
adjustments to the hospitals' approved budgets.
(/) The preparation of the Annual Report on Hospital Statistics covering
the administration of the Hospital Act.
One hundred and fifty-five hospital-operating, pre-construction, and regional
hospital district budgets were reviewed and processed in 1970. Inspection visits
were made to each of 102 public general, rehabilitation, and extended-care hospitals
during the year. Construction projects involving approved expenditures of $6,802,-
400 were audited, and cost reports involving approved expenditures of $1,338,950
for minor construction projects were prepared for regional hospital districts.
Hospital Claims Section
W. J. Wade, Supervisor
The staff of Hospital Claims is responsible for processing the Admission-Separation Records (accounts), which hospitals submit for each patient, and approving
for payment all acceptable claims. Assistance is provided to hospitals by this Section
in the proper method of submitting the individual accounts. This is accomplished
by correspondence, telephone, and personal visits. During the year the supervisor
visited hospitals in the Vancouver Island, Lower Mainland, and Northern areas.
The filing, accounting, and review of the quarterly billings for extended-care
hospital patients continued to increase in volume as new units were added to hospitals
or new hospitals were added to the programme.
Research and adjustments to accounts, due primarily to changes of responsibility, showed an increase in volume.
Accounts processed were in excess of 1,800 per working-day for in-patients
and over 850 emergency-service and minor-surgery account forms were handled
per working-day. Discussions with the Data Processing Centre were continued
during the year regarding the efficient use of the IBM electronic data-processing
equipment. These included discussions on special surveys and statistical procedures.
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
HOSPITAL INSURANCE SERVICE, 1970 P 25
500 claims had to be returned each month 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 Adnrssion Control
visited hospitals for discussions of the procedures being used for verification of the
residence of patients.
A regional meeting held at Terrace was attended by representatives from hospitals in the northern part of the Province. Regional meetings were also held at
Comox and Victoria and attended by representatives of Vancouver Island hospitals.
The supervisor of Admission Control attended a seminar held by the British Columbia Hospital Association in Vancouver.
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 the British Columbia Hospital Insurance
Service, Workmen's Compensation Board, the Department of Veterans Affairs,
or other provinces and territories. During the year over 6,000 queries on such
accounting matters were addressed to the British Columbia hospitals.
Preliminary figures for 1970 show that more than 425,000 accounts (excluding
out-of-Province) were processed. For comparison, the figures for 1969 were 415,-
844 processed.
The Day-care Surgical Services, Day-care/Night-care Psychiatric Services, and
Out-patient Psychiatric accounts increased in volume from over 1,900 per month
in 1969 to over 3,100 per month at the year-end. Several new hospitals were
authorized to make Day-care/Night-care and Out-patient Psychiatric Services available as an insured benefit.
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 punching of the IBM cards 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. This procedure includes punching cards for out-of-Province accounts
and Day-care Surgical Services accounts.
This section is also compiling statistics for a linkage study of congenital anomalies being carried on by the Atomic Energy of Canada Limited. The study will
involve the punching of over 140,000 statistical IBM cards, of which 90,000 cards
were punched at the year-end.
The Hospital Claims Section sends statements to patients advising them of the
amount paid to hospitals on their behalf through the British Columbia Hospital
Insurance Service. During the year, over 325,000 statements were prepared and
mailed.
The Out-of-Province personnel process all claims for hospital accounts incurred
by British Columbia residents in hospitals outside of the Province. This requires
establishing eligibility and the payment of claim. During 1970, over 5,400 accounts,
amounting to an estimated $1,900,000, were paid on behalf of qualified residents
who were hospitalized in other provinces and territories of Canada and the continental United States, including Alaska and Hawaii; Australia, Austria, Belgium,
Bermuda, Denmark, England, Finland, France, Germany, Greece, Guam, Holland,
Hong Kong, India, Iran, Ireland, Israel, Italy, Japan, Java, Kenya, Malaysia, Mexico,
P 26 BRITISH COLUMBIA
Nepal, New Zealand, Norway, Philippines, Portugal, Puerto Rico, Republic of
Ch'na, Republic of Panama, Saint Lucia, South Africa, Spain, Sweden, Switzerland,
Taiwan, Trinidad, and Yugoslavia.
Correspondence to accomplish the procedures amounted to over 19,000 letters
for the year. This office also compiles up-to-date hospital rate schedules for every
approved hospital in Canada. All accounts were coded for statistical purposes and
an IBM card punched for each account.
The Filing and Mail Unit sorted and filed over 8,000 documents and letters
daily, an increase of 1,500 over last year. The filing system was expanded and new
procedures instituted, in order to accommodate the increase.
Hospital Construction and Planning Division
John Glenwright, Manager
The main functions of this Division can be briefly
described as follows:
1. The Division provides hospital boards of management, their architects and planning committees,
with a consultative service in the planning of hospital
construction projects, including new hospital facilities
as well as additions and renovations to existing hospitals. Special emphasis is given to the need for the
development of written functional programmes for
construction projects related to the proposed new or
expanded facilities.
During the year a great deal of time was spent in
reviewing programmes and plans of proposed hospital
projects, both at the sketch-plan stage and the working-drawing stage. Drawings
and architectural programmes which evolved from the hospital's functional programme were reviewed with the various professions represented in the Consultation
and Medical Consultation Divisions, as well as in allied organizations, including the
Radiology Advisory Council and the Laboratory Advisory Council.
Reviews are made with several objectives in mind, but basically the intent is
to ensure that, in terms of the capital funds available, the greatest benefit consistent
with economical operation is derived from the construction projects. 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 250 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 detailed drawings,
and final working drawings and specifications, including the architectural, mechanical, electrical, and plumbing drawings.
2. The division is responsible for processing, and recommending for approval,
applications for Provincial grant assistance, either by direct grants-in-aid or by funds
provided through regional hospital districts, for major expansion and improvement
projects as well as minor renovations for all public hospitals throughout the Province.
Continuing benefit was derived during 1970 from the co-operation of the Department of Public Works in the assignment of architects to this Division.
HOSPITAL INSURANCE SERVICE, 1970 P 27
In March, John Glenwright returned to his former position as Manager of the
Hospital Construction and Planning Division following Wi years as Administrator
of the Matsqui-Sumas-Abbotsford General Hospital. The Manager of the Division
is a member of the BCHIS 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. He is also Chairman
of the Functional Programme Review Committee and a member of the Equipment
Committee, which are subcommittees of Planning Group.
Mr. J. M. Phillips, Senior Architect of the Division, continued during the year
as a member of the Hospital Cost Analysis Group.
Through the co-operation of Health Branch personnel, and members of the
medical and nursing profession, hospital boards were provided with a full consultative planning service. The Provincial Health Branch provided assistance through the
Technical Supervisor of Clinical Laboratory Services and the Technical Supervisor
of Radiology. Through the co-operation of the Provincial Department of Labour,
the Office of the Inspector of Factories provided a consultative service to this
Division, related to proposals for elevators and dumb-waiter installations in hospitals.
The Manager of the Division acted as a member of the committee established
to review and recommend revisions to the publication Hospitals for Extended Care,
a Programme and Design Guide.
In the interests of applying effective cost-control measures for capital-expenditure projects, policy was established requiring that independent quantity surveyors
be retained by hospitals on all major construction projects. The Manager and
members of the Division participated in the production of the booklet Cost Control
in Hosptial Design, Using Quantity Surveyors, which is designed to clarify the role
of the quantity surveyor. The booklet includes an outline of the function of a
quantity surveyor as well as recommended procedures for preparing estimates and a
draft of a suggested form of agreement between the hospital and the quantity surveyor.
During the year, liaison was maintained with the mechanical engineering profession in recognition of the need to design high-quality mechanical systems which
would make a maximum contribution toward an efficient and economical hospital
operation. Some of the elements included in designs for mechanical systems for
new hospital buildings, reflecting this approach, included air recirculation and zoned
heating and ventilating controls. Consultative advice is provided in the field of
plant operation and maintenance and equipment selection. During 1970, 24 visits
were made for inspection and advice pertaining to hospital mechanical plants and
electrical installations. A simplified system of preventive maintenance, i.e., the
Comae System, has been introduced and is either in use or is being incorporated
in 16 hospitals throughout the Province.
Liaison was maintained with the Hospitals Committee of the Architectural
Institute of British Columbia. The function of this committee is to review and
endeavour to resolve problems arising out of hospital construction projects which
affect members of the Architectural Institute. An architect on the Division's staff
is a member of this committee.
During 1970, the architects and engineers made a number of inspectional,
advisory, and educational visits to hospitals throughout the Province. In addition,
the Manager visited convalescent hospitals in California to make comparisons
between these facilities and extended-care units in British Columbia.
P 28 BRITISH COLUMBIA
(fl) Hospital Projects Completed During 1970
Chilliwack General Hospital, Chilliwack—Phase I of expansion programme:
Moving nurses' residence and altering building for alternate use.
Creston Valley Hospital, Creston—On May 4, 1970 the Honourable W. D.
Black officially opened the expanded Creston hospital. This project involved the
construction of a wing, bringing the total capacity up to 52 beds; of these, 44 are
being used. The addition included new emergency and administrative departments,
new operating-rooms, and boiler-room; also, extensive renovations were carried out
in the existing hospital.
Houston Diagnostic and Treatment Centre—The construction of this new
facility was completed late in the year and it is now expected to be officially opened
and brought into service in the new year.
Royal Inland Hospital, Kamloops—Thirty additional acute and 10 additional
psychiatric beds were brought into service on May 1, 1970, as a result of renovations
to this hospital.
Kelowna General Hospital, Kelowna—The new acute addition to the Kelowna
General Hospital was officially opened by the Honourable Ralph R. Loffmark,
Minister of Health Services and Hospital Insurance, on February 28, 1970. This
new building, known as Block B, contains 175 acute beds and most of the diagnostic
and treatment services for the hospital complex. The 71-bed extended-care unit was
also completed this year and the first patients were admitted on December 2, 1970.
Nicola Valley General Hospital, Merritt—A four-bed ward was completed at
this hospital and brought into service on January 1, 1970, making the revised capacity of this hospital 41 acute beds.
Langley Memorial Hospital, Murrayville—All unfinished areas in this hospital
have now been completed, and by moving the 10 activation beds out of the extended-
care unit, 10 additional extended-care beds have been gained. The revised capacity
of this hospital is now 107 acute and 50 extended-care beds.
Powell River General Hospital—The last four beds left unfinished in the extended-care unit were completed and brought into service on January 2, 1970. The
revised capacity of this unit is now 34 extended-care beds.
Princeton General Hospital—The Honourable Ralph R. Loffmark officially
opened the new 25-bed acute hospital at Princeton on May 9, 1970. However, due
to the construction strike during the summer which delayed the final completion of
the building, patients were not admitted or transferred until October 17.
Queen Victoria Hospital, Revelstoke—The construction strike also delayed by
several months the completion of the new hospital at Revelstoke, which was officially
opened by the Hon. Ralph R. Loffmark on December 19, 1970. The new building,
which has 50 acute beds and 10 more beds which can quickly be brought into use
when required, replaces the old hospital, part of which dated back to 1901.
Mater Misericordia; Hospital, Rossland—Renovations.
Surrey Memorial Hospital—A 78-bed extended-care unit was completed and
placed in operation during May 1970.
Trail Regional Hospital—Two projects were constructed concurrently at this
hospital—a 50-bed extended-care unit and an addition to provide 24 psychiatric
beds on one floor and a regional laboratory above. Both projects were opened
officially on January 31, 1970.
Royal Jubilee Hospital, Victoria—New laboratory facilities were officially
opened at this hospital on January 16, 1970, as a result of adding another floor onto
the South Wing. Adjacent areas were also renovated as part of the project.
HOSPITAL INSURANCE SERVICE, 1970 P 29
(b) Hospital Projects Under Construction at Year-end
Burns Lake and District Hospital—Construction of additions and alterations
to provide an additional 17 acute beds and six extended-care beds.
Chetwynd and District Hospital—A new facility of 30 acute beds to serve the
Chetwynd and Hudson's Hope area.
Chilliwack General Hospital—Phase II of the expansion project is currently
under way involving an addition for 75 extended-care, 20 psychiatric, and 16 activation beds; new laboratory, physical medicine and dietary departments, laundry; plus
the renovation of part of the existing hospital.
Fort St. James Hospital—A new facility of 25 acute beds.
Golden and District General Hospital—Additions and alterations to provide
eight more acute beds (plus two unfinished) and six extended-care beds.
Victorian Hospital, Kaslo—A new hospital of 10 beds is being built to replace
the existing Kaslo hospital.
Mackenzie and District Hospital—Construction of a prefabricated unit of 18
beds.
Nanaimo Regional General Hospital—Construction of a two-story addition to
provide 24 psychiatric and 25 activation/rehabilitation beds and an 84-bed
extended-care unit, as well as renovations, etc.
Royal Columbian Hospital, New Westminster—The construction of modular
units to provide 174 acute beds temporarily to allow the demolition of the 1912
Wing preparatory to the construction of permanent additions to the hospital; plus
renovation of existing areas.
Lions Gate Hospital, North Vancouver—A 169-bed extended-care unit is being
constructed adjacent to the acute hospital.
Ocean Falls General Hospital—Renovations to an existing building, Kimsquit
Lodge, are being carried out to convert the building to a 12-bed hospital.
Penticton Hospital—An extensive expansion programme at this hospital involves the construction of additions to provide a further 38 acute beds, 63 extended-
care beds, a floor in "shell" form, enlarged diagnostic and treatment facilities, and
renovations to the existing building.
West Coast General Hospital, Port Alberni—Due to the strike, construction
has been delayed and work on the additions and renovations is still under way to
provide a net gain of 28 additional acute beds, a 30-bed extended-care unit, and
renovation of the existing building.
Prince Rupert General Hospital—New hospital of 128 acute beds and 18
extended-care beds to replace the existing building.
Richmond General Hospital—Construction of a 75-bed extended-care unit
adjacent to the acute hospital.
Shuswap Lake General Hospital, Salmon Arm—Additions and alterations to
provide 12 more acute beds, plus 25 extended-care beds.
St. Mary's Hospital, Sechelt—Expansion of the hospital to 45 acute beds.
Surrey Memorial Hospital—One hundred and eighty-six acute beds and supporting services which form part of the major expansion programme under way
since 1968 were declared "open" by the Honourable Ralph R. Loffmark on December 13, 1970. Patients were transferred a few days later to the new wings so that
the renovation of the older parts of the hospital could be started.
Vancouver General Hospital—Tenders were received and it is anticipated that
construction of the 201-bed extended-care unit will commence.
St. John Hospital, Vanderhoof—New 45-bed acute hospital to replace existing
building.
P 30 BRITISH COLUMBIA
In addition, at the year-end, the following projects were out to tender:
Lady Minto Hospital, Ashcroft—New 41-bed acute hospital.
G. F. Strong Rehabilitation Centre, Vancouver—Expansion of hospital and
facilities to 100 beds, plus "shell" floor.
Gorge Road Hospital, Victoria—Addition to provide 300 extended-care beds.
(c) Projects in Advanced Stages of Planning
Burnaby General Hospital—Extended-care unit.
Chilliwack General Hospital—Renovations.
Lady Minto Gulf Islands Hospital, Ganges—Extended-care unit.
Fraser Canyon Hospital, Hope—Expansion.
Kelowna General Hospital—Renovation of previous main hospital building.
Royal Columbian Hospital, New Westminster—New power plant.
St. Martin's Hospital, Oliver—Replacement.
Prince George Regional Hospital—Expansion and extended-care unit.
Vancouver General Hospital—Willow Pavilion renovations.
(d) Additional Projects Approved and in Various Planning Stages in 1970
R. W. Large Memorial Hospital, Bella Bella—Replacement.
Burnaby General Hospital—Expansion of acute beds and services.
Campbell River and District General Hospital—Expansion.
Clearwater—Diagnostic and treatment centre.
St. Joseph's General Hospital, Comox—Expansion.
Cranbrook and District Hospital—Expansion of extended-care unit.
Cowichan District Hospital, Duncan—Extended-care unit.
Fernie Memorial Hospital—New hospital to serve Fernie and Michel areas.
Gold River—Diagnostic and treatment centre.
Boundary Hospital, Grand Forks—Extended-care unit.
Wrinch Memorial Hospital, Hazelton—Replacement of acute hospital, plus
seven extended-care beds.
Windermere District Hospital, Invermere—Expansion.
Royal Inland Hospital, Kamloops—Expansion, including extended-care unit,
psychiatric and activation/rehabilitation beds.
Kimberley and District Hospital—Renovations to complete five additional
acute beds, air-conditioning, etc.
Ladysmith and District General Hospital—Expansion (six beds).
Lillooet District Hospital—Expansion of acute beds, plus extended-care unit.
Maple Ridge Hospital—Expansion of acute hospital and extended-care unit.
Mount Waddington Regional Hospital District—Approval given to acquire a
site and plan a central regional hospital facility, construct ambulatory care and
diagnostic facilities at Rumble Beach and Port Hardy, and renovate St. George's
Hospital, Alert Bay.
Langley Memorial Hospital, Murrayville—Expansion.
Arrow Lakes Hospital, Nakusp—Replacement to serve Nakusp and New
Denver.
Kootenay Lake General Hospital, Nelson—Expansion of services and bed reallocation.
Royal Columbian Hospital, New Westminster—Acute expansion and extended-
care unit.
Lions Gate Hospital, North Vancouver-—Expansion of services.
One Hundred Mile District General Hospital, One Hundred Mile House—
Expansion.
HOSPITAL INSURANCE SERVICE, 1970 P 31
Pouce Coupe Community Hospital—Conversion of acute beds to extended
care.
G. R. Baker Memorial Hospital, Quesnel—Extended-care unit.
Saanich Peninsula—New 75-bed acute hospital (replacing Rest Haven Hospital, Sidney) and 75 extended-care beds.
Bulkley Valley District Hospital, Smithers—Expansion.
Squamish General Hospital—Renovations.
Stewart General Hospital—Expansion.
Tahsis—New hospital to replace Esperanza General Hospital.
Children's Hospital, Vancouver—Replacement.
Holy Family Hospital, Vancouver—Expansion and extended-care unit.
Mount St. Joseph's Hospital, Vancouver—Expansion and extended-care unit.
St. Paul's Hospital, Vancouver—Services expansion.
St. Vincent's Hospital, Vancouver—Expansion of services, psychiatric beds,
extended-care unit, etc.
Vancouver General Hospital—Activation/rehabilitation unit.
Health Science Centre, Vancouver—Acute hospital (Phase III).
Mount St. Mary Hospital (St. Joseph's), Victoria—Extended-care beds.
Priory Hospital, Victoria—Extended-care unit.
Royal Jubilee Hospital, Victoria—Renovations.
St. Joseph's Hospital, Victoria—Renovations.
Cariboo Memorial Hospital, Williams Lake—Expansion.
L
Major Hospital Projects, 1970
Completed—Creston, Kamloops, Kelowna, Princeton, Revelstoke, Surrey,
Trail, Victoria (Royal Jubilee).
Under Construction—Burns Lake, Chetwynd, Chilliwack, Fort St. James,
Golden, Kaslo, Mackenzie, Nanaimo, New Westminster (Royal Columbian), North
Vancouver (Lions Gate), Ocean Falls, Penticton, Port Alberni, Prince Rupert,
Richmond, Salmon Arm, Sechelt, Surrey, Vanderhoof.
For details, see pages 28, 29, and 30.
Architect's perspective of the new Prince Rupert Hospital
now under way. (Architects: Thompson, Berwick, Pratt and
Partners.)
The new Extended-care Unit at Surrey Memorial Hospital.
(Architects: Underwood, McKinley, Cameron, Wilson, Smith
and Associates.)
The new Psychiatric Unit
and Regional Laboratory
addition at Trail Regional
Hospital.
(Architects: Paul Smith
Associates.)
The recently completed Extended-care Unit at Kelowna General
Hospital. (Architects: McCarter, Nairne and Partners.)
P 34
BRITISH COLUMBIA
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 BCHIS
Planning Group and Vice-Chairman of the Hospital
Rate Board. The work undertaken during the year
in connection with these activities is outlined on pages
21 and 19 respectively. He represents the Service
on a number of committees of Government and
community agencies, including the Co-ordinating Committee on Paramedical Training of the British Columbia Institute of Technology, Burnaby; the Liaison Committee between the Service and the British Columbia Hospitals' Association; and
the Sub-committee on Quality of Care and Research, Ottawa.
The Director participated in a research project, under Federal Public Health
Research Grant 609-7-197, on a system of patient classification according to need
for nursing care. The study was conducted through the Vancouver General Hospital and involved five British Columbia hospitals.
The Hospital Administrators' Association and the British Columbia Hospitals'
Association instigated discussion and reviews of the National Task Force Reports
on the Cost of Health Services in Canada. The Director, who was chairman of
one of the task forces, was involved in these programmes.
Reports of the activities undertaken by the two Divisions responsible to the
Director follow.
Hospital Consultation and Inspection Division
P. M. Breel, 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 that basic
standards are met, and for the licensing of private
hospitals.
Its staff is composed of administrative, nursing,
dietary, and management engineering consultants.
The Division co-operates with all other divisions
of the Service in achieving aims of mutual interest
and responsibility. It is responsible for the analysis,
and subsequent recommendations, for approved staffing patterns resulting from hospital estimates. The
Manager is a member of the Hospital Rate Board, the Planning Group, the Functional Programme Review Committee, and the Equipment Committee. Staff members also participate in the hospital-planning functions of the British Columbia
Hospital Insurance Service, including the review of the operational implications of
HOSPITAL INSURANCE SERVICE, 1970 P 35
construction projects, and the setting of standards. Programmes and plans for construction are analysed and assessed, in conjunction with the Medical Consultation
and Hospital Construction and Planning Divisions. The Division represents the
Service on a large number of councils, committees, and working parties associated
with hospitals and the health field, and works with Federal, Provincial, and
municipal representatives on related matters.
During 1970, 278 staff visits were made to acute, rehabilitation, chronic, convalescent, and extended-care hospitals. In addition, 203 visits by nursing and
other staff consultants were made to private hospitals giving nursing-home care.
During the course of 1970 the Management Engineering Unit has expanded
its scope of activities in hospitals. Study reports, released with the approval of
the hospitals concerned, were circulated throughout British Columbia, other parts
of Canada, the United States, and the United Kingdom. Consulting services are
now being provided in addition to in-depth studies.
Personnel of the Division attended a variety of educational sessions during the
year, as a necessary means of keeping abreast of changing concepts and techniques
in the hospital field.
Research Division
Wm. E. Selwood, B.A., Acting Director
The Research Division is responsible for compiling and maintaining statistical data relating to hospitalization and morbidity in British Columbia. The
hospitals submit Admission/Separation Records for
each in-patient and a similar record for each outpatient. These records serve as the major source of
reference in deriving statistical information. 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, which produces the required tabulations.
Each year the Division carries out bed-requirement studies and prepares statistical data on hospital utilization at the request of
hospitals and independent consultants. During 1970, over 80 requests were answered involving patient-flow data and population-growth projections relating to hospital catchment areas, school districts, and regional hospital districts.
The formation of regional hospital districts has brought about a greater need
for determining hospital requirements on a regional scale, particularly concerning
services that can be shared by one or more hospitals within a region. During 1970,
the Division took part in "team visits" to several regional hospital districts for the
purpose of providing guidelines for hospital development on a regional basis.
The team consisted of members from several divisions of this Service, and following
each visit a report was prepared for the region, outlining the needs for each of
the defined levels of hospital care. The regions visited were East Kootenay,
Central Kootenay, and Comox-Strathcona.
The Division is responsible for the publication of several annual bulletins which
have, over the years, been useful to various research groups and agencies throughout
the Province and Canada. This year the publications have been redesigned to
P 36 BRITISH COLUMBIA
conform to the change from the 7th revision of the International Classification of
Diseases, Adapted, to the 8th revision. Statistics of Hospital Cases Discharged
During 1969, completed during the year, included standard morbidity tables as
suggested by the Federal Advisory Committee on Hospital Insurance and Diagnostic
Services, along with an analysis of the Province's hospitalization experience by
race, age, regional hospital district, major diagnostic group, and type of service.
Statistics of Hospitalized Accident Cases provided a broad analytical coverage of
hospitalized accidents by circumstance, by type of accident, and by nature of
injury. Another bulletin prepared and issued by the Division was an Alphabetical
Listing of Place-names in British Columbia, With Geographical Code. In addition,
a number of statistical tables, entitled "Hospital Indicators," were circulated to all
hospitals. The format and detail of several tables were modified in order to give
a broad view of hospitalization on a regional scale. However, these indicators still
allow the individual hospital to focus attention on its own performance, as well as
making a comparison with hospitals of a similar size-group.
An increasing number of special requests by community agencies, private
organizations, and by Government are processed each year.
Mr. D. S. Thomson, Director of the Research Division, is presently on educational leave, and will be returning in mid-1971.
MEDICAL CONSULTATION DIVISION
D. G. Adams, M.D., Medical Consultant
This Division is responsible for medical consultation within the Service, between other Departments
of Government, with hospitals at all levels of care,
and with regional hospital districts. Additionally,
the Division is responsible for the medical coding
and assessing of all discharge records received from
hospitals, and for the central screening and quarterly
review of patients for eligibility under the extended-
care programme.
The Admission/Separation Record, which is
completed for each patient admitted to a hospital
either in British Columbia or outside of the Province,
is assessed with regard to its medical aspects by this
Division. This review includes coding, which is done in accordance with the
"International Classification of Diseases, Adapted for Indexing Hospital Records
by Diseases and Operations," and is a function which requires the professional
knowledge and training of medical coders. The competence and accuracy applied
to this work is reflected in the statistical end-product, and, to ensure a continuing
high standard, all coders on the staff of this Division are graduate nurses. The
statistical data are basic to planning decisions, for expanding or developing hospital
facilities generally, and special departments in certain hospitals, in particular. In
addition, this coded information is utilized by the Research Division of the British
Columbia Hospital Insurance Service and the Dominion Bureau of Statistics for
the publication of hospital morbidity and mortality data. Other functions of the
review include bed usage, identifying special area requirements by reason of
geographical or industrial development, and assessing complicated individual cases,
when required.
The assessment and review of individual patients' applications for extended-
care coverage continued to provide an increasing work load. A quarterly review of
HOSPITAL INSURANCE SERVICE, 1970 P 37
all extended-care hospitals was undertaken, with two objectives—(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. In the
development of this programme the Medical Consultation Division had the assistance
of qualified consultants in physical medicine and physiotherapy, whose specialized
knowledge has been of great value. New extended-care units were opened during
the year, increasing the application review load, and at the same time placing
increased demands for professional advice on the implementation of treatment
programmes in these new units.
Dr. D. M. N. Longridge, Assistant Medical Consultant, has major administrative supervisory responsibility for the Coding Section, and the survey and review
projects previously mentioned. In addition, administration of the medical aspects
of the extended-care programme is under his supervision. Management of the
day-to-day problems which arise in the administration of these matters enables
Dr. Longridge to participate with the Medical Consultant in the preparation of
policy recommendations to the Deputy Minister, dealing with hospital conditions
and needs.
Day-care surgical services, approved as a hospital insurance benefit in 1968,
have improved the utilization of the Province's health facilities, and the Medical
Consultant continued to advise the Service in its planning for an expanded role in
ambulatory patient care. As was the case with the in-patient admission records,
all day-care surgical services records were assessed and coded according to the
International Classification of Diseases, so that this data may be tabulated in
preparation for statistical reviews.
The Medical Consultants provided continuing and active liaison with all health
agencies, through visits to hospitals, special disease groups, societies, regional hospital districts, and professional bodies. Liaison with the British Columbia Medical
Association has become particularly important, and active participation on its
Hospitals Committee and the Advisory Sub-committees on Chronic Renal Failure,
Intensive Cardiac Care, Nuclear Medicine, and Cancer Therapy Services 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 staff of the hospital, the Medical Consultant is able, with the assistance of the Hospital Consultation and Inspection
Division, to render assistance.
The Medical Consultants assist in the planning and implementation of new
services in hospitals by representation on the Planning Group, the Equipment
Committee, and the Functional Programme Review Committee at the Hospital
Insurance Service.
The Medical Consultant and the Assistant Medical Consultant participated in
the postgraduate continuing medical education programmes sponsored through the
university and the Provincial and local medical societies, as well as special and
pertinent continuing medical education seminars or courses offered outside British
Columbia.
The Medical Record Consultant serves in a consultative capacity to the British
Columbia Hospital Insurance Service, and also to hospitals within the Province.
During the year, visits were made to hospitals, primarily to encourage a high
standard of medical record-keeping, in accordance with the guidelines offered by the
Canadian Council on Hospital Accreditation. Emphasis is placed on the need
P 38
BRITISH COLUMBIA
for accuracy and adequacy in the reporting of diagnoses and surgical procedures
for coding purposes. This ensures the production of meaningful statistical and
research studies undertaken by this Division and the Research Division. Plans for
construction and renovation projects for various hospitals were reviewed and
assessed, according to the work load within the respective medical record departments. Participation as a member of the Provincial Education Committee of the
British Columbia Association of Medical Record Librarians ensured further liaison
with medical record personnel.
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 were 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 worked closely with the officials of other departments and
of the various districts in arranging for money by-laws, temporary borrowing, and
related matters.
In collaboration with the Hospital Consultation and Inspection Division, the
Administrative Officer processes, for approval under section 14 of the Hospital Act,
transfers of private-hospital property and transfers of shares in the capital stock of
private-hospital corporations. In addition, close liaison is maintained with the Land
Registry Office to ensure that the property records of both general hospitals and
private hospitals are suitably endorsed so that land transfers are not made until they
are approved under sections 14 (2) and 41 (1) (c) of the Hospital Act.
As in previous years, considerable time was spent in 1970 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.
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 consider-
HOSPITAL INSURANCE SERVICE, 1970 P 39
able number of claims for hospital insurance benefits made by unqualified persons.
Numerous inquiries from the general public with regard to eligibility matters are
dealt with by personal interview, telephone, and correspondence.
Eligibility Representatives visit hospitals on a regular schedule to see that the
British Columbia Hospital Insurance Service eligibility procedures are being properly carried out. The Representatives also assist in the training of hospital admitting
personnel to deal with problems connected with the admission of patients to hospitals and the determination of their status under the Hospital Insurance Act. This
training assistance is provided by means of visits to hospitals and by regional
meetings.
This Section keeps the great majority of employers in British Columbia supplied with certificates on which an employee's length of employment can be certified.
The Representatives maintain close liaison with these firms to ensure their continuing co-operation in providing their employees with this form of proof of residence
for hospital insurance purposes.
Close liaison is maintained with the British Columbia Medical Plan, and Eligibility Representatives supply Medical Plan applications and information to the general public in many communities throughout the Province. Regional representatives
are located in Prince George, Kamloops, Nelson, and Kelowna, as well as in Vancouver and Victoria.
Third-party Liability Section
J. W. Brayshaw
The hospitalization reports that are completed by hospitals for every patient
admitted with accidental injuries are processed by the Third-party Liability Section.
This Section also handles the arrangements under which the British Columbia Hospital Insurance Service receives reimbursement from public liability insurance companies and self-insured corporations for hospital expenses paid by this Service on
behalf of accident victims. The Senior Eligibility Representative in Vancouver,
Mr. H. E. Drab, is responsible for maintaining a third-party liability clearing-house
for the convenience of solicitors and insurance adjusters in the Greater Vancouver
area. Up-to-date information regarding the hospitalization of accident victims is
available through the Vancouver office, and negotiations may be carried out in person or by telephone, thus avoiding the necessity of corresponding with the head
office in Victoria.
General Office
C. R. Leighton
The main responsibility of the General Office is the recording and accounting
of all receipts and expenditures connected with the internal administration of the
Hospital Insurance Service. This also includes preparation of the annual estimates,
which is done in conjunction with the Division Managers. This office is also
responsible for purchasing and distributing the office supplies and equipment used
by the Branch, and is generally responsible for maintenance and safe custody of
office machinery. In addition, the General Office handles the shipping of forms to
hospitals and the sorting and distribution of mail. Stenographic services were
provided to the Information Office, and to other Divisions when the work volume
permitted. The Supervisor of this office is also the Safety Officer for the Branch.
P 40 BRITISH COLUMBIA
INFORMATION OFFICE
C. N. Shave
The Information Office is responsible for the continuing development of public
information activities. Its three main areas of involvement are general hospitals,
public, and in-service requirements.
During the year, an effective public relations programme was carried out which
involved hospitals, employees of the British Columbia Hospital Insurance Service,
the press, and other branches of the Department.
The BCHIS Bulletin, an administrative aid providing detailed explanation of
policy and procedures, was changed in format to include interesting items and
pictures from hospitals and our own staff. This change had several purposes,
namely, to give hospitals a better understanding of the British Columbia Hospital
Insurance Service and its problems, to make the Bulletin more interesting, and to
improve morale. Published every two months, with a circulation of 1,800, it is sent
to public and private hospitals as well as interested members of the general public.
A departmental contest was held in May to find a suitable BCHIS symbol.
There were over 50 entries, from which the four judges (representing the Department staff) selected the winning entry which appears on the cover of this Report.
The use of symbols for identification of government and industry is increasing, so
it was felt that if the Service was to carry out an effective public relations programme,
an identifying symbol should be included as a basic element of that programme.
Recently, name tags bearing the symbol were purchased for our consultants for
ready identification in hospitals. And, besides appearing on our publications, it will
progressively be incorporated on stationery, pins, vehicles, and crests.
Emphasis has been placed on developing a close working relationship with
members of the press and press gallery, and, during the year, health reporters from
the local press were invited to visit with our senior officials for a "behind the scenes"
look, in order to give them a better understanding of the problems British Columbia
Hospital Insurance Service has to cope with. The result has been greater co-operation
on the part of both.
Excellent active co-operation was established with the Health Branch Audio-
Visual Section and Stockroom, which resulted in much of our photographic, art
work, and printing being done at considerable saving. BCHIS films were also
transferred to the Health Branch Film Library during the year, where they are now
being cared for with the latest film-cleaning facilities, and distributed to hospitals
as part of their own film stock. This has resulted in greater efficiency.
Visits were made to the Pacific National Exhibition, Vancouver, in July for
a complete updating of the BCHIS display. Later, in September, our display for
the British Columbia Hospitals' Association Convention was redesigned, set up,
and manned at the convention, which was held in October at the Bay shore Inn,
Vancouver. In addition, a small pamphlet was printed to coincide, which gave
the latest hospital statistics on construction and costs of benefits. Hotel accommodation and transportation facilities were also arranged for the saff.
Numerous telephone and mail inquiries were received regarding hospital insurance benefits, many from new residents of the Province. In addition, there were
700 Annual Reports and over 36,000 pamphlets sent out to hospitals and the
general public on the British Columbia Hospital Insurance Service and its benefits.
Several manuals and serial letters were also sent out.
Numerous press releases were issued during the year to keep the public informed on hospital construction programmes, policy changes, and other items of
HOSPITAL INSURANCE SERVICE, 1970
P 41
public interest. Several articles were also written, as well as newspaper fillers, and
a history of the British Columbia Hospital Insurance Service has been started.
Other duties included summarizing annual reports from hospitals for the information of the Minister and Deputy Minister, maintaining a photograph file and
a newspaper clipping service, replying to general correspondence, and the preparation and editing of this 22nd Annual Report.
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 Hos-
pi:al, Campbell River.
Cariboo Memorial Hospital, Williams Lake.
Castlegar and District Hospital, Castlegar.
Chemainus General Hospital, Chemainus.
Children's Hospital, Vancouver.
* Chilliwack General Hospital, Chilliwack.
* Cowichan District Hospital, Duncan.
*Cranbrook and District Hospital, Cranbrook.
Creston Valley Hospital, Creston.
Cumberland General Hospital, Cumberland.
Enderby and District Memorial Hospital,
Enderby.
Esperanza General Hospital, Esperanza.
Fernie Memorial Hospital, Fernie.
Fort Nelson General Hospital, Fort Nelson.
Fraser Canyon Hospital, Hope.
G. R. Baker Memorial Hospital, Quesnel.
Golden and District General Hospital,
Golden.
Grace Hospital, Vancouver.
Kelowna General Hospital, Kelowna.
Kimberley and District Hospital, Kimberley.
Kitimat General Hospital, Kitimat.
Kootenay Lake General Hospital, Nelson.
Lady Minto Hospital, Ashcroft.
Lady Minto Gulf Islands Hospital, Ganges.
Ladysmith and District General Hospital,
Ladysmith.
* Langley Memorial Hospital, Murray ville.
Lillooet District Hospital, Lillooet.
Lions Gate Hospital, North Vancouver.
McBride and District Hospital, McBride.
Maple Ridge Hospital, Maple Ridge.
Mater Misericordia. 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. loseph 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 Regional 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, 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. 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, Salmon
Arm.
Slocan Community Hospital, New Denver.
Squamish General Hospital, Squamish.
P 42
BRITISH COLUMBIA
Stewart General Hospital, Stewart.
Summerland General Hospital, Summer-
land.
*Surrey Memorial Hospital, North Surrey.
Tofino General Hospital, Tofino.
*Trail Regional Hospital, Trail.
University Health Service Hospital, University of British Columbia, Vancouver.
University of British Columbia Health
Sciences Centre Hospital, 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.
Outpost Hospitals
Red Cross Outpost Nursing Station, Alexis
Creek.
Red Cross Outpost Nursing Station, Atlin.
Red Cross Outpost Nursing Station, Bamfield.
Red Cross Outpost Nursing Station, Blue
River.
Red Cross Outpost Nursing Station, Edge-
wood.
Red Cross Outpost Nursing Station, Kyu-
quot.
Red Cross Outpost Nursing Station, Masset.
Federal Hospitals
Veterans' Hospital, Victoria.
Shaughnessy Hospital, Vancouver.
*Miller Bay Indian Hospital, Prince Rupert.
RCAF Station Hospital, Holberg.
Licensed Private Hospitals
Industrial Hospitals in Remote Areas With Which the Province Has Entered Into
an Agreement Requiring Them to Furnish the General Hospital Services
Provided Under the Hospital Insurance Act.
Bralorne Private Hospital, Bralorne.
Cassiar Asbestos Corporation Private Hospital, Cassiar.
Mica Creek Private Hospital, Mica Creek.
Port Alice Private Hospital, Port Alice.
Rehabilitation Hospitals
Van-
*Shaughnessy Hospital, Vancouver.
*Sunny Hill Hospital for Children, Vancouver.
*Veterans' Hospital, Victoria.
(A number of the larger public hospitals
also have rehabilitation units.)
G. F. Strong Rehabilitation Centre,
couver.
The Gorge Road Hospital, Victoria.
Holy Family Hospital, Vancouver.
Pearson Hospital (Poliomyelitis Pavilion),
Vancouver.
Queen Alexandra Solarium for Crippled
Children, Victoria.
Other
Hollywood Hospital Ltd., New Westminster (licensed under the Mental Health Act).
Extended-care Hospitals
The Louis Brier Hospital, Vancouver.
Menno Hospital, Abbotsford.
Mount St. Francis Hospital, Nelson.
Mount St. Mary Hospital, Victoria
eluding top floor).
(ex-
* Hospitals with extended-care units.
Pearson Hospital, Vancouver (excluding
facilities for tuberculosis patients).
Priory Hospital, Colwood (24-bed unit and
71-bed unit).
HOSPITAL INSURANCE SERVICE, 1970
P 43
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.
P 44 BRITISH COLUMBIA
In 1970 there were 91 public general hospitals approved to accept British
Columbia Hospital Insurance Service patients. Care was also provided in seven
outpost hospitals, four Federal hospitals, five contract hospitals, five public rehabilitation hospitals, and one rehabilitation hospital operated by the Provincial Government. Hospital insurance coverage for patients in nonprofit extended-care hospitals and units commenced December 1, 1965. At the end of 1970 there were 27
hospitals providing extended care. Data for the year 1970 have been estimated
from reports submitted by hospitals to October 31, and are subject to minor revision
when actual figures for the year are submitted.
Table Ia shows a total of 354,700 British Columbia Hospital Insurance Service
adult and children patients were separated (discharged) from British Columbia
hospitals in 1970, an increase of 15,291 or 4.4 per cent over 1969. This table also
shows that 95.6 per cent of the total patients separated (discharged) from British
Columbia public hospitals were covered by hospital insurance, compared to 95.7
in 1968 and 95.6 in 1969. Table 1b indicates that in 1970 the British Columbia
Hospital Insurance Service paid public hospitals in British Columbia for 3,233,100
days of care for adults and children, an increase of 76,929 days or 2.4 per cent
over 1969.
As shown in Table 2a, the average length of stay of British Columbia adult and
child patients in public hospitals during 1970 was 9.12 days, and the days of
care per thousand population were 1,736. For comparison purposes, the data for
extended-care hospitals is not included in the above observations, but it should be
noted that an additional 260 days of care per thousand population were provided
for these patients.
Table 2b, under "Minor Surgery Patients," includes an estimated 30,000 daycare surgery and psychiatric patients. An additional estimated 30,000 out-patient
cancer treatments were covered by the British Columbia Hospital Insurance Service,
which are not included in this table.
HOSPITAL INSURANCE SERVICE, 1970
P 45
Table 1a—Patients Separated and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public General
Hospitals1 Only (Excluding Federal, Private, Extended-care, and
Out-of-Province Hospitalization).
Total Hospitalized
Hospitals
in Public
Covered by BCHIS
Adults
and
Children
Newborn
Total
Adults
and
Children
Newborn
Total
Patients separated—
1Q40
164,964
216,743
261,128
271,609
277,073
285,998
292,119
301,510
314,585
326,793
338,923
354,766
370,600
26,272
33,190
39,599
38,226
37,697
37,231
35,688
33,555
32,488
32,014
33,529
36,550
38,000
191,236
249,933
300,727
309,835
314,770
323,229
327,807
335,065
347,073
358,807
372,452
391,316
408,600
140,168
199,774
249,654
259,953
264,655
272,597
278,023
286,799
299,518
311,718
324,769
339,409
354,700
84.9
92.2
95.6
95.7
95.5
95.3
95.2
95.1
95.2
95.4
95.8
95.7
95.7
24,640
31,515
38,980
37,558
36,505
35,878
34,196
31,863
30,814
30,377
31,635
34,576
36,000
93.8
95.0
98.4
98.3
96.8
96.4
95.8
95.0
94.8
94.9
94.4
94.6
94.7
164,808
1955
231,289
1060
288,634
1961
297,511
1067
301,160
1963 - .-
308,475
1964 -- --
1965
1966
1967
312,219
318,662
330,332
342,095
1968
356,404
19692.
1970S.
Percentage of total, patients separated—
1040
373,985
390,700
86.2
10.5
92.5
1060
96.0
1061
96.0
1067.
95.7
1063
95.4
1064
95.2
1965
95.0
1966
95.2
1967..
95.3
1968.. -_
95.7
19692 '
95 6
19703
95 6
1
1 Includes rehabilitation hospitals.
2 Amended as per final reports received from hospitals.
3 Estimated, based on hospital reports to October 31, 1970.
P 46
BRITISH COLUMBIA
Table 1b—Total Patient-days and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public General
Hospitals1 Only (Excluding Federal, Private, Extended-care, and
Out-of-Province Hospitalization) .
Total Hospitalized in Public
Hospitals
Covered by BCHIS
Adults
and
Children
Newborn
Total
Adults
and
Children
New- T . ,
horn lom
Patient-days—
1949
1,682,196
2,198,863
2,581,042
2,675,402
2,708,337
2,778,668
2,820,122
2,895,476
3,008,632
3,093,372
3,225,333
3,315,760
3,386,500
213,874
227,674
249,273
240,207
274,032
270,298
260,979
245,756
235,796
239,972
244,715
248,324
253,800
1,896,070
2,426,537
2,830,315
2,915,609
2,982,369
3,048,966
3,081,101
3,141,232
3,244,428
3,333,344
3,470,048
3,564,084
3,640,300
1,430,646
2,005,165
2,451,839
2,546,344
2,573,634
2,631,671
2,670,176
2,747,232
2,861,260
2,946,000
3,074,959
3,156.171
3,233,100
85.0
91.2
95.0
95.2
95.0
94.7
94.7
94.0
95.1
95.2
95.3
95.2
95.5
1
I
200,585 | 1,631,231
1955
212.514 1 2.217.679
I960
241,157
231,043
263,475
257,736
246,813
230,096
220,270
222,543
226.633
2,692,996
1°61
2,777,387
1962
2,837,109
1%^
2,889,407
1064
2,916,989
1965 -
1966
1967 -
1968 -
2,977,328
3,081,530
3,168,543
3.301.592
19692
231 803 I 3.387.974
19703
238,500
93.8
93.3
96.7
96.1
96.1
95.4
94.6
93.0
3,471,600
Percentage of total, patient-days—
1040
86.0
1955
91.4
1960
95.1
1061
95.3
1962
95.1
1Q63
94.8
1Q64
94.7
1965 _
94.0
1966
93.4 I 95.0
1967
92.7 95.0
1968 --
92.6 1 95.1
19692 ___ ...
93.3 | 95.1
19703
04 0 05 4
1
1 Includes rehabilitation hospitals.
2 Amended as per final reports received from hospitals.
3 Estimated, based on hospital reports to October 31, 1970.
HOSPITAL INSURANCE SERVICE, 1970
P 47
Table 2a—Patients Separated, Total Patient-days, and Average Length
of Stay According to Type and Location of Hospital for BCHIS
Patients Only, and Days of Care per Thousand of Covered Population.
Total
(Excluding
Extended Care)
Adults
and
Children
Newborn
B.C. Public
Hospitals
Adults
and
Children
Newborn
Other B.C. Hospitals
Including Federal
and Private
Adults
and
Children
Newborn
Institutions
Outside B.C.
Adults
and
Children
Newborn
Extended-
care
Hospitals
(Including
Federal)
Patients separated—
1949
1955
1960...
1961
1962
1963
1964 _
1965
1966
1967...
1968
19691
19702
Patient-days—
1949
1955
1960
1961
1962
1963
1964
1965
1966
1967 _.
1968
19691
19702
Average days of
stay—
1949
1955
1960
1961
1962
1963
1964
1965
1966
1967
1968.
19691
19702
149,280
209,999
264,120
273,293
278,021
286,753
293,144
301,522
314,391
325,861
338,706
353,457
368,270
1,498,121
2,100,386
2,650,129
2,756,665
2,789,355
2,850,559
2,905,544
2,985,092
3,110,701
3,189,212
3,309,533
3,397,005
3,467,575
10.03
10.00
10.03
10.09
10.03
9.94
9.91
9.90
9.89
9.79
9.77
9.61
9.42
24,989
32,035
39,488
37,968
36,942
36,326
34,652
32,240
31,152
30,804
32,031
34,974
36,385
203,197
215,980
244,480
233,794
266,351
260,771
| 249,827
| 232,438
| 222,475
| 225,479
| 229,053
234,098
241,065
8.13
6.74
6.19
6.16
7.21
7.18
7.21
7.21
7.14
7.32
7.15
6.69
6.62
140,168
199,774
249,654
259,953
264,655
272,597
278,023
286,799
299,518
311,718
324,769
339,409
354,700
1,430,646
2,005,165
2,451,839
2,546,344
2,573,634
2,631,671
2,670,176
2,747,232 j
2,861,260 I
2,946,000 I
3,074,959 |
3,156,171 I
3,233,100 |
24,640
31,515
38,980
37,558
36,505
35,878
34,196
31,863
30,814
30,377
31,635
34,576
36,000
200,585
212,514
241,157
231,043
263,475
257,736
246,813
230,096
220,270
222,543
226,633
231,803
238,500
10.21
10.04
9.82
9.80
9.72
9.65
9.60
9.57
9.55
9.45
O An
9.30
9.12
I
8.14
6.74
6.19
6.15
7.22
7.18
7.22
7.22
7.15
7.32
7.ift
6.70
6.62
7,093
8,313
11,557
10,361
10,226
10,895
11,605
11,417
11,459
9,436
9,310
8,867
8,120
45,960
75,599
169,401
182,690
183,042
187,714
199,164
205,488
212,413
195,564
188,152
186,565
178,475
6.48
9.09
14.66
17.63
17.90
17.23
17.16
18.00
18.53
20.72
20.21
21 01
21.98
151
361
241
151
157
169
149
114
101
83
80
94
85
1,146
2,271
1,417
878
850
1,018
878
619
541
451
434
463
415
7.59
6.29
5.88
5.81
5.41
6.02
5.89
5.43
5.36
5.43
5.42
4 92
4.88
2,019
1,912
2,909
2,979
3,140
3,261
3,516
3,306
3,414
4,707
4,627
5,181
5,450
21,515
19,622
28,889
27,631
32,679
31,174
36,204
32,372
37,028
47,648
46,422
54,269
56,000
10.66
10.26
9.93
9.27
10.41
9.56
10.30
9.79 [
10.84
10.12
10.03
10.47
10.28
I
198
159
267
259
280
279
307
263
237
344
316
304
300
1,466
1,195
1,906
1,873
2,026
2,017
2,136
1,723
1,664
2,485
1,986
1,832
2,150
7.40
7.52
7.14
7.23
7.24
7.23
6.96
6.55
7.02
7.22
6.28
6.03
7.17
699
873
990
1,100
835
305,940
358,675
409,514
502,365
556,500
437.68
410.85
413.64
456.70
666.47
1 Amended as per final reports from hospitals.
2 Estimated, based on hospital reports to October 31, 1970. Estimated patient-days (including newborn
days) per thousand of population covered by British Columbia Hospital Insurance Service: 1949, 1,528; 1950,
1,548; 1951, 1,496; 1952, 1,527; 1953, 1,600; 1954, 1,733; 1955, 1,720; 1956, 1,688; 1957, 1,626; 1958, 1,665;
1959, 1,724; 1960, 1,804; 1961, 1,806; 1962, 1,841; 1963, 1,835; 1964, 1,815; 1965, 1,799; 1966, 1,779; 1967,
1,754; 1968, 1,774; 1969, 1,757; 1970, 1,736. (1954 and subsequent years are based on total population. Because the Armed Forces, Royal Canadian Mounted PoUce, 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 243 in 1969 and 260 in 1970. Population
figures are revised according to latest census figures.
P 48 BRITISH COLUMBIA
Table 2b—Summary of the Number of BCHIS In-patients and Out-patients
Total Adults,
Children, and
Newborn
In-patients
Estimated
Number of
Emergency,
Minor-surgery,
Day Care, and
Out-patients
Total
Receiving
Benefits
1949—
1955—
I960...
1961—
1962...
1963...
1964 ...
1965—
1966...
1967...
1968...
1969L.
19702..
174,269
242,034
303,608
311,261
314,963
323,079
327,7%
333,762
346,242
357,538
371,727
389,531
404,655
29,000
70,553
107,312
121,000
128,000
135,000
141,000
160,000
175,000
195,000
210,000
220,000
235,000
203,269
312,587
410,920
432,261
442,963
458,079
468,796
493,762
521,242
552,538
581,727
609,531
639,655
Totals.
6,267,649
2,534,073 8,801,722
1 Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to October 31, 1970.
Table 3—Patients Separated, Total Days' Stay, and Average Length of
Stay in British Columbia Public Hospitals for BCHIS Patients Only,
Grouped Accordingly to Bed Capacity, Year 19701 (Excluding Extended-care Hospitals).
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Patients separated—
Adults and children
Newborn
Patient-days—
Adults and children
Newborn
Average days of stay—
Adults and children
Newborn.—
354,700
36,000
3,233,100
238,500
9.12
6.62
175,000
16,600
1,701,300
114,100
9.72
6.87
86,400
9,700
718,100
62,700
8.31
6.46
51,700
6,400
507,000
41,500
9.80
6.48
34,200
2,700
251,500
16,600
7.35
6.15
7,400
600
55,200
3,600
7.46
6.00
i Estimated, based on hospital reports to October 31, 1970.
Table 4—Percentage Distribution of Patients Separated and Patient-
days for BCHIS Patients Only, in British Columbia Public Hospitals,
Grouped According to Bed Capacity, Year 19701 (Excluding Extended-care Hospitals).
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Patients separated—
Adults and children
Newborn
Patient-days—
Adults and children
Per Cent
100.00
100.00
100.00
100.00
Per Cent
49.34
46.11
52.62
47.84
Per Cent
24.36
26.94
22.21
26.29
Per Cent
14.57
17.78
15.68
17.40
Per Cent
9.64
7.50
7.78
6.96
Per Cent
2.09
1.67
1.71
1.51
1 Estimated, based on hospital reports to October 31, 1970.
HOSPITAL INSURANCE SERVICE, 1970
P 49
CHARTS
The statistical data shown in the following charts prepared by the Research
Division are derived from Admission/Separation forms submitted to the British
Columbia Hospital Insurance Service.
The major diagnostic categories used for the table on pages 55 to 60 are more
detailed than the diagnostic groups shown on the charts. Both lists are based on
the 8th Revision, International Classification of Diseases, Adapted, prepared by the
Public Health Service of the United States Department of Health, Education, and
Welfare.
Readers interested in more detailed statistics of hospitalization in this Province
may wish to refer to Statistics of Hospital Cases Discharged During 1969 and
Statistics of Hospitalized Accident Cases, 1969, available from the Research Division.
P 50
BRITISH COLUMBIA
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BRITISH COLUMBIA
Chart V—Average Length of Stay of Cases* in Hospitals in British
Columbia, by Major Diagnostic Groups in Descending Order, 1969
(Excluding Newborns).
Certain cases of perinatal
morbidity and mortality
Diseases of the circulatory
system
Neoplasms
Endocrine, nutritional, and
metabolic diseases
Diseases of the musculoskeletal
system and connective tissue
Congenital anomalies
Mental disorders
Accidents, poisonings, and
violence
Diseases of the digestive
system
Diseases of the skin and
subcutaneous tissue
PROVINCIAL AVERAGE
LENGTH OF STAY
Diseases of the blood and
blood-forming organs
Diseases of the nervous
system and sense organs
Infective and parasitic
diseases
Diseases of the genito-urinary
system
Diseases of the respiratory
system
Complications of pregnancy,
childbirth, and the
puerperium
Symptoms and ill-defined
conditions
W///M///////A s W/////A.
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HOSPITAL INSURANCE SERVICE, 1970 P 61
STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE
FISCAL YEAR ENDED MARCH 31, 1970
Administration-
Salaries $873,411.00
Temporary assistance 7,633.00
$881,044.00
Office expense 60,080.00
Travelling expense 59,101.00
Office furniture and equipment 14,393.00
Printing and publications 2,677.00
Tabulating and rentals 3,806.00
Motor-vehicles and accessories 2,356.00
Incidentals and contingencies 879.00
Construction and consultation fees 60,995.00
Technical surveys 50,587.00
$1,135,918.00
Payments to hospitals 155,782,683.00
Grants in aid of construction 1,982,409.00
Total $158,901,010.00
Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1971
780-1170-8687
BC Sessional Papers
Twenty-second Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1970 British Columbia. Legislative Assembly 1971
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