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Twenty-third Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1971 British Columbia. Legislative Assembly 1972

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 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.
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 DEPARTMENT OF HEALTH SERVICES AND
HOSPITAL INSURANCE
BRITISH COLUMBIA HOSPITAL INSURANCE SERVICE
The Honourable Ralph R. Loffmark, Minister of Health Services
and Hospital Insurance.
Senior Administrative Staff
D. M. Cox, F.A.C.H.A., F.C.I., F.C.I.S., Deputy Minister of Hospital Insurance.
W. 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
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BRITISH COLUMBIA
Chart V—Average Length of Stay of Cases* in Hospitals in British
Columbia, by Major Diagnostic Groups in Descending Order, 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
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subcutaneous tissue
Diseases of the digestive
system
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violence
PROVINCIAL AVERAGE
LENGTH OF STAY
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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
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V 57
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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

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