{"http:\/\/dx.doi.org\/10.14288\/1.0348776":{"https:\/\/open.library.ubc.ca\/terms#identifierAIP":[{"value":"91ff3285-3538-48f4-b2c7-662c06b126f5","type":"literal","lang":"en"}],"http:\/\/www.europeana.eu\/schemas\/edm\/dataProvider":[{"value":"CONTENTdm","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/alternative":[{"value":"HOSPITAL INSURANCE SERVICE REPORT, 1953","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/isReferencedBy":[{"value":"http:\/\/resolve.library.ubc.ca\/cgi-bin\/catsearch?bid=1198198","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/isPartOf":[{"value":"Sessional Papers of the Province of British Columbia","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/creator":[{"value":"British Columbia. Legislative Assembly","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/issued":[{"value":"2017-06-27","type":"literal","lang":"en"},{"value":"[1954]","type":"literal","lang":"en"}],"http:\/\/www.europeana.eu\/schemas\/edm\/aggregatedCHO":[{"value":"https:\/\/open.library.ubc.ca\/collections\/bcsessional\/items\/1.0348776\/source.json","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/elements\/1.1\/format":[{"value":"application\/pdf","type":"literal","lang":"en"}],"http:\/\/www.w3.org\/2009\/08\/skos-reference\/skos.html#note":[{"value":" PROVINCE OF BRITISH COLUMBIA\n\"HOSPITAL INSURANCE ACT\"\nFifth Annual Report\nB.C. Hospital Insurance\nService\nJANUARY 1st TO DECEMBER 31st\n1953\nVICTORIA, B.C.\nPrinted by Don McDiarmid, Printer to the Queen's Most Excellent Majesty\n1954  Victoria, B.C., February 16th, 1954.\nTo His Honour Clarence Wallace, C.B.E.,\nLieutenant-Governor of the Province of British Columbia.\nMay it please Your Honour:\nThe undersigned has the honour to present the Fifth Annual Report of the B.C.\nHospital Insurance Service covering the calendar year 1953.\nE. C. MARTIN,\nMinister of Health and Welfare. B.C. Hospital Insurance Service,\nVictoria, B.C., February 16th, 1954.\nThe Honourable E. C. Martin,\nMinister of Health and Welfare,\nParliament Buildings, Victoria, B.C.\nSir,\u2014I have the honour to present herewith the Report of the B.C. Hospital\nInsurance Service covering the calendar year 1953.\nL. F. DETWILLER,\nCommissioner, B.C. Hospital Insurance Service. CONTENTS\nPage\nGeneral Introduction   7\nInsurance (a)\u2014\u25a0\nThe Collection of Revenue  7\nInsurance (b)\u2014\nClaims and Accounting  8\nMethod of Payment to Hospitals  8\nHospital Services  9\nSummary  9\nOrganization and Administration\u2014\nRegistration and Collection\u2014\nPayroll Division   10\nField Division :  10\nTabulating Division  10\nCentral Accounts Division  11\nDepartmental Comptroller  11\nPublic Relations  11\nLiability and Adjustment Division  12\nResearch Division  12\nHospital Services Group  12\nHospital Finance Division\u2014\nHospital Claims Section  13\nHospital Accounting Section  13\nHopsital Consultation and Inspection Division, Victoria  13\nHospital Consultation and Inspection Division, Vancouver  14\nMedical Consultation Division  15\nHospital Construction Division  15\nGeneral Hospital Care  16\nTable Ia.\u2014Patients Discharged and Days of Care in B.C. Public Hospitals,\n1949-53, and Proportion Covered by B.C. Hospital Insurance Service  16\nTable Ib.\u2014Percentage of Patients Covered by B.C. Hospital Insurance Service\nduring 1953  17\nTable IIa.\u2014Patients Discharged, Total Days' Stay, and Average Length of Stay\nAccording to Type and Location of Hospital, and Days of Care per Thousand of Covered Population for B.C.H.I.S. Patients Only, 1949-53  17\nTable IIb.\u2014Summary of the Number of B.C.H.I.S. In-patients and Short-stay\nPatients, 1949-53  17\nTable III.\u2014Patients Discharged, Total Days' Stay, and Average Length of Stay\nin B.C. Public Hospitals for B.C.H.I.S. Patients Only, Grouped According\nto Bed Capacity, Year 1953  18\nTable IV.\u2014Percentage Distribution of Patients Discharged and Patient-days for\nB.C.H.I.S. Patients Only, in B.C. Public Hospitals, Grouped According to\nBed Capacity, Year 1953  18\n5 NN 6 BRITISH COLUMBIA\nGraphs  Page\nPrincipal Causes of Hospitalization, July 1st to December 31st, 1952  19\nAverage Lengths of Stay for Nineteen Major Diagnostic Categories of Illness,\nJuly 1st to December 31st, 1952  20\nCase Fatality Rates for Nineteen Major Diagnostic Categories of Illness, July 1st\nto December 31st, 1952  21\nStatements\u2014\nStatement of Receipts and Disbursements for the Fiscal Year 1952-53, Ended\nMarch 31 st, 1953  22\nStatement Showing Cash Reconciliation with the Public Accounts of the Province\nof British Columbia as at March 31st, 1953  23\nBenefits in B.C. Hospitals, 1953  24\nBenefits in Hospitals outside British Columbia  24\nClasses of Persons Covered by or Excluded from the Benefits of the Hospital Insurance Service  24 Fifth Annual Report of the B.C. Hospital\nInsurance Service\nGENERAL INTRODUCTION\nThe main purpose of the B.C. Hospital Insurance Service is to provide universal\nand comprehensive coverage against the cost of acute in-patient hospital care to the\npeople of British Columbia. It exists to answer two definite needs: to protect the people\nof British Columbia from crippling hospital bills, and to protect the hospitals of British\nColumbia from a large proportion of non-collectable accounts. Sufficient proof of these\nneeds lies in the fact that before the inception of the B.C. Hospital Insurance Service as\nmany as 35 to 55 per cent of the patients of some hospitals could not afford to pay\ntheir bills.\nUniversal coverage\u2014coverage of all\u2014is achieved in three principal ways:\u2014\n(1) The \" Hospital Insurance Act\" requires every citizen, with the exception\nof certain small groups, to pay hospital insurance premiums or have them\npaid on his or her behalf; thus all categories are included, regardless of\nage or physical condition:\n(2) The regulations to the \"Hospital Insurance Act\" allow the inclusion of\na wide range of family dependents:\n(3) Groups receiving social-welfare assistance from the Provincial Government\nreceive hospital insurance coverage paid for by the Province.\nComprehensive coverage is achieved by making available to the insured patient\nsubstantially all of the hospital's services in return for the premium paid (see Benefits,\npage 24).    Benefits consist of:\u2014\n(1) Payments at the public-ward level for acute treatment that can be obtained\nonly in an acute general hospital:\n(2) Payments for emergency treatment (short-stay benefits);  and\n(3) Payments for treatment in hospitals outside British Columbia (out-of-\nProvince benefits).\nThe B.C. Hospital Insurance Service has two broad functions\u2014insurance and\nhospital services. The insurance side, in turn, is broken down into two main parts, which\nare as follows:\u2014\nInsurance (a)\nThe Collection of Revenue\nPremium Rates.\u2014These are $27 a year for a single registrant and $39 a year for\nthe head of a family and his dependents, or approximately 8 cents a day and 11 cents\na day respectively.\nMethods of Payment.\u2014There are two methods of payment\u2014payroll deduction and\ndirect payment.\nPayroll Deduction.\u2014This has been recognized as the most practical method of\ncollection. Over one-half of the people in British Columbia pay their premiums in this\nway, and expansion of the system to include as many employed persons as possible was\nbegun in the latter half of 1953. Standard monthly deductions of $2.25 and $3.25\na month are made in advance through employers, and, as a result of the new payment\nplan introduced on July 1st, 1953 (see New Payment Plan, page 10), registrants are\neligible for benefits during the month for which a deduction has been made;   those NN 8 BRITISH COLUMBIA\nregistrants whose premiums were paid six months in advance under the old payroll system\nmaintain their payments and the advance protection.\nDirect Payment.\u2014Those persons not participating in the payroll deduction plan are\nbilled direct from Victoria every six months for the following six-month insurance period,\nfrom January to June or from July to December. Registrants who have paid the premium\nfor the current six-month insurance period by due date are eligible for benefits during\nthat period.\nThe improved collection procedure, implemented in 1953, was responsible for\nseveral changes in collection policy. Effective July 1st, all arrears were suspended to\nenable registrants who had fallen behind with premium payments to reinstate their\ncoverage, subject to the following waiting periods:\u2014\n(1) Persons who have paid regularly but who miss paying their current\npremium by the due date are subject, upon payment of premium, to\na fourteen-day waiting period before being eligible for benefits:\n(2) Persons who have not paid their premium for the previous insurance\nperiod can reinstate themselves by paying the full premium for the current\ninsurance period. To prevent abuse of the new plan, such persons are\nsubject to a one-month waiting period before becoming eligible for benefits.\nOn the same date, a new feature, \"insured benefits,\" was introduced, to begin to\ntake effect from January 1st, 1954. All persons who regularly pay their hospital insurance\npremiums build up an \" insured benefits \" period. One month's \" insured benefits \" are\nacquired at the end of each full-paid six-month insurance period. This will continue to\nbuild up, provided all premiums are regularly paid until a maximum \" insured benefits \"\nperiod of three months is attained at the end of eighteen months of premium payment.\nThis \" insured benefits \" period will be available during unemployment or when direct\npayment of premium by the due date is not possible owing to temporary financial\ndifficulties.    AH B.C.H.I.S. benefits will be available during this period.\nInsurance (b)\nClaims and Accounting\nThe second part of the insurance side of the Hospital Insurance Service, which is\norganized under the Hospital Services Group (see page 12), is concerned with the\nredistribution to the hospitals of the money collected in premiums. This is accomplished\nthrough the meeting of claims\u2014the payment of the insured patients' hospital bills\u2014at\ndaily rates established under the budget system after review of hospital accounting records.\nMethod of Payment to Hospitals\nEffective January 1st, 1951, a system of firm budgets was instituted for hospitals.\nUnder this system, hospital estimates submitted were reviewed by the Rate Board of the\nHospital Insurance Service, and, after such adjustments as were found necessary, the\nresulting budgets were established. Hospitals were advised that, with the exception of\ncertain items (particularly fluctuation in days' treatment), they would be required to live\nwithin their approved budgets, and that deficits incurred through expenditures in excess\nof the approved budget would not be met. Calculations were made to determine the value\nof variable supplies used in the care of patients. The budgets were subject to adjustment\nupward or downward by the number of days by which the actual experience differed from\nthe estimate, multiplied by the patient-day value of the variable supplies. In those\ninstances where the fluctuations in occupancy were sufficiently great to entail additions\nto or reductions in stand-by costs, individual studies were made and budget adjustments\nestablished.\nDuring 1953 this procedure was modified somewhat, and hospitals were required to\noperate on their budgets as approved for 1952 and per diem rates were not increased. HOSPITAL INSURANCE SERVICE REPORT,  1953\nNN 9\nHowever, authority was given the Service to adjust a hospital's budget, up to the amount\nof 1953 salary increases paid to employees included in the 1952 approved budget, where\nsuch increased wage rates caused the hospital to incur an operating deficit.\nOwing to the fact that all hospitals treat a certain number of non-B.C.H.I.S. patients\n(Workmen's Compensation Board, transients, non-insured individuals, and persons\nexempt from hospital insurance coverage by reason of membership in the Canadian\nPacific Railway and B.C. Telephone medical plans), the Service is not responsible for the\nentire patient-load. The Service, therefore, pays to each hospital each month the portion\nof one-twelfth of the yearly budget that is represented by the B.C.H.I.S. insured days as\ncompared to the total days' treatment. Remittances to hospitals are made twice monthly.\nAt the end of any month each hospital is paid the approximate amount of its earnings\nto date for B.C.H.I.S. patients, including those remaining in hospital at the end of the\nmonth. All insured patients are required to pay $1 for each day's hospitalization. The\n$1 a day collectable from insured persons is deducted in calculating payments due to\nhospitals from the Service.\nHospitals collect from non-insured persons at established per diem rates.\nHospital Services\nThe other main function of the B.C. Hospital Insurance Service is that concerned\nwith what the patient receives from the hospital in return for the money paid on his\nbehalf, the standards of patient care (see Hospital Services Group, page 12).\nThe group of staff consultants who share this responsibility are organized into the\nfollowing divisions:\u2014\nHospital Finance (in addition to its activities in the insurance side of the Service):\nTo give advice to hospitals on problems of accounting and finance.\nConsultation and Inspection:    To assist hospitals with administrative  and\noperational problems and ensure that proper standards of patient care are\nmaintained at all times.\nMedical Consultation:   To review all medical matters affecting the Service\nunder the advice and guidance of a Medical Review Board.\nHospital Construction:   To give advice to hospitals in the preparation of plans\nfor new buildings and renovations and to process applications for grants\nfor construction and purchase of equipment.\nResearch:*   To conduct studies of hospital occupancy and develop medical\nand financial information required to guide the Service regarding the\nhospital requirements of the people of the Province.\nLiability and Adjustment: *   To assist in the formation of hospital districts in\nareas where no municipal organizations exist and to give guidance in the\nreview of hospital by-laws and the many related problems.\nThese expert advisory services are available at every stage of the construction of\na hospital and in every phase of its operation.\nSummary\nIn summary, the B.C. Hospital Insurance Service protects the patient from hospital\nbills, both large and small, and the hospitals from a large proportion of uncollectable\naccounts. From the point of view of the insured citizen, maintenance of the standards\nof care is assured. From the point of view of the hospitals, although the Hospital\nInsurance Service inevitably exercises a broad over-all financial control in handling their\nrevenue, autonomy as community hospitals is retained.\n* Not organized specifically under Hospital Services Group as the work ot these divisions is utilized by the whole\nService. NN 10 BRITISH COLUMBIA\nORGANIZATION AND ADMINISTRATION\nRegistration and Collection\nPayroll Division\nOn December 31st, 1953, 5,100 firms were registered for payroll deductions and\nmaking monthly deductions of British Columbia hospital insurance premiums from their\nemployees. Two hundred and twenty-eight thousand registrants were paying their\npremiums through the payroll deduction plan. This number represents protection against\nhospital bills for more than 500,000 persons in British Columbia.\nNew Payment Plan.\u2014On July 1st, 1953, the Government eliminated the six months'\nprepayment of premium and the collection of premium arrears by payroll deductions.\nAfter this date, employers were billed for standard monthly premiums on a month-for-\nmonth basis in accordance with the new payment plan. Prepayments resulting from the\nformer plan were credited to the accounts concerned. As a result of the change in procedure, there was a marked reduction in the amount of work required by employers and\nthe Service in the administration of the payroll plan.\nDuring the months of August and September a simplified accounting procedure was\ndeveloped for payroll accounts. This new procedure involved the extensive use of\npunched-card methods and of tabulating equipment.\nThe simplified payment plan and the improved accounting and record system commenced on October 1st, 1953, permitting expansion of the payroll deduction plan in the\nlast half of the year.\nRegistration of New Employees.\u2014The intensive programme for the registration\nof new employers and the enrolment of their employees in the payroll plan resulted in\nthe commencement of deductions in December, 1953, by 1,500 new employers from\n35,000 employees.\nField Division\nThe Hospital Insurance Service was represented by the Field Division throughout\nthe Province as follows:\u2014\n(1) Four Hospital Insurance Service district offices, located in Chilliwack,\nNew Westminster, Vancouver, and Victoria:\n(2) Seven collection offices, operating on a commission basis\u2014six located in\nFraser Valley communities and one at Trail:\n(3) Thirty-nine Government Agencies, where premium payments were\naccepted and general information was provided.\nPayroll Expansion.\u2014A programme to expand the payroll deduction plan was undertaken in September and October by the Field Division in conjunction with Payroll Division.   No difficulty was experienced in enlisting the co-operation of employers.\nThroughout the year this Division provided service to the general public and to all\nfirms enrolled under the payroll deduction plan.\nTabulating Division\nMajor projects completed during the year were as follows:\u2014\nA wide variety of statistical reports were prepared for the Research Division. All\nstatistical cards accumulated from the 1952 hospital discharge forms were included in\nthese reports. Four new accounting-machines were installed, replacing older-style\nmachines and enabling the Division to accomplish the additional punched-card accounting work necessitated by the major changes to the accounting system that were adopted\nin 1953. Preparation of billing files for new companies registered as a result of the\npayroll expansion programme was completed. HOSPITAL INSURANCE SERVICE REPORT,  1953\nNN 11\nRoutine work included the preparation of monthly group billings for all registrants\non payroll deduction, of two semi-annual billings for all direct-paying registrants and\ntwo arrears billings for delinquents, the weekly preparation of hospital remittance lists,\nbillings to municipalities for the per diem grant, and statements to patients for income-tax\npurposes for all hospital accounts submitted during the year, and the daily processing of\ncash and adjustments to provide a daily entry journal covering all accounts held by the\nHospital Insurance Service.\nCentral Accounts Division\nThe past year was marked by two important administrative and organizational\nchanges:\u2014\n(1) The use of punched cards was extended in premium accounting in conjunction with the simplification and expansion of the payroll deduction\nmethod of collecting premiums.\n(2) A central registry was established, containing approximately 700,000 files,\none for every person registered under the \" Hospital Insurance Act.\"\nThe Division records all premium payments, both direct and through payroll deduction, and all exemptions (see Table V, Claims for Exemption, page 25), as well as\nmaintaining an index of all persons registered under the \" Hospital Insurance Act.\"\nDepartmental Comptroller\nAll disbursements relative to premium refunds, payments to hospitals, advance\nwarrants, travelling expenses, and trade accounts incurred by the Hospital Insurance\nService were checked, approved, and passed for payment.\nThe accounting operation for the three Provincial Infirmaries was supervised, and\nall financial transactions relative to the construction, renovation, and equipping of hospitals were checked and recorded.\nAn internal audit of the Hospital Insurance Service and its collection agencies was\ncompleted. Statements relating to revenue and expenditure were prepared and issued\nmonthly.\nThe premium revenue of the entire Hospital Insurance Service was checked and\ncashiered.\nAn inquiry office was operated at head office to receive premium payments and\ntransact other hospital insurance business with the public.\nThe number of receipts for Payroll Division payments cashiered at head office from\nJanuary 1st, 1953, to December 31st, 1953, was over 43,000. Central Accounts receipts\nduring the same period exceeded 350,000.\nOffice supplies were requisitioned, furniture and equipment were maintained, and\nstationery inventories kept.\nPublic Relations\nThe organization and execution of localized publicity campaigns, designed to \" sell \"\nthe B.C. Hospital Insurance Service, was the major project of the year's activities. Radio\nand newspaper campaigns were conducted by staff members in Prince Rupert, Prince\nGeorge, Quesnel, and Kamloops at different times during the last five months of the year.\nFrom January to August the Service's News Letter (35,000 circulation) received\npriority and necessitated repeated trips into the field for the purpose of obtaining specialized material. On these occasions every effort was made to improve the Service's public\nrelations through the media of the press, radio, and public speaking. At the request of\nmany hospitals, detailed information was made available on such matters as opening-\ndays, community relations, and public relations.\nThe bulletin was expanded in March to include hospital news in addition to the\nService's administration features, and space was made available to the hospitals to NN 12 BRITISH COLUMBIA\npublicize their needs for, or surplus of, equipment, thereby making possible exchanges\nand purchases with economy and to the common advantage.\nTwo pamphlets were prepared for public consumption, along with advertising\nmaterial for semi-annual premium-payment campaigns. Articles written and submitted,\ntogether with photographs, were from time to time published in British Columbia newspapers and the \" Canadian Hospital \" magazine.\nAn internal public-relations programme was continued.\nLiability and Adjustment Division\nThis Division prepared legislation, regulations, and Orders in Council, and was\nresponsible for liaison between the B.C. Hospital Insurance Service and the Attorney-\nGeneral's Department.\nIt provided a consulting service to the other divisions of B.C. Hospital Insurance\nService, to ensure that a uniform interpretation of the various Acts and regulations was\nmaintained throughout the Service.\nThe Division also assisted communities in unorganized territory to establish hospital\nimprovement districts for the purpose of raising funds for hospital construction, and\nassisted hospitals in the review and revision of by-laws in collaboration with the Hospital\nConsultation and Inspection Division.\nIn addition, this Division collected reports on all persons involved in accidents who\nreceived hospital treatment and secured reimbursement of hospital bills paid by the\nService from public-liability insurance companies and self-insured corporations under\nan agreement which has been in effect for some years.\nResearch Division\nDuring 1953 numerous studies dealing with Provincial hospital experience and\nrequirements, sickness incidence, population trends, and income statistics were completed.\nHospital Bed Facilities.\u2014Detailed reports were prepared on the hospital bed facilities of ten districts in order to determine the additional number which would be required\nto serve adequately the needs of these areas. The assessment of the hospital bed needs\nwas based on incidence of sickness, utilization of hospital facilities within the Province\nby the residents, population trends, geographic location, climatic conditions, transportation facilities and costs, type of economy which supports the area, and the financial\nstructures of the municipalities involved. Where it was felt that a particular area needed\nspecial attention, staff members visited the district concerned to gather additional information. A study to estimate the hospital bed requirements of the Lower Fraser Valley\nwas commenced at the end of the year.\nCauses of Hospitalization.\u2014In April a statistical analysis of the causes of hospitalization among British Columbia residents was completed. The report was based on the\nmedical data appearing on the admission-discharge forms submitted by the hospitals to\nthe Service and represented the first attempt made by this Division to summarize the\ndetails of the individual admissions and to present them in a useful form.\nMajor Statistical Studies.\u2014Other major statistical studies completed: Six population studies, twelve hospitalization experience reports, two studies on recipients of social\nwelfare, and a study on maternity cases and new-born babies.\nIn addition to supplying statistical information pertaining to hospitalization and\ndisease incidence to other branches of the Service and the Provincial Government, information was gathered and compiled for government services throughout Canada and the\nUnited States.\nHospital Services Group\nThe Hospital Services Group comprises that part of the Hospital Insurance Service\nwhich deals with hospitals and with hospital matters.    Its four divisions are Hospital HOSPITAL INSURANCE SERVICE REPORT, 1953\nNN 13\nFinance, Hospital Consultation and Inspection, Medical Consultation, and Hospital\nConstruction.\nHospital Finance Division\nHospital Claims Section\nThe main functions of this Section were to advise hospitals of patients' eligibility\nstatus and to screen and process hospital accounts for payment. Approximately 900\nadmission notices and an equal number of hospital accounts were received each working-\nday throughout the year. Admission notice forms were screened by the Medical Consultant's Division before the patient's eligibility status was determined. Hospitals were\nnotified with regard to B.C.H.I.S. responsibility on each admission notice received.\nDuring 1953, 208,111 hospital accounts were processed and approved for payment,\nan increase of 18,240 over 1952. This total included 3,131 out-of-Province accounts,\npaid on behalf of beneficiaries who were admitted to hospitals in other Provinces of\nCanada, United States, South America, and many European countries, and other areas\nof the world.\nDuring 1953 this Section paid hospital accounts for persons in receipt of welfare\nfunds, and then billed and recovered reimbursement from the Provincial Welfare Branch.\nThe previous year's records\u2014over 610,000 documents\u2014were microfilmed, effecting\na considerable saving in filing space and equipment.\nHospital Accounting Section\nThis Section was primarily concerned with hospital budgets, maintaining close\nworking relations with the hospitals, and the inspection of hospital accounting records.\nFrequent inspections were made of hospital financial and statistical records. Where\nsmaller hospitals had changes in accounting staff, and local assistance was not available,\nthis Section, upon request, sent accountants to write up the hospital's books and to train\nnew staff.\nMonthly statistical reports and statements of revenue and expenditure were received\nfrom hospitals and compared with the approved budgets, and cash advances were calculated and made semi-monthly.\nThe Annual Hospital Report for 1952, required under the \" Hospital Act,\" was\nprepared; financial and statistical reports prepared by hospitals for the Dominion Bureau\nof Statistics were checked and amended; requests for payment of grants in connection\nwith capital expenditures made by hospitals for equipment were studied and recommended for approval; audits of accounts relating to hospital-construction projects were\ncarried out in collaboration with Federal Treasury officials; and accounting studies were\ncarried out in nursing homes and chronic hospitals at the request of the Provincial Welfare Branch, to assist them in establishing rates to be paid for the care of welfare patients.\nHospital Consultation and Inspection Division, Victoria\nDuring the year this Division continued its programme of hospital inspection and\nits efforts to help hospitals with their administrative problems. It assisted other divisions\nof the Service in their work relating to hospitals.\nMembers of the staff visited forty-eight hospitals. Duration of visits varied from\none or two days, in cases of regular inspection, to a week where hospitals had specifically\nrequested a longer visit.\nRevision of By-laws.\u2014Many hospitals reviewed and undertook revision of then-\nby-laws. Revised by-laws of twenty-five hospitals were processed during the year in\nco-operation with the Liability and Adjustment Division. Medical staffs of hospitals\nwere active in developing new medical-staff by-laws; the Division assisted by providing\nreference material.    Several sets of newly developed by-laws were received for comment. NN 14 BRITISH COLUMBIA\nPersonnel Procedures Reviews.\u2014Information on personnel matters was distributed,\nand a sample set of personnel policies was developed to assist smaller hospitals. The\nmanual of medical-record procedures developed in 1952 was tested in several hospitals\nduring the year, and general distribution of the manual was started in December. The\nmanual is especially intended for use by hospitals which do not have a trained medical-\nrecord librarian. The Division continued to assist in reviewing hospital estimates and\nwas represented on the Hospital Rate Board. The staff also helped with the review of\nhospital plans, requests for equipment grants, and acted as official representatives of the\nService at three regional hospital meetings.\nBy request, nutrition consultants of the Provincial Health Branch visited a number\nof hospitals. This continued the co-operative arrangement with this Service started in\n1952. Information on the day-to-day utilization of beds in the Greater Vancouver\nand New Westminster areas was assembled throughout the year.\nHospital Consultation and Inspection Division, Vancouver\nA hospital consultation and inspection service, the licensing and inspection of private\nhospitals, the hospital-clearance programme, and the screening of applications for admission to the Provincial Infirmary were carried on by the Vancouver office during 1953.\nClose liaison was maintained with the Social Welfare Branch. Investigations were made\nand service given in matters referred to by other divisions of the Hospital Insurance\nService.\nThere were fifty-four licensed private hospitals in the Province on December 31st,\n1953.\nCases Referred.\u2014Two hundred and ninety-three problem cases were referred by\ngeneral hospitals throughout the Province, for whom request for removal from hospital\nwas made and which involved referral to and investigation by the Social Welfare Branch.\nThere were thirty-one inquiry cases where interpretation was given to hospitals\nregarding hospital-clearance cases, but where service was not given by the Social Welfare\nBranch and where the cases did not constitute true hospital clearance. Eleven inquiries\nwere received concerning situations where hospitals or persons requested information\ninvolving other departments of the Government, but which did not pertain to either\nhospital clearance or private hospitals. While some of these inquiries were directed to\nthe Hospital Insurance Service, they were not, upon investigation, necessarily hospital\ninsurance problems and were therefore, in turn, referred to the agency or department\nresponsible for the case-handling. Fifty-six inquiries were made regarding the establishment of private hospitals. Seven new private-hospital licences were issued and three\nprivate hospitals ceased operation during the year.\nInspectional Visits.\u2014An annual inspectional visit was made to all licensed private\nhospitals. Any complaints received with respect to the operation of any private hospital\nwere thoroughly investigated. Interpretation and guidance were given to private hospitals\nupon request and, as a result, a large number of the private hospitals were visited several\ntimes.\nA number of private hospitals voluntarily made inquiries with respect to improving\nconditions and service facilities within their private hospitals. A larger number of private\nhospitals evidenced interest in, and have actually established, diversional and recreational\nprogrammes for patients under care.\nOne hundred and two applications for admission to the Provincial Infirmary were\nreceived and considered. Of these, ninety-eight were recommended for Infirmary\nadmission. This Division continued to administer the \" Mental Hospitals Act,\" sections\n6 and 7. There is one licensed private mental hospital in the Province, and two borderline homes under observation and supervision by the Inspector of Hospitals for the\nMedical Superintendent of the Provincial Mental Hospital under section 6 of the \" Mental\nHospitals Act.\" HOSPITAL INSURANCE SERVICE REPORT, 1953\nMedical Consultation Division\nNN 15\nIn essence, the function of this Division is to supply technical knowledge to all\nbranches of the Service requiring it. The Medical Consultant, along with the Assistant\nCommissioner in charge of hospital services, represents the Service on the Medical Review\nBoard. The other three members of this Board are physicians designated by the College\nof Physicians and Surgeons of British Columbia. The Board, by its advice and guidance,\ndoes much to create and maintain good relations among the Service, the medical\nprofession, and the hospitals.\nIn accordance with the British Columbia \" Hospital Insurance Act\" and its regulations, the Medical Consultant and his staff review and approve all hospital accounts\nfrom a medical point of view before payment to the hospitals, giving particular attention\nto chronic and short-stay patients. Medical statistics are prepared under the guidance\nof the Medical Consultant. In the majority of hospitals visited during 1953 by the\nMedical Consultant, advice was given, in conjunction with other divisions, in connection\nwith drug usage and the purchase of hospital equipment. A new procedure for the\nsubmission of medical-treatment forms by hospitals was introduced, to ensure that correct\ndiagnoses were provided, with the object of improving the accuracy of medical statistics.\nHospital Construction Division\nThe primary function of this Division was to render an advisory or consulting\nservice to hospitals or hospital groups contemplating building improvements, reconstruction, additions to existing structures, or the construction of a new hospital. Reference\nmaterial on the planning and construction of hospitals is available, and was loaned upon\nrequest to interested groups.\nDuring 1953, hospital projects were completed at Powell River (7 beds), Penticton\n(121 beds), Creston (28 beds), Abbotsford (50 beds), North Vancouver (22 beds),\nand the St. Vincent's Hospital addition at Vancouver was substantially completed, which\nprovided an increase of 141 beds. A new boiler plant was brought into operation at the\nProvidence Hospital, Fort St. John, and at Rossland a new kitchen and laundry were\nfinished.\nDuring the year, hospital projects were under way at Pouce Coupe, St. Paul's in\nVancouver, Trail, White Rock, and Tofino. The Vancouver General Hospital continued\nwith its main-building alterations and heating- and power-plant projects. Two chronic-\nand convalescent-hospital projects were started in Vancouver\u2014the Holy Family Hospital\nand the Western Society for Rehabilitation.\nProvincial payments based upon progress certificates submitted by hospitals undertaking construction projects in 1953 amounted to $2,877,326, which would represent\na gross expenditure of $4,804,903.\nOn December 7th, 1953, the Government approved a revised financing formula for\nhospital construction. The new formula eliminated the repayable loan previously\nadvanced by the Province and provided an outright grant of 50 per cent for approved\ncosts of new projects.\nThe Division also advised hospitals and hospital groups of the financing formulae\nof the Federal and Provincial Governments and outlined in detail the conditions attached\nto their financial assistance. Federal and Provincial grants became available to hospitals\nonly after the approval of the project in principle and a detailed review of the plans by\nthe Hospital Insurance Service. Particular attention was paid to the design, to make sure\nit would permit quality of care, efficient and economical operation, and adequate provision\nfor expansion. Specifications and contract documents were also submitted to this Service\nfor review. Fourteen major reviews of hospital projects were completed during 1953,\nand several site inspections were undertaken. NN 16\n-\nBRITISH COLUMBIA\nThis Division acts on behalf of the Federal Government to ensure that its minimum\nstandards are met. This includes ensuring that the plans satisfy the Provincial Fire\nMarshal, and that minimum floor areas, corridor-widths, and adequate services exist.\nGENERAL HOSPITAL CARE\nStatistical data compiled by the Hospital Finance Division and dealing with the\nvolume of hospital care provided to the population of British Columbia by the Service\nare presented in the tables on the following pages. Seventy-eight public hospitals\nwere approved to accept B.C.H.I.S. patients. In addition, a proportion of care was\ngiven in company-operated hospitals in remote areas and in Red Cross outpost units and\nthe veterans' hospitals at Vancouver and Victoria.\nThe 1953 data given have been prepared from preliminary unrevised reports\nsubmitted by the hospitals of the Province and are subject to minor revision.\nThe average length of stay of B.C.H.I.S. adult and children patients in British\nColumbia public hospitals decreased from 10.17 days in 1952 to 10.12 days in 1953.\nThe total adult and children days covered by B.C. Hospital Insurance Service in British\nColumbia public hospitals were 1,712,494 during 1953, an increase of 142,520 or\n9 per cent over 1952.\nA total of 169,259 B.C.H.I.S. adult and children patients were discharged from\nBritish Columbia public hospitals during 1953, an increase of 14,923 or 9.7 per cent\nover 1952. This marked increase in the number of B.C.H.I.S. patients and patient-days\nis equivalent to the total increase experienced during the preceding three years. It would\nappear that additional hospital accommodation, made available through construction, is\nan important factor in this situation.\nTable Ia.\u2014Patients Discharged and Days of Care in B.C. Public Hospitals,\n1949-53, and Proportion Covered by B.C. Hospital Insurance Service\nTotal Hospitalized\nCovered by B.C.H.I.S.1\nAdults and\nChildren\nNew-born\nTotal\nAdults and\nChildren\nNew-born\nTotal\nPatients discharged\u2014\n1949\t\n1950. _ \t\n1951\t\n19522\t\n1953\t\nPercentage of total, patients discharged-\n1949 \t\n1950\t\n1951\t\n1952=....\n1953......\nPatient-days\u2014\n1949\t\n1950\t\n1951\t\n19522\t\n1953\t\nPercentage of total, patient-days\u2014\n1949   \t\n1950  \t\n1951  \t\n19522..\n1953....\n164,964\n26,272\n191,236\n172,645\n26,205\n198,850\n181,160\n27,096\n208,256\n188,355\n28,675\n217,030\n200,985\n29,915\n230,900\n1,682,196\n213,874\n1,896,070\n1,766,680\n212,979\n1,979,659\n1,795,438\n214,285\n2,009,723\n1,916,486\n214,701\n2,131,187\n2,041,231\n220,317\n2,261,548\n\t\n\t\n\t\n140,168\n144,959\n150,116\n154,336\n169,259\n84.9\n84.0\n82.9\n81.9\n84.2\n1,430,646\n1,476,615\n1,467,102\n1,569,974\n1,712,494\n85.0\n83.6\n81.7\n81.9\n83.9\n24,640\n23,943\n24,172\n25,023\n27,033\n93.8\n91.4\n89.2\n87.3\n90.4\n200,585\n193,307\n187,891\n184,160\n197,209\n93.8\n90.8\n87.7\n85.8\n89.5\n164,808\n168,902\n174,288\n179,359\n196,292s\n86.2\n84.9\n83.7\n82.6\n85.0\n1,631,231\n1,669,922\n1,654,993\n1,754,134\n1,909,703s\n86.0\n84.4\n82.3\n82.3\n84.4\n1 B.C.H.I.S. excludes Workmen's Compensation Board patients and days.\n3 Amended as per final reports received from hospitals.\n3 New-born total included. HOSPITAL INSURANCE SERVICE REPORT,  1953\nNN 17\nTable Ib.\u2014Percentage of Patients Covered by B.C. Hospital\nInsurance Service during 1953\nPer Cent\nPatients charged to agencies\u2014Workmen's Compensation Board, approved insurance plans, and\nFederal Government\nSelf-responsible\u2014non-B.C.  residents\nSubject to B.C.H.I.S. coverage \t\n7.7\n1.0\n91.3\n100.0\nB.C.H.I.S. patients hospitalized (85.0 per cent of total, see Table Ia) in relation to proportion\nof patients subject to insurance coverage (91.3 per cent, see Table Ib)    93.1\nTable IIa.\u2014Patients Discharged, Total Days' Stay, and Average Length of\nStay According to Type and Location of Hospital, and Days of Care per\nThousand of Covered Population for B.C.H.I.S. Patients Only, 1949-53.\nTotal\nAdults and I    New-\nChildren  I    born\nI\nB.C. Public\nHospitals\nAdults and I    New-\nChildren  I    born\nB.C. Private\nHospitals\nAdults and\nChildren\nNewborn\nInstitutions\noutside B.C.\nAdults and\nChildren\nNewborn\nPatients discharged-\n1949 \t\n1950\t\n1951  \t\n19521\t\n1953\t\nPatient-days\u2014\n1949\t\n1950\t\n1951\t\n19521 \t\n1953 \t\nAverage days of stay-\n1949 \t\n1950..... \t\n1951\t\n19521\t\n1953\t\n149,280\n154,643\n159,739\n164,379\n180,543 s\n1,498,121\n1,564,222\n1,551,954\n1,663,149\n1,814,1462\n10.03\n10.11\n9.71\n10.12\n10.04\n24,989\n140,168\n24,640\n24,336\n144,959\n23,943\n24,587\n150,116\n24,172\n25,492\n154,336\n25,023\n27,568\n169,259\n27,033\n203,197\n1,430,646\n200,585\n196,333\n1,476,615\n193,307\n190,948\n1,467,102\n187,891\n187,923\n1,569,974\n184,160\n201,081\n1,712,494\n197,209\n8.13\n10.21\n8.14\n8.07\n10.19\n8.07\n7.76\n9.77\n7.77\n7.37\n10.17\n7.36\n7.29\n10.12\n7.30\n7,093\n151\n7,617\n173\n7,308\n171\n7,431\n161\n8,475\n213\n45,960\n1,146\n65,326\n1,288\n62,771\n1,155\n68,892\n974\n75,704\n1,287\n6.48\n7.59\n8.58\n7.44\n8.59\n6.75\n9.27\n6.05\n8.93\n6.04\n2,019\n2,067\n2,315\n2,612\n2,809\n21,515\n22,281\n22,081\n24,283\n25,948\n10.66\n10.78\n9.54\n9.29\n9.24\n198\n220\n244\n308\n322\n1,466\n1,738\n1,902\n2,789\n2,585\n7.40\n7.90\n7.79\n9.06\n8.03\n1 Amended as per final reports received from hospitals.\n2 New-born totalled separately.\nEstimated days per thousand of population covered by B.C. Hospital Insurance Service:   1949, 1,528;   1950, 1,548;\n1951, 1,496;   1952, 1,545;   1953, 1,638.\nTable Hb.\u2014Summary of the Number of B.C.H.I.S. In-patients\nand Short-stay Patients, 1949-53\n1949\n1950\n1951\n19521\n1953\nTotal\nTotal adults, children, and new-born in-patients\n174,269\n29,000\n178,979\n44,502\n184,326\n47,656\n189,871\n46,767\n208,111\n44,342\n935,556\n212,267\nTotal receiving benefits \t\n203,269\n223,481\n231,982\n236,638\n252,453\n1,147,823\n1 Amended as per final reports received from hospitals. NN 18\nBRITISH COLUMBIA\nTable III.\u2014Patients Discharged, Total Days' Stay and Average Length of Stay\nin B.C. Public Hospitals for B.C.H.I.S. Patients Only, Grouped According\nto Bed Capacity, Year 1953.\nBed Capacity\nTotal\n250 and\nOver\n100 to 249\n50 to 99\n25 to 49\nUnder 25\nSpecial\nPatients discharged\u2014\n169,259\n27,033\n1,712,494\n197,209\n10.12\n7.30\n70,243\n9,906\n852,600\n77,198\n12.14\n7.79\n28,746\n4,440\n280,053\n32,162\n9.74\n7.24\n39,363\n8,274\n328,006\n57,999\n8.33\n7.01\n15,686\n2,363\n127,379\n16,233\n8.12\n6.87\n11,249\n1,754\n84,535\n11,640\n7.51\n6.64\n3,972\n296\n39,921\nNew-born\t\nPatient-days\u2014\n1,977\nAverage days of stay\u2014\n10.05\nNew-born  \t\n6.68\nTable IV.\u2014Percentage Distribution of Patients Discharged and Patient-days\nfor B.C.H.I.S. Patients Only, in B.C. Public Hospitals, Grouped According\nto Bed Capacity, Year 1953.\nBed Capacity\nTotal\n250 and\nOver\n100 to 249\n50 to 99\n25 to 49\nUnder 25\nSpecial\nPatients discharged\u2014\nAdults and children\t\nPer Cent\n100.00\n100.00\n100.00\n100.00\nPer Cent\n41.49\n36.65\n49.79\n39.15\nPer Cent\n16.98\n16.42\n16.35\n16.31\nPer Cent\n23.26\n30.61\n19.15\n29.41\nPer Cent\n9.27\n8.74\n7.44\n8.23\nPer Cent\n6.65\n6.49\n4.94\n5.90\nPer Cent\n2.35\n1.09\nPatient-days\u2014\nAdults and children  \u2014\n2.33\n1.00\nIn Tables III and IV those public hospitals in which B.C. Hospital Insurance Service\ndoes not cover certain types of hospitalization have been shown under the heading\n\" Special.\"    The figures, however, include only B.C.H.I.S. patients. HOSPITAL INSURANCE SERVICE REPORT, 1953\nNN 19\nPrincipal Causes of Hospitalization, July 1st to December 31st, 1952\nAge Group 1 \u2014 0\n\u2022  1\nAge Group 2 -- 1\n\u2022 4\nAge Group 3 \u2014 5\n\u2022 H\nAge Group 4 \u201415\n\u25a0 24\nMalp     TTpmnlp\nAge Group 5\nAge Group 6\nAge Group\nAge Group\n7 -\n25 - U\nA5 - 6i\n65 - 69\n\u2014 70 and over\nAge Group 9 -- Hot Specified\nl\u2014i\u2014i\u2014i\u2014i\u2014r\nTONSILS & ADENOIDS\n1250\n1000\n750\n500\n250\n0\n9000\n8000\n7000\n6000\n5000\n4000\n3000 -\n2000\n1000\nBENIGN & UNSPECIFIED\nNEOPLASMS\nDELIVERIES\nAGE GH0UPS NN 20\nBRITISH COLUMBIA\nAv. Days'\nStay\t\nAverage Lengths of Stay for Nineteen Major Diagnostic Categories of Illness, ft\nJuly 1st to December 31st, 1952\n30\n25\n20\n15\n10\nKey to Diagnostic Categories\nInfective and Parasitic  10 Genito-urinary System\nNeoplasms\nAllergic, etc.\nBlood\nMental\nNervous System\n7 Circulatory System\n8 Respiratory System\n9 -Digestive\n11 Deliveries, Pregnancy, etc.\n12 Skin\n13 Bones\n14 Congenital Malformations\n15 Early Infancy\n16 Symptoms, Senility, etc.\n17 Accidents, etc.\n18 Live Births\n19,-- Impairment due to Birth Injury, etc.\n1   2  3   4   5   6   7   8  9  10  11  12  13  14 15  16  17  18 19\nBroad Diagnostic Category\nft Based on Manual of the International Statistical Classification of Diseases, Injuries and\nCauses of Death, 6th ed., 1948. HOSPITAL INSURANCE SERVICE REPORT,  1953\nNN 21\nCase Fatality Rate\n15\n14\n13\n12\n11\n10\n9\n8\n7\n6\n5\n4\n3\n2\n1 \"\nCase Fatality Rates for Nineteen Major Diagnostic Categories of Illness,\nJuly 1st to December 31st, 1952\nKey to\nDiagnostic Categories\n1\nInfective & Parasitic\n10\nGenito-urinary System\n2\nNeoplasms\n11\nDeliveries, Pregnancy, etc.\n5\nAllergic, etc.\n12\nSkin\n4\nBlood\n13\nBones\n5\nMental\nH\nCongenital Malformations\nb\nNervous System\n15\nEarly Infancy\n7\nCirculatory System\n16\nSymptoms, Senility, etc.\n8\nRespiratory System\n17\nAccidents, etc.\n9\nDigestive\n18\nLive Births\n19 Impairment due\nto Birth Injury, etc.\nl        2     ?       4       5       67       8      9     10     11     12     13   14     15     16     17     18   19\nBroad Diagnostic Category\nk    Based on Manual of the International Statistical Classification of Diseases, Injuries and\nCauses of Death, 6th ed-, 1948- NN 22 BRITISH COLUMBIA\nSTATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE\nFISCAL YEAR ENDED MARCH 3 1st,  1953\nRevenue receipts\u2014\nPremiums\u2014\nGeneral (net)   $14,882,288.84\n  $14,882,288.84\nCost of hospitalization re social-assistance cases    $3,546,278.15\nMunicipal per diem grants   977,136.91\nProvincial per diem grants        1,520,171.20\n       6,043,586.26\n$20,925,875.10\nCash disbursements\u2014\nAdministration\u2014\nSalaries      $ 1,410,974.39\nAdvisory Council   161.14\nAdvertising and publicity  28,045.74\nTabulating equipment, rentals, etc.   77,379.32\nAutomobiles and accessories   6,686.52\nHospital surveys   $8,113.88\nLess recovered   13,184.33\n  5,070.45\nOffice supplies and general   126,177.18\nOffice furniture and equipment  14,769.04\nPostage   46,865.84\nRentals and maintenance  79,377.61\nTravelling expenses   25,118.01\nUpkeep of automobiles  12,591.22\n1,823,075.56\nPayments to hospitals\u2014claims     21,309,963.72\n$23,133,039.28\nExcess of disbursements over revenue receipts for the fiscal year ended March 31st,\n1953      $2,207,164.18\nThe Statement of Revenue Receipts and Cash Disbursements for the fiscal year ended March 31st,\n1953, together with the Statement Showing Cash Reconciliation with the Public Accounts of the\nProvince of British Columbia as at March 31st, 1953, show the cash transactions only of the Hospital\nInsurance Fund for the period according to the books of the Province.\nC. J. FERBER, C.A.,\nComptroller-General, Province of British Columbia. HOSPITAL INSURANCE SERVICE REPORT,  1953\nNN 23\nSTATEMENT SHOWING CASH RECONCILIATION WITH THE PUBLIC ACCOUNTS\nOF THE PROVINCE OF BRITISH COLUMBIA AS AT MARCH 31st,  1953\nPeriod ended March 31st, 1949 (Public Accounts, page\n215)   $5,305,908.18\nLess financed by Provincial loans and grants\u2014\nHospital Insurance Stabilization Fund         $50,000.00\n\"Amusements Tax Act \"     1,445,573.40\n1,495,573.40\nOperating receipts over disbursements      $3,810,334.78*\nFiscal year ended March 31st, 1950, disbursements over\nreceipts (Public Accounts, page 147)   $4,550,580.32\nAdd financed by Provincial loans and grants\u2014\nHospital Insurance Stabilization Fund   $1,950,000.00\n\" Revenue Surplus Appropriation Act, 1950 \"     2,500,000.00\n$4,450,000.00\n'Amusements Tax Act \" (fiscal\nyear 1949, above)     1,445,573.40\n3,004,426.60\nOperating disbursements over receipts        7,555,006.92\nFiscal  year ended  March   31st,   1951,  disbursements  over  receipts\n(Public Accounts, page 144)        5,118,697.76\nFiscal  year  ended  March  31st,   1952,  receipts  over  disbursements\n(Public Accounts, page 99)   46,321.32*\nFiscal  year  ended  March  31st,   1953,  disbursements  over receipts\n(Public Accounts, page 99)        2,207,164.18\nOperating disbursements over receipts, 1949-53   $11,024,212.76\nAdd balance at March 31st, 1953\u2014\nAmount adjusted on advances to hospitals .... $2,508,482.01t\nCredit balance, Hospital Insurance Fund     7,216,955.25\nFinanced by Provincial loans and grants\u2014\nHospital Insurance Stabilization Fund\u2014\nPublic Accounts, 1948-49, page 210\n$50,000.00\n4,708,473.24\n$15,732,686.00\nPublic Accounts, 1949-50, page 134       1,950,000.00\n$2,000,000.00\n\"Revenue Surplus Appropriation Act, 1950\" (Public Accounts,\n1949-50, page 134)   2,500,000.00\nAmount voted under Vote 118, 1950-51   2,545,696.00\n\"Revenue Surplus Appropriation Act, 1951 \" (Public Accounts,\n1950-51, page 144)   1,500,000.00\nAmount voted under Vote 124, 1951-52  2,500,000.00\nAmount voted under Vote 124, 1952-53   4,686,990.00\n15,732,686.00\nCredits.\nt 1950-51 credits, $1,934,062.62;   1951-52 credits, $618,740.95;   1952-53 debit, $44,321.56. NN 24 BRITISH COLUMBIA '\".~3\nBENEFITS IN B.C. HOSPITALS,  1953\nThe general hospital services to be provided shall include such of the following\nservices as are recommended by the attending physician, and as are available in the\nhospital to which the person is admitted as an in-patient, and when there is definite\nmedical necessity for in-patient care: \u2014\n(a) Public-ward accommodation:\n(b) Operating-room facilities, including the use of all equipment and material\nrequired in the proper care of surgical cases:\n(c) Case-room facilities, including the use of all equipment and material\nrequired in the proper care of maternity cases:\n(d) Surgical dressings and casts as required, as well as other surgical materials\nand the use of any equipment which may be required while in hospital:\n(e) Anaesthetic supplies and the use of anaesthesia equipment:\n(\/) All other services rendered by individuals who receive any remuneration\nfrom the hospital, provided that the provision of such services in a particular hospital is approved by the Commissioner. Services which may\nbe approved by the Commissioner for the purpose of this section may\ninclude:\u2014\n(1) Radiological, diagnostic, and therapeutic services, including the\nservices of a radiologist:\n(2) Clinical laboratory and other diagnostic procedures, including\nthe services of a pathologist:\n(3) Physiotherapy services:\n(g) Care of the acute stage of chronic diseases where, in the opinion of the\nCommissioner, such care is necessary and desirable. Such chronic\ndisease shall include cardiac disease, tuberculosis, mental disease, and\nacute anterior poliomyelitis; the acute stage of venereal disease only where\ngeneral hospital care is recommended by the Division of Venereal Disease\nControl; the acute stage of drug addiction where overdosage and poisoning have to be given prompt treatment; and the acute stage of alcoholism,\nprovided in the case of acute alcoholism that hospitals establish under\ntheir own by-laws the conditions under which such persons may be\nadmitted to hospital:\n(h) Such drugs and related preparations listed in the British Columbia Formulary and such other preparations as the Commissioner may from time to\ntime prescribe.\nBENEFITS IN HOSPITALS OUTSIDE BRITISH COLUMBIA\nPayments for hospital services rendered by hospitals outside the Province of British\nColumbia to persons who are beneficiaries under the Act shall be made on the basis of\nnot more than $8 per day (new-born, $3.50 per day) and for a period of time not to\nexceed thirty days. Payments for a longer period of time than thirty days may be\nauthorized by the Commissioner where he is satisfied that further care of a type provided\nfor under the Act is required.\nWhere a beneficiary produces receipts showing that he has himself paid an account\nto a hospital situated outside the Province, he may be reimbursed within the limitations\nand subject to the conditions provided in the regulations under the Act.\nCLASSES OF PERSONS COVERED BY OR EXCLUDED FROM THE\nBENEFITS OF THE HOSPITAL INSURANCE SERVICE\nA. Covered by the Plan upon Payment of the Required Premium\nEvery person who is a resident of the Province, except persons classified in Groups\nB, C, and D hereunder.   Participation in the plan is compulsory, except for those in the\nfar northern areas, who may voluntarily pay premiums and be entitled to benefits. HOSPITAL INSURANCE SERVICE REPORT,  1953 NN 25\nB. Covered by the Plan by the Provincial Government\nThose persons who are in receipt of any form of social assistance to which the\nProvincial Government of British Columbia contributes financially and who, in addition,\nhave been certified by the Deputy Minister of Welfare to be persons entitled to free\nhealth services.\nC. Persons Entitled to Claim Exemption\n1. Members of the Canadian Armed Forces (but not their dependents).\n2. Members of the Royal Canadian Mounted Police (but not their dependents).\n3. Students in training under the Department of Veterans' Affairs (but not their\ndependents).\n4. Veterans in receipt of war veterans' allowance (but not their dependents).\n5. Members of the Christian Science Church.\n6. Persons resident in certain far northern regions of the Province which have no\nhospital facilities. Such persons, if they pay premiums voluntarily, are entitled to the\nbenefits under the Act in any acute general hospital in the Province.\n7. Members of the Canadian Pacific Employees' Medical Association of British Columbia and the Telephone Employees' Medical Services Association of British Columbia.\n8. Persons covered by the Saskatchewan Hospital Services Plan.\nD. Persons Excluded from the Plan\n1. A person who is a patient or an inmate of an institution maintained by the\nProvince.\n2. Persons in the Provincial tuberculosis sanatorium.\n3. Persons committed to a gaol or penitentiary.\nTABLE V.\u2014CLAIMS FOR EXEMPTION\nClaims Approved Total Exemptions\nduring 1953 at Dec. 31, 1953\nOld-age pension, blind pension, Old Age\nSecurity bonus,  mother's  allowance,\nand social assistance  6,574 27,171\nW.V.A. and Class 6 patients, and D.V.A.\nstudents     814 1,370\nRoyal Canadian Mounted Police  148 1,027\nExempted area   93 355\nPrisons   27 124\nArmed Forces  1,439 8,250\nChurch of Christ, Scientist  75 1,660\nSaskatchewan Hospital Services Plan  295 71\nProvincial institutions\u2014tuberculosis, mental, and infirmaries  748 1,516\nGeneral   111 186\nCanadian Pacific Employees' Medical Association of British Columbia  4,433 14,000\nTelephone   Employees'   Medical   Services\nAssociation of British Columbia  1,403 4,347\nTotals  16,160 60,077\nNote.\u2014A large number of persons in receipt of social allowance have not registered with the B.C. Hospital Insurance Service. NN 26 BRITISH COLUMBIA\nClaims granted retroactively for various periods  2,549\nApproved claims cancelled   11,343\nNew claims refused  758\nAdjustments to existing claims  14,123\nAdjustments to medical identity cards   14,107\nHospital claims received for approval  32,506\nMedical identity cards received  10,663\nRefunds approved   4,510\nClaims for Dependency\nApproved    2,09 8\nNot approved  57\nReviewed and reapproved  15\nReviewed and not approved  2\nClaims cancelled  9\nVICTORIA, B.C.\nPrinted by Don McDiarmid, Printer to the Queen's Most Excellent Majesty\n1954\n500-454-8530    ","type":"literal","lang":"en"}],"http:\/\/www.europeana.eu\/schemas\/edm\/hasType":[{"value":"Legislative proceedings","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/identifier":[{"value":"J110.L5 S7","type":"literal","lang":"en"},{"value":"1954_V03_18_NN1_NN26","type":"literal","lang":"en"}],"http:\/\/www.europeana.eu\/schemas\/edm\/isShownAt":[{"value":"10.14288\/1.0348776","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/language":[{"value":"English","type":"literal","lang":"en"}],"http:\/\/www.europeana.eu\/schemas\/edm\/provider":[{"value":"Vancouver : University of British Columbia Library","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/publisher":[{"value":"Victoria, BC : Government Printer","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/rights":[{"value":"Images provided for research and reference use only. For permission to publish, copy or otherwise distribute these images please contact the Legislative Library of British Columbia","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/source":[{"value":"Original Format: Legislative Assembly of British Columbia. Library. Sessional Papers of the Province of British Columbia","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/title":[{"value":"Fifth Annual Report B.C. Hospital Insurance Service JANUARY 1ST TO DECEMBER 31ST 1953","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/type":[{"value":"Text","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/description":[{"value":"","type":"literal","lang":"en"}]}}