PROVINCE OF BRITISH COLUMBIA HOSPITAL INSURANCE ACT Twenty-third Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1971 Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty in right of the Province of British Columbia. 1972 Victoria, British Columbia, January 20, 1972. 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-third Annual Report of the British Columbia Hospital Insurance Service covering the calendar year 1971. RALPH R. LOFFMARK Minister of Health Services and Hospital Insurance British Columbia Hospital Insurance Service, Victoria, British Columbia, January 20, 1972. 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 1971. 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. H m< < X U o H < z < o o <z a> B.-0< owns C | S^5 COW , Z-< sWh (U vi Q ° C rt O £ Set OJJC .§8 3 'Io Z\ 0 -2^ *a ~ rt 0J.2 u § *H n) O tu 2 3 a. 3 '5 85 i> B cOO-0 ra ^ c S.S-S: :cu«q S-aQ rt rt "■3 3 3 rt 2 « d £ Hi - rt ru ■as 5"1 fl tfl c il.9 rt w Or,u DO •a-go ofio Ph OQ S2 w! >>& « a* *z o « >* rt 2 3s = 2 £ .9 cu tfl.3 Su^ 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. I. Lyle, F.C.I.S., Assistant Deputy Minister of Hospital Insurance. J. W. Mainguy, B.A., 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. D. S. Thomson, B.A., M.P.A., Director, Research Division. J. G. Glenwrioht, 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 15 The Hospital Insurance Act 16 The Hospital Act 16 Persons Entitled to or Excluded From the Benefits Under the Hospital Insurance Act 16 Entitled to Benefits 16 Excluded From Benefits 17 Hospital Benefits Available in British Columbia 17 In-patient Benefits 17 Other Benefits - 17 Application for Hospital Insurance Benefits 18 The Hospital Rate Board and Methods of Payment to Hospitals 18 BCHIS Planning Group 19 Organization and Administration 20 Assistant Deputy Minister 20 Hospital Finance Division 20 Hospital Accounting 21 Hospital Claims Section 22 Hospital Construction and Planning Division 24 Hospital Projects Completed During 1971 27 Hospital Projects Under Construction at Year-end 28 Projects in Advanced Stages of Planning 29 Additional Projects Approved and in Various Planning Stages in 1971 30 Director of Hospital Consultation, Development, and Research 34 Hospital Consultation and Inspection Division 34 Research Division 35 Medical Consultation Division i 3 6 Administration Division 38 Eligibility Representatives' Section 3 8 Third-party Liability Section 39 General Office 39 Information Office 39 11 V 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 1971 (Excluding Extended-care Hospitals) 48 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 1971 (Excluding Extended-care Hospitals) 48 Charts 49 I—Percentage Distribution of Days of Care by Major Diagnostic Groups, 1970 . 50 II—Percentage Age Distribution of Male and Female Hospital Cases and Days of Care, 1970 51 III—Percentage Distribution of Hospital Cases by Type of Clinical Service, 1970 52 IV—Percentage Distribution of Hospital Days by Type of Clinical Service, 1970 53 V—Average Length of Stay of Cases in Hospitals in British Columbia by Major Diagnostic Groups, 1970 (Excluding Newborns) 54 Hospitalization by Major Diagnostic Categories, 1970 (Excluding Newborns)____ 55 Therapeutic Abortions Performed in British Columbia Hospitals 60 Statement of Receipts and Disbursements for the Fiscal Year Ended March 31, 1971 61 Twenty-third Annual Report of the British Columbia Hospital Insurance Service GENERAL INTRODUCTION Donald M. Cox, F.A.C.H.A., Deputy Minister of Hospital Insurance Since the inception of hospital insurance coverage in British Columbia in 1949, residents of the Province have witnessed a development of hospital facilities which today rank among the finest to be found anywhere in the world. Credit for this development must go to the fine co-operation and efforts of the boards and staffs of hospitals, the medical profession, regional hospital districts, and the Provincial Government. During this 23-year period, there has been a steady increase in population and a corresponding increase in the need for new or renovated hospital buildings, equipment, and services, as indicated by the following comparisons: 1949 Population 1,113,000 Active-treatment beds Rehabilitation beds Extended-care beds Adult and child admissions- 5,840 164,964 1971 (Estimated) 2,196,000 10,700 415 2,100 1,682,196 10.21 7,068 395,303 1,647 3,633,713 670,000 8.95 23,600 $205,000,000 Acute and rehabilitation Extended care Adult and child days of care— Acute and rehabilitation Extended care Average hospital stay—active-treatment beds Staff employed in hospitals Payments to hospitals $16,533,000 The average length of stay in the Province for 1971 is the lowest on record in British Columbia. This did not occur by chance but is due to the combined efforts of the medical profession and hospital staffs. The significance of this accomplishment is evident when it is realized that a reduction of only one-tenth of a day in the average stay in a 400-bed hospital makes possible the admission of at least 120 more patients each year. During the past year, payments to hospitals toward expenses incurred by residents totalled $205,000,000, which is the equivalent of $93.35 being paid on behalf of each man, woman, and child residing in British Columbia. Hospital insurance daily payments to hospitals amounted to $560,000, as compared to $490,410 in the 1970/71 fiscal year, an increase of 15 per cent. 13 V 14 BRITISH COLUMBIA Since January 1, 1949, British Columbia's programme of hospital construction, initiated by public-minded citizens at community level and stimulated by generous financial aid from the Provincial Government, has produced 56 new hospitals plus major additions to many other hospitals, and including new diagnostic and treatment centres, emergency departments, laboratory facilities, laundry buildings, and schools of nursing. In all, over 10,000 beds, including 2,100 extended-care beds, have been provided. Building programmes under way at year-end, many due for completion early in 1972, will cost an estimated $51,000,000. Major projects completed during 1971 involved a total of 772 new beds, of which 221 were for extended care. In addition, 1,799 beds were under construction at year-end, with 1,054 of these for extended care. Building programmes, including major construction, renovations, and alterations, were completed in the following communities: Burns Lake, Chetwynd, Golden, Kaslo, Mackenzie, New Westminster, North Vancouver, Ocean Falls, Prince Rupert, Sechelt, Surrey, and Victoria (Glendale). During the past year, this Service worked closely with St. Paul's Hospital, Vancouver; the Vancouver General Hospital; and the Royal Jubilee Hospital, Victoria, to develop plans for major expansion of open-heart surgery programmes. Arrangements were also made to bring under Hospital Insurance coverage the methadone-treatment programme provided through the Narcotic Addiction Foundation in Vancouver. Payments have been in effect since April 1, 1971. In addition, this Service brought under coverage the out-patient services at the G. F. Strong Rehabilitation Centre. Other services involving Hospital Insurance personnel during 1971 included the sharing in the development of a programme for personal-care units in Vancouver, Victoria, and Kamloops to be constructed by the Provincial Government; representation on a ways-and-means committee set up to assist in the implementation of recommendations as contained in a report prepared for the Minister on cancer services in British Columbia; representation on a therapeutic abortion committee to study therapeutic abortion facilities in the Greater Vancouver Regional Hospital District; and to assist financially the Vancouver General Hospital to establish the first medical computer of its kind in Canada as a pilot project. In late May, J. R. Ham, Chief Inspector of the Hospitals and Charities Commission, Melbourne, Australia, visited with the British Columbia Hospital Insurance Service staff to inquire about services and to discuss matters relating to hospital administration, staffing, industrial matters, and ambulance services in British Columbia. The laboratory and radiological advisory councils continued to be of outstanding value in helping hospitals to improve the laboratory and radiological services, and in advising the Hospital Insurance Service regarding the approval of Provincial grants-in-aid for the purchase of major hospital equipment. I should like also to express my appreciation for the advice and guidance by the College of Physicians and Surgeons, the British Columbia Medical Association, the medical profession generally, and for the continuing assistance of the British Columbia Hospitals' Association and Registered Nurses' Association of British Columbia. Finally, may I offer my sincere thanks to the skilled and devoted staff of the British Columbia Hospital Insurance Service for helping make 1971 another successful year of operation. Reports by the various divisions which comprise the administrative structure of our Branch appear under "Organization and Administration" beginning on page 20. HOSPITAL INSURANCE SERVICE, 1971 V 15 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 below) will in due course issue and sell its own debentures in the amount required, which may cover a number of district debenture issues. At that time the districts will then be able to sell 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. 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. 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. V 16 BRITISH COLUMBIA THE HOSPITAL INSURANCE ACT This is the statute which authorizes British Columbia's hospital insurance plan, and under which the British Columbia Hospital Insurance Service is established. The main provisions of this Act and the regulations may be summarized as follows: (1) Generally speaking, every permanent resident who has made his home in British Columbia for at least three consecutive months is entitled to benefits under the Act. (2) Approved hospitals are paid an all-inclusive per diem rate for medically necessary in-patient care rendered to qualified British Columbia residents who are suffering from an acute illness or injury, and those who require active convalescent rehabilitative and extended hospital care. The payment made to a hospital by the British Columbia Hospital Insurance Service amounts to $1 less than the per diem rate approved for the particular hospital, and the patient is responsible for paying the remaining dollar. The Provincial Government pays the dollar-a-day charge on behalf of Provincial social welfare recipients. (3) The wide range of in-patient benefits, 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 Act. 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. (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 require 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 INSURANCE SERVICE, 1971 V 17 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 (/->) A qualified person who leaves British Columbia temporarily and fails to return and re-establish residence within 12 months; or (c) A qualified person who leaves British Columbia and who establishes residence elsewhere; or (d) An inmate of a Federal penitentiary; or (e) A resident who receives hospital treatment provided under the Workmen's Compensation Act, or a war veteran who receives treatment for a pensionable disability; or (/) Persons entitled to receive hospital treatment under the Statutes of Canada or any other government; for example, members of the Armed Forces or Royal Canadian Mounted Police, and consular officials of other countries. HOSPITAL BENEFITS AVAILABLE IN BRITISH COLUMBIA In-patient Benefits In addition to standard-ward accommodation with meals and necessary nursing services, a beneficiary may receive any of the other services available in the hospital, which may include: Laboratory and X-ray services. Drugs, biologicals, and related preparations (with a few exceptions). Use of operating-room and caseroom facilities. Use of anaesthetic equipment, supplies, and routine surgical supplies. Use of radiotherapy and physiotherapy facilities where available. Other approved services rendered by employees of the hospital. (Note—Private or 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: V 18 BRITISH COLUMBIA 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 1971 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. 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. 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 HOSPITAL INSURANCE SERVICE, 1971 V 19 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. 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 26 meetings held during the year, seven were with outside groups, including regional hospital districts. 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 continued activity by regional hospital districts in planning total hospital programmes to meet district needs. The Planning Group worked with seven regional hospital districts in developing comprehensive programmes on which V 20 BRITISH COLUMBIA money votes were held and with four other districts whose programmes are expected to go before the ratepayers in 1972. Following receipt of the report from the special task committee on cancer services in British Columbia, the Minister approved the formation of a Ways and Means Committee representative of the interested agencies to guide the implementation of the recommendations. Studies of day-care services and of diagnostic and treatment centres were continued. 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 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 1971 by the various divisions and offices which comprise the administrative structure of this branch. ASSISTANT DEPUTY MINISTER W. J. Lyle, F.C.I.S. The Assistant Deputy Minister is responsible for the operation of the Hospital Finance Division, the Hospital Construction and Planning Division, and for the administration of the Service in the absence of the Deputy Minister. He is Chairman of the Hospital Rate Board (see page 18), Vice-Chairman of the BCHIS Planning Group (see page 19), and a member of the following committees: Advisory Committee on Hospital Insurance and Diagnostic Services (a committee appointed by the Federal Government to advise on the administration of the Hospital Insurance and Diagnostic Services Act), the Radiological Advisory Council, and the British Columbia Hospitals' Association Liaison Committee. A summary of the activities of the divisions for which the Assistant Deputy Minister is responsible follows. Hospital Finance Division N. S. Wallace, 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 Authority Act. The Finance Division is responsible for reviewing the annual budgets prepared by each regional hospital district as required by the legislation, and works closely with the Hospital Financing Authority and the regional hospital districts in the financing of hospital capital projects HOSPITAL INSURANCE SERVICE, 1971 V 21 and repayment of debentures. During 1971, the Finance Division assisted the regional hospital districts in debenture sales to the British Columbia Regional Hospital Districts Financing Authority amounting to $29,000,000. The Finance Division is also responsible for the approval of grants to assist hospitals in the purchase of equipment. In 1971, after a review of approximately 6,000 applications received from hospitals, grants estimated at $2,200,000 were approved, on movable and fixed technical equipment costing $7,000,000. As a means of assisting hospital employees to maintain high working standards, the Hospital Insurance Service provided over $140,000 during the year to enable hospital employees to attend or participate in short-term training programmes. This 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 Subcommittee 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 1971 amounted to $202,000,000. V 22 BRITISH COLUMBIA (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. (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 recommendations 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 hospital-operating, pre-construction, and regional hospital district budgets were reviewed and processed in 1971. Inspection visits were made to each of 102 public general, rehabilitation, and extended-care hospitals during the year. Construction projects involving approved expenditures of $10,205,000 were audited, and cost reports involving approved expenditures of $424,000 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 the payment of 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 of Hospital Claims attended Admitting and Eligibility seminars held at Kamloops, Prince George, Fort St. John, and Castlegar. These seminars were attended by hospitals in the various regions. The Supervisor also visited new hospitals opened at Houston, Mackenzie, and Chetwynd to give advice and guidance on all matters handled by the Hospital Claims Section. He also visited the hospitals at Pouce Coupe, Dawson Creek, Smithers, and hospitals HOSPITAL INSURANCE SERVICE, 1971 V 23 in the Greater Vancouver area. While in Vancouver, the Supervisor of Hospital Claims visited the Workmen's Compensation Board to discuss matters of mutual concern. Research and adjustments to accounts showed an increase in volume, due primarily to changes in responsibility. Accounts processed were in excess of 1,850 per working-day, 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 IBM electronic data-processing equipment in order to refine 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 also checked with the verifying documents, and as a result over 4,000 claims had to be returned to hospitals during the year 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 assist further in the co-operation between the British Columbia Hospital Insurance Service and hospitals, the Supervisor of Admission Control visited hospitals for discussions of the procedures being used for verification of residence of patients. The Accounts Payment staff pre-audits the charges made to the British Columbia Hospital Insurance Service, and ensures that all information shown on each claim is completed so that it can be coded for statistical purposes, also 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 500 queries per month were addressed to the British Columbia Hospitals on such accounting matters. Preliminary figures for 1971 show that more than 440,000 accounts (excluding out-of-Province) were processed. For comparison, the figures for 1970 were 435,385 accounts processed. The Day-care Surgical Services, Day-care/Night-care Psychiatric Services, and Out-patient Psychiatric accounts increased in volume from 3,326 per month in 1970 to over 4,000 per month in 1971. During the year a quarterly statistical run of Day-care Surgical Services was introduced. 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 the punching of the data-processing 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. Over 140,000 statistical cards have been punched and verified. The Hospital Claims Section sends statements to patients advising them of the amount paid to hospitals on their behalf through the British Columbia Hospital V 24 BRITISH COLUMBIA Insurance Service. During the year, over 340,000 statements were prepared and mailed. The out-of-Province personnel process all claims for hospital accounts incurred by British Columbia residents in hospitals outside the Province. This requires establishing eligibility and the payment of claims. During 1971 over 5,800 accounts amounting to an estimated $2,000,000 were paid on behalf of qualified residents hospitalized in other provinces and territories of Canada, the continental United States (including Alaska and Hawaii), Antigua, Australia, Belgium, Bermuda, Bolivia, British Honduras, Canary Islands, Ceylon, Colombia, Costa Rica, Denmark, England, Finland, France, Germany, Greece, Holland, Hong Kong, Hungary, India, Ireland, Israel, Italy, Japan, Liberia, Mexico, Morocco, Nepal, New Zealand, Norway, Philippines, Portugal, Rhodesia, Spain, Sweden, Switzerland, Tahiti, Taiwan, Uganda, and Yugoslavia. Correspondence to accomplish the procedures amounted to over 20,000 letters for the year. This office also maintains up-to-date hospital rate schedules for every hospital in Canada. All claims were coded for statistical purposes and a data- processing card punched for each account. The Filing and Mail Unit sorted and filed over 9,000 documents and letters daily. In order to handle increased volume, new procedures were instituted. Hospital Construction and Planning Division John Glenwright, Manager '"'■' -—— ^'le rna'n 'unct'ons of tn's Division can be briefly '•Ifcfc described as follows: 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 riffijB JB the development of master programmes which con- Hl K/» jm tain a clear definition of the hospital's role, supported I JmJm ky 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 other 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 most logical and the 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. 5 MS nl Q V 26 BRITISH COLUMBIA During the year, over 200 sets of plans were received by the Division. These drawings covered many phases of planning, including small-scale schematic drawings, preliminary sketch drawings, large-scale detailed drawings, and final working drawings and specifications, including the architectural, mechanical, electrical, and plumbing drawings. 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. The Division works with representatives of hospitals and regional hospital districts in the review and processing for consideration of Government those programmes of proposed capital expenditure to be included in a by-law and made the subject of regional hospital district referendums. Continuing benefit was derived during 1971 from the co-operation of the Department of Public Works in the assignment of architects to this Division. 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. The Manager of the Division also acted as a member of a special interdepartmental committee established to develop a "Design Guide" for personal-care homes. The Design Guide was used as a basis for proposals submitted by developers for the erection of personal-care homes planned for certain specific locations within the Province. J. M. Phillips, Senior Architect of the Division, continued during the year as a member of the Hospital Cost Analysis Group. O. Brian Padden returned to the Division in August and resumed duties as a consultant architect. Donald G. Coolidge, formerly Assistant Administrator at the Royal Inland Hospital, Kamloops, joined the staff of the Division as a Planning Consultant. The members of the medical and nursing professions, and the staff of the Provincial Health Branch, through the Technical Supervisor of Clinical Laboratory Services and Technical Supervisor of Radiology, contributed materially to the provision of consultative services to hospitals. Also, 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 dumbwaiter installations in hospitals. 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. A five-day seminar for hospital maintenance engineers was held in Vancouver in September. This was conducted through the co-operation of the British Columbia Hospitals' Association. The Comae System, which is a simplified system of preventive maintenance developed by members of the Engineering staff of the Division is now in use or is being incorporated in many hospitals throughout the Province. Consultative advice is provided in the field of plant operation and maintenance and equipment selection. During the year a num- HOSPITAL INSURANCE SERVICE, 1971 V 27 ber of visits was made for inspection and advice pertaining to hospital mechanical plants and electrical installations. 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 1971 the Manager, as well as the architects and engineers, made a number of inspectional, advisory, and educational visits to hospitals throughout the Province. (a) Hospital Projects Completed During 1971 Burns Lake and District Hospital — Seventeen additional acute and six extended-care beds came into operation on July 1, 1971, as a result of the addition and alterations project. The official opening was held on September 11, 1971. Chetwynd and District Hospital—This new facility of 30 acute beds to serve the Chetwynd and Hudson's Hope area was officially opened by the Prime Minister, the Honourable W. A. C. Bennett, on October 4, 1971. Golden and District General Hospital ■— The construction project to provide eight more acute beds (plus two for future use), six extended-care beds, and enlarged service departments was completed and officially opened by the Honourable J. R. Chabot on November 27, 1971. Victorian Hospital, Kaslo—This new 10-bed acute hospital, replacing the old Victorian Hospital, was opened by the Honourable Patricia Jordan and Burt Campbell, M.L.A., on October 16, 1971. Kimberley and District Hospital—A project, including a chiller unit, ventilation system, and sun screens, to provide air conditioning was completed during the summer, and the patient accommodation was rearranged on two floors, which resulted in five additional acute beds being brought into operation at the beginning of December. Ladysmith and District General Hospital—A small project was completed at this hospital involving the provision of six additional acute beds for a total of 49, and an addition for the administrative department. Mackenzie and District Hospital—The Minister of Health Services and Hospital Insurance, the Honourable Ralph R. Loffmark, officially opened the new facility at Mackenzie on July 9, 1971, although the prefabricated hospital actually came into operation on May 3, 1971. Royal Columbian Hospital, New Westminster—The modular units containing 174 acute beds and the new department of physical medicine were opened by the Honourable Grace McCarthy on October 7, 1971. (The demolition of most of the 1912 wing and the renovation of existing areas, all part of this project, are still continuing.) Lions Gate Hospital, North Vancouver—The first patients were admitted to the new 169-bed extended-care unit on June 1, 1971. The unit was officially opened by the Honourable Ralph R. Loffmark on June 26, 1971. Ocean Falls General Hospital—The renovation of an existing building, known as Kimsquit Lodge, was completed to provide a 12-bed hospital. The official opening was held on September 14, 1971, although the first patients were transferred or admitted on May 22, 1971. V 28 BRITISH COLUMBIA Prince Rupert Regional Hospital — Her Majesty the Queen officiated at the opening ceremonies for the new hospital on May 10, 1971. The new building has accommodation for 128 acute and 18 extended-care patients and replaces the old Prince Rupert hospital which had a capacity of 88 beds. St. Mary's Hospital, Sechelt—The construction of a second storey to this hospital resulting in 10 additional acute beds, and an extended-care unit of 22 beds was completed and certain areas of the existing hospital were renovated. The project was officially opened by the Honourable Isabel Dawson on December 5, 1971. Surrey Memorial Hospital—The final phase of the expansion programme was completed and the first patients admitted to the renovated old hospital building on August 1, 1971. This hospital now has a rated capacity of 297 acute and 78 extended-care beds. Glendale Lodge, Victoria — On October 20, 1971, the Honourable W. A. C. Bennett officially opened this building, which includes accommodation for 150 extended-care patients. (b ) Hospital Projects Under Construction at Year-end Lady Minto Hospital, Ashcroft—New 41-bed acute hospital to replace the old existing hospital which has a capacity of 29 acute beds. Burnaby General Hospital—A 150-bed extended-care unit is being constructed adjacent to the acute hospital. Chilliwack General Hospital — Phase II of the expansion project is nearing completion. The project involves 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. Cranbrook and District Hospital—Fifteen-bed addition to extended-care unit. Dr. Helmcken Memorial Hospital, Clearwater—A new facility of 10 beds. Stuart Lake Hospital, Fort St. James—A new facility of 25 acute beds. Lady Minto Gulf Islands Hospital, Ganges—A 15-bed extended-care unit is being added on to the existing acute hospital. In addition, the dietary department and mechanical room are being enlarged. Fraser Canyon Hospital, Hope—Additions and alterations to provide a total of 38 acute beds and enlarged service departments. Windermere District Hospital, Invermere — Additions and alterations to provide a total of 31 acute beds and enlarged service departments. Kelowna General Hospital—The final phase of the expansion programme, consisting of the renovation of the old existing hospital (now known as Block A), is currently under way. The project, when complete, will provide 74 acute beds, including a 23-bed psychiatric unit, a 21-bed activation/rehabilitation unit, and new physio- and occupational-therapy departments; an addition at the main-floor level to provide an enlarged regional laboratory facility; and five beds for future use. Nanaimo Regional General Hospital—Construction of a two-storey addition to provide 24 psychiatric, 25 activation/rehabilitation beds, and an 84-bed extended- care unit, as well as renovations, an enlarged dietary department, etc. Royal Columbian Hospital, New Westminster—Renovation of existing areas. In addition, a new power plant, including two new water-tube boilers and related mechanical and electrical services, is under construction. South Okanagan General Hospital, Oliver — A new 45-bed acute hospital to replace the existing St. Martin's Hospital, which has a capacity of 37 acute beds. HOSPITAL INSURANCE SERVICE, 1971 V 29 Penticton Hospital—The extensive expansion programme is expected to be finished early in the new year. The project 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 renovation of the existing building. West Coast General Hospital, Port Alberni—The expansion programme at this hospital is also nearing completion. This project involves additions and renovations which will result in a net gain of 28 additional acute beds, a 30-bed extended-care unit, and the renovation of the existing building. Port Hardy and Rumble Beach—Diagnostic and treatment centres; the one at Port Hardy will have 10 temporary in-patient beds and the one at Rumble Beach, three emergency beds. Prince George Regional Hospital—Construction of the West Wing Addition to provide a net gain of 135 beds, of which 35 will be used for extended care; an enlarged power plant, dietary, central sterilizing, laundry departments, storage, etc. Richmond General Hospital — 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, 25 extended-care beds, and enlarged service departments. Stewart General Hospital—Additions and renovations to provide 10 more acute beds, expanded diagnostic and treatment facilities, doctors' clinic. Vancouver General Hospital—A 201-bed extended-care unit. G. F. Strong Rehabilitation Centre, Vancouver—Construction of an addition containing 100 activation/rehabilitation beds as well as the renovation of the existing building. St. John Hospital, Vanderhoof—A new 45-bed acute hospital to replace the existing building. Gorge Road Hospital, Victoria—An addition of 300 extended-care beds to the existing 99-bed activation/rehabilitation hospital. St. Joseph's Hospital, Victoria—An ambulatory care unit for day-care surgery patients. (c) Projects in Advanced Stages of Planning Armstrong and Spallumcheen Hospital, Armstrong—Alterations and renovations to upgrade diagnostic, treatment, and service facilities. R. W. Large Memorial Hospital, Bella Bella—Replacement of existing building with a new hospital of 19 acute and four extended-care beds. Campbell River and District General Hospital—Thirty additional acute beds and expansion of services. Chilliwack General Hospital—Third phase of expansion programme—the renovation of existing areas of the hospital. St. Joseph's General Hospital, Comox—Completion of the unfinished top floor to provide approximately 50 acute beds, additional construction of 20 psychiatric beds, day-care facilities, expansion of services. Cowichan District Hospital, Duncan—A 100-bed extended-care unit (75 beds to be finished) to be built on the old King's Daughters' Hospital site. Enderby and District Memorial Hospital—Alterations and additions to improve diagnostic, treatment, and service facilities. V 30 BRITISH COLUMBIA St. Vincent's Hospital, Vancouver—Expansion of the hospital to provide a 75-bed extended-care unit, 20 psychiatric beds, 10 day-care psychiatric spaces, occupational-therapy facilities, personnel lockers, storage, dietary facilities. Vancouver General Hospital—Renovation of the Willow Pavilion, expanded open-heart surgery facilities. (d) Additional Projects Approved and in Various Planning Stages in 1971 Matsqui-Sumas-Abbotsford General Hospital, Abbotsford — Expansion programme to include extended-care beds. St. George's Hospital, Alert Bay—Improvements to buildings and grounds. Central Saanich—Seventy-five extended-care beds and 75 acute beds to replace Rest Haven Hospital, Sidney. Chemainus General Hospital—Alterations and renovations to upgrade diagnostic, treatment, and service facilities. Fernie Memorial Hospital—Replacement of existing building with a new hospital to serve Fernie and Michel areas. Gold River—Diagnostic and treatment centre. Boundary Hospital, Grand Forks—Addition of extended-care beds. Wrinch Memorial Hospital, Hazelton—Replacement of existing building with a new acute hospital to include extended-care beds. Royal Inland Hospital, Kamloops—Expansion of acute hospital, including psychiatric and activation/rehabilitation and extended-care unit. Lillooet District Hospital—Expansion of acute hospital, plus extended-care unit. Maple Ridge Hospital-—Expansion of acute hospital and extended-care unit. Nicola Valley General Hospital, Merritt—Completion of four acute beds. Mount Waddington Regional Hospital District—Approval to select and acquire a site and plan a central regional hospital facility. Langley Memorial Hospital, Murrayville—Expansion of acute hospital. Arrow Lakes Hospital, Nakusp—Replacement hospital to serve Nakusp and New Denver. Kootenay Lake District Hospital, Nelson—Expansion of acute hospital and services. Mount St. Francis Hospital, Nelson—Renovations and improvements to upgrade the facilities. 100 Mile District General Hospital, 100 Mile House—Expansion of acute hospital. Pouce Coupe Community Hospital—Conversion of acute beds to extended care. G. R. Baker Memorial Hospital, Quesnel—Extended-care unit, expanded X-ray and dietary departments. Bulkley Valley District Hospital, Smithers—Expansion of acute hospital to include extended-care beds. Squamish General Hospital—Additions and alterations. Tahsis—New hospital to replace Esperanza General Hospital. Tatla Lake—Outpost nursing station. Burnaby General Hospital—Expansion of acute beds and services. Royal Columbian Hospital, New Westminster—Expansion of acute beds and services. HOSPITAL INSURANCE SERVICE, 1971 V 31 Lions Gate Hospital, North Vancouver—Expansion of services. Children's Hospital, Vancouver—Care-by-parent unit; children's diagnostic, treatment, and services. 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. Vancouver General Hospital—Activation/rehabilitation unit. Health Sciences Centre, Vancouver—350-bed acute hospital (Phase III). Vernon Jubilee Hospital — New extended-care unit, including extended-care beds for children; conversion of existing extended-care unit for acute care. Royal Jubilee Hospital, Victoria—Expansion. Cariboo Memorial Hospital, Williams Lake—Expansion. Major Hospital Projects, 1971 Completed—Burns Lake, Chetwynd, Cranbrook, Golden, Kaslo, Kimberley, Ladysmith, Mackenzie, New Westminster (Royal Columbian), North Vancouver, Ocean Falls, Prince Rupert, Sechelt, Surrey, Victoria (Glendale). Under construction — Ashcroft, Burnaby, Chilliwack, Clearwater, Fort St. James, Ganges, Hope, Invermere, Kelowna, Nanaimo, New Westminster (Royal Columbian), Oliver, Penticton, Port Alberni, Port Hardy, Rumble Beach, Prince George, Richmond, Salmon Arm, Stewart, Vancouver (Vancouver General) (G. F. Strong Rehabilitation Centre), Vanderhoof, Victoria (Gorge Road) (St. Joseph's). For details, see pages 27, 28, 29, 30, and 31. The new Lions Gate Hospital Extended-care Unit, North Vancouver. (Architects: Underwood, McKinley, Cameron, Wilson, and Associates.) I ■;r, ■■"" ■:& , Royal Columbian Hospital, New Westminster, showing new modular units (insert). The new addition at Chilliwack Ueneral, which includes care, rehabilitation, atric beds. extended and psychi- Artist's rendition of the new prefabricated Mackenzie Hospital. Burns Lake and District Hospital with the new addition shown at left—(Architects: Wagg & Hamble- ton.) Golden and District General Hospital, showing the new addition at right, which includes six extended-care beds. V 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 18 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 the programme development for four personal- care homes to be constructed by the Provincial Government in Victoria, Vancouver, and Kamloops. 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 management. The services of the members of this Division are available to all hospitals in the areas of hospital organization and management, problem- solving, educational roles, planning, and operational research capacities. The Division is also responsible for an inspectional programme to ensure that basic standards are met, and for the licensing of private hospitals. The staff of the Division is composed of trained and qualified administrators, nurses, management engineers, and a dietitian. The manager is a member of the Hospital Rate Board, the Planning Group, and chairman of the Equipment Committee, while E. C. Luscombe, the senior administration consultant, provides liaison as a member on the Community Care Facilities Licensing Board, Functional Programme Review Committee, and B.C.H.A. Education Committee. These duties are in addition to his responsibilities of co-ordinating the activities of the administration consultants and the analysis and recommendations for approved staffing patterns on hospital estimates. Each of the five administrators has been assigned the consultation and inspection responsibilities for groups of specific hospitals. In addition to streamlining the Division's flow of work, it has given each hospital a definite liaison with the Service. HOSPITAL INSURANCE SERVICE, 1971 V 35 P. B. Langran, head of the management engineering unit, has continued to be active in the organization of regional management engineering units in the Capital Region and in Vancouver. Unit members have been actively involved in promoting understanding of management engineering among the hospitals in the Province and have co-operated with the BCHA in providing an educational programme. The unit has completed methodologies on hospital housekeeping and studies in hospital laundry and CSR operations, in addition to many other studies for individual hospitals on a variety of subjects. Two summer students were employed during 1971 and each completed a basic research study, one in housekeeping methodology and the other on the operational implications of nurseservers. Miss E. E. Nordlund, senior nursing consultant, represents BCHIS on many nursing and nursing education committees, providing valuable liaison with the profession. During 1971 the nursing section completed a review of the level of nursing care in all private hospitals in British Columbia, in addition to their ever-growing task of providing nursing consultation for an increasing number of hospital beds in the Province. Miss H. E. Armstrong, dietary consultant, together with Mr. Langran and dietitians from Penticton Hospital and the Federal Government, is engaged in a research project at the Penticton Hospital aimed at evaluating the efficiency and cost of a new chilled- and frozen-food method. She has also been active in the planning of new facilities, regular consultative visits, as well as taking part in an educational seminar for hospital dietary personnel. During the year, members of this Division, in co-operation with the members of the Medical Consultant's Division, completed an extended-care programme guide which describes the basic principles of an extended-care programme; the responsibilities of the parties involved, that is, board, individual staff classifications, and volunteers, and describes in detail an organization and programme aimed at providing a high level of extended care. A total of 444 staff visits was made to acute, rehabilitation, extended-care, convalescent, and other hospitals. And, in addition, 294 visits were made to private hospitals giving nursing-home care. Also, as a necessary means of keeping abreast of changing concepts and techniques in the hospital field, personnel of the Division attended a variety of educational sessions during the year. Research Division D. S. Thomson, B.A., M.P.A., Director The Research Division is responsible for advising the Service on the need for additional hospital beds and services. In order to assess the demand for new facilities, the Division carries out bed-need studies, both on an individual hospital and regional basis. These studies involve a comprehensive analysis of hospitalization data as well as economic and demographic information. The formation of regional hospital districts has brought about a greater need for planning hospital services on a regional scale, and this Division co-operates with other divisions of the Service for the purpose of providing guidelines for hospital development on a regional basis. This Division is also responsible for compiling and maintaining statistical data relating to hospitalization V 36 BRITISH COLUMBIA and morbidity in the Province. The admission/separation records submitted by the hospitals for each patient form the basis of this information. All diagnoses and operations are coded according to the International Classification of Diseases Adapted (8th revision). By use of this classification system it is possible to analyse the incidence of disease by age, sex, and geographical location as well as other variables. In connection with morbidity reporting, the Division publishes a number of annual reports. Statistics of Hospital Cases Discharged 1970 includes the standard morbidity tables which all provinces have agreed to publish in order that national health statistics can be developed. Statistics of Hospitalized Accident Cases, which is also prepared annually, provides a broad analytical coverage of hospitalized accident cases by circumstance, by type of accident, and by nature of injury. A report of the Day Care Surgery British Columbia Hospitals is prepared in conjunction with the Medical Consultation Division for the purpose of showing the potential of this type of service. In addition to these reports the Division supplies data to many agencies both inside and outside of the Government. The demand for hospital morbidity data continues to grow and has become particularly useful in the planning of specialized hospital services. Every attempt is made to provide information for worth-while projects. Since the change in the Criminal Code in 1969 permitting therapeutic abortions, the Division has maintained a reporting system for all therapeutic abortions performed in hospitals in the Province. The current interest in this subject has stimulated an increasing demand for information relating to therapeutic abortions. In August 1971, D. S. Thomson returned to his position as Director of the Division after a one-year educational leave of absence. MEDICAL CONSULTATION DIVISION D. G. Adams, M.D., Medical Consultant This Division is responsible for medical consultation within the Hospital Insurance Service, between the Service and other Departments of Government, with hospitals at all levels of care, and with regional hospital districts. Other responsibilities include liaison with other health agencies such as the British Columbia Medical Association, the British Columbia Hospitals' Association, and the University of British Columbia; the medical coding and assessing of all discharge records received from hospitals; the initial medical assessment and continuing quarterly review of patients to determine their eligibility for coverage by the Hospital Insurance Service under the extended- care programme; and medical record consultation to hospitals and related organizations. The staff of the Division is composed of physician, physiotherapy, medical record librarian consultants, and nurses who are trained to undertake the assessment and coding of claims received from hospitals. The Medical Consultants assist in the planning and implementation of new services in hospitals by representation on the Planning Group, the Equipment Com- HOSPITAL INSURANCE SERVICE, 1971 V 37 mittee, and the Functional Programme Review Committee at the Hospital Insurance Service. The Medical Consultants provide continuing and active liaison with all health agencies, through visits to hospitals, special disease groups, societies, regional hospital districts, and professional bodies, and represent the Service as members of committees developed by these organizations. 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 Medical Consultant also represented the Service on an advisory committee established to make recommendations regarding therapeutic abortion facilities in the Greater Vancouver Regional Hospital District. The Admission/Separation Record, which is completed for each patient admitted to a hospital either in British Columbia or outside the Province, is assessed with regard to medical eligibility for coverage, and is then coded in accordance with the "International Classification of Diseases, Adapted for Indexing Hospital Records by Diseases and Operations." Graduate nurses undertake the review and coding functions, and in areas of difficulty receive the assistance of a Medical Consultant. The coded records are then utilized by the Research Division for compiling and maintaining statistical data relating to hospitalization and morbidity in British Columbia. Applications for admission to the extended-care programme, submitted on behalf of patients, were assessed for medical eligibility by the Medical Consultation Division. At the end of 1971, extended-care coverage was being provided to some 2,150 patients in the Province. During the year, 3,192 applications for admission to this programme were assessed for medical eligibility by the Medical Consultation Division. Additionally, 65 reviews of extended-care hospitals were undertaken to ensure that the hospitals' extended-care population continued to remain medically eligible for this benefit. During this audit review the hospital's programme is also assessed to ensure that the care which the patient receives is commensurate with current thinking in the management of chronically disabled individuals. The Medical Record Consultant provided consultative advice to the Service, to hospitals visited in the Province, and participated as a member of the Provincial Education Committee of the British Columbia Association of Medical Record Librarians. 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, and the Hospitals Committee of the British Columbia Medical Association, to render assistance. 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. V 38 BRITISH COLUMBIA ADMINISTRATION DIVISION K. G. Wiper, Senior Administrative Officer The Senior 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 and corporations are provided with assistance in connection with the drafting of hospital constitutions and by-laws, and their interpretation and application. Changes in hospital by-laws are reviewed by this office prior to their submission for Government approval, as required under the Hospital Act. A set of model by-laws has been developed for use by hospitals as a guide in making revisions. Under the Regional Hospital Districts Act, described earlier in this Report, the staff of this Division worked closely with the officials of other divisions, Government departments, and the various districts in arranging for money by-laws, temporary borrowing, and related matters. In collaboration with the Hospital Consultation and Inspection Division, the Senior 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. The Division is also involved in the acquisition and disposal of hospital sites. 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 1971 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. The Senior 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 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 considerable number of claims for hospital insurance benefits made by unqualified persons. Numerous inquiries from the general public with regard to eligibility matters are dealt with by personal interview, telephone, and correspondence. Eligibility Representatives visit hospitals on a regular schedule to see that the British Columbia Hospital Insurance Service eligibility procedures are being properly carried out. The Representatives also assist in the training of hospital admitting personnel to deal with problems connected with the admission of patients to hospitals and the determination of their status under the Hospital Insurance Act. HOSPITAL INSURANCE SERVICE, 1971 V 39 This training assistance is provided by means of visits to hospitals and by regional meetings. During 1971, regional meetings were held in Kamloops, Prince George, Fort St. John, and Castlegar, which were attended by 159 persons representing 53 hospitals. This Section also participated in a workshop on admitting procedures held by the British Columbia Hospitals' Association in Vancouver. 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, 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 in the Lower Mainland area 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, which deals with cases arising elsewhere in British Columbia. General Office C. R. Leighton One of the main responsibilities of the General Office is the handling of funds and the review of requisitions and vouchers submitted by other divisions. These include travel expenses, requisitions for supplies and equipment, grant payments to hospitals, and administrative vouchers. These are then forwarded to the appropriate branch of Government for further action. The Supervisor is responsible for gathering information from all divisions and co-ordinating this material in the preparation of the annual estimates of the Hospital Insurance Service which are submitted to Treasury Board for inclusion in the Provincial Budget. The General Office also handles the storage and dispatch of the various forms supplied by this Department to hospitals. Mail is opened, sorted, and distributed in this office and stenographic services to other offices are provided on an occasional basis. INFORMATION OFFICE C. N. Shave This office is responsible for providing a basic programme of general information and public relations. Its three main areas of involvement are general public, approved hospitals, and in-service requirements. V 40 BRITISH COLUMBIA To keep the public informed during the year, numerous press releases were prepared for the news media, dealing with hospital construction programmes, policy changes, and other items of interest. Regular editions of the BCHIS Bulletin were published every two months for distribution to public and private hospitals, as well as interested members of the public. (A total of 10,800 were sent out during 1971.) The Bulletin is an administrative aid providing detailed explanation of policy and procedures with items of interest for hospitals and our own staff. Circulation at the present time is 1,800. A general outline of the organizational structure of the British Columbia Hospital Insurance Service was updated at the request of the British Columbia Hospitals' Association, and 1,000 copies were supplied for inclusion in their Trustees' Manual. The General Information pamphlet was revised and reprinted, and over 32,000 copies were distributed to hospitals, business and industry, civic organizations, welcome-wagon agencies, and other services which come in regular contact with new residents of the Province. A pamphlet on extended care was produced as a joint effort by the Assistant Medical Consultant and the Information Officer. This is now being sent to interested parties in limited quantities. Hospital posters outlining BCHIS benefits and clarifying additional charges for private and semiprivate accommodation were updated for admitting office and reception areas of hospitals. These were sent to BCHIS Eligibility Representatives for distribution to hospitals throughout the Province. Visits were made to the Pacific National Exhibition in July for the purpose of having our Departmental exhibit redesigned. Later, in September, a new portable display was built for the British Columbia Hospitals' Association Convention which was held in Vancouver in October. A pamphlet containing statistical data and other information of interest to administrative personnel of hospitals was prepared for distribution at the same convention, and a BCHIS information booth was set up and manned for the convenience of delegates meeting with the Minister and Departmental personnel. A history of the British Columbia Hospital Insurance Service was completed during the year, and historical information on British Columbia hospitals was researched for the late Dr. Harvey Agnew. Descriptive material concerning new hospital facilities was prepared prior to the official opening of the facilities. BCHIS films located in the Health Branch Film Library, which are maintained for the free use of hospitals for in-service training purposes, were used quite extensively throughout 1971. In all, a total of 88 screenings were made by hospitals. During the year the Information Officer visited several hospitals in the Province. The discussions held proved to be very worth while, and future trips are planned. Other duties included summarizing reports for the Deputy Minister, drafting speech material, maintaining newspaper and photograph files, writing news and feature items for the BCHIS Bulletin, preparing annual estimates for the Information Office, answering telephone inquiries, and replying to an ever-increasing number of written requests for information, also the compiling and initial editing of this 23rd Annual Report. In addition, there were 650 annual reports sent out, as well as several manuals and serial letters. HOSPITAL INSURANCE SERVICE, 1971 V 41 APPROVED HOSPITALS General Public Hospitals Armstrong and Spallumcheen Hospital, Armstrong. Arrow Lakes Hospital, Nakusp. Bella Coola General Hospital, Bella Coola. Boundary Hospital, Grand Forks. British Columbia Cancer Institute, Vancouver. Bulkley Valley District Hospital, Smithers. Burnaby General Hospital, Burnaby. *Burns Lake and District Hospital, Burns Lake. ''Campbell River and District General Hospital, Campbell River. Cariboo Memorial Hospital, Williams Lake. Castlegar and District Hospital, Castlegar. Chemainus General Hospital, Chemainus. Chetwynd General Hospital, Chetwynd. 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 District Hospital, Nelson. Lady Minto Hospital, Ashcroft. Lady Minto Gulf Islands Hospital, Ganges. Ladysmith and District General Hospital, Ladysmith. *Langley Memorial Hospital, Murrayville. Lillooet District Hospital, Lillooet. *Lions Gate Hospital, North Vancouver. McBride and District Hospital, McBride. Mackenzie and District Hospital, Mackenzie. Maple Ridge Hospital, Maple Ridge. Mater Misericordiae Hospital, Rossland. Matsqui, Sumas, and Abbotsford General Hospital, Abbotsford. Michel-Natal District Hospital, Sparwood. 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, Princ 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 General 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. 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. * Hospitals with extended-care units. V 42 BRITISH COLUMBIA General Public Hospitals—Continued *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, Bam- field. 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. Canadian Forces Station Hospital Holberg, San Josef. *Miller Bay Indian Hospital, Prince Rupert. Canadian Forces Station Hospital, Masset. 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. Cassiar Asbestos Corporation Private Hospital, Cassiar. Mica Creek Private Hospital, Mica Creek. Port Alice Private Hospital, Port Alice. Rehabilitation Hospitals G. F. Strong Rehabilitation Centre, Vancouver. The Gorge Road Hospital, Victoria. Holy Family Hospital, Vancouver. Pearson Hospital (Poliomyelitis Pavilion), Vancouver. Queen Alexandra Solarium for Crippled Children, Victoria. *Shaughnessy Hospital, Vancouver. *Sunny Hill Hospital for Children, Vancouver. ^Veterans' Hospital, Victoria. (A number of the larger public hospitals also have rehabilitation units.) 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 (excluding top floor). Pearson Hospital, Vancouver (excluding facilities for tuberculosis patients). Priory Hospital, Colwood (24-bed unit and 71-bed unit). Glendale Lodge, Victoria. Out-patient Clinics Houston Hospital, Houston. The Narcotic Addiction Foundation of British Columbia, Vancouver. * Hospitals with extended-care units. HOSPITAL INSURANCE SERVICE, 1971 V 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. V 44 BRITISH COLUMBIA In 1971 there were 94 public general hospitals, including two diagnostic and treatment centres, approved to accept British Columbia Hospital Insurance Service patients. Care was also provided in seven outpost hospitals, five 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 1971 there were 34 hospitals providing extended care Data for the year 1971 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 1a shows a total of 365,021 British Columbia Hospital Insurance Service adult and children patients were discharged (separated) from British Columbia hospitals in 1971, an increase of 9,572 or 2.7 per cent over 1971. This table also shows that 95.8 per cent of the total patients discharged (separated) from British Columbia public hospitals were covered by hospital insurance, compared to 95.6 in 1969 and 95.7 in 1970. Table 1b indicates that in 1971 the British Columbia Hospital Insurance Service paid public hospitals in British Columbia for 3,266,675 ,days of care for adults and children, an increase of 33,122 days, or 1 per cent over 1970. As shown in Table 2a, the average length of stay for British Columbia adult and child patients in public hospitals during 1971 was 8.95 days, and the days of care per thousand population were 1,693. For comparison purposes, the data for extended-care hospitals are not included in the above observations, but it should be noted that an additional 305 days of care per thousand population were provided for these patients. Table 2b, under "Minor Surgery Patients," includes an estimated 48,000 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, 1971 V 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— 1949.- 164,964 216,743 261,128 271,609 277,073 285,998 292,119 301,510 314,585 326,793 338,923 354,766 371,266 381,243 26,272 33,190 39,599 38,226 37,697 37,231 35,688 33,555 32,488 32,014 33,529 36,550 36,931 35,354 191,236 249,933 300,727 309,835 314,770 323,229 327,807 335,065 347,073 358,807 372,452 391,316 408,197 416,597 140,168 199,774 249,654 259,953 264,655 272,597 278,023 286,799 299,518 311,718 324,769 339,409 355,449 365,021 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 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 35,047 33,919 93.8 95.0 98.4 98.3 96.8 96.4 95.8 95.0 94.8 94.9 94.4 94.6 94.9 95.9 164,808 1955 I960 231,289 288,634 1961 - 297,511 1962 1963 1964 - a 1965 1966 1967. 1968 301,160 308,475 312,219 318,662 330,332 342,095 356,404 1969 373,985 19702 19713 390,496 398,940 Percentage of total, patients separated— 1949 86.2 1955 - ... 92.5 1960 96.0 1961 96.0 196?. 95.7 1963 95.4 1964 95.2 1965 95.0 1966 - .. 95.2 1967 95.3 1968 95.7 1969 95.6 19702 95.7 19713 _ 95.8 i Includes rehabilitation hospitals. 2 Amended as per final reports received from hospitals. 3 Estimated, based on hospital reports to October 31, 1971. V 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 Hospitals in Public Covered by BCHIS Adults and Children Newborn Total Adults and Children Newborn Total 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 3,384,586 3,403,488 213,874 227,674 249,273 240,207 274,032 270,298 260,979 245,756 235,796 239,972 244,715 248,324 253,081 229,404 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 3,637,667 3,632,892 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,?33,553 3,266,675 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 95.9 200,585 212,514 241,157 231,043 263,475 257,736 246,813 230,096 220,270 222,543 226,633 231,803 238,049 218,063 93.8 93.3 96.7 96.1 96.1 95.4 94.6 93.0 93.4 92.7 92.6 93.3 94.1 95.0 1,631,231 10SS 2,217,679 1°60 2,692,996 1961 - _ 2,777,387 106? 2,837,109 1%3 2,889,407 1064 2,916,989 1965 2,977,328 1966 - - - 1967 - 3,081,530 3,168,543 1968 3,301,592 1969 3,387,974 19702... 19713 Percentage of total, patient-days— 1040 3,471,602 3,484,738 86.0 lOS". 91.4 lOfin 95.1 1061 95.3 106? 95.1 1061 94.8 1964 a_ 94.7 1965 - 94.0 1966 - - 95.0 1967 a 95.0 1968 95.1 1969 95 1 19702. 95.4 19713 95.9 1 Includes rehabilitation hospitals. 2 Amended as per final reports received from hospitals. 3 Estimated, based on hospital reports to October 31, 1971. HOSPITAL INSURANCE SERVICE, 1971 V 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. Patients separated— 1949 1955 .- 1960 _ 1961 1962 1963 - 1964 - 1965 1966.. 1967... 1968 _ 1969 19701 _ 19712- — Patient-days— 1949 1955 1960 1961 1962 — 1963 1964 _. 1965 1966 1967... 1968 a. 1969 -- 19701 19712 Average days of stay— 1949 1955 - 1960 1961 1962 1963 _ _- 1964 1965 1966 1967. 1968..- -- 1969- -.. 19701 -- 19712 Total (Excluding Extended Care) Adults and Children Newborn 149,280 209,999 264,120 273,293 278,021 286,753 293,144 301,52? 314,391 325,861 | 338,706 | 353,457 369,210 379,081 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 3,465,504 3,496,900 10.03 10.00 10.03 10.09 10.03 9.94 9.91 9.90 9.89 9.79 9.77 9.61 9.39 9.22 24,989 32,035 39,488 37,968 36,942 36,326 34,652 32,240 31,152 30,804 32,031 34,974 35,431 34,369 203,197 215,980 j 244,480 j 233,794 | 266,351 | 260,771 | 249,827 | 232,438 | 222,475 | 225,479 | 229,053 | 234,098 240,657 220,778 8.13 6.74 6.19 6.16 7.21 7.18 7.21 7.21 7.14 7.32 7.15 6.69 6.79 6.42 B.C. Public Hospitals Adults and Children 140,168 199,774 249,654 259,953 264,655 272,597 278,023 286,799 299,518 311,718 324,769 339,409 355,449 365,021 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 3,233,553 3,266,675 Newborn 24,640 31,515 38,980 37,558 36,505 35,878 34,196 31,863 30,814 30,377 31,635 34,576 35,047 33,919 200,585 212,514 241,157 231,043 263,475 257,736 246,813 230,096 220,270 222,543 226,633 | 231,803 | 238,049 218,063 I 10.21 10.04 9.82 9.80 9.72 9.65 9.60 9.57 9.55 9.45 9.47 9.30 9.10 8.95 8.14 6.74 6.19 6.15 7.22 7.18 7.22 7.22 7.15 7.32 7.16 6.70 6.79 6.43 Other B.C. Hospitals, Including Federal and Private Adults and Children Newborn 7,093 8,313 11,557 | 10,361 j 10,226 | 10,895 | 11,605 I 11,417 | 11,459 | 9,436 9,310 8,867 8,307 8,160 45,960 75,599 169,401 182,690 183,042 187,714 199,164 205,488 212,413 195.564 [' 188,152 | 186.565 | 176,086 170,225 6.48 9.09 14.66 17.63 17.90 17.23 17.16 18.00 18.53 20.72 20.21 21.04 21.20 20.86 I 151 361 241 151 157 169 149 114 101 83 80 94 87 100 1,146 2,271 1,417 878 850 1,018 878 619 541 451 434 463 450 465 7.59 6.29 5.88 5.81 5.41 6.02 5.89 5.43 5.36 5.43 5.42 4.92 5.34 4.65 Institutions Outside B.C. Adults and Children 2,019 1,912 2,909 2,979 3,140 3,261 3,516 3,306 3,414 4,707 4,627 5,181 5,454 5,900 21,515 19,622 28,889 27,631 32,679 Newborn Extended- care Hospitals (Including Federal) 198 159 267 259 280 279 307 263 237 344 316 304 297 350 1,466 1,195 1,906 1,873 2,026 31,174 | 2,017 36,204 | 2,136 32,372 | 1,723 | 699 873 990 1,100 1,022 1,647 37,028 47,648 46,422 54,269 55,865 60,000 10.66 10.26 9.93 9.27 10.41 9.56 10.30 | 9.79 | 10.84 10.12 10.03 10.47 10.24 10.17 1,664 2,485 1,986 1,832 2,158 2,250 7.40 7.52 7.14 7.23 7.24 7.23 6.96 6.55 7.02 7.22 6.28 6.03 7.27 6.43 305,940 358,675 409,514 502,365 531,808 670,000 437.68 410.85 413.64 456.70 520.36 405.91 1 Amended as per final reports from hospitals. 2 Estimated, based on hospital reports to October 31, 1971. 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, 1,734; 1971, 1,693. (1954 and subsequent years are based on total population. Because the Armed Forces, Royal Canadian Mounted Police, and some other groups are not insured under the Provincial plan, the actual incidence of days would be somewhat higher than shown.) In addition, estimated patient-days per thousand population for extended care amounted to 250 in 1970 and 305 in 1971. Population figures are revised according to latest census figures. L V 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 1969 - 19701— 19712-- Totals. 174,269 242,034 303,608 311,261 314,963 323.079 327,796 333,762 346,242 357,538 371,727 389,531 405,663 415,097 29,000 70,553 107,312 121,000 128,000 135,000 141,000 160,000 175,000 195,000 210,000 220,000 235,000 265,000 6,683,754 2,799,073 203,269 312,587 410,920 432,261 442,963 458,079 468,796 493,762 521,242 552,538 581,727 609,531 640,663 680,097 9,482,827 1 Amended as per final reports received from hospitals. 2 Estimated, based on hospital reports to October 31, 1971. 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 19711 (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.- 365,021 33,919 3,266,675 218,063 8.95 6.43 194,515 16,755 1,805,182 111,178 9.28 6.63 85,366 8,647 710,525 54,021 8.32 6.25 47,732 5,679 482,853 36,340 10.11 6.40 29,475 2,165 217,193 12,887 7.37 5.95 7,933 673 50,922 3,637 6.42 5.40 1 Estimated, based on hospital reports to October 31, 1971. 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 19711 (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 100.00 100.00 100.00 100.00 53.29 49.40 55.26 50.99 23.38 25.49 21.75 24.77 13.08 16.74 14.78 16.66 8.08 6.38 6.65 5.91 2.17 1.99 1.56 1.67 1 Estimated, based on hospital reports to October 31, 1971. HOSPITAL INSURANCE SERVICE, 1971 V 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 1970 and Statistics of Hospitalized Accident Cases, 1970, available from the Research Division. V 50 BRITISH COLUMBIA o O < s So O n < 5 £. «-* u iilpL s z s E (/ o ffiplp^_ ppj L I t> —. JliK pPTL . ■ aO 03 60 C HOSPITAL INSURANCE SERVICE, 1971 V 51 u 23 Oto\tO\i,^,t^^*'fliO\'td-*o\'t u a cot-r-^ovom'n^^mmfs.tS'-H^H H * 0""lOaaiO»'.©aa,Oaa|OanOl*.©l/,©l/.aH OOOQraf^ aOaOlOa-1 ,«l* "a* **. <*. Pa fa .— H O, £ S * ES ft, Q Z < X U £ V 3 Ph o re r* «a W o = u !H- 0 Q, 43 X g C c -o o 5j 3 0 S c V 52 BRITISH COLUMBIA U a" H < U aJ < 2 O 35 z o < U HOSPITAL INSURANCE SERVICE, 1971 V 53 o OS a. < 2 w o X a < Z < S i u :=\ ft, Cfl VO g/ (2 \ \i>y V 54 BRITISH COLUMBIA Chart V—Average Length of Stay of Cases* in Hospitals in British Columbia, by Major Diagnostic Groups in Descending Order, 1970 (Excluding Newborns). Certain causes of perinatal morbidity and mortality Diseases of the circulatory system Neoplasms Endocrine, nutritional, and metabolic diseases Diseases of the musculoskeletal system and connective tissue Mental disorders Congenital anomalies Diseases of the skin and subcutaneous tissue Diseases of the digestive system Accidents, poisonings, and violence 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 I I I m. I l ¥/. I I I 17.1 15.6 M 14.3 13.4 7//, 13.3 . 77, 13.2 11.9 9.9 9.8 9.8 9.3 1 9.3 t. 8.3 EM 6.5 5.5 WEM 1 i 1 * Including rehabilitative care. HOSPITAL INSURANCE SERVICE, 1971 V 55 Z bS O « o z 3 D _> o X w o r~ as O o ft) E-l ■< U H tn O Z o PS o <! ta z g H < H E 8 W RJJ3 >> >H tt W WS H ih N Q ri 6 h d d rtr*lriTFP'*V.OvMOHOO(N»Hr)OlNrt(SH^(iiVjOOf''H oooooo.o OOOO ooooo'ooooooooo ooo J O t-# T-H -H -i o' i-h o' o O IN VO lH odd o N^w'H^NNH;oqrHH-^rtrto«m'HqNNmO^00N O fi o d d d o o d o —' ■ • - ■ ■ jHH/^HrtOMm'-qfsr.r.q'HOON ido'dddoodddodddoo'd cn cn o fi mi ! fN fN vo i-h >cmiflriNM^^OMNhls;ts;r.MVDiocJ;ini oo vo vo r- m j *n ■"* 00 «o CCHc)»TtOV.HI r- vo oo fi oo r- in i *"t "1 ^ ^t °^ *"* °i.' ri(N t-^vo hi r-ooKnm<m>/"jcovoi— -•idv-Hcor-TJ,ciom'H--T4-iHiHMoor.rHin w^^^vO-^w^^^NOv»MM(T.(vicOff,r-vDvooo^r--vot~" ooiodv ^HnNN^Nrt iHp-qcJvivrNO^,"nOsO\-s'(TiHr»f'. O c>-ff r-rTr*invo"r-" m* ,- inM" i> «<n r-' rn rn rT r-' t' fnoTvD <-h cn Tt .-h o i-h ri i-* i-1 cn «n (N--h i-i mi ca mf t~~ VO OO fN O ' en fi VO VO Ov i H!HN(f|H O 'tt3\r-tfit>Hi/iOMO'HTJ,*C>H(*l>COl€''l^M^ClM)\N i-h C7\ o ov o Cr\ •—■ ONT^oor^rsioooN'^'-Hr^rNi--oi/-i,rj-'---v-.t~-o^-l"r-l~~ fN r~VO(N-Oc7iVDVOI/,'H ^t VO r-i/. Tt THOCliHr-^Oir-^-OMO z < 8 O O TT ooo ooo s Os fi cn s s t— cn -^ v ; o o o c I - I O ^1- O I i-H cn Tf I OOO' ,22 oooooc _ on O. o rn Tt rtrtrt, Os cn oo vo Ov 00 Ov 7 <N ,sql •H O , 1^ OS r o o , 2"' fN r- oo ON Ov © o i-h a^.iTtOi-1 ■m-r.cor-'-H'-H.NtNvor- rNo i «-i vo vo r- .. r- oo . f co oo oo oo ov -I ., *-< ,—t „ cn ,rtwHHNHrtrt00Hr.Hr-rtO^fn(Sr.Q0n r- 001-h.s „ovOo *-• i-h fN <N «N fi VC' oo T-H 1-H O •o .2 .3 o *J3 13 rt cs ft" Jh w 3 c 5 ° rt r- «s > rt 'a3 W CJ u ^ ® 3 -■ 3 S ' -H £ rt ft-S .3 og rt 3 j- O ^3 tn '53 u O D. -3 cfl tu O y '-3 QJ c« 3 ll§a§jl O OJ ft 5 "3 CJ - n iii 3 ™ u 3 a a s p a » « i w S3 0 22 ft cj > -g n 't'S 9 i o> 3 Si o E 3 '... o 0 B S en (Tt ft ft o tu V cy" rt "3 3 fi L: W ■ rt 3 Ju a> If II S B ° 2 JD ft oj *> o o d rt JO 3 oooooooooo O O i Ufa rtrt^rt^rtrtrtrtrtrtrtciirtrtrtrtrtc rt a ■'ft'& a*& OOOO i a ft O o ft ft ft ooo aj oj uj ft ft ft ?s 9 9. ftrt o >, S33CP3CSS33S32 3 d 3 3 3 C 3 • 3 3 3 3 3 3 3 . tij cij bii t* oc bjj S) bij co m od t 3 3 3 3 3 3 >o 00 ojj Ofi DD OU OC i/irtrtrtrtrtrtrtrartrtrtrtrtrtrtrtrt a. Hffl « C 3 3 .13 oj co rt c v> j_ a > ^■'S X> 3 O tj. t+H tj_i ti-i en 0 o O o o 1 I I 53 I cfl rt rt rt rt 5ft ft ft ft ft o o o o O QJ 0> QJ V QJ 3 3 3 3 G 3 3 3 3 U OO 00 CO oo 3 J3 'S *S 'S "S tN cn Tt fi \o l> oo I M r 1 so C^ CO Os <Z> mi ( V 56 BRITISH COLUMBIA TS ^> 3 •5 1 cn Z di o W o z S 5 ml U X W o Os PS Q O w H < H s Z o < at. o « rH z o H < N < » o 00 rt-3 >» o oo<-> > CM <3 go < Q U .23 O -h cn o d o" **} "". *"1 ■". **. '"I **! *1j *i *m> ca »h tj- m Tt o_ oo tj- oo en r-t r> -- oo *-< i-j cn cn cn vq cn <-j fNoddi-'ddoddddd»odi-Hdo'i-H'ododcndoo'dodod *°. H. ^ "^ °! H, 'i 9 "! ^ "I ° "^ ° n ^ ^ ^ ^ ^ ". "^ 1 * H. ^ 1 1 T*! m N i-'ddddddddddddTtodddT-.do'oO'-n'dddo'oddd Tf on \q Tt oo* vd r- vo vo" ON TtTfiiOTfcnTt^c^iu^cnooTtvoMON>ri'-^TtoocN'-H>cof^ en vd t-i m' Tt .-■ cn oo' cn on «n co r-" rn d d vd >-. ,-! vd r^ (N fN ov oo cn oo" od on c-- ov r-" ,_, ,_,,_,_,_,,_.,_,,_, T-H rH "^-irNl-HfNr-" T-. Tt r4 « (N (N T-H Tt fi r- o fN tn on cn on in CN oo On cn un *h fN i-h" t> en r^inTtTtr^OTti-HfNONvoocn*^vocni>'-Hcni^ONc>vovocjog\c^^ N-OMalwrtc>m^l^^lvocJ^o^w^^»^oo\co^fSMll^Hlf^gx^^lC io*N>r.ift»(vl«i cn oo in Ttrn r-T-H m vo r» m vo on cn o fi inr-winrtftflSmt^ orTrN cnov Tt ov n" m" n" <n ro ro vo" n" Tt ^o" tN ■*" on m vd ■* t" ^f co r- ON on cjC o Tt 00 Tf «N i-HONi-HcntN'-HVO fNcn i-H t-h t-H in rn -I —ion ONTtmcnOi-HTtooTtTtm... com*— os so i-h inrNONOr-cnr-vofNtNooi-Hi (Shoo Om OP.NHinfrihiitt'tHMCCNVO^init1 ..-TtOTtvor-ooNfNr- looitOt^HOr-^Nhn )TtO'"H<nCNl-HTtmOl-Hl-HNO i-h m tN CN (N cN tN • cn Tt fN oo cn | cn o <N - tN • -cn ° 3. <N fN ON T-I r- ■* tN tN CN I -Tt Q O (N Tt Tt «N fN vo oo o\ m os ov Tt >n vot~-r-oo (NOfNfNfNfNfNO' f} fi ov Tt cn OnoOtSfn HinvDTtOenTtr*"lcnmenmOfN»n cntN--iOOTtO(NfNfNOfNfN(NfNcncncnCNOC_ _ Tt mvor-r-oo oo os o^riiNn tN cNcNfNtNfN cn cn tN cncncncnm Tt cn cn 4 | I cn o o ^ m vo cjS rt o At « s s 52 op oo Jj § 3 3 J3 ft to TJ 3 cc £ ft a> J2 o 3 3 cu uo o 00 tl C-Q -c -3 - * o 3 1 « S2 tfl •3 I .ti "cfl oj 33 ! O O 22 <U I M-0 S S « I o 6 1) - (fl -J TJ Tj TJ *0 u s n y C rt O -mA i y x .22 i * 2 tj s j, O o u OJ 1ZHOQ . 5 « a. c M, ca c &1 go ■a! I. JO §•0 5 c 0 ra O w __ --. CO T3 13 -O-g c O ■o G ca O S S ^s ."to o >. a «, 0»B« _o « ca -* 1> '-a ^3 a-. T3 a) ^ ° £ i S: S. « CJ £ m '3 >n 0 n H « J3 ft oj o, o sirs V ^ TJ I a on tl o &-t5 a ™ ■g « lag?3 S s JS « a a. a «j = S a> 0 ^ §68 l"#2 Cfl "" -H >. Ih -3 tfl 4J G «5 I o °S' > "al " aa C C u ca ca , 5-S & flf | ° 3 V 11 ! a o s ca £ o I 81,1 2P.WO o - 05 ■ in vo t> oo _ ■TtTtTtTt<-:Tr-n>n ,22 On O "-h cj ' t 3 i-h tN c ! vo vo v HOSPITAL INSURANCE SERVICE, 1971 V 57 H-/.r-cj^q(SW^Ttir.i(iHir,MOrnTr^r-H.OLf,r-hconNit^ dddoddoTt'o'ddfNTtdoi-HCNoo'do'i-HddoNi-'dcni-HOi-HodddddT^ TtinT-<fSON^cnONT-.fOTt-N00TtT-icnc>fNTt^m do'dodoondddH^do'odddddddo^'d TttNi^inTtooovqpT-iNoi^T—lOTtTtt^r^ooovr^t^tNcnin cNO.i>i^vdi>inincoTtdcT.Tt — TtvoTtvdc^in HMHr.HrHHrNNr.HlHHHH T-I T-.T-H fN i— i-H t-i i-H T-I 1-H ONOfNpT—1-Ht^inOTtt^Ttooinooovi-Hi^oocnooovOT—ooT^cntNcnONOooocncN^ v-lO\l/.Tjlt^^nHM\OOOTj-^T-HinhltOTf^r-grtHVOfnh>^^X^OlTrTf^[J(^TjHTrOM-l inc^oovo^oinr^^incnooi—c^ONi-HrnininTtON—.\0<ftONvVOOiHv.or*«)VOvo*f oor|0 . t- cnvoi-H i— vo" <s" cr) n t~>* t->" in in oo" »/ ri" m ic rf m* t" vo' ■* tj-* «' tN ca os mi co ci t^ fi t— . cnoot-ifN i-Hcni-H Ttvoi-HT-iTtmcn • tNc3v-noooooN»n--i un tn ^H^H^^Mcoo^r^NNvofM-noolnlt^oc^^o«w^W"Ot*w^^^^HM^'*vooo^ r>r^ooovooininc>TtcocNr^aoMC7vfn^cn^«n«nT-oooOfNTtTtT-i\o»nfNvovoincnoo^ Ttco-nootNfNtNTtr-ioNvoTtcncncntNcnoocnf/ncjNTtcnrnr^r^c^.^ «n in .—i m ' ~ 1-ht-h m i—m" th" -tf o" -- i-Tcn i-h cntN tN on i-h on Tt cn r-^ HH i-h — m cn r- cn cn .. Os vo r- »-i t- Tt ON Tf CO VO cn Tt in cn r- r- r- .. cn cn cn rN oo I t-h cn tJ- 00 - 00 cn cA en cc cA oo "rt Ttov '^■"nI" oo cn ■nOvovo i-HtN cnl Tt m -,••—* t- *** **, nnstis,rs|:Ts.'TSi!.i5?iI5si«B OOtnOTtl-HOTtfNTtTtT-TtT-HTtTtVOOOOOOTtinin onOono —tN cn m Tt in mvovor-ooav CnnCnTt TtTt TtO Tf Tf TtTtTtTtTtTt I m cn vo O 1-H T-I Tt fi fi fi O - - - f> fN O fi O T— T- m m in ■n r— fi ov "t- CN fN Tt «n »n m tN t-h ! J | cn ft o O vo in - CA CA fN tN fi fi f> en vo cn t-h tn en cn Tt fi >n m in f> fi fi fi -cn - I - _ 1 O fN "i in cn v m fi i i fi B.B. &E|iSfe<i >, £• iii aa. O >. uS a. -r; co sag _ -H +H hri rt -— SS " s •3 u o « ; 6 g 13 '3 * B a - a 5 JI i-UOOOZO SS .3 Jo -3 OJ s -: _^ « 43 ,3 ! TJ TJ y (H ' <0 rt 'S ° Ills- Sill- K<00 •S a s-s " 6* 0.2 ft O o — -- ta _C 4) 0> J-* uuo .2 ■j § :■ S aj g- ta-SB' <Oft &S a o 2£ 3 " a u >,o '3 S._. aa. C3 '-. O .t. " • ft" 0> tfl H tf, <U a. ca s. u « « g.„ .-. j= O. ca 2 ca (i Ph >ffi -13 « Fl Ct- Sill . OJ . . i-h « in cn ON —. Os Os U TJ 3 .3 2 3 "£ li .1 Q u ca m-SS ... c ^ a -. xi SS~2 -- o rt 6 S SS *; au^ D. a wi C g. « ssS'; rt cu E? ( •th jn to 9- fciTa-, « h.H 8 M ,3 3 J- «3 >,J- OJ oj ra Q Ifl c u -3 3 o: ^ u c <H >■ S OJ ft 3 -.ES' O.Wftl f.m e3 O « j=J QJ OJ DO S 0) O •H-H K fl « 5 I O C aT3 o a o S < a-ossjiagg ■•3 "S 01 -31 j M- IS! SB &S S3 05SOO<SK V 58 BRITISH COLUMBIA T3 3 •S z 3 o CO 6 z 5 p ml O X B o r-- o\ CO s 5 o o W H < u O H c/> O z o o hi < Z g < < H 5. CO O E 3 O O „ tfl aa 3 ^^fflvjowwHft.vQ\qvDr»^dNNH^N^tno\^\fiN t-i m «n Tt vo »n cn oo ovt-h .D a-.ca cacj doHodfJddtNVdddddrlddddddddco ddodoTt d o do Cfl Q s OJ 00 rt G 4) CA TttNtNcNOO*ni-HtN,r^ONr~ooinocotNininvoinoo--oo i-h m cn fN oo Tt Tt Os ihm ci odT-"dotNoddoT-.ddoT-|ddddddoT-HT^Tt o o d >-.,-. r^ d d ho Ih u T-I T-H ft. flJ^ eow rt,3 X OJ OD+j W O ^ vfl'vO ce ^ q it. l> O V. » a\ tN ih o vo ■* VO N (J\ M p tl m U\ r^ oo ■* oo cn Tt vo vc Ooooovr^T^oNtNcnvorncor^voooTtcn^cr.r^vdOcnvoin in Tt' in cN cn -n oo oo r-^cn > 3« <3 ou voi>OTtT-HaNfNinTtcnfMOT-oovvO'-HTtvONOvocoinOvin vo m oo m i~« -h av i-h oOi— oovoi-Hi»voccTtcor-fNoocnfnr^i^vocncnT-iinOTtoocor-- Tt Tt m on on o o Tt voTt. tfl a. Ttr^Or^t^r^T-ir-ooi^tNcntNint^TtT-iiotNOOcnOrnONOO O i— Tt on oo On i-h o vovo t».ca TtcnvooOi-HcjNC»tNOvaNi-HtNTttNOcnfNfNvoir.T-.T— mtNT-i cn O r- tN CN ON fN On -h m T-HT-ITti-H OOt-H VO (N N tN rH (T, it T-H l-l H Cfl r- (\| O, T-H r-, CA fi T-H fN tT) fN CN i-i (fl Ovt^i-HTtoooi>-t^i-Hr-Ttvooc^voinr--infNinO'-'cnTtin m cn on r- tN Tt oo o ovoo OJ vovotNtnOcncncncncoONi—iCT>fNt>r--OOcncJ\cnvo^oT— oo m vd o Tt vo Tt vo in mtN cnr-TtoN'-HvooNr4r-.^toNvoooovoor~-aNoooooooT-Hoor~ momvovor- Tt .Tt wh u t-i Tt r-i-H ovotNcni-Hcncn i-ii-HfNi-ifNTtcnfN cn r- rt vo r- t-h rn Tt Tt in tN On ON C- On vO ON O fN 2 P 7 * -t S Tt tn ovTt Tt vo vo — NOfNTt r- co *n ovvom cn r- cn oo vo ca oo os os OT^i-HtNfsjtNr-cncn-Tt in in vo r- < Q fr. "1 H -T«t V. vo C- VO IT vovo -r-£;t--r-r--r--| | ininfNin[-.mmminoc vO V1 oo oc O'nm'noinvovoNO^ovovovoNq so rA so en so co vo vq sovo ON~ON-^oo«-«-*tN*l * cn T m 1 m 11 0 intNmmvOv£)TtOfNOcnvoinO ovovovoovo t-h Tt ooo On O 0T_|T-HfNtN cA en en cn„Tt fi m mr- u f. if m f m f> so so so so SO SO so SO VO r. to VO vO vo^o fz. I - cn VO m*) Ov O fN m m vo vo 00 3 'in Ih a o a o 3 TJ CU 00 o ft CJ 3 3 s -3 Ih o .5 o Ih o ft ! CJ E H ■o ct 1 .C -3 CJ TJ l/1 3 E e, 5 ! b i a 3 3 s 3 ca C u > 1 o 4J CJ Cfl c 3 o. Ej a> 0. & aj c £ ca — c a-! 60 B ^ ca o, _c' 00 S-9 II 111 ><iJ h S-; rt « J 3 . «r c Cfl "53 O 3 00 rt 5 TJ § u JO S s z 3 rt 'c OJ J3 tH O |§.« S 3 S c c 7 a2 Ctf F = a c cSal SSI £ S 'C n C ■c ! a .£ J ! It a s| 2 - 3€ Is Is uf a, o = -3 cc u 0 fl D tl E a > C 5. E a > E CJ m > rH a c 'f c 1 tC c •a 3 CC 4 C rt 01 u C c . to 01 « "ci E ) .2 U rt e> « m. rt > TJ E 1 rt a «.E _o fi 3 ca 9 «■ .2 3 &! a" c 3 Ih OJ 3 =*H O 3 .2 o i> rt a "2 c to cc cfl 3 ft 1- ffl t. C CC 0 C 0 "c a 01 4 a; E > c rt 3 a E : a c i 3 P tu -3 c C. > CJ i P C c c 01 4 c c cc c C _c S t, o E 5 c, C c c c a E h 2-53 o-g a CJ Ow- t > E ° g S M &| co E 2 -n c3gg 5Sall -O a. _Q C is o 3 c CJ L, fl a Nil 0 QJ O rt " O Ot- a 3 rt 00 3 1 3 3 o rt ft s o CJ u CJ -3 E 3 ft tH cu 3 ft fc 0 ~ «h fc u 3 .3 O <L "S5 S12 O 4) « %} « oj ,s •A aC 8° rt K w ■£ 0J C 1 c A cu 2 p OJ c 00 rt CU w . c 2 S c CS 3 3 «H 0 o &E |Sfc S "rt ^ -.°°'-Ei5SSa.r?^Sg. z 0 "5 O > ■S I TJ O ■ji 3 O cd 5 3 •-. "O 'w 'O ■- caa -3 C ., 2 la 5 S^UOOOL rt £*tj to 5 .3 ii 3 rt "H ^ O-S S 2 P J3 +3 -!3 S a) 0 3 tf- Ti ca > TJftTjTJ OJ <U #> ^^TJ S.O 3 v., "3 fj_C h 8 a fe « w tj O'-tH-fe-rt'-'g. O § 8 JsJ t OK^OQO£DQO^aKHO< £ 4) 'a £-ftb^ _h CO .£ C w '.a "S 75 SS E UOQ JZ5UO QO«Q gQp.U m m" it in vo" h-' od ol d th « fN| m ^' in vd t^' tc o\ d th tN rn ■*' "n ™ vd r-* od ov d th fj cn Tt »n H X >< HOSPITAL INSURANCE SERVICE, 1971 V 59 invoinTtc^Oc^TtMinvotNr^^tNtNT-HfNcnTtcn i-.ddd'n i-'000-^000—"ddddddd 000 odd cnofNtNcninr-oovo **} ^ T-H O 1-H Tf T-H 1-H O tN H ■ T-. 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HH 3 U 3 rt H o H cos 1 HfJvO*i-«eNcn'Tt »n .£ r-^ od ^r^oooococpoo CO™ 00 00 > x ,-1 < H ►H PU. cn O DC oq p o cj cn HH H HH PQ Q a S s 8 OS w Oh cn fc O HH H Oh o pa < o r—( H P HH Ph < Oh a S - on vo t— as r- S; ooohok. - vo m vo vo \o o CM 00 IT) VO CN £ oo -n "* >/-. vo - CN IT) "aj" "aj" IT. u HI ta! •2 •" o Ov o CN ON CN O H X> Ih 45 J5 S OCNOr^ooOvvo S cNt--cN~nvoovt^ — in co vo ^ in v. in Tt Ov O <ri -rt CN t-» Tt vo oo Ov in c-» t— rH ^H CN >s a Ih to h 03 3 •§ 1 J S HOSPITAL INSURANCE SERVICE, 1971 V 61 STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE FISCAL YEAR ENDED MARCH 31, 1971 Administration— $ Salaries 1,007,467 Temporary assistance 12,453 1,019,920 Office expense 68,460 Travelling expense 61,911 Office furniture and equipment 7,578 Printing and publications 2,676 Tabulating and rentals 5,289 Motor-vehicles and accessories Incidentals and contingencies 901 Construction and consultation fees 35,028 Technical surveys and new service development 60,177 1,261,940 Payments to hospitals— Claims 178,266,296 Grants in aid of equipment 2,370,714 Grants in aid of construction 3,169,923 Total 185,068,873 Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty in right of the Province of British Columbia. 1972 730-1171-8898
BC Sessional Papers
Twenty-third Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1971 British Columbia. Legislative Assembly 1972
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