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BC Sessional Papers

Twenty-fifth Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1973 British Columbia. Legislative Assembly 1974

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 PROVINCE OF BRITISH COLUMBIA
HOSPITAL INSURANCE ACT
Twenty-fifth Annual Report
Britisli Columbia
Hospital Insurance Service
JANUARY 1 TO DECEMBER 31
1973
Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1974
  Victoria, B.C., January 20, 1974.
To the Honourable Walter S. Owen, 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-fifth Annual Report
of the British Columbia Hospital Insurance Service covering the calendar year 1973.
DENNIS G. COCKE
Minister of Health
  British Columbia Hospital Insurance Service,
Victoria, B.C., January 20, 1974.
The Honourable Dennis G. Cocke,
Minister of Health,
Parliament Buildings, Victoria, B.C.
Sir: I have the honour to present herewith the Report of the British Columbia
Hospital Insurance Service covering the calendar year 1973.
WILLIAM J. LYLE, F.C.I.S.
Deputy Minister of Hospital Insurance
  The Honourable Dennis G. Cocke, Minister of Health.
  DEPARTMENT OF HEALTH
BRITISH COLUMBIA HOSPITAL INSURANCE SERVICE
The Honourable Dennis G. Cocke, Minister of Health.
Senior Administrative Staff
W. J. Lyle, F.C.I.S., Deputy Minister of Hospital Insurance.
J. W. Mainguy, B.A., M.H.A., Assistant Deputy Minister of Hospital Insurance.
C. F. Baixam, M.D., Senior Medical Consultant.
N. S. Wallace, C.G.A., Director, Hospital Finance Division.
K. G. Wiper, Director, Administrative Services
P. Breel, Director, Hospital Consultation and Inspection Division.
D. S. Thomson, B.A., M.P.A., Director, Research Division.
J. G. Glenwright, Director, Hospital Construction and Planning Division.
D. M. N. Longridge, M.A., B.Ch., F.R.C.S., Medical Consultant.
D. E. Mackay, M.D., C.R.C.P.(C)., Medical Consultant (Extended Care).
  CONTENTS
Page
General Introduction  13
British Columbia Regional Hospital Districts Act  15
British Columbia Regional Hospital Districts Financing Authority Act  16
The Hospital Insurance Act  16
The Hospital Act  17
Persons Entitled to or Excluded From the Benefits Under the Hospital Insurance
Act  17
Entitled to Benefits  17
Excluded From Benefits  18
Hospital Benefits Available in British Columbia  18
In-patient Benefits  18
Other Benefits  18
Application for Hospital Insurance Benefits  19
The Hospital Rate Board and Methods of Payment to Hospitals  20
BCHIS Planning Group  20
Organization and Administration  21
Assistant Deputy Minister  21
Hospital Consultation and Inspection Division  21
Research Division  24
Hospital Finance Division   25
Hospital Accounting  26
Hospital Claims Section   27
Hospital Construction and Planning Division  29
Hospital Projects Completed During 1973  31
Hospital Projects Under Construction at Year-end  35
Projects in Advanced Stages of Planning  36
Additional Projects in Various Planning Stages  36
Medical Consultation Division  37
Administration Division  40
Eligibility Representatives' Section  40
Third-party Liability Section  41
General Office  41
Information Office  41
Approved Hospitals  43
Public Hospitals  43
Outpost Hospitals  44
Federal Hospitals  44
Private Hospitals (Providing General Hospital Services)  44
Rehabilitation Hospitals  44
Extended-care Hospitals  44
11
 Q 12
BRITISH COLUMBIA
Page
Statistical Data  45
Table Ia—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)  46
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)  47
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  48
Table 2b—Summary of the Number of BCHIS In-patients and Outpatients  49
Table 2c—Summary of BCHIS Out-patient Treatments by Category, Years
1971-73, Inclusive  49
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 1973 (Excluding Extended-care Hospitals)  50
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 1973 (Excluding Extended-care Hospitals)  50
Charts  51
I—Percentage Distribution of Days of Care by Major Diagnostic Groups,
1972   52
II—Percentage Age Distribution of Male and Female Hospital Cases and
Days of Care, 1972  53
III—Percentage Distribution of Hospital Cases by Type of Clinical Service,
1972  54
IV—Percentage Distribution of Hospital Days by Type of Clinical Service,
1972  55
V—Average Length of Stay of Cases in Hospitals in British Columbia by
Major Diagnostic Groups, 1972 (Excluding Newborns)  56
Hospitalization by Major Diagnostic Categories, 1972 (Excluding Newborns)  57
Statement of Receipts and Disbursements for the Fiscal Year Ended March 31,
1973  63
 Twenty-fifth Annual Report of the
British Columbia Hospital Insurance Service
GENERAL INTRODUCTION
Wm. J. Lyle, F.C.I.S., Deputy Minister
In the quarter of a century since Government-
operated hospital insurance coverage started in British
Columbia, residents have witnessed a tremendous expansion of hospital facilities and vastly improved services. Hospital boards, hospital staff, medical staff,
regional hospital districts, the Provincial Government,
and many individuals have collectively contributed to
the development of improved and efficient hospital
services.
In the current fiscal year ending March 31, 1974,
an estimated $268,000,000 will be paid by this Service
to hospitals toward expenses incurred by residents.
Daily payments to British Columbia hospitals have
increased from $50,000 in 1949/50, the first complete
fiscal year of coverage, to $734,000 for each of the 365 days in 1973/74.
The British Columbia hospital construction programme, since January 1, 1949,
has produced a total of 12,851 beds (acute and extended care) at a total cost of
approximately $237,289,329. In latter years, most of these projects have been
financed by the Provincial Government through regional hospital districts, with the
Province contributing 60 per cent of the approved cost and the regional hospital
district the remaining 40 per cent.
In the past year, new hospitals were opened at Bella Bella, Tahsis, and Vanderhoof. Major additions and renovation projects were completed at Armstrong,
Chemainus, Enderby, Kelowna, Squamish, Vancouver General Hospital, G. F.
Strong Rehabilitation Centre and the Royal Jubilee Hospital, Victoria. New
extended-care facilities were constructed at Burnaby, Duncan, Quesnel, and Gorge
Road Hospital, Victoria. A new power plant was brought into operation at the
Royal Columbian Hospital, New Westminster, and a diagnostic and treatment centre
at Gold River.
These projects involved a total of 1,071 beds, and construction costs were
approximately $27,800,000. As the year drew to a close, some 1,000 beds were
under construction throughout British Columbia and 550 new beds were in advanced
stages of planning.
The Provincial Government, in its efforts to increase extended-care facilities, is
continuing negotiations for the purchase of a number of suitable private hospitals.
The first such acquisition was the 75-bed Richmond Heights Private Hospital (renamed Mount Tolmie Hospital), purchased last fall by the Provincial Government
and the Capital Regional Hospital District.
It should be borne in mind that the majority of new in-patient hospital accommodation relates to replacement beds, acute psychiatric and activation/rehabilitation
programmes, with few additional general hospital beds being provided for increased
13
 Q  14 BRITISH COLUMBIA
population. The more effective utilization of general hospitals, the expanded coverage of out-patient care by BCHIS, and the greater availability of extended-care beds
are having an impact on the need for acute accommodation. See Table 2c on
page 49 regarding ambulatory services, also narrative in statistical data on page 45.
It can be seen from Table 2a on page 48 regarding total patient-days that the opening of new extended-care beds has enabled the hospitals to provide an increase of
220,000 days of care for extended-care patients over the care provided in 1972.
During the year, expanded facilities and 21 additional beds for open-heart
surgery came into operation at the Vancouver General Hospital. A new 15-bed
unit was opened at St. Paul's Hospital, Vancouver, and existing surgical facilities at
the Royal Jubilee Hospital, Victoria, were renovated and upgraded to carry out
open-heart surgery.
Three intermediate-care hospitals located at Vancouver, Burnaby, and Kamloops were assigned to the Hospital Insurance Service in December 1973 and are
expected to come into use shortly.
The Medical Centre of British Columbia Act was passed at the Fall Session of
the Legislature in 1973. This statute established a corporation to be known as the
British Columbia Medical Centre, the objects of which are as follows: To establish
and operate a medical and health sciences centre for the Province which will comprise a large community hospital, tertiary hospital facilities providing specialized
services of Province-wide application; extensive teaching facilities for medical,
dental, nursing, paramedical, and technical personnel, as well as facilities for research
in the health field. The corporation may also be given responsibility for the direction and co-ordination of the policies and planning function of a number of hospitals
in the Vancouver area to integrate properly their activities with those of the hospital
operated by the new corporation. In addition, the statue provides for the establishment of a Provincial Council comprised of the corporation's directors, together with
regional and other representatives which may, when directed by the Lieutenant-
Governor in Council, co-ordinate and direct all aspects of clinical teaching in the
health field carried on in hospitals and education institutions in the Province. The
Board of Directors of the corporation has been established, the President and a
number of senior officers appointed, and preliminary planning for this large complex
is under way. The concept is to use Shaughnessy Hospital and its approximately
50-acre site as the base for the Centre. I am pleased to report that, at the time of
printing, the Federal and Provincial teams are close to resolving all major issues
with regard to a transfer of Shaughnessy Hospital to Provincial jurisdiction.
Discussions were held and an agreement reached between the Minister of Health
and the Hospital Employees' Union for the orderly elimination of discrimination in
wages, category, and promotion of female employees. As a first step toward the
achievement of wage parity, funds for a special salary adjustment retroactive to
January 1, 1973, for all employees earning less than $669.50 per month, were made
available to hospitals. The agreement calls for the negotiating parties to ensure
that all discrimination in wage rates, job descriptions, etc., shall be ended by January
1, 1976.
In November 1973 the Lieutenant-Governor in Council established a Cancer
Control Task Committee to advise the Minister of Health regarding the formation
of a British Columbia Cancer Control Agency. The objects and powers of the
Agency will be to organize and administer a comprehensive, co-ordinated, Province-
wide cancer control programme, designed to provide the people of British Columbia
with the services and facilities necessary to prevent, detect, and treat all forms of
cancer as promptly and as effectively as modern knowledge, skill, and technology
 HOSPITAL INSURANCE SERVICE,  1973 Q 15
make possible. The Senior Medical Consultant and the Director, Administrative
Services, represent the Hospital Insurance Service on this Committee.
During 1973 the Hospital Act was amended and the regulations were revised to
reconstitute the Medical Appeal Board. The function of this body is to hear and
determine appeals from physicians against decisions made by hospital boards regarding the granting of medical staff privileges. The membership of the board is comprised of representatives of the medical profession, the B.C. Hospitals' Association,
and the general public. The Hospital Act was also amended to ensure that contracts
for hospital construction projects contain requirements regarding the payment of
fair wages and maintenance of fair working conditions for workmen.
The regulations governing cash grants on hospital construction projects financed
by hospitals were changed during the year to the sharing basis (60:40 per cent)
which previously applied only to projects financed under the Regional Hospital Districts Act.
An Order in Council was passed under which the equipment grant structure
was changed. This enables the Hospital Insurance Service to pay a 100-per-cent
grant on approved equipment, instead of the usual one-third grant, where the equipment purchase will result in savings of approved operating costs and recovery of
the capital cost in a reasonable time. Otherwise, a Provincial grant of 33VS per cent
is available.
During the year a bursary programme for occupational and physiotherapy
students to assist in financing their training was authorized by the Government.
Under the training programme, students in the second, third, and fourth year are
required during the summer to obtain practical experience in hospital and institutional settings, and as a result their opportunities to earn money are very limited.
For the first time, a Student Summer Employment Programme sponsored by
the Provincial Government provided funds to hospitals. Our Service administered
the appropriation for hospitals, and under this programme over 1,000 students were
employed for periods ranging from eight to sixteen weeks at a cost of $1,300,000.
Out-patient physiotherapy became an authorized benefit to eligible British
Columbia residents on April 1, 1973, with the patient paying an authorized charge
of $1 a visit.
The work of the laboratory and radiological advisory Councils was again of
inestimable value in assisting hospitals to improve their radiological and laboratory
services, and in advising the Service regarding the approval of Provincial grants-in-
aid for the purchase of major hospital equipment.
I should like to thank the College of Physicians and Surgeons, the B.C. Medical
Association, and the medical profession for their advice and guidance, and also for
the continuing assistance of the British Columbia Hospitals' Association and the
Registered Nurses' Association of British Columbia.
In conclusion, I would like to express my appreciation to the loyal and devoted
staff of the Hospital Insurance Service for the way in which they carried out their
duties during the past year.
Reports by the various divisions comprising the administrative structure of our
Branch appear under "Organization and Administration," beginning on page 21.
BRITISH COLUMBIA REGIONAL HOSPITAL DISTRICTS ACT
The Act provides for the division of the Province into large districts to enable
regional planning, development, and financing of hospital projects to be carried out
under a formula which provides substantial financial assistance from the Provincial
Government toward the capital cost of hospital projects.  The Province was divided
 Q 16 BRITISH COLUMBIA
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, subject
to the requirements of the Act, is 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, the district is able to raise any funds
immediately required by temporary bank borrowing on a uniform basis. Periodically the Regional Hospital Districts Financing Authority (see page 16) provides
long-term financing by purchasing debentures issued by districts, thus enabling them
to repay their temporary bank borrowings.
Each year the Provincial Government pays through the Hospital Insurance
Service its share of the amortization cost in accordance with section 22 of the Act.
Each district in turn raises, by taxation, the remainder of the annual amortization
cost required to retire the debentures which are held by the Financing Authority.
Under the formula the Province pays annually to each district 60 per cent of
the approved net cost of amortizing the district's borrowings for hospital projects,
after deduction of any 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 hospital projects, 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 is responsible for co-ordinating and evaluating 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
Act if the cost of the project, over and above the amount of the Provincial Government grant, can be raised by other means.
BRITISH COLUMBIA REGIONAL HOSPITAL DISTRICTS
FINANCING AUTHORITY ACT
This Act established a Provincial Government authority similar to the one set
up to assist school districts in financing their projects. The functions of the Authority
are referred to briefly in the second paragraph of the preceding commentary regarding the Regional Hospital Districts Act.
THE HOSPITAL INSURANCE ACT
This is the statute which authorizes British Columbia's hospital insurance plan,
and under which the British Columbia Hospital Insurance Service is established.
The main provisions of this Act and the regulations may be summarized as follows:
(1) Generally speaking, every permanent resident who has made his
home in British Columbia during the statutory waiting-period is
entitled to benefits under the Act.
 HOSPITAL INSURANCE SERVICE, 1973 Q 17
(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 and out-patient benefits provided under
the Act is described on the following pages.
(4) Qualified persons who are temporarily absent from British Columbia
are entitled to certain benefits for a period of 12 months following
their departure from the Province.
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 hospital insurance coverage.
(3) Rehabilitation and extended-care hospitals. These nonprofit hospitals are 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 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 statutory waiting-period (which expires at midnight of the last day of the
second month following the month in which the person moved to
the Province); 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.
 r
Q 18 BRITISH COLUMBIA
During the statutory waiting-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 resides outside the Province; or
(b) A qualified person who leaves British Columbia temporarily and fails
to return and re-establish residence within 12 months; or
(c) A qualified person who leaves British Columbia and who establishes
residence elsewhere; or
(d) An inmate of a Federal penitentiary; or
(e) A resident who receives hospital treatment provided under the Workmen's Compensation Act, or a war veteran who receives treatment
for a pensionable disability; or
(/) Persons entitled to receive hospital treatment under the Statutes of
Canada or any other government; for example, members of the
armed forces or Royal Canadian Mounted Police, and consular
officials of other countries.
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:
Emergency treatment within 24 hours of being accidentally injured.
Operating-room or emergency-room services for minor surgery, including application and removal of casts.
 HOSPITAL INSURANCE SERVICE,  1973 Q  19
Day-care surgical services are available to patients who require operating room or other specialized-treatment facilities, but who can 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 a designated 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 a designated hospital for a particular psychiatric service. (During 1972
the number of hospitals authorized to provide day-care and outpatient psychiatric services as insured benefits was increased.)
A cytology service provides for examination of cervical smears sent by
physicians to the B.C. Cancer Institute for the early detection of
cancer in women. In addition, hospital laboratories perform many
tissue examinations for the detection of a variety of diseases and
conditions.
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 methadone substitution programme established by the Narcotic Addiction Foundation of British Columbia is available at six centres in the
Province.
Coverage for diabetic day-care services is available in a number of the
larger hospitals in the Province.
Day-care services at The Arthritis Centre of British Columbia, Vancouver,
which is operated by the Canadian Arthritis and Rheumatism Society,
British Columbia Division, is now under hospital insurance coverage.
This centre provides physiotherapy and other services on an outpatient basis to persons suffering from arthritis and rheumatism.
Out-patient physiotherapy service is provided by hospitals.
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 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 if either the patient's status as a qualified resident or the medical
necessity for his receiving hospital-care benefits has not been satisfactorily
established.
 Q 20 BRITISH COLUMBIA
THE HOSPITAL RATE BOARD AND METHODS OF
PAYMENT TO HOSPITALS
The Hospital Rate Board, appointed by Order in Council, is responsible for
advising the Deputy Minister in regard to the rates of payments to hospitals for
both in-patient and out-patient benefits.
A system of firm budgets for hospitals, which, with modifications, has been in
use since January 1, 1951, provides for a review of hospitals' estimates by the
Rate Board. Under the firm-budget procedure, hospitals are required to operate
within the total of 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 in-patient 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 cover 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. It is composed of six senior
members of the service.
Planning Group held 15 full meetings during the year, in addition to which
members of Planning Group held a number of meetings with regional hospital district
boards or committees and with representatives of hospitals.
 HOSPITAL INSURANCE SERVICE,  1973
Q 21
ORGANIZATION AND ADMINISTRATION
The British Columbia Hospital Insurance Service is a branch of the Department
of Health, the other branches being Health, Mental Health, and the Overall Medical
Services Plan.
The following reports provide a brief outline of the work carried out during
1973 by the various divisions and offices which comprise the administrative structure
of this branch:
ASSISTANT DEPUTY MINISTER
J. W. Mainguy, B.A., M.H.A.
The Assistant Deputy Minister is responsible for
the operation of the Service in the absence of the Deputy
Minister. He is directly responsible for the Hospital
Consultation and Inspection Division and the Research
Division. He is a member of both the Hospital Rate
Board and Planning Group, and represents the Service
on a number of committees of Government and community agencies, including the Liaison Committee between the Service and the B.C. Hospitals' Association
and the Sub-Committee on Quality of Care and Research, Ottawa.
Hospital Consultation and Inspection Division
P. M. Breel, Director
A high quality of patient care, efficient operation,
and effective utilization is the objective of this Division.
Kg Public and private hospitals receive consultative services
in all areas of organization and management from
the Division's Inspector Consultants in Administration,
Nursing, Dietary, Clinical Laboratory, and Management
Engineering. Inspectorial programmes ensure basic
standards are met and private hospitals are appropriately licensed.
The Division co-operates with all other divisions of
the Service in achieving aims of mutual interest and
responsibility. It is responsible for the analysis, and
makes recommendations, relative to hospital staffing patterns for current and proposed programmes which are considered in establishing approved operating budgets.
The Division is represented on the Hospital Rate Board and the Planning Group.
It represents the Service on a large number of councils, committees, and working
parties associated with hospitals and the health field, and works with Federal, Provincial, and municipal representatives on related matters. Staff members participate
in the Functional Programme Review Committee and the Equipment Committee,
and in the hospital planning functions of the British Columbia Hospital Insurance
Service, including the review of the operational implications of construction projects,
and the setting of standards. Programmes and plans for construction are analysed
and assessed in conjunction with the Medical Consultation and Hospital Construction and Planning Divisions.
Acute, rehabilitation, and extended-care hospitals received advice and assistance through 225 consultative and inspectorial visits, and private hospitals giving
 Q 22
BRITISH COLUMBIA
nursing-home care, through more than 250 visits. Inspection reports recommending
ways and means of improvement were made to both Government and to the hospitals, and appropriate follow-up visits and actions were scheduled.
Special investigatory studies were undertaken by members of the Division in
concert with the Medical Consultants' Division of board, medical staff, management, and staff relations at the Ashcroft and District General, Squamish General,
and Fernie Memorial Hospitals, with reports and recommendations being submitted
for the hospitals' guidance.
Ever-increasing salary and wage costs necessitated the concentration once
again of the Administrative Consultants' time and efforts on staffing requests and
allowances, and on actual utilization of staff. The continuing evaluation and validation of standards resulted in a number of changes to allowances to the advantage
of our hospitals. Board, medical staff, and administration relations and labour/
management relations required increased time and attention, with several hospitals
experiencing major problems. The assumption of responsibility for intermediate-
care facilities in Vancouver, Victoria, and Kamloops placed an increased burden on
the Administrative Consultants' section. Liaison was maintained by membership
on the Radiological Advisory Council, Laboratory Advisory Council, the Community Care Facilities Licensing Board, the British Columbia Hospitals' Association
Education Committee, Federal and Provincial Pharmacy Committees, and many
other ad hoc boards and committees. The Director of the Division is a member of
the Federal Advisory Committee on Canadian Health Standards. One Administrative Consultant was appointed Public Administrator of the Ocean Falls General
Hospital, and by the end of the year was able to organize a new society, establish a
board, and see the hospital functioning under its own direction. An Administrative
Consultant was lost to the Health Security Programme Project group and had not
been replaced by the end of the year. Several staff members participated in presentations to community college courses and programmes sponsored by the British
Columbia Hospitals' Association.
The Hospitals' Management Engineering Unit of the Division continued to
develop its services to hospitals and other health care agencies in the Province.
Close co-operation was maintained with the three regional management engineering
units and other agencies involved in health care, both within and outside the Province. In this unit there has been a shift in emphasis from the in-depth type of
investigation for the individual hospital toward the ongoing development of methodologies in the wider field, for example, in housekeeping, materials management,
laundries, processing functions, admitting and O.R. scheduling systems, dietetic and
information systems. As a result there has been a significant increase in the consultative services provided by unit personnel in relation to both planning and operational matters, through visits, participation on both standing and ad hoc committees,
and through involvement in educational programmes. Unit personnel responded to
many individual queries from hospitals and others. The library continues to distribute reports and information, much of which is sent to other provinces and to
other countries.
The assessment and improvement of the quality of patient care continued to
occupy the attention of the nursing consultants. Lack of staff seriously curtailed
the number of hospitals and the units that could be visited, and the follow-up action
so necessary to effective operation. Advice on matters related to staffing, nursing
procedures and techniques, patient-care programmes, construction plans, and hospital equipment demanded ever-increasing Nursing Consultants' time. Additional
commitments such as the assessment of the suitability of private hospitals for
 HOSPITAL INSURANCE SERVICE,  1973 Q 23
extended care and the classification of types of health-care criteria further encroached
on the time available, and required great flexibility on the part of the Nursing Consultants. These consultants actively participated in both national and Provincial
nursing organizations. The senior consultant is a member of the Council of Practical Nurses, the Nursing Advisory Consultants' Committee for the Health Security
Programme Project group, and of the Nursing Advisory Committee of the British
Columbia Institute of Technology. During December the employment of an additional nurse greatly enhanced the ability of this nursing section to carry out its
consultative and inspectorial role.
The Division's Consultant in Dietetics attended the International Congress of
Dietetics held in May in Hanover, Germany. Her attendance at the Congress was
preceded by visits to hospitals, food-manufacturing plants, and equipment manufacturers in Switzerland, Sweden, and Germany. Activities apart from regular hospital
visits included participation in the course for senior cooks held in Nelson, attendance
at the Federal/Provincial Consultants in Dietetics meeting held in Winnipeg, advice
to students taking the Canadian Hospital Association Food Service Supervisors
correspondence course, membership on the Advisory Committee for the Food Service Technicians course at Vancouver City College, representative to the B.C.
Dietetic Association Administrative Dietitians' Committee, continuing assistance to
the Royal Columbia Hospital in implementation of the study recommendation of
last year, continuing involvement with the food production and service study being
conducted at Penticton Hospital, and assistance in the shared dietetic service project
proposed for the Surrey Memorial and Richmond General Hospitals, which includes
the establishment of a limited commissariat service. A work-sampling study of the
Department of Dietetics was conducted at the Penticton Hospital in co-operation
with the Division's Management Engineering Unit. Information from this study
and one conducted last year is being used by the Federally based Working Party
studying departments of dietetics. With the co-operation of Dr. Vance Witchell, of
the Faculty of Commerce, UBC, a questionnaire was designed to obtain patient
reaction to food service. Depending upon the results of test runs, it is hoped to
make the questionnaire available to hospitals throughout British Columbia. A second
Consultant in Dietetics joined the Division in December, increasing materially the
section's consultative and inspectorial capacity.
During August a Consultant Inspector in Clinical Laboratory joined the staff
of the Division, providing a much needed service capability to our hospitals. This
consultant acts as Secretary to the Laboratory Advisory Council, and much of his
time to date has been spent in revitalizing that Council's organization and functions.
Service programmes and proposals are under way, including the promotion of region-
alization of laboratory services for all major areas of the Province, the establishment
of a joint programme with the Laboratory Accreditation Committee of the College
and Medical Association to determine ways and means of improving laboratory
services to small, isolated hospitals and initiation of a Province-wide telephone
service to provide rapid access to assist with laboratory instrumentation problems.
The Vancouver office of the Division maintained a close watch over the private
hospital field, with more than 250 visits and inspections being completed. Four
private hospitals, totalling 157 beds, closed down during the year, leaving 57 hospitals providing 2,822 beds. Special studies were carried out by specially employed
Consultants in Nursing and Dietetics encompassing the quality of nursing care and
the quality of food service being provided in private hospitals. These studies
resulted in many instructions and recommendations to assist operators in improving
the quality in both areas, with appropriate follow-up action being taken to ensure
 Q 24
BRITISH COLUMBIA
that standards were being met and maintained. The Division's Vancouver-based
Administrative Consultant participated in studies of the Special Planning and
Review Council of British Columbia and in the development of education programmes in aging.
Three university students were employed during the summer on research studies
encompassing a review and listing of standards and guidelines for health care in
British Columbia, statistical data evaluating comparative departmental production
of hospitals in the Province, and a Management Engineering study in the collection
and analysis of data and programming of the resulting system proposal.
Members of the Division attended a number of in-service and other educational
and informative sessions to maintain currency in the health care field and in the
efficiency and effectiveness of the consulting practice. The Director of the Division
completed part two of the Advanced Programme in Health Services Organization
and Administration presented by the University of Toronto, School of Hygiene.
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. Studies are carried out by the Division to
assess the demand for new facilities, both on an individual hospital and regional basis. These studies involve
a comprehensive analysis of hospitalization data as well
as economic and demographic information. Recommendations from these studies are referred to the BCHIS
Planning Group through the Director, who is a member
of the group.
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 the districts in developing regional programmes. During the year, specific studies of hospital requirements
were carried out for the Cariboo, Fraser-Fort George, Okanagan-Similkameen, and
Central Okanagan Regions.
The Division is also responsible for compiling and maintaining statistical data
relating to hospitalization 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 Eighth Revision of the
International Classification of Diseases Adapted (ICDA). Through this classification system, the incidence of disease can be analysed by age, sex, 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 includes the standard morbidity tables which all provinces publish and
affords an opportunity to make interprovincial comparisons of hospital data. Statistics of Hospitalized Accident Cases, which is also prepared annually, provides a
broad analytical coverage of hospitalized accident cases by circumstance, type of
accident, and by nature of injury. A report of the Day Care Surgery British Columbia
Hospitals is also prepared annually 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
the Government. The demand for hospital morbidity data continues to grow and
has become particularly useful in the planning of specialized hospital services.
 HOSPITAL INSURANCE SERVICE,  1973
Q 25
The Division also maintains a reporting system for therapeutic abortions performed in hospitals in the Province. Interest in this subject continues to stimulate
demand for information. During 1972, 8,211 abortions were performed; the total
for 1973 is expected to exceed 9,000.
Hospital Finance Division
N. S. Wallace, C.G.A., Director
Hospital accounting, processing of hospital budgets, the payment of hospital claims, and financing of
hospital capital projects are the four main functions of
the Hospital Finance Division.
At the 1967 Session of the Legislature, two Acts
were passed which changed the method of financing
hospital capital projects—the Regional Hospital Districts Act and the British Columbia Regional Hospital
Districts Financing Authority Act. The Finance Division is responsible for reviewing the annual budgets
prepared by each regional hospital district as required
by the legislation and works closely with the Hospital
Financing Authority and the regional hospital districts in the financing of hospital
capital projects and repayment of debentures. The regulations governing grants
on construction projects financed by hospitals themselves were changed during the
year to the same sharing basis which applied to projects financed by the regional
hospital districts. During 1973 the Finance Division assisted the regional hospital
districts in debenture sales to the British Columbia Regional Hospital Districts
Financing Authority amounting to $17,500,000.
The Financing Division is also responsible for the approval of grants to assist
hospitals in the purchase of equipment. An Order in Council was passed during
the year under which the equipment grant structure was changed. This enables
the Hospital Insurance Service to pay a 100 per cent grant on equipment instead
of a one-third grant where equipment purchase will result in savings of approved
operating costs which will recover the capital cost of the equipment in a reasonable
time. In 1973, after a review of approximately 6,300 applications received from
hospitals, grants estimated at $2,800,000 were approved on movable and fixed
technical equipment costing $8,500,000.
As a means of assisting hospital employees to maintain high working standards, the Hospital Insurance Service provided over $175,000 during the year to
enable hospital employees to attend or participate in short-term training programmes. This was additional to the longer-term educational training courses
sponsored for certain hospital employees.
As a result of an agreement established between the Minister of Health and
the Hospital Employees' Union, mentioned earlier in this report, a considerable
amount of work was carried out to determine the amount to be paid hospitals
and enable the latter to pay the agreed salary adjustment retroactive to January
1, 1973.
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 reached maximum retirement age.
The Director continued to perform duties as a member and Secretary of the
Hospital Rate Board and a member of the following committees: Subcommittee on
 Q 26
BRITISH COLUMBIA
Hospital Finance and Accounting (a subcommittee appointed by the Federal
Government to advise on the administration of the Hospital Insurance and Diagnostic Services Act), the Radiological Advisory Council, the B.C. Hospitals'
Association Computer Committee, and the Health Services Centre Computer
Advisory Committee.
Experience during the first few years' operation of the British Columbia Hospital Insurance 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
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 1973
amounted to $260,000,000.
(b) The detailed annual inspecting of each budget-review hospital for
purposes of verification of annual and other financial statements.
Final settlement with each hospital for that year is based on inspection and review results.
(c) The assembling of relevant information and preparation of data for
the Deputy Minister in the review of the annual budgets of regional
hospital districts.
(d) The auditing of hospital construction projects, in the field, to determine the amount shareable by the Province and the regional hospital
district.
(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.
 HOSPITAL INSURANCE SERVICE,  1973 Q 27
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 calculation 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-six hospital-operating, pre-construction, and regional
hospital district budgets were reviewed and processed in 1973. Inspection visits
were made to each of 114 public general, rehabilitation, and extended-care hospitals
during the year. Construction audits were carried out on major construction projects involving approved expenditure of $20,900,000 and minor projects costing
$315,000. The amount of approved costs shareable with regional hospital districts
is derived from the audit reports.
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 an Admitting and
Eligibility Seminar held at Nelson, which was attended by staff of hospitals in the
region. The Supervisor also visited hospitals in the Greater Vancouver area as
well as hospitals on Vancouver Island.
The Assistant Supervisor of Hospital Claims attended Admitting and Eligibility
Seminars held at Kamloops and Prince George. These seminars were well attended
by hospitals in the regions.
Research and adjustment to accounts showed an increase in volume, due
primarily to changes in responsibility for payment. In addition to the required
accounting amendments, it was necessary to direct over 1,000 queries to the hospital
concerning claims.
Accounts processed were in excess of 1,950 per working-day, and over 1,300
emergency-service and minor-surgery account forms were handled per working-day.
* After  over 25  years  of  service with BCHIS,  W.  J.  Wade has retired  and Vern Richards,  formerly
Assistant Supervisor, has been appointed as Supervisor to succeed Mr. Wade, effective December 1, 1973.
 Q 28 BRITISH COLUMBIA
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 under
the Hospital Insurance Act. Details of residence are checked with the verifying
documents, and as a result over 500 claims per month had to be returned to the
hospitals during the year because they were incomplete or unacceptable, and over
2,000 letters were written on eligibility, verification, and related matters.
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 Supervisors of the Admission Control and Accounts Payment Units attended an Admitting and Eligibility seminar
held in conjunction with the British Columbia Hospital Association Convention at
Vancouver.
The Accounts Payment staff pre-audits the charges made to the British Columbia Hospital Insurance Service, and ensures that all information shown on
each claim is completed so that it can be coded for statistical purposes, 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 British Columbia hospitals on such matters.
Preliminary figures for 1973 show that more than 450,000 accounts (excluding out-of-Province) were processed.
The Day-Care Surgical Services, Day-care/Night-care Psychiatric Services, outpatient Psychiatric Services, and Day-care Diabetic Services accounts increased in
volume to over 5,600 per month in 1973. During the year the Service continued
to provide a quarterly statistical run of Day-care Surgical Services for the hospitals
of the Province.
A new service for Out-patient Physiotherapy patients was provided during
the year and preliminary figures indicate that accounts for over 250,000 treatments will be processed in a year.
The Voucher and Key-punch staff are responsible for batching and voucher-
ing 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 Service accounts.
From the first of the year the medical number issued to the patient by one of
the licensed carriers of the Overall B.C. Medical Plan has been included in the
statistical information recorded on the data processing card by the Key-punch
staff. In order to key-punch this information it has been necessary to use a second
data processing card for each account.
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 1973 over 6,500
accounts amounting to an estimated $3,000,000 were paid on behalf of qualified
 HOSPITAL INSURANCE SERVICE,  1973 Q 29
residents hospitalized in other provinces and territories of Canada, the United
States of America, Argentina, Australia, Austria, Barbados, Belgium, Canary Islands, Ceylon, Colombia, Cyprus, Czechoslovakia, Denmark, Ecuador, Eire, England, Fiji, Finland, France, Germany, Greece, Holland, Hong Kong, Hungary,
India, Iran, Israel, Italy, Jamaica, Japan, Kenya, Korea, Macau, Malta, Manila,
Mexico, Morocco, Nepal, Netherlands, New Caledonia, New Zealand, Northern
Ireland, Norway, Paraguay, Peru, Phillippines, Poland, Portugal, Rhodesia, Samoa,
Scotland, Senegal, Singapore, Spain, Sweden, Switzerland, Tahiti, Taiwan, Thailand, Transvaal, Wales, and Yugoslavia.
An up-to-date Hospital Rate Schedule is maintained for every hospital in
Canada. All claims are coded for statistical purposes and a data processing card
is punched for each account.
The Fifing and Mail Unit sorted and filed over 10,000 documents and letters
daily.   In order to handle increased volume, new procedures were instituted.
Hospital Construction and Planning Division
John Glenwright, Director
The main functions of the Construction and Planning Division can be briefly 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 development of master programmes which contain a clear definition of the
hospital's role, supported by 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 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.
Over 200 sets of plans were received by the Division during the year. These
drawings covered many phases of planning, including small-scale schematic drawings and final working drawings and specifications, including the architectural,
mechanical, electrical, and plumbing drawings.
During 1973, 23 hospital construction projects were completed throughout
the Province.    These projects resulted in a total of 1,071 new and replacement
 Q 30 BRITISH COLUMBIA
beds coming into service, together with supporting improved and expanded diagnostic, treatment, and service facilities.
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 expenditures to be included in money by-laws and
made the subject of regional hospital district referendums.
Continuing benefit was derived during 1973 from the co-operation of the Department of Public Works in the assignment of architects to the Division. During
the year, J. M. Phillips, Senior Architect with the Division, was seconded to the
Development Group for Community Health and Human Resources Centres.
In September 1973, G. M. Blackburn was added to the staff of the Division
as an Engineering Consultant in matters pertaining to electrical plant and equipment.
The Director 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 Chairman of the Functional Programme Review
Committee. During the past year the Director has served as a member of the
Canadian Standards Association Sectional Committee on Health Facilities. The
Division also has representation on the Equipment Committee. These committees
are subcommittees of Planning Group. Members of the Division are also involved
in the Systems Advisory Committee which acts as an advisory subcommittee to
the Equipment Committee.
The members of the medical and nursing professions and the staff of the Provincial Health Branch, through the Technical Supervisor of Radiology as well as
the Technical Supervisor, Laboratory, 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.
W. H. Cox, Engineer in the Division, was also actively engaged in studies
undertaken by a Committee on Electrical Safety in Hospitals and is a member of
an Advisory Committee on Biomedical Electronics which provided recommendations to enable the formation of a Biomedical Engineering Service to hospitals in
British Columbia. As with the Electrical Safety Committee, the provision of a
safe patient environment was the basic aim of the Committee.
A simplified system of preventive maintenance (known as the COMAC system) developed by members of the engineering staff of the Division is now in use
in a high percentage of hospitals throughout the Province and is also being introduced in more hospitals.    Consultative advice is provided in the field of plant
 HOSPITAL INSURANCE SERVICE,  1973 Q 31
operation and maintenance and equipment selection. During the year, 45 visits
were made to hospitals for inspection and advice pertaining to 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.
During 1973 the Director, 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 1973
Armstrong and Spallumcheen Hospital—Alterations and renovations to upgrade diagnostic, treatment, and service facilities, including an addition for a new
and enlarged operating and emergency room facilities and the installation of a fire
alarm and sprinkler system.
R. W. Large Memorial Hospital, Bella Bella—A new hospital of 19 acute
and four extended-care beds replacing the obsolete 25-bed hospital was officially
opened on March 25, 1973, although the building was not ready to admit patients
until later in the year.
Burnaby General Hospital—The Honourable Dennis G. Cocke, Minister of
Health, opened the new 147-bed extended-care unit on February 18, 1973. This
two-storey addition is connected to the acute hospital on the north side. The project also included enlarged dietary facilities.
Chemainus General Hospital—A renovation programme to upgrade diagnostic,
treatment, and service facilities was completed in the spring. Opening ceremonies
were held on May 9, 1973.
Chilliwack General Hospital—The third phase of the expansion programme
at this hospital, the renovation of existing areas to provide a new emergency department, enlarged operating suite, central sterilizing room, etc., was completed and the
various areas affected brought into use during the summer and fall.
St. Joseph's General Hospital, Comox—Ceremonies were held on December
15, 1973, to mark the completion of an expansion project which included a new
20-bed psychiatric unit constructed on the east side of the hospital, the completion of
the top floor of the acute hospital to provide an additional 51 acute beds (including
a three-bed intensive-care unit), day-care facilities, and expansion of services.
Cranbrook and District Hospital—In May this year this hospital brought a
10-bed psychiatric unit into operation by utilizing five existing beds and completing
five others for a revised capacity of 80 acute beds.
Cowichan District Hospital, Duncan—The Honourable R. M. Strachan
officially opened the new 78-bed extended-care unit on June 23, 1973. This unit
has been constructed on the site of the old King's Daughters' Hospital.
Enderby and District Memorial Hospital—-The alterations and additions project to improve diagnostic, treatment, and service facilities was officially opened
and the areas brought into operation on July 7, 1973.
Gold River Diagnostic and Treatment Centre—This new diagnostic and treatment centre was officially opened by the Honourable Dennis G. Cocke on October
13, 1973.   The unit was actually brought into operation on June 1, 1973.
 Major Hospital Projects, 1973
Completed—Armstrong, Bella Bella, Burnaby, Chemainus, Chilliwack, Comox, Cranbrook, Duncan, Enderby, Gold River, Kelowna, Nelson (Kootenay
Lake District), New Westminster (Royal Columbian), Quesnel, Squamish, Tahsis,
Vancouver (Vancouver General, G. F. Strong Rehabilitation Centre), Vanderhoof, Victoria (Gorge Road, Royal Jubilee).
Under construction—Abbotsford, Campbell River, Central Saanich, Fernie,
Kamloops, Langley, Lillooet, Maple Ridge, Nakusp, Nelson (Mount St. Francis),
Prince George, Richmond, Smithers, Vancouver (Children's, St. Vincent's), Vernon, Victoria (Royal Jubilee), Williams Lake.
For details, see pages 35, 36, 37.
The new extended-care hospital at Duncan. (Architects: Paul Smith Associates.)
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The extended-care unit which is part of the Gorge Road Hospital, Victoria.
(Architects: Wade, Stockdill, Armour & Blewett.)
 Block A, Kelowna General Hospital, which includes psychiatric and activation beds, and
Regional Laboratory.    (Architects: McCarter, Nairne, & Partners.)
The enlarged G. F. Strong Rehabilitation Centre, Vancouver.
(Architects: Thompson, Berwick, Pratt & Partners.)
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The new extended-care unit at Burnaby General Hospital.
(Architects: The Gardiner Thornton Partnership.)
 Q 34 BRITISH COLUMBIA
Kelowna General Hospital—The third and final phase of the expansion programme was completed when the Minister, the Honourable Dennis G. Cocke,
officially opened the Block A project on March 31, 1973. This project involved the
renovations of the old hospital building to provide 23 psychiatric, 22 activation/
rehabilitation, and 30 "self-care" beds, the physical medicine department, as well
as an addition to accommodate an enlarged regional laboratory. The revised
capacity of the hospital is now 250 acute beds and 71 beds for extended care.
Kootenay Lake District Hospital, Nelson—The first phase of an expansion and
renovation programme involving the upgrading of the electrical service, a four-bed
intensive care/coronary care unit, and a second X-ray room was completed in
October of this year.
Royal Columbian, New Westminster—The new boilers have been in operation
since January 1, 1973, but the new power plant building was not completed until
February 9, 1973. In addition, the demolition of most of the 1912 wing was
completed.
G. R. Baker Memorial Hospital, Quesnel—The new 40-bed extended-care unit,
constructed adjacent to the existing hospital, was officially opened by W. J. Lyle,
Deputy Minister of Hospital Insurance, on July 22, 1973. Owing to a strike which
delayed the completion of the pneumatic control system, patients were not admitted
until October 15, 1973.
Squamish General Hospital—A project which provided an addition for new
operating, postanesthetic recovery/labour rooms, and renovations to the existing
building and services, was officially opened by the Minister of Health on August 24,
1973.
Tahsis Hospital—The first patient was admitted to this new 10-bed facility,
replacing Esperanza General Hospital, on July 17, 1973. W. J. Lyle presided at
the official opening on September 8, 1973.
Vancouver General Hospital—Three projects were completed in March this
y ' (1) Personnel and administrative services were relocated into the
Women's Residence building to make way for Phase I of the
pathology expansion programme.
(2) A 15-bed psychiatric assessment unit.
(3) The expansion of open-heart surgery facilities in the Willow Chest
Centre, including the provision of 21 beds.
St. Paul's Hospital, Vancouver—Alterations to convert the old chapel to provide 15 cardiac surgical nursing beds and a pulmonary unit on the upper floor were
completed and the facility was officially opened by the Minister on September 7,
1973.
G. F. Strong Rehabilitation Centre—On October 28, 1973, Lieutenant-Governor W. S. Owen, Q.C, and the Honourable Dennis Cocke opened the new addition
to the centre, which now provides accommodation for 100 activation/rehabilitation
beds (an increase of 47), and greatly enlarged physio-, hydro- and occupational
therapy departments, brace shop, and outside recreational areas.
St. John Hospital, Vanderhoof—The new 45-bed hospital, which replaces the
old hospital on the same site, was brought into operation on May 16 of this year.
Gorge Road Hospital, Victoria—An addition to this activation/rehabilitation
hospital to accommodate 300 extended-care patients was completed in the new
year. The Honourable Dennis G. Cocke officially opened the new wing on January
31, 1973.
Royal Jubilee Hospital, Victoria—Open-heart surgery facilities at this hospital
were brought into operation in July this year.
 HOSPITAL INSURANCE SERVICE,  1973
Q 35
(b) Hospital Projects Under Construction at Year-end
Matsqui-Sumas-Abbotsford General Hospital—75-bed extended-care unit;
expansion of dietary department.
Campbell River and District General Hospital—Addition and alterations project to provide 30 more acute beds; expansion of services, etc.
Saanich Peninsula Hospital, Central Saanich—A new 75-bed extended-care
facility.
Fernie Memorial Hospital—A new 66-bed hospital to replace the existing 43-
bed hospital.
Langley Memorial Hospital—Expansion programme, including the finishing of
"shell" and unfinished areas, expansion of services, to provide a total of 157 acute
beds.
Lillooet District Hospital—Expansion of acute hospital, plus three extended-
care beds; alterations to improve diagnostic, treatment, and service facilities.
Maple Ridge Hospital—A 75-bed extended-care unit is being constructed
adjacent to the acute hospital.
Arrow Lakes Hospital, Nakusp—A new 16-bed hospital to replace the existing
15-bed hospital.
Mount St. Francis Hospital, Nelson—Renovations and improvements to upgrade the facilities required by the 84 extended-care bed hospital.
Prince George Regional Hospital—Construction of the West Wing addition to
provide a net gain of 135 beds; an enlarged power plant, dietary, central sterilizing
and laundry departments, storage, etc. (The programme calls for 35 beds in the
existing hospital to be allocated to extended care when the new beds come into
operation early next January.)
Richmond General Hospital—Renovations are under way to provide an improved temporary emergency department; a prefabricated unit is also being provided
to accommodate the physio-therapy department.
Bulkley Valley District Hospital, Smithers—Additions and alterations to provide eight additional acute beds and seven extended-care beds; services expansion.
Children's Hospital, Vancouver—Two projects are nearing completion: An
eight-bed care-by-parent unit, and an addition to the registry building to provide
class-rooms and activity areas, etc.
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 and dietary areas, etc.
Vernon Jubilee Hospital—A new extended-care unit to provide 75 adult beds
and 26 pediatric beds is being constructed adjacent to the acute hospital; expansion
of the laundry.
Royal Jubilee Hospital, Victoria—Renovation of Bay Pavilion to provide 27
pediatric beds; plus five renal dialysis and three home dialysis beds.
Cariboo Memorial Hospital, Williams Lake—Additions and alterations for a
new emergency department, laboratory and central storage, and three-bed intensive
care/coronary care unit. (A portion of the top floor of the hospital was completed
in 1972.)
Chilliwack General Hospital—Phase IV of expansion programme: Six-bed
intensive-care unit; finishing a 20-bed acute area for 10 extended-care beds; improvement of pediatric department and services.
 Q 36 BRITISH COLUMBIA
(c) Projects in Advanced Stages of Planning
Royal Inland Hospital, Kamloops—Construction of a ninth floor on the acute
block (completed in 1965) to accommodate 38 additional acute beds.
Kitimat General Hospital—Renovation of unused portion of building for 35
extended-care beds.
Kootenay Lake District Hospital, Nelson—Phase II of expansion and renovation programme; additional acute beds and improvement of services.
100 Mile District General Hospital—Expansion to provide a total of 38 acute
beds, and improvement and expansion of diagnostic, treatment, and service facilities.
Trail Regional Hospital—Construction of a seven-bed intensive care/coronary
care unit and three-bed renal unit.
Holy Family Hospital, Vancouver—Expansion to 80 activation and rehabilitation beds, plus day-care facilities; 150-bed extended-care unit.
Mount St. Joseph Hospital, Vancouver—Conversion of existing extended-
care beds to acute; upgrading services, and a 150-bed extended-care unit.
Vancouver General Hospital—Renovation of Willow Pavilion to upgrade the
intensive-care nursery, electrical services, etc.
Vernon Jubilee Hospital—Conversion of existing extended-care unit for acute
care; expansion of services; renovations.
(d) Additional Projects in Various Planning Stages
Matsqui-Sumas-Abbotsford General Hospital, Abbotsford—Expansion programme to provide additional acute beds and expansion of services.
Armstrong and Spallumcheen Hospital, Armstrong—Additional renovations.
St. George's Hospital, Alert Bay—Improvements to buildings and grounds.
Dawson Creek and District Hospital—Expansion and improvement of services.
Fort Nelson General Hospital—Expansion and renovation, including improvement of services.
Fort St. John General Hospital, Fort St. John—Expansion and renovation, including improvement of services.
Boundary Hospital, Grand Forks—Addition for 14 extended-care beds.
Wrinch Memorial Hospital, Hazelton—Replacement of existing buildings with
a new hospital of 35 acute beds plus 4 extended-care beds.
Royal Inland Hospital, Kamloops—Expansion of diagnostic services; plus
additional beds for a total of 424 acute beds.
Kamloops area—100-bed extended-care unit.
Langley Memorial Hospital—25 additional extended-care beds.
Maple Ridge Hospital—Air-conditioning; new administration department and
planning expansion of services for 64 future acute beds.
Mount Waddington Regional Hospital District—Approval to select and acquire a site and plan a central regional hospital f acility.
Pemberton—Diagnostic and treatment centre.
Powell River General Hospital—Upgrading diagnostic and treatment services;
air-conditioning.
Sparwood—New 27-bed hospital.
 HOSPITAL INSURANCE SERVICE,  1973
Q 37
Mills Memorial Hospital, Terrace—Expansion of acute beds (including psychiatric) and services.
Trail Regional—Reallocation programme and upgrading facilities.
Burnaby General Hospital—Expansion of acute beds and services.
Coquitlam and District Hospital—New facility of 150 acute and 75 extended-
care beds.
Delta Centennial Hospital—Planning of health facilities.
Royal Columbian Hospital, New Westminster—Expansion of acute beds and
services.
Queen's Park Hospital Society, New Westminster—Extended-care unit.
Lions Gate Hospital, North Vancouver—Expansion of services.
Richmond General Hospital—Expansion of acute beds and services.
Grace Hospital, Vancouver—Upgrading dietary facilities.
Louis Brier Hospital, Vancouver—Expansion of extended-care unit.
St. Paul's Hospital, Vancouver—Services expansion; conversion of School
of Nursing for patient-treatment facilities, including psychiatric and addiction treatment programmes.
St. Vincent's Hospital, Vancouver—Renovations and additions to upgrade
existing hospital facilities.
Sunny Hill Hospital, Vancouver—Expansion and renovations.
Vancouver General Hospital—Activation unit; improvement of service facilities.
Medical Centre of British Columbia (Shaughnessy)—Major referral centre
and teaching facility for the Province.
Royal Jubilee Hospital—Approval for master plan.
Williams Lake—Additional acute beds.
MEDICAL CONSULTATION DIVISION
Charles F. Ballam, M.D., Senior Medical Consultant
There are two quite distinct areas of commission
for which this Division has responsibility. The first relates to the special elements of physician consultation
and advice, having to do with hospital medical matters,
as opposed to hospital business operational problems.
The second relates to an audit function which, while
incorporating some distinct elements of medical judgment, has, as its primary concern, assessment of eligibility, whether this be for acute or some other level of
hospital care or insured benefit.
An example of the first element finds the Division
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 B.C. Medical Association, the B.C. Hos-
 Q 38 BRITISH COLUMBIA
pitals' Association, and the University of British Columbia Faculty of Medicine.
Concerning the second role, an example would be the medical coding and assessing
of all discharge records received from hospitals, and 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.
The Medical Consultants assist in the planning and implementation of new
services in hospitals by representation on the Planning Group, the Equipment Committee, and the Functional Programme Review Committee of the Service.
The Medical Consultants provide continuing and active liaison with many
health agencies through visits to hospitals, special disease groups, societies,
regional hospital districts, and professional bodies, and represent the Service as a
member of committees developed by these organizations. Liaison with the B.C.
Medical Association continues to be of particular importance, and active participation on its Hospitals Committee, the Advisory Committees on Chronic Renal Failure, Intensive Cardiac Care, Nuclear Medicine, and the like continues. In addition, during the year the fourth review of open-heart surgical facilities, a special
study concerning neonatal and perinatal metabolic diseases, as well as the Minister's
special task committee on cancer care, provided considerable activity for the Division.
During the year a Central Registry for Extended Care applications was
established in Victoria, with direct dedicated telephone-lines available from Vancouver as well as from the Capital city. The institution of this registry overcomes
the previously existing unsatisfactory situation where an individual applying for
extended care was required to make separate applications to a number of extended-
care hospitals, with the hope of gaining an early admission to one of them. With
the Central Registry a single application only is required, and the registry ensures
the applicant's correct placement, according to chronological order, on the various
waiting-lists. The registry also provides updated waiting-lists to the hospitals,
so that the patients can be reviewed just prior to admission.
During the year, in addition to its other assignments, the Medical Consultants
participated in the review of several private hospitals, both from the point of view
of the eligibility status of the residents as well as participating with other divisions
of the Service in a review of the physical plant. These reviews have resulted in
the take-over of one such hospital to date as an extended-care facility, and the
purchase of a second unit is in the final negotiation stage.
During the year the Medical Consultation Division was asked by the Health
Branch to participate in preparation of the publication Types of Health Care in
British Columbia. This Division contributed most of the information related to
Type II, or Intermediate Care, Type III, or Extended Care, and Types IV and
V, Acute and Rehabilitation Care. This Division already had responsibility for
eligibility and administration related to all but personal and intermediate care, and
toward the end of the year was assigned major responsibility for the assignment
of, and continuing review of, continuing eligibility for the Government's intermediate-care facilities.
Physiotherapy services for out-patients at acute-care hospitals became an insured benefit during the year. The full impact of the extent of this benefit has yet
to be felt. The potential for developing out-patient physiotherapy and activation
and rehabilitation medical services as a part of, or in association with acute-care
hospitals, presents an unparalleled opportunity for the future.
 HOSPITAL INSURANCE SERVICE,  1973 Q 39
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.
Day-care surgical services, approved as a hospital insurance benefit in 1968,
have improved the utilization of the Province's health facilities, and the Senior
Medical Consultant continues to advise the Service in its planning for an expanded
role in ambulatory patient care. As is the case with the in-patient admission records, all day-care surgical services records are assessed and coded according to
the International Classification of Diseases, so that this data may be tabulated in
preparation for statistical reviews.
Applications for admission to the Extended Care Programme, submitted on
behalf of patients, were assessed for medical eligibility by the Medical Consultation
Division after tabulation in the Central Registry. At the end of 1973, extended-
care coverage was being provided in approximately 3,000 beds in the Province.
Also, during 1973, approximately 5,000 applications for admission to this programme were assessed for medical eligibility by the Division, and approximately
110 reviews of extended-care hospitals were undertaken. These reviews combine
the dual function of assessing the continued eligibility of the resident for extended-
care benefit, and during these reviews the hospital's programme was also assessed
to ensure that the care which the patient received was appropriately related to
current thinking in the management of the chronically ill and disabled individual.
The Medical Record Consultant provides consultative advice to the Service,
to hospitals visited in the Province, and participates as a member of the Provincial Education Committee of the British Columbia Association of Medical Record
Librarians.
Increasing concern with standards and quality of care, and the encouragement
of hospitals to achieve accreditation status, imposes certain pressures to conform
to the requirements of such accreditation, and when these pressures produce problems for the medical staff of the hospital, the Senior Medical Consultant is able to
render assistance with the help of the Hospital Consultation and Inspection Division, and the Hospitals Committee of the British Columbia Medical Association,
together with representation from the College of Physicians and Surgeons of British
Columbia, as well as the British Columbia Hospitals' Association.
The Medical Consultants endeavour to continue participation in postgraduate
continuing medical education programmes in order that their consultative advice
will reflect an up-to-date overview of developments which continue to go on in
relation to new techniques and new ways of dealing with health care problems in
the hospital and in the community.
 Q 40
BRITISH COLUMBIA
ADMINISTRATION DIVISION
K. G. Wiper, Director, Administrative Services
The Director 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.
This officer provides advice and information on a
wide range of matters to the Minister, Deputy Minister,
and other officials of the 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, this
Division 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 and problems arising in connection therewith. 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 1972 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.
This Division handles pay and personnel matters concerning the staff of the
Hospital Insurance Service and works closely with the Public Service Commission
and the Finance Department in this regard. The Director is also responsible for
the over-all supervision of the Eligibility and the Third-party Liability Sections and
the General Office.
Eligibility Section
P. A. Bacon, Supervisor
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.
 HOSPITAL INSURANCE SERVICE, 1973
Q 41
Eligibility representatives visit hospitals on a regular schedule to see that the
British Columbia Hospital Insurance Service eligibility procedures are being properly
carried out. The representatives also assist in the training of hospital admitting
personnel to deal with problems connected with the admission of patients to hospitals
and the determination of their status under the Hospital Insurance Act. This training assistance is provided by means of visits to hospitals and by regional meetings.
During 1973, regional meetings were held in Nelson, Prince George, Kamloops,
Victoria, and Vancouver.   In all, 208 persons attended, representing 48 hospitals.
This Section keeps the greater 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. Eligibility representatives
are located in Prince George, Kamloops, Nelson, Kelowna, Vancouver, and Victoria.
Third-party Liability Section
J. W. Brayshaw, Supervisor
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 convenence 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, Supervisor
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.
Information Office
C. N. Shave
In carrying out a programme of information and public relations during the
past year, the Information Officer, in addition to regular duties, worked with the
 Q 42 BRITISH COLUMBIA
Health Education Branch for the purpose of narrating film documentaries, writing
television scripts, and assisting in the production of "The Community Health in
Action" series, now being shown on television throughout the Province. Altogether,
a total of 13 documentaries was filmed. In addition, the Information Officer was
called upon to narrate a training film on "Nutrition" for public health nurses, and
two audiology tests for children hard of hearing. The scripting and narrating for
Health Services is a continuing programme.
The writer was also involved in handling administrative arrangements for the
Conference of Western Health Ministers, the 27th Federal/Provincial Advisory
Committee Meeting on Hospital Insurance and Diagnostic Services, the Western
Interprovincial Committee Meeting, and the Meeting of the Working Party on
Patient Care Classification. Besides these new duties, the Information Officer has
been appointed the BCHIS representative on the British Columbia Hospitals' Association Information Service and Conference Programme Committees, and correspondent for the B.C. Medical Journal.
Regular duties included editing the BCHIS Bulletin (a total of 22,800 distributed in 1973). Several news releases were sent out to the media dealing with
hospital construction and policy changes. Reports were summarized for the
Deputy Minister. News stories and feature items were written for the Bulletin
and B.C. Medical Journal. The General Information pamphlet was revised and
reprinted and over 30,000 copies distributed. The Extended Care pamphlet was
also revised, with limited quantities sent to interested parties. Visits were made to
the Pacific National Exhibition to update the BCHIS exhibit. A pamphlet containing statistical data and other information for hospital personnel was prepared and
distributed at the B.C. Hospitals' Association Convention in October, and an
information booth was set up and manned for the convenience of delegates meeting
with Departmental personnel. The booth was also used to distribute copies of the
Greater Vancouver Regional Hospital District Linen Catalogue to hospital administrators, as a working document to build toward the eventual development of broader
independent regional laundries.
In addition, the Information Officer was involved in replying to numerous written requests for information, and on several occasions visited hospitals to discuss
public relations.
 HOSPITAL INSURANCE SERVICE,  1973
Q 43
APPROVED HOSPITALS
Public Hospitals
Armstrong    and   Spallumcheen   Hospital,
Armstrong.
Arrow Lakes Hospital, Nakusp.
Ashcroft   and   District   General   Hospital,
Ashcroft.
*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,   Cran
brook.
Creston Valley Hospital, Creston.
Cumberland   General   Hospital,   Cumberland.
Dr. Helmcken Memorial Hospital,  Clearwater.
Enderby and District Memorial Hospital,
Enderby.
Esperanza General Hospital, Esperanza.
Fernie Memorial Hospital, Fernie.
Fort Nelson General Hospital, Fort Nelson.
Fort St. lohn General Hospital, Fort St.
lohn.
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 Gulf Islands Hospital, Ganges.
Ladysmith and District General Hospital,
Ladysmith.
*Langley Memorial Hospital, Langley.
Lillooet District Hospital, Lillooet.
*Lions Gate Hospital, North Vancouver.
McBride and District Hospital, McBride.
Mackenzie and District Hospital, Mackenzie.
Maple Ridge Hospital, Maple Ridge.
Matsqui-Sumas 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 Regional Hospital, Penticton.
Port Alice Hospital, Port Alice.
Port Hardy Hospital, Port Hardy.
* Pouce Coupe Community Hospital, Pouce
Coupe.
*Powell   River   General   Hospital,   Powell
River.
Prince George  Regional Hospital,  Prince
George.
*Prince  Rupert  Regional   Hospital,   Prince
Rupert.
Princeton General Hospital, Princeton.
Queen  Alexandra  Hospital  for   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 lubilee Hospital, Victoria.
R.   W.   Large   Memorial   Hospital,   Bella
Bella.
St. Bartholomew's Hospital, Lytton.
St. George's Hospital, Alert Bay.
St. lohn Hospital, Vanderhoof.
St.    Joseph    General    Hospital,    Dawson
Creek.
*St. Joseph's General Hospital, Comox.
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.
South Okanagan General Hospital, Oliver.
Squamish General Hospital, Squamish.
Stewart General Hospital, Stewart.
Stuart Lake Hospital, Fort St. James.
Summerland   General   Hospital,   Summer-
land.
*Surrey Memorial Hospital, North Surrey.
* Hospitals with extended-care units.
 Q 44                                                    BRITISH
COLUMBIA
Public Hospitals—Continued
The Mater Misericordiae Hospital, Rossland.
Tofino General Hospital, Tofino.
*Trail Regional Hospital, Trail.
University Health Service Hospital, University of British Columbia, Vancouver.
University   of   British   Columbia   Health
Sciences Centre Hospital, Vancouver.
♦Vancouver General Hospital, Vancouver.
* Vernon Jubilee Hospital, Vernon.
Victoria General Hospital, Victoria.
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, Barn-
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.
Red Cross Outpost Nursing Station, Tatla
Lake.
Federal Hospitals
Veterans' Hospital, Victoria.                                     Canadian Forces Station Hospital Masset,
Shaughnessy Hospital, Vancouver.                               Masset.
Canadian Forest Station Hospital Holberg,
San Josef.
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, Van-          * Shaughnessy Hospital, Vancouver.
couver.                                                                         * Sunny Hill Hospital for Children, Vancou-
*The Gorge Road Hospital, Victoria.                              ver.
Holy Family Hospital, Vancouver.                           *Veterans' Hospital, Victoria.
Pearson Hospital (Poliomyelitis Pavilion),             (A number of the larger public hospitals
Vancouver.                                                                also have rehabilitation units.)
Queen Alexandra Hospital for Children,
Victoria.
Other
Hollywood Hospital Ltd., New Westminster (licensed under the Mental Health Act).
Extended-care Hospitals
(See also Public Hospitals marked*.)
The Louis Brier Hospital, Vancouver.
Menno Hospital, Abbotsford.
Mount St. Francis Hospital, Nelson.
Mount St.  Mary Hospital, Victoria   (excluding top floor).
Mount St. Joseph Hospital, Vancouver.
Pearson Hospital, Vancouver (excluding
facilities for tuberculosis patients).
Priory Hospital, Colwood (24-bed unit and
71-bedunit).
Glendale Lodge, Victoria.
Mount Tolmie Hospital, Victoria.
Out-patient Clinics
Houston Hospital, Houston.
The Arthritis Centre of British Columbia, Vancouver.
Gold River Health Clinic, Gold River.
* Hospitals with extended-care units.
 HOSPITAL INSURANCE SERVICE,  1973 Q 45
STATISTICAL DATA
The tables on the following pages represent statistical data compiled by the
Hospital Finance Division. The data deal with the volume of hospital insurance
coverage provided to the people of British Columbia through the British Columbia
Hospital Insurance Service.
In 1973 there were 100 public general hospitals, including two diagnostic and
treatment centres, approved to accept British Columbia Hospital Insurance Service
patients. Care was also provided in eight Red Cross outpost hospitals, four Federal
hospitals, four contract hospitals, five public rehabilitation hospitals, one rehabilitation hospital operated by the Provincial Government, and two specialized out-patient
facilities—the Canadian Arthritic Society Vancouver Centre and the Narcotic
Addiction Foundation in various centres throughout the Province. Hospital insurance coverage for patients in nonprofit extended-care hospitals and units commenced December 1, 1965. At the end of 1973 there were 42 hospitals, including
two Federal and two Provincial hospitals providing extended care.
Data for the year 1973 have been estimated from reports submitted by hospitals
to October 31, 1973, and are subject to minor revision when the actual figures for
the year are submitted.
Table Ia shows that 373,007 BCHIS adult and children patients were discharged (separated) from British Columbia hospitals in 1973, a decrease of 2,366
or 0.6 per cent less than 1972. This table also shows that 95.6 per cent of the
total adult and children patients discharged (separated) from British Columbia
public hospitals were covered by hospital insurance, compared to 95.8 per cent
in 1972. Table 1b indicates that in 1973 the British Columbia Hospital Insurance
Service paid public hospitals in British Columbia for 3,261,696 days of care for
adults and children, a decrease of 61,556 days or 1.9 per cent less than 1972.
As shown in Table 2a, the average length of stay for adult and child patients
in British Columbia public hospitals during 1973 was 8.74 days and the days of
care per thousand population were 1,602. These figures which show a continuation
of the long-term trend of decreased length of stay are a result of more effective
utilization of hospital beds and ambulatory services. For comparison purposes the
data for extended-care hospitals are not included in the above observations, but
it should be noted that an additional 451 days of care per thousand population were
provided for these patients.
Table 2b is now supplemented by Table 2 c as the number and volume of
ambulatory services covered by BCHIS have expanded considerably. It should be
noted that psychiatric and diabetic day-care services are only in a limited number
of hospitals. Services listed under "Other" relate to special out-patient services
provided by B.C. Cancer Institute, G. F. Strong Rehabilitation Centre, and the Narcotic Addition Foundation of British Columbia. The growth of ambulatory services
reflects a trend toward the broader provision of hospital-based services, providing greater patient convenience and reducing the pressure for construction and
maintenance of in-patient beds, which is partially reflected by the reduction in
incidence of patient-days noted above.
 Q 46
BRITISH COLUMBIA
Table Ia—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
380,651
391,732
390,314
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
35,101
34,774
34,338
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
415,752
426,506
424,652
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
364,452
375,373
373,007
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
95.8
95.6
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
33,732
33,595
33,841
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
96.1
96.6
98.6
164,808
1955                              - _
231,289
1960
288,634
1961   _   -	
196?.
297,511
301,160
1961
308,475
1964   .                            	
312,219
1965       	
318,662
1966             	
330,332
1967                                	
342,095
1968       	
356,404
1969    . .                     	
373,985
1970 ..  ....	
1971	
390,496
398,184
19722                 	
408,968
19733   _                                                   	
406,848
86.2
Percentage of total, patients separated—
1949	
1955
92 5
1960                                   	
	
96.0
1961
96 0
1962..    _	
95.7
1963
95.4
1964
95 2
1965
	
95 0
1966
95.2
1967 ....
	
95.3
1968
95.7
1969
95.6
1970      .               	
	
95.7
1971     _
	
95.8
19722     	
95 9
19733   ....                                                 	
95.8
i Includes rehabilitation hospitals.
2 Amended as per final reports received from hospitals.
3 Estimated, based on hospital reports to October 31,1973.
 HOSPITAL INSURANCE SERVICE,  1973
Q 47
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
New-
horn
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
3,400,366
3,462,509
3,401,988
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
227,372
219,158
210,873
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
3,627,738
3,681,667
3,612,861
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
3,259,097
3,323,252
3,261,696
85.0
91.2
95.0
95.2
95.0
94.7
94.7
94.0
95.1
95.2
95.3
95.2
94.5
95.8
96.0
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
216,305
210,764
203,455
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
95.1
96.2
96.5
1,631,231
1955   ...	
2,217,679
1960   _
2,692,996
1961
2,777,387
196?
2,837,109
1963
2,889,407
1964 _   	
2,916,989
1965
2,977,328
1966            _   _
3,081,530
1967  ., 	
1968            .     _   _.               	
3,168,543
3,301,592
1969 	
3,387,974
1970
3,471,602
1971              	
3,475,402
19722  __ __ _	
3,534,016
19733     _      	
3,465,151
Percentage of total, patient-days—■
1949             	
86.0
1955	
	
91.4
1960
	
95.1
1961	
95.3
1967.
	
95.1
1963 	
	
94.8
1964...	
94.7
1965	
	
94.0
1966 _
	
95.0
1967              	
95.0
196R
95.1
J969
	
95.1
1970
95.4
1971    "	
95.8
19722	
96.0
19733      	
95.9
1 Includes rehabilitation hospitals.
2 Amended as per final reports received from hospitals.
3 Estimated, based on hospital reports to October 31, 1973.
 Q 48
BRITISH COLUMBIA
Table 2a—Patients Separated, Total Patient-days, and Average Length of Stay
According to Type and Location of Hospital for BCHIS Patients Only, and
Days of Care per Thousand of Covered Population.
Total
(Excluding
Extended Care)
Adults
and
Children
Newborn
B.C. Public
Hospitals
Adults
and
Children
Newborn
Other B.C. Hospitals,
Including Federal
and Private
Adults
and
Children
Newborn
Institutions Out
side British
Columbia
Adults
and
New
Chil
born
dren
2,019
198
1,912
159
2,909
267
2,979
259
3,140
280
3,261
279
3,516
307
3,306
263
3,414
237
4,707
344
4,627
316
5,181
304
5,454
297
6,038
351
5,234
244
6,900
350
21,515
1,466
19,622
1,195
28,889
1,906
27,631
1,873
32,679
2,026
31,174
2,017
36,204
2,136
32,372
1,723
37,028
1,664
47,648
2,485
46,422
1,986
54,269
1,832
55,865
2,158
60,235
3,224
51,385
1,521
65,000
2,300
10.66
7.40
10.26
7.52
9.93
7.14
9.27
7.23
10.41
7.24
9.56
7.23
10.30
6.96
9.79
6.55
10.84
7.02
10.12
7.22
10.03
6.28
10.47
6.03
10.24
7.27
9.98
6.34
9.82
6.23
9.42
6.57
Extended-
care
Hospitals
(Including
Federal)
Patients separated-
1949	
1955	
1960	
1961	
1962	
1963	
1964	
1965	
1966	
1967	
1968	
1969	
1970....
1971....
1972L.
19732...
Patient-days—
1949	
1955	
1960	
1961	
1962	
1963 _
1964	
1965	
1966	
1967	
1968	
1969	
1970	
1971 ...
19721..
19732..
Average days of
stay—
1949  	
1955	
1960	
1961	
1962..._	
1963 	
1964	
1965	
1966. 	
1967— _
1968 	
1969	
1970	
1971	
19721.
19732..
149,280
24,989
209,999
32,035
264,120
39,488
273,293
37,968
278,021
36,942
286,753
36,326
293,144
34,652
301,522
32,240
314,391
31,152
325,861
30,804
338,706
32,031
353,457
34,974
369,210
35,431
379.144
34,192
388,747
33,878
388,097
34,220
,491,121
203,197
,100,386
215,980
,650,129
244,480
,756,665
233,794
,789,355
266,351
,850,559
260,771
,905,544
249,827
,985,092
232,438
,110,701
222,475
,189,212
225,479
,309,533
229,053
,397,005
234,098
,465,504
240,657
,486,671
218,971
,543,587
212,549
,482,196
205,885
10.03
8.13
10.00
6.74
10.03
6.19
10.09
6.16
10.03
7.21
9.94
7.18
9.91
7.21
9.90
7.21
9.89
7.14
9.79
7.32
9.77
7.15
9.61
6.69
9.39
6.79
9.20
6.40
9.12
6.27
8.97
6.02
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
364,452
375,373
373,007
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
3,259,097
3,323,252
3,261,696
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
8.94
8.85
8.74
1
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
33,732
33,595
33,841
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
216,305
210,764
203,455
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
6.41
6.27
6.01
7,093
8,313
11,557
10,361
10,226
10,895
11,605
11,417
11,459
9,436
9,310
8,867
8,307
8,654
8,140
8,190
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
167,339
168,950
155,500
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
19.34
20.76
18.99
151
361
241
151
157
169
149
114
101
83
80
94
87
109
39
29
1,146
2,271
1,417
878
850
1,018
878
619
541
451
434
463
450
442
264
130
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
4.06
6.77
4.48
699
873
990
1,100
1,022
1,495
1,822
2,235
305,940
358,675
409,514
502,365
531,808
672,099
817,321
1,039,084
437.68
410.85
413.64
456.70
520.36
449.56
448,58
464.91
i Amended as per final reports from hospitals.
2 Estimated, based on hospital reports to October 31, 1973. 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, 1,696; 1972, 1,669; 1973, 1,602 (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
308 in 1971, 372 in 1972, and 451 in 1973.   Population figures are revised according to latest census figures.
 HOSPITAL INSURANCE SERVICE, 1973 Q 49
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	
1960	
1961—
1962.....
1963—
1964.....
1965	
1966—
1967	
1968....
1969	
1970—
1971—
1972L.
19732.
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
414,831
424,447
424,552
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
292,850
453,589
715,000
203,269
312,587
410,920
432,261
442,963
458,079
468,796
493,762
521,242
552,538
581,727
609,531
640,663
707,681
878,036
1,139,552
1 Amended as per final reports received from hospitals.
2 Estimated, based on hospital reports to October 31, 1973.
Table 2c—Summary of BCHIS Out-patient Treatments by Category,
Years 1971-73, Inclusive
1971
1972
1973
Psychiatry—
Out-patient-
Day care-
Minor and emergency..
Day-care surgery	
Diabetic day care_	
Physiotherapy	
Others 	
5,012
7,536
191,113
40,289
48,900
292,850
7,955
8,131
267,203
44,633
1671
125,500
453,589
8,900
9,200
325,000
51,000
1,000
180,0002
139,900
715,000
i Commenced October 1972.
2 Commenced April 1973.
3 Other includes
(a) Cancer out-patients.
(b) Rehabilitation day care.
(c) Narcotic addiction out-patients (1972 and 1973 only).
 Q 50
BRITISH COLUMBIA
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 19731 (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
373,007
33,841
3,261,696
203,455
8.74
6.01
202,759
16,594
1,862,616
103,930
9.19
6.26
78,649
8,264
653,362
48,197
8.31
5.83
46,695
5,552
448,582
33,511
9.61
6.04
34,967
2,564
242,270
13,680
6.93
5.33
9,937
867
Patient-days—
Adults and children
54,866
4,137
Average day's stay—
Adults and children
5.52
4.77
1 Estimated, based on hospital reports to October 31, 1973.
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 19731 (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.—	
Per Cent
100.00
100.00
100.00
100.00
Per Cent
54.36
49.03
57.11
51.08
Per Cent
21.09
24.42
20.03
23.69
Per Cent
12.52
16.41
13.75
16.47
Per Cent
9.37
7.58
7.43
6.73
Per Cent
2.66
2.56
1.68
2.03
T- Estimated, based on hospital reports to October 31, 1973.
 HOSPITAL INSURANCE SERVICE,  1973
Q 51
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 57 to 62 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 1972 and
Statistics of Hospitalized Accident Cases, 1972, available from the Research Division.
 Q 52
BRITISH COLUMBIA
O
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 HOSPITAL INSURANCE SERVICE, 1973
Q 53
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  HOSPITAL INSURANCE SERVICE,  1973
Q 55
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 Q 56
BRITISH COLUMBIA
Chart V—Average Length of Stay of Cases* in Hospitals in British
Columbia, by Major Diagnostic Groups in Descending Order, 1972
(Excluding Newborns).
Diseases of the circulatory
system
Neoplasms
Mental disorders
Endocrine, nutritional, and
metabolic diseases
Certain causes of perinatal
morbidity and mortality
Diseases of the musculoskeletal
system and connective tissue
Congenital anomalies
Diseases of the skin and
subcutaneous tissue
Diseases of the digestive
system
Accidents, poisonings, and
violence
PROVINCIAL AVERAGE
LENGTH OF STAY
Diseases of the blood and
blood-forming organs
Diseases of the nervous
system and sense organs
Infective and parasitic
diseases
Diseases of the respiratory
system
Diseases of the genito-urinary
system
Complications of pregnancy,
childbirth, and the
puerperium
Symptoms and ill-defined
conditions
I
I
I
I
1
I
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I
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13.0
12.9
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_t
M "WMM
9.3
^^
7.6
6.4
'L
6.3
% " m
5.0
I
m
m
* Including rehabilitative care.
 HOSPITAL INSURANCE SERVICE, 1973
Q 57
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X
 HOSPITAL INSURANCE SERVICE,  1973 Q 63
STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE
FISCAL YEAR ENDED MARCH 31, 1973
Administration—
Salaries 	
Temporary assistance
Office expense	
Travelling expense
Office furniture and equipment.
Printing and publications	
Tabulating and rentals 	
Educational material	
Motor-vehicles and accessories .
Incidentals and contingencies _
Construction and consultation __.
1,267,264
19,974
1,287,238
56,349
76,131
12,166
3,523
5,515
94
6,321
1,624
23,735
66,209
1,538,905
226,286,542
2,746,225
Grants in aid of construction       6,561,427
Total  237,133,099
Technical surveys and new service development 	
Payments to hospitals-
Claims 	
Grants in aid of equipment
Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1974
1030-274-2068
 

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