{"http:\/\/dx.doi.org\/10.14288\/1.0373686":{"https:\/\/open.library.ubc.ca\/terms#identifierAIP":[{"value":"e009867b-b5ad-450e-8be3-0bca48d32ddf","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, 1969","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":"2018-10-18","type":"literal","lang":"en"},{"value":"1970","type":"literal","lang":"en"}],"http:\/\/www.europeana.eu\/schemas\/edm\/aggregatedCHO":[{"value":"https:\/\/open.library.ubc.ca\/collections\/bcsessional\/items\/1.0373686\/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\nHOSPITAL INSURANCE ACT\nTwenty-first Annual Report\nBritish Columbia\nHospital Insurance Service\nJANUARY 1 TO DECEMBER 31\n1969\nPrinted by A. Sutton, Printer to the Queen's Most Excellent Majesty\nin right of the Province of British Columbia\n1970\n  Victoria, British Columbia, January 22, 1970.\nTo Colonel the Honourable John R. Nicholson, P.C., O.B.E., Q.C, LL.D.,\nLieutenant-Governor of the Province of British Columbia.\nMay it please Your Honour:\nThe undersigned has the honour to present the Twenty-first Annual Report of\nthe British Columbia Hospital Insurance Service covering the calendar year 1969.\nRALPH R. LOFFMARK,\nMinister of Health Services and Hospital Insurance.\n  r\nBritish Columbia Hospital Insurance Service,\nVictoria, British Columbia, January 22, 1970.\nThe Honourable Ralph R. Lotjmark,\nMinister of Health Services and Hospital Insurance,\nParliament Buildings, Victoria, British Columbia.\nSir,\u2014I have the honour to present herewith the Report of the British Columbia\nHospital Insurance Service covering the calendar year 1969.\nDONALD M. COX, F.A.C.H.A.,\nDeputy Minister of Hospital Insurance.\n  The Honourable Ralph R. Loffmark, Minister of Health Services and Hospital Insurance, officially opened the Intensive Care Unit of Mount St. loseph's Hospital, Vancouver,\non October 1st. He was assisted by Sister Andree Dupuis, Administrator of the hospital,\nand Master Douglas Friesen.\n j\"\nrt\no\nCA\nrt\nas\nxS 3TJ\nO w\ne\n2iu\nc\nQrt\nR\nc.\no\nj;\nQ\n11\nrt vi\n*Q\nrt\nc\no\nrt\nu\nCfl\nCfl\n3\nc\n>\nX\nc\n0\nd\nJ c\nra\ntt.tn<\nnao!\n^\"3\nS'H.S\nN\nz~<\nSJS\na\nai\nas\n_- c\/m\u00abS\nKB.Q\n5a M 5 em\nrt-- I\nSJ5\n\u00bb> 0.33\nu >.\u00ab O\n3 \u00a3E\na. 00\nSQ<Q\nm\nSu\u00ab\n DEPARTMENT OF HEALTH SERVICES AND\nHOSPITAL INSURANCE\nBRITISH COLUMBIA HOSPITAL INSURANCE SERVICE\nThe Honourable Ralph R. Loffmark, Minister of Health Services\nand Hospital Insurance.\nSenior Administrative Staff\nD. M. Cox, F.A.C.H.A., F.C.I., F.C.I.S., Deputy Minister of Hospital Insurance.\nW. J. Lyle, F.C.I.S., Assistant Deputy Minister of Hospital Insurance.\nJ. W. Mainguy, M.H.A., Director of Hospital Consultation, Development, and Research.\nD. G. Adams, M.D., CM., Medical Consultant.\nN. S. Wallace, C.G.A., Manager, Hospital Finance Division.\nK. G. Wiper, Administrative Officer.\nP. Breel, Manager, Hospital Consultation and Inspection Division.\nD. S. Thomson, B.A., Director, Research Division.\nE. M. Browning, Acting Manager, Hospital Construction and Planning Division.\nD. M. N. Longridge, M.A., B.Ch., F.R.C.S., Assistant Medical Consultant.\n  CONTENTS\nOrganization Chart____\nGeneral Introduction.\nPage\n_   11\n. 13\n_ 15\nBritish Columbia Regional Hospital Districts Act\t\nBritish Columbia Regional Hospital Districts Financing Authority Act  16\nThe Hospital Insurance Act  16\nThe Hospital Act\t\nPersons Entitled to or Excluded from the Benefits under the Hospital Insurance\nAct\t\nEntitled to Benefits\t\nExcluded from Benefits\t\nHospital Benefits Available in British Columbia\nIn-patient Benefits\t\nEmergency Services and Minor Surgery\t\nApplication for Hospital Insurance Benefits\t\n16\n17\n  17\n  17\n  17\n  17\n  18\n  18\nThe Hospital Rate Board and Methods of Payment to Hospitals  18\nB.C.H.I.S. Planning Group  19\nOrganization and Administration  20\nAssistant Deputy Minister  21\nHospital Finance Division  21\nHospital Accounting  22\nHospital Claims  23\nHospital Construction and Planning Division  25\nHospital Projects Completed during 1969  26\nHospital Projects under Construction at Year-end  27\nProjects in Advanced Stages of Planning  28\nAdditional Projects Approved and in Various Planning Stages  28\nDirector of Hospital Consultation, Development, and Research  32\nHospital Consultation and Inspection Division.\nResearch Division\t\n  32\n  33\n  34\n  36\n  37\n  37\nGeneral Office  37\nPublic Information  38\nMedical Consultation Division.\nAdministrative Officer\t\nEligibility Representatives' Section..\nThird Party Liability Section\t\n11\n L 12 BRITISH COLUMBIA\nPage\nApproved Hospitals  39\nPublic Hospitals  39\nOutpost Hospitals  40\nFederal Hospitals  40\nPrivate Hospitals (Providing General Hospital Services)  40\nRehabilitation, Chronic, and Convalescent Hospitals  40\nExtended Care Hospitals  40\nStatistical Data  41\nTable 1a.\u2014Patients Separated (Discharged or Died) and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public Hospitals Only (Excluding Federal, Private, and Out-of-\nProvince Hospitalization) (Including Rehabilitation Hospitals)  43\nTable 1b.\u2014Total Patient-days and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public Hospitals\nOnly (Excluding Federal, Private, and Out-of-Province Hospitalization) (Including Rehabilitation Hospitals)  44\nTable 2a.\u2014Patients Separated, Total Days' Stay, and Average Length of\nStay According to Type and Location of Hospital for B.C.H.I.S. Patients Only, and Days of Care per Thousand of Covered Population\n(Including Rehabilitation Hospitals)  45\nTable 2b.\u2014Summary of the Number of B.C.H.I.S. In-patients (Including\nExtended Hospital Care Patients) and Short-stay Patients  46\nTable 3.\u2014Patients Separated, Total Days' Stay, and Average Length of\nStay in British Columbia Public Hospitals for B.C.H.I.S. Patients\nOnly, Grouped According to Bed Capacity, Year 1969 (Excluding\nExtended-care Hospitals)  46\nTable 4.\u2014Percentage Distribution of Patients Separated and Patient-days\nfor B.C.H.I.S. Patients Only, in British Columbia Public Hospitals,\nGrouped According to Bed Capacity, Year 1969 (Excluding Extended-care Hospitals)  46\nCharts  47\nI.\u2014Percentage Distribution of Days of Care by Major Diagnostic Groups,\n1968  48\nII.\u2014Percentage Age Distribution of Male and Female Hospital Cases and\nDays of Care, 1968  49\nIII.\u2014Percentage Distribution of Hospital Cases by Type of Clinical Service,\n1968  50\nIV.\u2014Percentage Distribution of Hospital Days by Type of Clinical Service,\n1968  51\nV.\u2014Average Length of Stay of Cases in Hospitals in British Columbia by\nMajor Diagnostic Groups, 1968 (Excluding Newborns)  52\nHospitalization by Major Diagnostic Categories, 1968  53\nStatement of Receipts and Disbursements for the Fiscal Year Ended March 31,\n1969  57\n Twenty-first Annual Report of the\nBritish Columbia Hospital Insurance Service\nGENERAL INTRODUCTION\nDonald M. Cox, F.A.C.H.A., Deputy Minister of Hospital Insurance\nThe British Columbia Hospital Insurance Service completed\nits twenty-first year of operation on December 31, 1969. In\nthe 1969\/70 fiscal year an estimated $159,000,000 will be\npaid by the British Columbia Hospital Insurance Service to the\nhospitals of the Province toward expenses incurred by permanent residents. This is the equivalent of $72 being paid on\nbehalf of each man, woman, and child living in British Columbia\nHMk. at the present time. Hospital Insurance Service daily payments\namounted to $435,600, as compared to $378,000 in the 1968\/69 fiscal year, an\nincrease of 15 per cent. The expressions of concern on the part of economists\nand health authorities, in both Canada and the United States, become more apparent when one considers these rapidly increasing costs at the Provincial level.\nDuring the year, British Columbia's programme of hospital construction\ncontinued with an accelerated pace which has been evident throughout the length\nand breadth of the Province for over the past decade. Building programmes which\nwere under way at the year-end, many of which were due for completion early in\n1970, will cost an estimated $41,500,000; and projects in the advanced stages of\nplanning represented an additional $25,000,000 in capital expenditure.\nCommunities which witnessed the completion of building programmes in\n1969, including major renovations and alterations, were Abbotsford, Castlegar,\nLillooet, Powell River, Quesnel, Vancouver, and New Westminster. Centres in\nwhich construction projects were under way as the year drew to a close included\nCreston, Chilliwack, Kelowna, Nanaimo, North Vancouver, Penticton, Port Alberni, Prince Rupert, Princeton, Revelstoke, Surrey, Trail, and Vancouver.\nIn June, the Honourable Ralph R. Loffmark, Minister of Health Services and\nHospital Insurance, announced the completion of a publication titled \" Hospitals\nfor Extended Care, a Programme and Design Guide,\" which had been prepared\nby a task force consisting of three nominees of the Architects Institute of British\nColumbia and three members of the British Columbia Hospital Insurance Service.\nThe guide consisted of a written description of all facilities to be provided in an\nextended care hospital of a size suitable for construction in chosen locations, together with detailed drawings of the various hospital elements, such as ward units,\nnursing stations, recreational and service areas, and so on. The electrical and\nmechanical requirements were also specified in writing, and composite hospital\nsketches appeared in the report. In releasing the report the Minister stated, \" The\nmain objective of the guide is to expedite the design, production, and approval\nprocesses for extended care hospital projects.\" It is of interest to note that this\npublication received a great deal of publicity throughout Canada and the United\nStates, and was written up in the journals of both the Canadian Hospital Association\nand the American Hospital Association.\n13\n L 14 BRITISH COLUMBIA\nIn the following month of July, the Minister announced that the Provincial\nGovernment had organized a Cost-Analysis Team which would be assigned to the\nstudy of major hospital projects. The Minister stated that the Cost-Analysis Team\nwould perform three major functions:\u2014\n(1) The review and analysis of the capital costs of proposed projects:\n(2) The development of cost-control procedures during the detailed design\nand construction phases of projects:\n(3) To provide the Hospital Rate Board of the British Columbia Hospital\nInsurance Service with information required in the review of estimated\noperating costs of the proposed hospitals or units.\nThe Cost-Analysis Team will be responsible to the Treasury Board and will report\nto the Minister of Health Services and Hospital Insurance, through regular monthly\nprogress reports to the Deputy Minister of Hospital Insurance.\nIn December, the Provincial Government authorized the Hospital Insurance\nService to increase the equipment allowance of 30 cents per patient-day for acute\ngeneral hospitals to 40 cents per patient-day. The increase was made retroactive\nto January 1, 1969, and would provide over $300,000 in additional payments to\nhospitals.\nIn November, 1968, the Provincial and Federal Ministers of Health directed\nthat intensive studies be undertaken into the Costs of Health Services in Canada.\nSeven task forces were appointed, broadly representative of the medical profession,\nhospitals, and other health agencies, health education, and government. The\nBritish Columbia Hospital Insurance Service pledged its full support to the studies.\nOf the seven task force chairmen, only two were Provincial personnel and significantly both were from British Columbia. Mr. J. W. Mainguy, Director, Hospital\nConsultation, Development, and Research, chaired the committee on \" Beds and\nFacilities,\" and Dr. K. I. G. Benson, Assistant Provincial Health Officer, chaired\nthe committee \" Costs of Public Health Services.\"\nThe Deputy Minister of Hospital Insurance and the Assistant Deputy Minister\nserved as members of the steering committee on Cost of Health Services. It is the\nintention of the British Columbia Hospital Insurance Service to make full use of\nthe information contained in the task force reports, and in the findings of the\ncontinuing studies.\nIt should be noted that although salary scales are generally higher in British\nColumbia than elsewhere in Canada, the per capita cost of hospital care in British\nColumbia is significantly lower than the Canadian average. That fact is stated as\nan indication of the co-operation and assistance of hospital boards, hospital administrators, and the medical profession, in efforts to provide a fully satisfactory hospital\nservice within the limits of the ability of the people of the Province to finance.\nThe regional hospital districts programme fills a great need. Elsewhere in this\nreport will be found an outline of the extensive hospital planning and construction\nprogramme, that would not be possible without the orderly procedure of financing\ncapital costs through regional hospital districts and the Regional Hospital Districts\nFinancing Authority.\nIt gives me pleasure to again express our appreciation for the good advice and\nguidance so readily extended to the Hospital Insurance Service by the College of\nPhysicians and Surgeons, and by the British Columbia Medical Association.\nHospital laboratory and radiological services continued to improve through the\nvaluable assistance of the laboratory and radiological advisory councils.\nAs in previous years, the continuing assistance of the British Columbia Hospitals\nAssociation was greatly appreciated.\n HOSPITAL INSURANCE SERVICE, 1969\nL 15\nReports submitted by the various divisions which comprise the administrative\nstructure of our Branch appear under \" Organization and Administration,\" commencing on page 20.\nBRITISH COLUMBIA REGIONAL HOSPITAL DISTRICTS ACT\nThe Act provides for the division of the Province into large districts to enable\nregional planning, development, and financing of hospital projects to be carried out\nunder a revised formula, which provides increased financial assistance from the\nProvincial Government toward the capital cost of hospital projects. The Province\nwas divided into 29 areas, and 28 of them have been incorporated as regional hospital districts. The district not incorporated is located in an area without hospitals in\nthe northern part of the Province.\nAs is the case with school construction, each regional hospital district will, subject to the requirements of the Act, be able to pass money by-laws authorizing\ndebentures to be issued covering the total cost of one or more hospital projects.\nWhen approval has been obtained from the Minister of Health Services and Hospital\nInsurance, the district will be able to raise any funds immediately required by\ntemporary bank borrowing on a uniform basis. The Regional Hospital Districts\nFinancing Authority (see next page) will in due course issue and sell its own debentures in the amount required, which may cover a number of district debenture issues.\nAt that time the districts will then be able to sell their long-term debentures to the\nAuthority. Following this a district can repay any sum which has been temporarily\nborrowed.\nEach year the Provincial Government will pay through the Hospital Insurance\nService its share of the amortization cost in accordance with section 22 of the Act.\nEach district will in turn raise, by taxation, the remainder of the annual amortization\ncost required to retire its debentures which are held by the Authority.\nUnder the new formula the Province pays annually to each district 60 per cent\nof the net cost of amortizing the district's borrowings for an approved hospital\nproject, after deduction of Federal Government capital grants and items which are\nthe district's responsibility, such as provision of working funds for hospital operation,\netc. If a 4-mill tax levy by the district is inadequate to discharge its responsibility\nin regard to annual charges on old debt for hospital projects, as well as the remaining\n40 per cent of the charges on the new debt resulting from a hospital project, the\nProvince will provide 80 per cent of the funds required in excess of the 4-mill levy.\nThe affairs of each regional hospital district are managed by a board comprised\nof the same representatives of the municipalities and unorganized areas who comprise the board of the regional district (incorporated under the Municipal Act),\nwhich has the same boundaries as the regional hospital district. The board of the\nregional hospital district will be responsible for co-ordinating the requests for funds\nfrom hospitals within the district, and for presenting money by-laws to the taxpayers\nin respect of either single projects or an over-all programme of hospital projects\nfor the district.\nA hospital society or corporation is not compelled to seek financing under this\nnew Act. In situations where the community's share of the cost can be, or has\nalready been, raised by other means, a Provincial Government grant under the\nold 50-per-cent formula can be applied for under the procedure which was applicable up to this time.\n L 16 BRITISH COLUMBIA\nBRITISH COLUMBIA REGIONAL HOSPITAL DISTRICTS\nFINANCING AUTHORITY ACT\nThis Act establishes a Provincial Government authority similar to the one set up\na few years ago to assist school districts in financing their projects. The functions\nof the Authority are referred to briefly in the second paragraph of the preceding\ncommentary regarding the Regional Hospital Districts Act.\nTHE HOSPITAL INSURANCE ACT\nThis is the Statute which authorizes British Columbia's hospital insurance plan,\nand under which the British Columbia Hospital Insurance Service is established.\nThe main provisions of this Act and the regulations may be summarized as\nfollows:\u2014\n(1) Generally speaking, every permanent resident who has made his home in\nBritish Columbia for at least three consecutive months is entitled to\nbenefits under the Act.\n(2) Approved hospitals are paid an all-inclusive per diem rate for medically\nnecessary in-patient care rendered to qualified British Columbia residents\nwho are suffering from an acute illness or injury, and those who require\nactive convalescent rehabilitative and extended hospital care. The payment made to a hospital by the British Columbia Hospital Insurance\nService amounts to $1 less than the per diem rate approved for the particular hospital, and the patient is responsible for paying the remaining\ndollar. The Provincial Government pays the dollar-a-day charge on\nbehalf of Provincial social welfare recipients.\n(3) The wide range of in-patient benefits, together with the emergency outpatient, minor surgery, and day-care surgical services, provided under the\nAct are described on the following pages.\n(4) Qualified persons who are temporarily absent from British Columbia are\nentitled to certain benefits for a period of six months if they are admitted\nto an approved hospital within the first six months following their departure from the Province. These periods may be extended for an additional period of up to six months by the Lieutenant-Governor in Council.\nTHE HOSPITAL ACT\nOne of the important functions of the British Columbia Hospital Insurance\nService is the administration of the Hospital Act. The Deputy Minister of Hospital\nInsurance is also the Chief Inspector of Hospitals for British Columbia under the\nStatute.\nThe Hospital Act controls the organization and operation of hospitals, which\nare classified as follows:\u2014\n(1) Public hospitals\u2014non-profit hospitals caring primarily for acutely ill\npersons.\n(2) Private hospitals. This category includes (a) small public hospitals, most\nof which are operated in remote areas by industrial concerns primarily\nfor their employees, and (b) licensed nursing homes which are not under\nB.C.H.I.S. coverage.\n(3) Rehabilitation, chronic, and convalescent hospitals. These are non-profit\nhospitals approved under Part III of the Hospital Act, primarily for the\ntreatment of persons who will benefit from intensive rehabilitative and\nextended hospital care.\n HOSPITAL INSURANCE SERVICE, 1969\nL 17\nPERSONS ENTITLED TO OR EXCLUDED FROM THE BENEFITS\nUNDER THE HOSPITAL INSURANCE ACT\nEntitled to Benefits\nA person is entitled to benefits if he qualifies as a beneficiary under the Hospital\nInsurance Act. Generally speaking, a person is a beneficiary if the provision of\nhospital care is a medical necessity, and if he establishes that he qualifies under one\nof the following categories:\u2014\n(a) He is the head of a family, or a single person, who has made his home in\nthe Province and has lived continuously therein during the preceding three\nconsecutive months; or\n(b) Having qualified under item (a), he leaves the Province temporarily and\nreturns after an absence of less than 12 months and resumes residence\nwithin the Province; or\n(c) He is living within the Province and is a dependent of a resident of the\nProvince.\nDuring the three-month residence qualification period, a person is permitted\nto be temporarily absent from British Columbia for a brief period without incurring\nany postponement of the date on which he becomes a beneficiary.\nWith regard to item (c) above, a dependent is either the spouse of the head\nof a family or a child under 21 years of age who is mainly supported by the head\nof a family.\nExcluded from Benefits\nSome of the main classes of persons either permanently or temporarily excluded from benefits are as follows:\u2014\n(a) A person who works full or part time in British Columbia but who resides\noutside the Province; or\n(b) A qualified person who leaves British Columbia temporarily and fails to\nreturn and re-establish residence within 12 months;  or\n(c) A qualified person who leaves British Columbia and who establishes residence elsewhere; or\n(d) An inmate of a Federal penitentiary; or\n(e ) A resident who receives hospital treatment provided under the Workmen's\nCompensation Act, or a war veteran who receives treatment for a pensionable disability;  or\n(\/) Persons entitled to receive hospital treatment under the Statutes of Canada or any other government; for example, members of the Armed\nForces or Royal Canadian Mounted Police, and consular officials of other\ncountries.\nHOSPITAL BENEFITS AVAILABLE IN BRITISH COLUMBIA\nIn-patient Benefits\nIn addition to standard-ward accommodation with meals and necessary nursing\nservices, a beneficiary may receive any of the other services available in the hospital,\nwhich may include:\u2014\nLaboratory and X-ray services.\nDrugs, biologicals, and related preparations (with a few exceptions).\nUse of operating-room and caseroom facilities.\nUse of anaesthetic equipment, supplies, and routine surgical supplies.\n L 18 BRITISH COLUMBIA\nUse of radiotherapy and physiotherapy facilities where available.\nOther approved services rendered by employees of the hospital.\n(Note.\u2014Private or semi-private rooms cost more to maintain than standard\nwards, and the patient is required to pay extra for such accommodation if it is\nrequested by or on behalf of the patient.)\nEmergency Services, Minor Surgery, and Day-care Surgical Services\nThe following services and treatments are also provided in British Columbia\npublic hospitals to beneficiaries who do not require in-patient care:\u2014\nEmergency treatment within 24 hours of being accidentally injured.\nOperating-room or emergency-room services for minor surgery, including\napplication and removal of casts.\nDay-care surgical services are available to patients who require operating-room\nor other specialized treatment facilities, but who would be discharged within 24\nhours.\nA beneficiary is required to pay $2 for each visit to the hospital for the services,\netc., it has provided, and the remainder of the cost is paid by the British Columbia\nHospital Insurance Service. However, if the patient received treatment from a\nphysician while at the hospital, he is responsible for paying the doctor, as such\ncharges are not payable by the British Columbia Hospital Insurance Service. Non-\nbeneficiaries are required to pay the full charge for the hospital services and treatment received.\nAPPLICATION FOR HOSPITAL INSURANCE BENEFITS\nAt the time of admission to hospital, a patient wishing to apply for coverage\nunder the hospital insurance programme is required to make an Application for\nBenefits. 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\ndefined in the Hospital Insurance Act and regulations. Payment is then requested\nby the hospital from the British Columbia Hospital Insurance Service, which may\nreject any account where either the patient's status as a qualified resident or the\nmedical necessity for his receiving hospital care benefits has not been satisfactorily\nestablished.    (See Eligibility Section.)\nTHE HOSPITAL RATE BOARD AND METHODS OF PAYMENT\nTO HOSPITAL\nThe Hospital Rate Board, appointed by Order in Council, is composed of the\nAssistant Deputy Minister of Hospital Insurance (Chairman); the Director of\nHospital Consultation, Development, and Research (Vice-Chairman); the Hospital Finance Manager; and the Hospital Consultation and Inspection Manager. The\npurpose of the Board is to advise the Deputy Minister in regard to the rates of payments to hospitals for both in-patient and out-patient benefits.\nA system of firm budgets for hospitals, which has been in use since January 1,\n1951, provides for a review of hospitals' estimates by the Rate Board. Under the\nfirm-budget procedure, hospitals are required to operate within their approved budgets, with the exception of fluctuation in days' treatment and other similar items.\nThey are further advised that deficits incurred through expenditures in excess of\nthe approved budget will not be met by the Provincial Government. The value of\nvariable 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\npatient-day costs because certain overhead expenses (such as heating, etc.) are not\n HOSPITAL INSURANCE SERVICE, 1969 L 19\naffected. However, some additional supplies will be consumed, and it is the cost\nof these variable supplies which has been determined. When the number of days'\ntreatment provided by the hospital differs from the estimated occupancy, the budgets\nare increased or decreased by the number of days' difference multiplied by the\npatient-day value of the variable supplies. Individual studies and additional budget adjustments are made in those instances where large fluctuations in occupancy\ninvolve additions or reductions in stand-by costs.\nApproximately 96 per cent of all hospital accounts incurred in British Columbia\nare the responsibility of the British Columbia Hospital Insurance Service. Cash\nadvances to hospitals are made on a semi-monthly basis, so that hospitals are not\nrequired to wait for payment until patients' accounts are submitted and processed\nby the British Columbia Hospital Insurance Service. Qualified patients are charged\n$1 per day, which is deductible when calculating payments to hospitals from the\nService. Non-qualifying residents are charged the hospitals' established per diem\nrates, which are all-inclusive; that is, the daily rate covers the cost of all the regular\nhospital services, such as X-ray, laboratory, operating-room, etc., provided to patients, in addition to bed, board, and nursing care.\nB.C.H.I.S. PLANNING GROUP\nThe Planning Group co-ordinates and expedites planning for hospital facilities.\nIts functions are to review research reports on hospital bed needs; study submissions from hospitals and regional hospital districts for increases in beds or services;\nconsider other problems related to orderly planning and provision of facilities and\nservices to meet the needs of the Province; and to consider other matters referred\nto it by the Deputy Minister. The Planning Group is responsible for making recommendations on these matters to the Deputy Minister.\nThe regular members are as follows: Director, Hospital Consultation, Development, and Research (Chairman); Assistant Deputy Minister (Vice-Chairman);\nMedical Consultant; Manager, Hospital Construction and Planning Division; Director, Research Division; Manager, Hospital Consultation and Inspection Division.\nOf the 39 meetings held during the year, 11 were with outside groups, mostly\nwith regional hospital districts. Meetings with regional hospital districts involved\ndiscussion on comprehensive programmes for hospital services for a whole region.\nRepresentatives of the Planning Group also took part in panels and meetings arranged by regional hospital districts and by agencies concerned with regional planning for hospitals.\nIn keeping with the emphasis on planning by regional hospital districts, the\nPlanning Group reviewed material prepared by the Research Division on over-all\nneeds by region and the Province as a whole.\nThe sub-committee appointed in 1968 to develop a programme and design\nguide for extended care hospitals continued its work in 1969. The members of\nthis sub-committee joined representatives of the Architectural Institute of British\nColumbia to form a task group, which completed the first edition of the guide in\nApril, 1969. The guide was adopted by Government as a standard for the construction of extended care units. Many requests for copies were received from\nelsewhere in Canada and from other countries. A second sub-committee, examining the feasibility of new types of facility for health service in smaller communities,\nwas expected to bring in specific recommendations at the beginning of 1970.\nThe subject of day-care services was among the other planning matters reviewed. A sub-committee was appointed to develop recommendations on this type\nof service.\n L 20 BRITISH COLUMBIA\nORGANIZATION AND ADMINISTRATION\nThe British Columbia Hospital Insurance Service is a branch of the Department\nof Health Services and Hospital Insurance, the other branches being Health, and\nMental Health Services. The administrative head of the Hospital Insurance Service\nis Mr. Donald M. Cox, F.A.C.H.A., Deputy Minister of Hospital Insurance.\nThe following reports provide a brief outline of the work carried out during\n1969 by the various divisions and offices which comprise the administrative structure\nof this branch.\n HOSPITAL INSURANCE SERVICE, 1969 L 21\nASSISTANT DEPUTY MINISTER\nW. J. Lyle, F.C.I.S.\nThe Assistant Deputy Minister is responsible for the operation of the Hospital Finance Division and the Hospital Construction and Planning Division, and for the administration of\nthe Service in the absence of the Deputy Minister. He is\nChairman of the Hospital Rate Board (see page 18), Vice-\nChairman of the B.C.H.I.S. Planning Group (see page 19), and\na member of the following committees: Advisory Committee\non Hospital Insurance and Diagnostic Services (a committee\nappointed by the Federal Government to advise on the administration of the\nHospital Insurance and Diagnostic Services Act), the Sub-committee on Finance,\nthe Radiological Advisory Council, and the British Columbia Hospitals' Association\nLiaison Committee.\nDuring 1969 the Assistant Deputy Minister was a member of the steering\ncommittee on Costs of Health Services, established by the Conference of Ministers\nof Health of Canada in November, 1968, to inquire into ways of restraining the\nrate of increase in health service expenditures.\nA summary of the activities of the two Divisions for which the Assistant\nDeputy Minister is responsible follows.\nHospital Finance Division\nN. S. Wallace, C.G.A., Manager\n^^ Hospital accounting, the payment of hospital claims, and\nfinancing of hospital capital projects are the three main functions\nof the Hospital Finance Division.\nf*ff. At the 3 967 Session of the Legislature, two Acts were\n\u25a0M;        passed which changed the method of financing hospital capital\nprojects\u2014the Regional Hospital Districts Act and the British\nJfe\u00bb    Columbia Regional Hospital Districts Financing Authority Act.\n^\u25a0j.i'       mSm    The Finance Division is responsible for reviewing the annual\nbudgets prepared by each regional hospital district as required by the legislation,\nand works closely with the Hospital Financing Authority and the regional hospital\ndistricts in the financing of hospital capital projects and repayment of debentures.\nDuring 1969 the Finance Division assisted the regional hospital districts in debenture sales to the British Columbia Regional Hospital Districts Financing Authority\namounting to $16,920,000 and provided capital grants of approximately $1,311,000\ntoward the repayment of principal and interest on capital borrowings of the regional\nhospital districts.\nThe Finance Division is also responsible for the approval of grants to assist\nhospitals in the purchase of equipment. In 1969, after a review of approximately\n5,200 applications received from hospitals, grants estimated at $1,909,000 were\napproved on movable and fixed technical equipment costing $5,800,000.\nAs a means of assisting hospital employees to maintain high working standards,\nthe Hospital Insurance Service provided over $130,000 during the year to enable\nhospital employees to attend or participate in short-term training programmes. This\nwas additional to the long-term educational training courses sponsored for certain\nhospital employees through Federal assistance.\nJ\n L 22 BRITISH COLUMBIA\nClose liaison was continued with the Commissioner of Municipal Superannuation in respect to the application of the Act to hospital personnel, and the postponement of retirement for certain employees who reach maximum retirement age.\nThe Division Manager continued to perform duties as a member and Secretary\nof the Hospital Rate Board and as a member of the Sub-committee on Hospital\nFinance and Accounting (a sub-committee appointed by the Federal Government\nto advise on the administration of the Hospital Insurance and Diagnostic Services\nAct).\nExperience during the first few years' operation of the British Columbia Hospital Insurance Service indicated that operating costs required serious consideration\nwhen planning new hospitals and additions to existing hospitals. In order to ensure\nthat plans for new hospitals or hospital additions are prepared with economical\nand efficient operation in mind, a system of pre-construction operating budgets\nis used.\nThe procedure requires a hospital to prepare an estimate of staff and other\ncosts, based upon a reasonable occupancy for the new area. These estimates are\nsubmitted to the British Columbia Hospital Insurance Service and are reviewed by\nthe Hospital Rate Board in the same manner as normal operating estimates. It is\nessential that the estimated operating costs of the new hospital, or new addition,\ncompare favourably with other hospitals actually in operation. Where the hospital's\npre-construction operating estimates do not indicate a reasonable operating cost,\nit is necessary for the hospital board to revise its construction plans to ensure\nefficient and economical operation. Once a satisfactory pre-construction operating\nestimate has been agreed upon by the hospital officials and the British Columbia\nHospital Insurance Service, the hospital board is required to provide written guarantees relative to the projected operating cost. It is considered that this method of\napproaching the operating picture for proposed hospital facilities ensures more\nsatisfactory planning, efficient use of hospital personnel, and an economical\noperation.\nHospital Accounting\nH. G. Benjamin, C.G.A., Supervisor\nThe work of the Hospital Accounting Section falls into three main categories: (a) the detailed inspection, in the field, of the financial records of the\nhospital for purposes of verification of annual and other financial statements;\n(b) the assembly of relevant information and preparation of tabulations and other\ndata for the use of the Hospital Rate Board in its review of the hospital's annual\noperating and pre-construction estimates; and (c) the assembly of information\nand preparation of data for the Deputy Minister in the review of the annual\nbudgets of regional hospital districts. Work in category (c) is a result of the\npassage of the Regional Hospital Districts Act at the 1967 sitting of the Legislature.\nIn carrying out the inspection duties in 1969, visits were made at least once to\neach of 102 public general, rehabilitation, and extended care hospitals. The gross\nexpenditure approved by the Hospital Rate Board for public general, rehabilitation,\nand extended-care hospitals for the year 1969 amounted to $151,000,000.\nOther functions performed by the Hospital Accounting staff include:\u2014\n(a) The tabulation of monthly statistical and financial reports from hospitals,\nand the correlating of these with the approved budgets.\n(b) The calculation of the semi-monthly cash advances to be made to\nhospitals.\n HOSPITAL INSURANCE SERVICE, 1969\nL 23\n(c) Checking and amending annual financial and statistical reports prepared\nby hospitals for the Dominion Bureau of Statistics and the Department of\nNational Health and Welfare.\n(d) The provision, on request, of accounting assistance and instruction to\nsmaller public hospitals in the Province.\n(e) The carrying-out of accounting reviews and cost studies of nursing homes,\nupon the request of the Social Welfare Department, for welfare payment\npurposes.\n(\/) The auditing of accounts of hospital construction projects, to determine\nthe amount of construction grants payable by the Province.\nThe Annual Report on Hospital Statistics, issued by the Department of Health\nServices and Hospital Insurance and covering the administration of the Hospital Act\nfor the preceding year, is prepared by this office.\nDuring 1969, construction projects involving expenditure of $14,450,000 were\naudited and the required statements prepared for the Federal Government, in order\nthat Federal construction grants could be claimed on behalf of the hospitals. In\naddition, cost reports involving expenditures of $33,200 for minor construction\nprojects were prepared for regional hospital districts.\nAnnual accounting inspections of hospitals were delayed because of the difficulty in recruiting experienced hospital accounting personnel.\nHospital Claims Section\nW. J. Wade, Supervisor\nThe staff of Hospital Claims is responsible for processing the Admission-\nSeparation Records (accounts), which hospitals submit for each patient, and\napproving for payment all acceptable claims. Assistance is provided to hospitals\nby the Section in the proper method of submitting the individual accounts. This\nis accomplished by correspondence, telephone, and personal visits. During the\nyear the supervisor visited hospitals in the Vancouver Island and Lower Mainland\nareas.\nDuring July, the Hospital Claims Section moved to a new location in the same\nbuilding, which provided greater space and relieved the overcrowding. This move\nwill allow the increased volume of Hospital Claims accounting requirements to be\nprocessed more efficiently.\nThe filing, accounting, and review of the quarterly billing for extended care\nhospital patients continued to increase in volume as new units were added to hospitals or new hospitals added to the programme.\nResearch and adjustments to accounts, due primarily to changes of responsibility, showed an increase in volume.\nAccounts processed were in excess of 1,700 per working-day for in-patients,\nand over 850 emergency-service or minor-surgery account forms were handled per\nworking-day. Discussions with the Data Processing Centre were continued during\nthe year regarding the efficient use of the I.B.M. electronic data-processing equipment.   These included discussions on special surveys and statistical procedures.\nA brief outline of the work and duties performed by the various offices of the\nHospital Claims Section follows.\nThe staff of Admission Control reviews each application for benefits made by\npatients who claim to be qualified for benefits under the Hospital Insurance Act.\nDetails of residence are checked with the verifying documents; during the year over\n8,000 had to be returned to hospitals because they were incomplete or unacceptable.\n L 24 BRITISH COLUMBIA\nAdvice and assistance were given to hospital admitting staffs on the proper method\nof obtaining and recording the patient's residence information and employment\nhistory.\nIn order to further assist in the co-operation between the British Columbia\nHospital Insurance Service and hospitals, the supervisor of Admission Control visited hospitals for discussions of the procedures being used for verification of the\nresidence of patients.\nAreas visited included Nanaimo, Prince George, Dawson Creek, Cranbrook,\nand Kamloops.\nThe Accounts Payment staff pre-audits the charges made to the British Columbia Hospital Insurance Service, and ensures that all information shown on each\nclaim is completed so that it can be coded for statistical purposes, and that it is\ncharged to the correct agency, such as to the British Columbia Hospital Insurance\nService, Workmen's Compensation Board, the Department of Veterans Affairs, or\nother Provinces and Territories. During the year over 700 queries per month on\nsuch accounting matters were addressed to British Columbia hospitals.\nPreliminary figures for 1969 show that more than 415,000 accounts (excluding out-of-Province) were processed. For comparison the figures for 1968 were\n400,000 processed.\nThe Day-care Surgical Services and Day-care Psychiatric Accounts area increased its monthly volume during the year from 1,135 to over 1,700 accounts at\nthe year-end.\nThe Voucher and Key-punch staff are responsible for batching and voucher-\ning the checked accounts, in order to determine the amounts payable to each hospital and for the punching of an I.B.M. card for each account. The cards are\npunched daily to record statistical, financial, and medical data, and are used to\ntabulate remittance listings of payments due to hospitals and for morbidity statistics\nfor the Research Division. New procedures included the new out-of-Province account cards and the day-care surgical services account cards.\nThe 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 1969 over 5,000\naccounts, amounting to an estimated $1,500,000, were paid on behalf of qualified\nresidents who were hospitalized in the other Provinces and Territories of Canada\nand the continental United States, including Alaska and Hawaii; Argentina, Austria, Australia, Bahamas, Belgium, British Honduras, Denmark, Ecuador, England,\nFinland, France, Holland, Hong Kong, Hungary, Iceland, Ireland, Israel, Italy,\nJamaica, Japan, Mexico, Morocco, New Zealand, Norway, Peru, Philippines, Portugal, Scotland, South Africa, Sweden, Switzerland, Trinidad, West Germany, and\nYugoslavia.\nCorrespondence to accomplish the procedures amounted to over 17,800 letters\nfor the year. This office also compiles up-to-date hospital rate schedules for every\napproved hospital in Canada. All accounts were coded for statistical purposes and\nan I.B.M. card punched for each account.\nThe Filing and Mail Unit sorted and filed over 6,500 documents and letters\ndaily, an increase of 1,000 over last year. The filing system was expanded and new\nprocedures instituted, in order to accommodate the increase.\n HOSPITAL INSURANCE SERVICE, 1969\nL 25\nHospital Construction and Planning Division\nE. M. Browning, Acting Manager\nThe primary responsibilities of this Division may be sum-\nII    marized as follows:\u2014\n(1) Working with hospital boards of management and\nhospital construction and planning committees in the\ndevelopment of programmes for the construction of\nnew hospital facilities, and additions to and renovations of, existing hospitals.\n(2) providing consultative services to hospitals which are\nplanning projects, and recommending such programmes for approval.\n(3) Processing and recommending for approval applications for Provincial\ngrant assistance, either by direct grants or through Regional Hospital Districts, for capital improvement and renovation projects. The Division\nalso initiates applications for Federal construction grants, and processes\nand submits claims for payment.\nSpecial emphasis is given to the need for the development of written programmes for proposed construction projects. Hospitals are assisted by this Division in the preparation of such programmes, which provide architects and their\nengineering consultants with basic planning criteria for the logical development of\nplans.\nDuring the year a great deal of time was spent in reviewing plans of proposed\nbuilding projects, both at the sketch-plan stage and the working-drawing stage.\nDrawings and the architectural programme which evolved from the hospital's functional programme were reviewed with the various professions represented in the\nConsultation, Finance, or Medical Consultation Divisions, or in allied organizations\nsuch as the Radiology Advisory Council and the Laboratory Advisory Council.\nReviews are made with several objectives, but basically the intent is to ensure\nthat, in terms of the construction funds available, the greatest benefit will be derived\nand that the funds are distributed in an equitable fashion. Therefore, comments\nincluded alternate solutions which might produce a better plan for the same amount\nof money, on items which may have an unwarranted influence on operating costs,\nand on items which were felt to be inconsistent with the philosophy of the lower\ninitial cost, consistent with good service and acceptable standards.\nDuring the year, liaison was maintained with the mechanical engineering profession in recognition of the need to design high-quality mechanical systems that\nwould make a maximum contribution toward an efficient and economical hospital\noperation. Some of the elements included in designs for mechanical systems for\nnew hospital buildings, that reflect this approach, included air recirculation and\nzoned heating and ventilating controls.\nConsultative advice is given to hospitals, as well as other departments of the\nHospital Insurance Service, in the fields of plant operation and equipment selection.\nLiaison was maintained with the Hospitals Committee of the Architectural\nInstitute of British Columbia. The function of this committee is to review and\nendeavour to resolve problems arising out of hospital construction projects which\naffect members of the Architectural Institute. An architect on the Division's staff\nis a member of this committee.\nHospital boards were provided with a complete consultative planning service\nthrough this Division, and through the co-operation of Health Branch personnel,\n L 26 BRITISH COLUMBIA\nmembers of the medical and nursing professions, and other divisions of the British\nColumbia Hospital Insurance Service. The Provincial Health Branch provided\nassistance through the Division of Public Health Engineering, the Technical Supervisor of Clinical Laboratory Services, and the Technical Superivsor of Radiology.\nProposed layouts for physical medicine departments were reviewed by the physio\nand occupational therapists on the staff of the School of Rehabilitation Medicine,\nFaculty of Medicine, University of British Columbia. Through the co-operation\nof the Provincial Department of Labour, the Office of the Inspector of Factories\nprovided a consultative service to the British Columbia Hospital Insurance Service\non proposals for elevators and dumb-waiter installations in hospitals.\nMembers of the staff of this Division participated in the development of the\npublication \" Hospitals for Extended Care, a Programme and Design Guide \" (please\nrefer to page 13).\nContinuing benefit was derived from the co-operation of the Department of\nPublic Works in the assignment of architects to this Division. In 1969 an additional architect, Mr. R. D. Goldsworthy, joined the staff, making a total of three\narchitects and a research assistant. Mr. W. M. MacLean, an engineer, also joined\nthe staff of this Division. At the year-end the position of Manager had been advertised and likely candidates were being considered.\nDuring 1969, the architects and engineers made a number of inspectional, advisory, and educational visits to hospitals throughout the Province, and Mr. J. M.\nPhillips visited the construction and planning offices in the Washington State Department of Health, Olympia. Mr. Phillips was also appointed as a member of the\nHospital Cost Analysis Group, the co-ordinator of which is Mr. J. E. Breeze, Head\nof the Division of Engineering in the British Columbia Research Council. A senior\narchitect and a quantity surveyor from the Department of Public Works comprise\nthe remainder of the group.\nA three-day seminar for hospital engineers was held at the Prince George Regional Hospital in November. This was conducted through the co-operation of\nthe British Columbia Hospitals Association and staff of this Division. Staff members devised a simplified system of plant maintenance, which was introduced at this\nseminar and has since been incorporated in some hospitals in the Province. The\nsimplicity of the system was proving to be beneficial in the care of plant and\nequipment.\n(a)  Hospital Projects Completed during 1969\nMatsqui-Sumas-Abbotsford General Hospital, Abbotsford.\u2014An addition and\nrenovation project resulted in a gain of 32 acute beds, making a total capacity of\n109 beds. As the renovation of existing areas continued into the month of December, no official opening was held, but the new patient accommodation had been in\nuse for some months.\nCastlegar and District Hospital, Castlegar.\u2014On November 8, 1969, the Honourable D. L. Brothers officially opened the expanded Castlegar hospital. This\nproject involved the construction of a second story, containing 60 acute beds, over\nthe existing hospital, which was then altered to expand the diagnostic, treatment,\nand service areas.\nLillooet District Hospital, Lillooet.\u2014At the beginning of the year this hospital's capacity was increased by 12 pediatric beds, housed in four temporary prefabricated units.\n HOSPITAL INSURANCE SERVICE, 1969\nL 27\nRoyal Columbian Hospital, New Westminster.\u2014Renovations were completed\nin the emergency department, to provide a 4-bed Trauma unit.\nPowell River General Hospital, Powell River.\u2014Four additional extended-care\nbeds were completed and brought into service in May, bringing the capacity of the\nextended-care unit to 30 beds.\nG. R. Baker Memorial Hospital, Quesnel. \u2014 Twenty-two previously semifinished beds were completed during the year, bringing the total acute capacity to\n100 beds.\nCanadian Red Cross Society, British Columbia-Yukon Division, Vancouver.\u2014\nThe Provincial Government, through the Hospital Insurance Service, provided funds\nfor the blood-transfusion section in the new Red Cross building completed in 1969.\nChildren's Hospital, Vancouver.\u2014A new laboratory, providing a metabolic\ninvestigation unit, was completed during the summer.\nVancouver General Hospital.\u2014Two separate projects were completed at this\nhospital\u2014(1) a Home Dialysis Training Unit was opened on June 27, 1969. This\nhome-like building, containing two beds, trains four patients at a time on a rotating\nbasis, in the method of haemodialysis which will be carried on in their own homes.\n(2) A 50-bed temporary building for emergency patients came into operation on\nNovember 4, 1969.\nHealth Sciences Centre, University of British Columbia, Vancouver.\u2014Patients\nadmitted to 60-bed psychiatric unit.\n(b) Projects under Construction at Year-End\nChilliwack General Hospital, Chilliwack.\u2014Phase I of expansion programme,\nmoving old nurses' residence and altering building for alternate use.\nCreston Valley Hospital, Creston.\u2014Construction of an addition and renovations to existing areas, to provide a total of 44 acute beds, plus 8 unfinished.\nKelowna General Hospital, Kelowna.\u2014Two separate projects were under way\n\u2014the first, which was nearly finished at the year-end, is a new 175-bed acute block;\nthe second a 71-bed extended-care unit.\nNicola Valley General Hospital, Merritt.\u2014This hospital is completing a previously unfinished 4-bed ward, increasing the hospital's capacity to 41 acute beds.\nNanaimo Regional General Hospital, Nanaimo.\u2014An addition is being constructed to provide 85 extended-care, 24 psychiatric, and 25 activation\/rehabilitation beds, as well as a large physio- and occupational-therapy department, and enlarged dietary and locker facilities, etc.\nLions Gate Hospital, North Vancouver.\u2014Construction of a 169-bed extended-\ncare unit.\nPenticton Hospital, Penticton.\u2014An expansion programme, consisting of additions which will eventually provide the hospital with 159 acute beds and an unfinished top floor in \" shell \" form; a 63-bed extended-care unit; expansion of services;\nand renovations to the existing hospital building.\nWest Coast General Hospital, Port Alberni. \u2014 Completion of top floor and\nadditional construction, which will increase the hospital's capacity to 139 acute\nbeds and 30 extended hospital-care beds. The project included renovations of\nexisting areas and construction of additions to provide enlarged service departments.\n L 28 BRITISH COLUMBIA\nPrince Rupert General Hospital, Prince Rupert.\u2014Construction of a new building to provide 128 acute beds and accommodation for 18 extended-care beds.\nPrinceton General Hospital, Princeton.\u2014New 25-bed acute hospital.\nQueen Victoria Hospital, Revelstoke.\u2014Construction of new 50-bed hospital\nwith an unfinished area for 10 additional beds.\nSurrey Memorial Hospital, Surrey.\u2014Two separate projects were under way\u2014\nconstruction of new additions to provide a further 186 finished beds and 72 unfinished, plus renovation of the existing hospital, and the construction of a 78-bed\nextended-care unit.\nTrail Regional Hospital, Trail.\u2014Two separate projects were under way\u2014an\naddition to accommodate a new regional laboratory and 24 psychiatric beds was\nnearly completed, a 50-bed extended-care unit was under construction.\nRoyal Jubilee Hospital, Victoria.\u2014Major laboratory addition and renovation.\n(c) Projects in Advanced Stages of Planning\nLady Minto Hospital, Ashcroft.\u2014Replacement.\nBurnaby General Hospital, Burnaby.\u2014Extended-care unit.\nBurns Lake and District Hospital, Burns Lake.\u2014Additions and renovations.\nChetwynd and District Hospital, Chetwynd.\u2014New facility of 30 beds.\nChilliwack General Hospital, Chilliwack.\u2014Additions and renovations.\nFort St. James Hospital, Fort St. James.\u2014New facility of 25 beds.\nFraser Canyon Hospital, Hope.\u2014Expansion and renovations.\nWindermere District Hospital, Invermere.\u2014Expansion.\nRoyal Inland Hospital, Kamloops.\u2014Renovations to provide approximately 40\nbeds in existing areas of hospital.\nVictorian Hospital, Kaslo.\u2014Replacement.\nKelowna General Hospital, Kelowna.\u2014Renovation of existing hospital.\nRoyal Columbian Hospital, New Westminster.\u2014Temporary accommodation in\nprefabricated units; renovations.\nOcean Falls General Hospital, Ocean Falls.\u2014Replacement.\nRichmond General Hospital, Richmond.\u2014Extended-care unit.\nShuswap Lake General Hospital, Salmon Arm.\u2014Expansion.\nSt. Mary's Hospital, Sechelt.\u2014Expansion programme and extended-care unit.\nVancouver General Hospital.\u2014Extended-care unit and Willow Pavilion renovations.\nHealth Sciences Centre, University of British Columbia, Vancouver. \u2014 New\nhospital facility (Stage III).\nG. F. Strong Rehabilitation Centre, Vancouver.\u2014Expansion.\nSt. John Hospital, Vanderhoof.\u2014Replacement.\n(d) Additional Projects Approved and in Various Planning Stages in 1969\nLady Minto Hospital, Ashcroft.\u2014Replacement.\nR. W. Large Memorial Hospital, Bella Bella.\u2014Replacement.\nBurnaby General Hospital, Burnaby.\u2014Expansion, including 427 additional\nacute beds.\n HOSPITAL INSURANCE SERVICE, 1969\nL 29\nCampbell River and District General Hospital, Campbell River.\u2014Expansion\nof acute hospital.\nCranbrook and District Hospital, Cranbrook. \u2014 Expansion of extended-care\nunit, 8 additional beds.\nSt. Joseph General Hospital, Dawson Creek.\u2014Expansion.\nCowichan District Hospital, Duncan.\u2014Extended-care unit.\nFernie Memorial Hospital, Fernie.\u2014New hospital to serve Fernie and Michel\nareas.\nLady Minto Gulf Islands Hospital, Ganges.\u2014Extended-care unit.\nGolden and District General Hospital, Golden. \u2014 Expansion and 4-bed extended-care unit.\nBoundary Hospital, Grand Forks.\u2014Completion of 5 acute beds and provision\nof 14 extended-care beds.\nMaple Ridge Hospital, Haney.\u2014New 75-bed extended-care unit.\nWrinch Memorial Hospital, Hazelton.\u2014Replacement of acute hospital, plus 7\nextended-care beds.\nRoyal Inland Hospital, Kamloops.\u2014Expansion, including extended-care unit,\npsychiatric, and activation\/rehabilitation beds.\nLillooet District Hospital, Lillooet.\u2014Expansion of acute beds, plus approval\nto plan 6 extended-care beds.\nMackenzie.\u2014New facility.\nLangley Memorial Hospital, Murrayville.\u2014Expansion.\nArrow Lakes Hospital, Nakusp. \u2014 New hospital to serve Nakusp and New\nDenver.\nRoyal Columbian Hospital, New Westminster.\u2014Expansion.\nLions Gate Hospital, North Vancouver.\u2014Expansion of services.\nSt. Martin's Hospital, Oliver.\u2014Replacement.\nPrince George Regional Hospital, Prince George.\u2014Expansion and extended-\ncare unit.\nSaanich Peninsula.\u2014New 75-bed acute hospital (replacing Rest Haven Hospital, Sidney) and 75 extended-care beds.\nBulkley Valley District Hospital, Smithers.\u2014Expansion.\nSquamish General Hospital, Squamish.\u2014Renovations and improvements.\nChildren's Hospital, Vancouver.\u2014Replacement.\nHoly Family Hospital, Vancouver.\u2014Expansion and extended-care unit.\nSt. Paul's Hospital, Vancouver.\u2014Expansion.\nMount St. Joseph Hospital, Vancouver.\u2014Expansion and extended-care unit.\nSt. Vincent's Hospital, Vancouver.-\u2014Extended-care unit.\nGorge Road Hospital, Victoria.\u2014Extended-care unit.\nMount St. Mary Hospital (St. Joseph's), Victoria.\u2014Extended-care unit.\nPriory Hospital, Victoria.\u2014Extended-care unit.\nRoyal Jubilee Hospital, Victoria.\u2014Extended-care unit; renovations.\nSt. Joseph's Hospital, Victoria.\u2014Expansion, ambulatory-care unit; renovations.\nCariboo Memorial Hospital, Williams Lake.\u2014Expansion.\n Major Hospital Projects, 1969\nCompleted.\u2014Abbotsford, Castlegar, Lillooet, New Westminster (Royal Columbian), Powell River, Quesnel, Vancouver (Children's Hospital, Vancouver\nGeneral).\nUnder Construction.-\u2014Chilliwack, Creston, Kelowna, Merritt, Nanaimo, North\nVancouver, Penticton, Port Alberni, Prince Rupert, Princeton, Revelstoke, Surrey,\nTrail, Victoria (Royal Jubilee).\nFor details see pages 26 to 27.\nCastlegar and District Hospital\u2014\nMajor expansion programme completed.\n New Ja?6y Memo\u00bbal Hospital-\nNeWaddlU0nsand novations under way.\nNew ,H^reSt0n Valley Hospital-\nNew addrtions and renovations under way.\n\/S!?\"Gfnfral Hospital-\nNew 25-bed acute hospital under\nway.\n L 32\nBRITISH COLUMBIA\nDIRECTOR OF HOSPITAL CONSULTATION, DEVELOPMENT,\nAND RESEARCH\nJ. W. Mainguy, M.H.A.\nThe Director is responsible for the operation of both the\nHospital Consultation and Inspection Division and the Research\nDivision, and is Assistant Chief Inspector of Hospitals under the\nHospital Act, the Chief Inspector being the Deputy Minister.\nThe Director is responsible for the administration of the Service\nin the absence of the Deputy and Assistant Deputy Minister.\nHe is Chairman of the B.C.H.I.S. Planning Group and Vice-\nChairman of the Hospital Rate Board. The work undertaken\nduring the year in connection with these activities is outlined on pages 19 and 18\nrespectively. He represents the Service on a number of committees of Government\nand community agencies, including the Co-ordinating Committee on Paramedical\nTraining of the British Columbia Institute of Technology, Burnaby; the Liaison\nCommittee between the Service and the British Columbia Hospitals' Association;\nand the Sub-committee on Quality of Care and Research, Ottawa.\nIn February, the Director was appointed as Chairman of the national Task\nForce on Beds and Facilities. This group was one of seven established by the\nConference of Ministers of Health of Canada to inquire into ways of restraining\nthe rate of increase in health service expenditures without impairing the quality of\ncare. Each task force examined a specific aspect of the cost of health care. Reports\nof all task forces were completed by mid-year.\nReports of the activities undertaken by the two Divisions responsible to the\nDirector follow.\nHospital Consultation and Inspection Division\nP. Breel, Manager\nThis Division provides public and private hospitals with\nconsultative services in all matters of hospital operation and\nadministration. It is responsible for an inspectional programme\nto ensure that basic standards are met, and for the licensing of\nprivate hospitals.\nIts staff is composed of administrative, nursing, dietary, and\nmanagement engineering consultants.\nThe Division co-operates with all other divisions of the\nService in achieving aims of mutual interest and responsibility. It is responsible\nfor the analysis, and subsequent recommendations, for approved staffing patterns\nresulting from hospital estimates. The Manager is a member of both the Hospital\nRate Board and the Planning Group. Staff members also participate in the hospital-\nplanning functions of the British Columbia Hospital Insurance Service, including\nthe review of the operational implications of construction projects, and the setting\nof standards. Sketch plans are analysed and assessed, in conjunction with the\nHospital Construction and Planning Division. The Division represents the Service\non a large number of councils, committees, and working parties associated with\nhospitals and the health field, and works with Federal, Provincial, and municipal\nrepresentatives on related matters.\nDuring 1969, 170 staff visits were made to acute, rehabilitation, chronic,\nconvalescent, and extended-care hospitals. In addition, 203 visits by nursing and\nother staff consultants were made to private hospitals giving nursing-home care.\n HOSPITAL INSURANCE SERVICE, 1969\nL 33\nDuring the past year, 18 studies were completed by the management engineering\nunit, 11 of which were requested by individual hospitals or groups of hospitals.\nStudy reports, released with the approval of the hospitals concerned, were\ncirculated throughout British Columbia, other parts of Canada, the United States,\nand the United Kingdom.\nPersonnel of the Division attended a variety of educational sessions during\nthe year, as a necessary means of keeping abreast of changing concepts and techniques in the hospital field.\nIn February, 1969, Mr. J. Bainbridge resigned as Manager of the Division\nto become Administrator of the Vernon Jubilee Hospital. Mr. Breel was appointed\nas Manager, and Mr. E. C. Luscombe became Senior Administrative Consultant.\nResearch Division\nD. S. Thomson, B.A., Director\nThe Research Division is responsible for compiling and\nmaintaining statistical data relating to hospitalization and morbidity in British Columbia. The Admission\/Separation Records,\nsubmitted by the hospitals for each in-patient, serve as the major\nsource of reference in deriving statistical information. The data\nused are key-punched by the Hospital Claims Section of this\nService, and then transferred to magnetic tape by the Data Processing Division of the Department of Industrial Development,\nTrade, and Commerce, which produces the required tabulations.\nEach year the Division carries out bed-requirement studies and prepares\nstatistical data at the request of hospitals and independent consultants on hospital\nutilization. During 1969, over 70 requests were answered involving patient-flow\ndata and population-growth projections, relating to hospital catchment areas, school\ndistricts, and regional hospital districts.\nThe formation of regional hospital districts brought about a greater need for\ndetermining hospital requirements on a regional scale, particularly concerning\nservices that can be shared by one or more hospitals within a region. In 1968,\na Province-wide study was undertaken to determine both school district and\nregional hospital district bed needs, and to account for all patient movement within\nand without each of the 27 regions. This study was completed during the past year\nand serves as a guide to future planning.\nThe Division is responsible for the publication of several annual bulletins\nwhich have, over the years, been useful to various research groups and agencies\nthroughout the Province and Canada. \" Statistics of Hospital Cases Discharged\nin 1968,\" completed during the year, included 10 standard morbidity tables as\nsuggested by the Federal Advisory Committee on Hospital Insurance and Diagnostic Services, along with an analysis of the Province's hospitalization experience\nby race, age, regional hospital district, major diagnostic group, and type of service.\n\" Statistics of Hospitalized Accident Cases \" provided a broad analytical coverage\nof hospitalized accidents by circumstance, type of accident, and by nature of\ninjury. In addition, a number of statistical tables, entitled \" Hospital Indicators,\"\nwere circulated to all hospitals. These indicators allow the individual hospital to\nfocus attention on its own performance, as well as making a comparison with\nhospitals of a similar size-group. A further series of reports produced by this\nDivision involved an analysis of patient-flow patterns within five of the larger\nregional hospital districts.\n L 34 BRITISH COLUMBIA\nAs the field of hospital development takes on an increasing and more complex\nrole in the provision of health care, a continuing study is being made of the assessment of hospital needs. In 1969, British Columbia co-operated in a comparative\nstudy, involving hospital utilization experience, with hospitals in Liverpool, New\nEngland, and Uppsala, Sweden. Also during the year the Division provided the\nstatistical analysis on a survey to identify factors affecting patient length of stay.\nAn increasing number of special requests by community agencies, private\norganizations, and by Government are processed each year.\nMEDICAL CONSULTATION DIVISION\nD. G. Adams, M.D., Medical Consultant\nDr. Charles F. Ballam, who served as Medical Consultant\nwith the Hospital Insurance Service since January, 1966, resigned his position in August to become Medical and Educational\nDirector for the Royal Jubilee Hospital, Victoria. Dr. Douglas\nG. Adams was appointed Medical Consultant on September 1,\n1969.\nThe Admission\/Separation Record, which is completed for\neach patient admitted to a hospital either in British Columbia or\nwhile out of the Province, is assessed with regard to its medical aspects by this\nDivision. This review includes coding, which is done in accordance with the\n\" International Classification of Diseases, Adapted for Indexing Hospital Records\nby Diseases and Operations,\" and is a function which requires the professional\nknowledge and training of medical coders. The competence and accuracy applied\nto this work is reflected in the statistical end-product, and to ensure a continuing\nhigh standard all coders on the staff of this Division are graduate nurses. The\nstatistical data are basic to planning decisions, for expanding or developing hospital\nfacilities generally, and special departments in certain hospitals, in particular. In\naddition, this coded information is utilized by the Research Division of the British\nColumbia Hospital Insurance Service and the Dominion Bureau of Statistics for\nthe publication of hospital morbidity and mortality data. Other functions of the\nreview include bed usage, identifying special area requirements by reason of\ngeographical or industrial development, and assessing complicated individual cases,\nwhen required.\nIn co-operation with such bodies as the Faculty of Medicine of the University\nof British Columbia, the College of Physicians and Surgeons of British Columbia,\nand departments of Government, special medical research projects were a part of\nthe work of this Division during the year. These studies were greatly benefited by\nlegislation which made the data of such studies privileged information, and not\nsubject to litigation.\nThe assessment and review of individual patients' applications for extended-\ncare coverage continued to provide an increasing workload. A quarterly review of\nall extended-care hospitals was undertaken, with two objectives\u2014(1) a medical\naudit, to ensure patients continue to be medically qualified for this benefit, and\n(2) for the purpose of reviewing and assisting in the treatment programme provided\nby the hospital\u2014in order that the care which the patient receives is commensurate\nwith current thinking in the management of chronically disabled individuals. In the\ndevelopment of this programme the Medical Consultation Division had the assistance\nof qualified consultants in physical medicine, whose specialized knowledge was of\ngreat value. Several new extended-care units were opened during the year, increasing the application review load, and at the same time placing increased demands\n HOSPITAL INSURANCE SERVICE, 1969\nL 35\nfor professional advice on the implementation of treatment programmes in these\nnew units.\nDr. D. M. N. Longridge was appointed Assistant Medical Consultant during\nthe year, and has major administrative supervisory responsibility for the Coding\nDivision, and the survey and review projects previously mentioned. In addition,\nadministration of the medical aspects of the extended-care programme is under his\nsupervision. Management of the day-to-day problems which arise in the administration of these matters enables Dr. Longridge to participate with the Medical\nConsultant in the preparation of policy recommendations to the Deputy Minister,\ndealing with hospital conditions and needs.\nDay-care surgical services, approved as a hospital insurance benefit in 1968,\nhave improved the utilization of the Province's health facilities, and the Medical\nConsultant continued to advise the Service in its planning for an expanded role\nin ambulatory-patient care. As was the case with the in-patient admission records,\nall day-care surgical services records were assessed and coded according to the\nInternational Classification of Diseases, so that these data may be tabulated in\npreparation for statistical reviews.\nThe Medical Consultant, while maintaining responsibility for the foregoing,\nalso ensured continuing and active liaison, through visits to hospitals, special disease\ngroups, societies, and health agencies. Liaison with the British Columbia Medical\nAssociation, and active participation on its Hospitals Committee and the Advisory\nSub-committee on Chronic Renal Failure, continued during the year. New committees to consider radioisotope facilities and intensive coronary-care services were\nset up by the British Columbia Medical Association at this Service's request, and\nboth Medical Consultants participated directly with these advisory bodies. As a\nresult of the reports received from the committees studying radioisotope and intensive cardiac-care facilities, continuing advisory sub-committees were developed,\nand the Medical Consultants were asked to serve on both continuing committees.\nDuring the year a new committee was formed to study future developments in\ncancer therapy for the Province, and the Medical Consultant was named as a\nmember of the committee.\nThe encouragement of hospitals to achieve accreditation standards imposes\ncertain pressures to conform to the requirements of accreditation, and when these\npressures produce problems for the medical staff of the hospital, the Medical Consultant is able, with the assistance of the Hospital Consultation and Inspection\nDivision, to render assistance.\nThe Medical Consultant also advises the Service on the proposed addition or\nextension of medical services in hospitals. New treatment services require additional equipment, and in current times not only must the traditional hospital departments be supplied with modified equipment, but new technology in the bio-medical\nsciences is introducing new diagnostic and treatment services which require equipment unheard of five to ten years ago. There is a constant and rising demand to\nkeep abreast of the change in medicine, and to call upon ancillary consultative\nadvice from specially talented individuals, as well as organized technical groups\nfrom the profession. During the year the resources of other Government departments, namely, the Health Branch and Mental Health Services, were utilized where\nproblems were related to these special fields, and particularly where the treatment\nservices being made available in acute general hospitals must complement those\nservices being provided through Health Branch and Mental Health agencies. The\nSocial Welfare Department was similarly involved.\nThe Medical Consultant and the Assistant Medical Consultant participated in\nthe postgraduate continuing medical education programmes sponsored through the\n L 36 BRITISH COLUMBIA\nuniversity and the Provincial and local medical societies, as well as special and\npertinent continuing medical education seminars or courses offered outside British\nColumbia.\nThe Medical Record Consultant serves in a consultatory capacity to the\nBritish Columbia Hospital Insurance Service, and also to hospitals within the\nProvince. During the year, visits were made to hospitals, primarily to encourage\na high standard of medical record-keeping, in accordance with the guidelines offered\nby the Canadian Council on Hospital Accreditation. Assistance was also given\nto medical record personnel, with problems which related to the Medical Consultation Division. At the same time, emphasis was placed on the need for accuracy\nand adequacy in the reporting of diagnoses and surgical procedures for coding\npurposes. This ensures the production of meaningful statistical and research studies\nundertaken by this Division and the Research Division. Plans for construction and\nrenovation projects for various hospitals were reviewed and assessed, according to\nthe workload within the respective medical record departments. Participation as a\nmember of the Provincial Education Committee of the British Columbia Association\nof Medical Record Librarians ensured further liaison with medical record personnel.\nADMINISTRATIVE OFFICER\nK. G. Wiper\nThe Administrative Officer is responsible for the drafting of\nlegislation, regulations, and Orders in Council for the British\nColumbia Hospital Insurance Service. In the performance of\nthese duties, a close working relationship exists between this\noffice and the Attorney-General's Department.\nHospital societies may apply to the Administrative Officer\nfor assistance in connection with the drafting of hospital constitutions and by-laws, and their interpretation and application.\nChanges in hospital by-laws were reviewed by this office prior to their submission for\nGovernment approval as required under the Hospital Act. A set of model by-laws\nhas been developed for use by hospitals as a guide in making revisions.\nUnder the Regional Hospital Districts Act, described earlier in this Report, the\nAdministrative Officer worked closely with the officials of other departments and\nof the various districts in arranging for money by-laws, temporary borrowing, and\nrelated matters.\nIn collaboration with the Hospital Consultation and Inspection Division, the\nAdministrative Officer processes, for approval under section 14 of the Hospital Act,\ntransfers of private-hospital property and transfers of shares in the capital stock of\nprivate-hospital corporations. In addition, close liaison is maintained with the Land\nRegistry Office to ensure that the property records of both general hospitals and\nprivate hospitals are suitably endorsed so that land transfers are not made until they\nare approved under sections 14 (2) and 41 (1) (c) of the Hospital Act.\nAs in previous years, considerable time was spent in 1969 on matters related\nto the Federal-Provincial hospital insurance arrangements. Methods of streamlining\nadministrative procedures and improving liaison were discussed with officials of the\nFederal Government and other Provinces at meetings held in Ottawa and Victoria.\nThe Administrative Officer is the Personnel Officer for the British Columbia\nHospital Insurance Service. He is also responsible for the over-all supervision of\nthe General Office and the Third Party Liability and the Eligibility Sections.\n HOSPITAL INSURANCE SERVICE, 1969\nL 37\nEligibility Representatives' Section\nP. A. Bacon\nIn order to ensure that only qualified British Columbia residents receive hospital insurance benefits, the staff of the Eligibility Section review the Applications\nfor Benefits made by, or on behalf of, persons admitted to hospital. A detailed\ncheck is made of all doubtful applications, resulting in the rejection of a considerable number of claims for hospital insurance benefits made by unqualified persons.\nNumerous inquiries from the general public with regard to eligibility matters are\ndealt with by personal interview, telephone, and correspondence.\nEligibility Representatives visit hospitals on a regular schedule to see that the\nBritish Columbia Hospital Insurance Service eligibility procedures are being properly carried out. The Representatives also assist in the training of hospital admitting\npersonnel to deal with problems connected with the admission of patients to hospitals and the determination of their status under the Hospital Insurance Act. This\ntraining assistance is provided by means of visits to hospitals and by regional\nmeetings.\nThis Section keeps the great majority of employers in British Columbia supplied with certificates on which an employee's length of employment can be certified.\nThe Representatives maintain close liaison with these firms to ensure their continuing co-operation in providing their employees with this form of proof of residence\nfor hospital insurance purposes.\nClose liaison is maintained with the British Columbia Medical Plan, and Eligibility Representatives supply Medical Plan applications and information to the general public in many communities throughout the Province. Regional representatives\nare located in Prince George, Kamloops, Nelson, and Kelowna, as well as in Vancouver and Victoria.\nThird Party Liability Section\nJ. W. Brayshaw\nThe hospitalization reports that are completed by hospitals for every patient\nadmitted with accidental injuries are processed by the Third Party Liability Section.\nThis 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\nbehalf of accident victims. The Senior Eligibility Representative in Vancouver,\nMr. H. E. Drab, is responsible for maintaining a third-party liability clearing-house\nfor the convenience of solicitors and insurance adjusters in the Greater Vancouver\narea. Up-to-date information regarding the hospitalization of accident victims is\navailable through the Vancouver office, and negotiations may be carried out in person or by telephone, thus avoiding the necessity of corresponding with the head\noffice in Victoria.\nGeneral Office\nC. R. Leighton\nThe main responsibility of the General Office is the recording and accounting\nof all receipts and expenditures connected with the internal administration of the\nHospital Insurance Service. This also includes preparation of the annual estimates,\nwhich is done in conjunction with the Division Managers. This office is also\nresponsible for purchasing and distributing the office supplies and equipment used\nby the Branch, and is generally responsible for maintenance and safe custody of\noffice machinery.   In addition, the General Office handles the shipping of forms to\n L 38 BRITISH COLUMBIA\nhospitals and the sorting and distribution of mail. Stenographic services were\nprovided to the Public Information Office, and to other Divisions when the work\nvolume permitted. The Supervisor of this office is also the Safety Officer for the\nBranch.\nPUBLIC INFORMATION\nR. H. Thompson\nThis office is responsible for the continuing development of public information\nactivities. Its three main areas of involvement are the general hospitals, the\ngeneral public, and in-service requirements. The following is a summary of the\nwork undertaken during 1969.\nHospital personnel continued to express increasing interest in the use of\nfilms for in-service training, and during the year an estimated 4,000 hospital\npersonnel viewed 200 separate screenings of films available from the B.C.H.I.S.\nlibrary. Staff consultants previewed nine 16-mm. films and three series of 35-mm.\nfilmstrips, in order to assess their desirability as additions to the library. As a\nresult of their recommendations, the Service purchased five filmstrips, three which\ndeal with the dietary department, and two dealing with basic nursing. The availability of these films on a loan basis makes it unnecessary, in many instances, for\nhospitals to purchase their own films for in-service training. In order to assist\nB.C.H.I.S. in selecting the size and type of film which would be utilized to the\nbest advantage by the majority of hospitals, an Audio-Visual Aid Questionnaire\nwas developed and sent to hospitals in October. Eighty-four of the 104 hospitals\nreceiving the questionnaire completed and returned the form.\nUpdating of the B.C.H.I.S. Manual on Policy, Organization, and Procedures\nwas continued during the year, but difficulty was experienced in drafting a major\nrevision of the chapters dealing with hospital construction and planning, and hospital finance. The heavy volume of work, coupled with staff turnover, on the part\nof the two Divisions concerned in the revision of this particular material, has delayed a complete rewrite of the chapters.\nThe two major pamphlets produced by B.C.H.I.S. were revised and reprinted\nduring the year. The \" General Information \" pamphlet, which is provided to new\nresidents of the Province, was received from the printers in November. The hospital pamphlet, \" 24 Hours a Day,\" was revised with the assistance of the Administrator's Section of the British Columbia Hospitals' Association, and it was expected\nthat the reprint would be available for distribution at the year-end. At the request\nof the Association, the B.C.H.I.S. material for their Trustee's Manual was also\nrevised, and 1,200 copies provided to the Association.\nRegular editions of the B.C.H.I.S. Bulletin were published during the year and\ndistributed to all public and licensed private hospitals. The Bulletin is an administrative aid providing clarification on policy and procedural changes, as well as publishing items of general interest to hospitals.\nNumerous press releases were issued during the year to ensure that the public\nwas kept informed regarding hospital construction programmes, policy changes, and\nother items of general interest.\nOther duties included the summarizing of reports for the information of the\nDeputy Minister, maintaining the newspaper and hospital photograph files, replying to general correspondence, and the preparation and editing of the 21st Annual\nReport.\n HOSPITAL INSURANCE SERVICE, 1969\nL 39\nAPPROVED HOSPITALS\nPublic Hospitals\nArmstrong and Spallumcheen Hospital, Armstrong.\nArrow Lakes Hospital, Nakusp.\nBella Coola General Hospital, Bella Coola.\nBoundary Hospital, Grand Forks.\nBritish Columbia Cancer Institute, Vancouver.\nBulkley Valley District Hospital, Smithers.\nBurnaby General Hospital, Burnaby.\nBurns Lake and District Hospital, Burns\nLake.\nCampbell River and District General Hospital, Campbell River.\nCariboo Memorial Hospital, Williams Lake.\nCastlegar and District Hospital,  Castlegar.\nChemainus General Hospital, Chemainus.\nChildren's Hospital, Vancouver.\nChilliwack General Hospital, Chilliwack.\nCowichan District Hospital, Duncan.\nCranbrook and District Hospital, Cranbrook.\nCreston Valley Hospital, Creston.\nCumberland General Hospital, Cumberland.\nEnderby and District Memorial Hospital,\nEnderby.\nEsperanza General Hospital, Esperanza.\nFernie Memorial Hospital, Fernie.\nFort Nelson General Hospital, Fort Nelson.\nFraser Canyon Hospital, Hope.\nG. R. Baker Memorial Hospital, Quesnel.\nGolden and District General Hospital, Golden.\nGrace Hospital, Vancouver.\nKelowna General Hospital, Kelowna.\nKimberley and District Hospital, Kimberley.\nKitimat General Hospital, Kitimat.\nKootenay Lake General Hospital, Nelson.\nLady Minto Hospital, Ashcroft.\nLady Minto Gulf Islands Hospital, Ganges.\nLadysmith and District General Hospital,\nLadysmith.\nLangley Memorial Hospital, Murrayville.\nLillooet District Hospital, Lillooet.\nLions Gate Hospital, North Vancouver.\nMcBride and District Hospital, McBride.\nMaple Ridge Hospital, Haney.\nMater Misericordia? Hospital, Rossland.\nMatsqui-Sumas-Abbotsford General Hospital,\nAbbotsford.\nMichel-Natal District Hospital, Michel.\nMills Memorial Hospital, Terrace.\nMission  Memorial  Hospital,  Mission City.\nMount St. Joseph Hospital, Vancouver.\nNanaimo Regional General Hospital, Nanaimo.\nNicola Valley General Hospital, Merritt.\nOcean Falls General Hospital, Ocean Falls.\n100 Mile District General Hospital, 100 Mile\nHouse.\nPeace Arch District Hospital, White Rock.\nPenticton Hospital, Penticton.\nPouce Coupe Community Hospital, Pouce\nCoupe.\nPowell River General Hospital, Powell River.\nPrince George Regional Hospital, Prince\nGeorge.\nPrince Rupert General Hospital, Prince\nRupert.\nPrinceton General Hospital, Princeton.\nProvidence Hospital, Fort St. John.\nQueen Alexandra Solarium for Crippled\nChildren, Victoria.\nQueen Charlotte Islands General Hospital,\nQueen Charlotte City.\nQueen Victoria Hospital, Revelstoke.\nRest Haven Hospital and Sanitarium, Sidney.\nRichmond General Hospital, Richmond.\nRoyal Columbian Hospital, New Westminster.\nRoyal Inland Hospital, Kamloops.\nRoyal Jubilee Hospital, Victoria.\nR. W. Large Memorial Hospital, Bella Bella.\nSt. Bartholomew's Hospital, Lytton.\nSt. George's Hospital, Alert Bay.\nSt. John Hospital, Vanderhoof.\nSt. Joseph General Hospital, Dawson Creek.\nSt. Joseph's General Hospital, Comox.\nSt. Joseph's Hospital, Victoria.\nSt. Martin's Hospital, Oliver.\nSt. Mary's Hospital, New Westminster.\nSt. Mary's Hospital, Sechelt.\nSt. Paul's Hospital, Vancouver.\nSt. Vincent's Hospital, Vancouver.\nShuswap Lake General Hospital, The, Salmon Arm.\nSlocan Community Hospital, New Denver.\nSquamish General Hospital, Squamish.\nStewart General Hospital, Stewart.\nSummerland General Hospital, Summerland.\nSurrey Memorial Hospital, North Surrey.\nTorino General Hospital, Torino.\nTrail Regional Hospital, Trail.*\nUniversity Health Service Hospital, University of British Columbia, Vancouver.\nUniversity of British Columbia Health Sciences Centre Hospital, Vancouver.\nVancouver General Hospital, Vancouver.\nVernon Jubilee Hospital, Vernon.\nVictorian Hospital, Kaslo.\nWest Coast General Hospital, Port Alberni.\nWindermere District Hospital, Invermere.\nWrinch Memorial Hospital, Hazelton.\n! Name changed from Trail-Tadanac Hospital on December 2, 1969.\n L 40 BRITISH COLUMBIA\nOutpost Hospitals\nRed Cross Outpost Nursing Station, Alexis           Red Cross Outpost Nursing Station, Edge-\nCreek, wood.\nRed Cross Outpost Nursing Station, Atlin.          Red Cross Outpost Nursing Station, Kyuquot.\nRed Cross Outpost Nursing Station,  Bam-           Red Cross Outpost Nursing Station, Masset.\nfield. Red Cross  Outpost Nursing Station,  Wad-\nRed Cross Outpost  Nursing  Station,  Blue               hams.\nRiver.\nFederal Hospitals\nVeterans' Hospital, Victoria. Miller Bay Indian Hospital, Prince Rupert.\nShaughnessy Hospital, Vancouver. R.C.A.F. Station Hospital, Holberg.\nCoqualeetza Indian Hospital, Sardis.\nLicensed Private Hospitals\nIndustrial Hospitals in Remote Areas with Which the Province Has Entered into\nan Agreement Requiring Them to Furnish the General Hospital Services\nProvided under the Hospital Insurance Act.\nBralorne Private Hospital, Bralorne. Mica Creek Private Hospital, Mica Creek.\nCassiar Asbestos Corporation Private Hos- Port Alice Private Hospital, Port Alice,\npital, Cassiar.\nOther\nHollywood Hospital Ltd., New Westminster (licensed under the Mental Health Act).\nRehabilitation, Chronic, and Convalescent Hospitals\nG. F. Strong Rehabilitation Centre, Vancou- Shaughnessy  Hospital,  Vancouver.\nver- Sunny Hill Hospital for Children, Vancou-\nThe Gorge Road Hospital, Victoria. ver\nHoly Family Hospital, Vancouver Veterans'  Hospital,  Victoria.\nPearson Hospital  (Poliomyelitis Pavilion), i   , .   ,\nVancouver '      number  of the larger public hospitals\nQueen   Alexandra   Solarium   for   Crippled also have rehabilitation units.)\nChildren, Victoria.\nExtended-care Hospitals\nMount St. Mary Hospital, Victoria (exclud- Pearson Hospital, Vancouver (excluding fa-\ning top floor). cilities  for tuberculosis patients).\nMount St. Francis Hospital, Nelson. The Louis Brier Hospital, Vancouver.\nMount St. Joseph Hospital, Vancouver (top Valleyhaven Hospital, Chilliwack.*\nfloor). Veterans' Hospital, Victoria (extended-care\nMenno Hospital, Abbotsford. unit).\nPriory Hospital, Colwood (24-bed unit and Shaughnessy Hospital, Vancouver (extended-\n71-bedunit). care unit).\n* Became part of the Chilliwack General Hospital in 1969.\n HOSPITAL INSURANCE SERVICE, 1969\nL 41\nSTATISTICAL DATA\nThe tables on the following pages represent statistical data compiled by the\nHospital Finance Division. The data deal with the volume of hospital insurance\ncoverage provided to the people of British Columbia through the British Columbia\nHospital Insurance Service.\n L 42 BRITISH COLUMBIA\nIn 1969 there were 91 public general hospitals approved to accept British\nColumbia Hospital Insurance Service patients. Care was also provided in seven\noutpost hospitals, five Federal hospitals, five contract hospitals, five public rehabilitation hospitals, and one rehabilitation hospital operated by the Provincial Government. Hospital insurance coverage for patients in non-profit extended-care hospitals\nand units commenced December 1, 1965. At the end of 1969 there were 25 hospitals providing extended care. Data for the year 1969 have been estimated from\nreports submitted by hospitals to October 31st, and are subject to minor revision\nwhen actual figures for the year are submitted.\nTable 1a shows a total of 339,600 British Columbia Hospital Insurance Service\nadult and children patients were separated (discharged) from British Columbia\nhospitals in 1969, an increase of 14,831 or 4.6 per cent over 1968. This table also\nshows that 95.6 per cent of the total patients separated (discharged) from British\nColumbia public hospitals were covered by hospital insurance, compared to 95.3\nin 1967 and 95.7 in 1968. Table 1b indicates in 1969 that the British Columbia\nHospital Insurance Service paid public hospitals in British Columbia for 3,141,100\ndays of care for adults and children, an increase of 66,141 days or 2.1 per cent\nover 1968.\nAs shown in Table 2a, the average length of stay of British Columbia adult and\nchildren patients in public hospitals during 1969 was 9.25 days, and the days of\ncare per thousand population were 1,769. For comparison purposes, the data for\nextended-care hospitals is not included in the above observations, but it should be\nnoted that an additional 243 days of care per thousand population were provided\nfor these patients.\nTable 2b, under \" Minor Surgery Patients,\" includes an estimated 19,000 daycare surgery and psychiatric patients. An additional estimated 30,000 out-patient\ncancer treatments were covered by the British Columbia Hospital Insurance Service,\nwhich are not included in this table.\nJ\n HOSPITAL INSURANCE SERVICE, 1969\nL 43\nTable 1a. \u2014 Patients Separated (Discharged or Died) and Proportion\nCovered by British Columbia Hospital Insurance Service, British\nColumbia Public Hospitals Only (Excluding Federal, Private, and\nOut-of-Province Hospitalization) (Including Rehabilitation Hospitals).\nTotal Hospitalized in Public\nHospitals\nCovered by B.C.H.I.S.\nAdults\nand\nChildren\nNewborn\nTotal\nAdults\nand\nChildren\nNewborn\nTotal\nPatients separated\u2014\n1949\n164,964\n216,743\n261,128\n271,609\n277,073\n285,998\n292,119\n301,510\n314,585\n326,793\n338,923\n354,800\n26,272\n33,190\n39,599\n38,226\n37,697\n37,231\n35,688\n33,555\n32,488\n32,014\n33,529\n35,200\n191,236\n249,933\n300,727\n309,835\n314,770\n323,229\n327,807\n335,065\n347,073\n358,807\n372,452\n390,000\n140,168\n199,774\n249,654\n259,953\n264,655\n272,597\n278,023\n286,799\n299,518\n311,718\n324,769\n339,600\n84.9\n92.2\n95.6\n95.7\n95.5\n95.3\n95.2\n95.1\n95.2\n95.4\n95.8\n95.7\n24,640\n31,515\n38,980\n37,558\n36,505\n35,878\n34,196\n31,863\n30,814\n30,377\n31,635\n33,300\n93.8\n95.0\n98.4\n98.3\n96.8\n96.4\n95.8\n95.0\n94.8\n94.9\n94.4\n94.6\n164,808\n1955\n231,289\n1960\n288,634\n1961\n297,511\n196?\n301,160\n1963\n308,475\n1964\n312,219\n1965\n318,662\n1966 \t\n330,332\n1967 \t\n19681 \t\n19692  \t\n342,095\n356,404\n372,900\nPercentage of total, patients separated\u2014\n1949\n86.2\n1955   ._\n92.5\nI960\n96.0\n1961\n96.0\n196?\n95.7\n1963\n\t\n95.4\n1964\n95.2\n1965   _ _\n\t\n95.0\n1966             \t\n\t\n95.2\n1967 \t\n95.3\n19681...   .   \t\n\t\n95.7\n19692...                                       \t\n95 6\n1\ni Amended as per final reports received from hospitals.\n2 Estimated, based on hospital reports to October 31,1969.\n L 44\nBRITISH COLUMBIA\nTable 1b.\u2014Total Patient-days and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public Hospitals\nOnly (Excluding Federal, Private, and Out-of-Province Hospitalization) (Including Rehabilitation Hospitals).\nTotal Hospitalized\nHospitals\nin Public\nCovered by B.C.H.I.S.\nAdults\nand\nChildren\nNewborn\nTotal\nAdults\nand\nChildren\nNewborn\nTotal\nPatient-days\u2014\n1949                             \t\n1,682,196\n2,198,863\n2,581,042\n2,675,402\n2,708,337\n2,778,668\n2,820,122\n2,895,476\n3,008,632\n3,093,372\n3,225,333\n3,297,900\n213,874\n227,674\n249,273\n240,207\n274,032\n270,298\n260,979\n245,756\n235,796\n239,972\n244,715\n248,300\n1,896,070\n2,426,537\n2,830,315\n2,915,609\n2,982,369\n3,048,966\n3,081,101\n3,141,232\n3,244,428\n3,333,344\n3,470,048\n3,546,200\n1,430,646\n2,005,165\n2,451,839\n2,546,344\n2,573,634\n2,631,671\n2,670,176\n2,747,232\n2,861,260\n2,946,000\n3,074,959\n3,141,100\n85.0\n91.2\n95.0\n95.2\n95.0\n94.7\n94.7\n94.0\n95.1\n95.2\n95.3\n95.2\n200,585\n212,514\n241,157\n231,043\n263,475\n257,736\n246,813\n230,096\n220,270\n222,543\n226,633\n232,300\n93.8\n93.3\n96.7\n96.1\n96.1\n95.4\n94.6\n93.0\n93.4\n92.7\n92.6\n93.5\n1,631,231\nlos\";\n2,217,679\n1960                        ...                 -\n2,692,996\n1961\n2,777,387\n1\u00b062\n2,837,109\n2,889,407\n1963\n1\"64\n2,916,989\n2,977,328\n1Q65\n1966                                    \t\n3,081,530\n3,168,543\n3,301,592\n3,373,400\n86 0\n1\u00b067\n19681                                   \t\nJQ6Q2\nPercentage of total, patient-days\u2014\n1Q\/JO\n1955  ..\t\n91.4\n1960      \t\n\t\n95.1\n1961                                      \t\n\t\n95.3\n1062\n\t\n95.1\n1963 _~      -\t\n\t\n94.8\n1\u00ab64\n94.7\n1965\t\n\t\n94.0\n1966     -  \t\n\t\n95.0\n1967 \t\n\t\n95 0\n19681\t\n95 1\n19692  \t\n\t\n95 1\ni Amended as per final reports received from hospitals.\n2 Estimated, based on hospital reports to October 31, 1969.\n HOSPITAL INSURANCE SERVICE, 1969\nL 45\nTable 2a.\u2014Patients Separated, Total Patient-days, and Average Length\nof Stay According to Type and Location of Hospital for B.C.H.I.S.\nPatients Only, and Days of Care per Thousand of Covered Population.\nTotal\n(Excluding\nExtended Care)\nAdults\nand\nChildren\nNewborn\nB.C. Public\nHospitals\nAdults\nand\nChildren\nNewborn\nOther B.C. Hospitals,\nIncluding Federal\nand Private\nAdults\nand\nChildren\nNewborn\nInstitutions\nOutside B.C.\nAdults\nand\nChildren\nNewborn\nExtended-\ncare\nHospitals\n(Including\nFederal)\nPatients separated-\n1949\t\n1955\t\n1960\t\n1961 \t\n1962\t\n1963\t\n1964\t\n1965\t\n1966..\n1967..\n19681- \t\n19692 \t\nPatient-days\u2014\n1949\t\n1955\t\n1960\t\n1961\t\n1962\t\n1963\t\n1964\t\n1965\t\n1966..\n1967...\n19681 \t\n19692 \t\nAverage    days    of\nstay\u2014\n1949  \t\n1955 \t\n1960 \t\n1961\t\n1962\t\n1963 \t\n1964\t\n1965\t\n1966...\n1967....\n1968L.\n19692..\n149,280\n209,999\n264,120\n273,293\n278,021\n286,753\n293,144\n301,522\n314,391\n325,861\n338,706\n353,746\n1,498,121\n2,100,386\n2,650,129\n2,756,665\n2,789,355\n2,850,559\n2,905,544\n2,985,092\n3,110,701\n3,189,212\n3,309,533\n3,398,838\n24,989\n32,035\n39,488\n37,968\n36,942\n36,326\n34,652\n32,240\n31,152\n30,804\n32,031\n33,683\n203,197\n215,980\nj 244,480\n| 233,794\n| 266,351\n| 260,771\n| 249,827\nI 232,438\n| 222,475\n| 225,479\n| 229,053\n| 234,497\n1\n10.03\n10.00\n10.03\n10.09\n10.03\n9.94\n9.91\n9.90\n9.89\n9.79\n9.77\n9.61\n8.13\n6.74\n6.19\n6.16\n7.21\n7.18\n7.21\n7.21\n7.14\n7.32\n7.15\n6.96\n140,168\n199,774\n249,654\n259,953\n264,655 I\n272,597 j\n278,023 |\n286,799 I\n299,518\n311,718\n324,769\n339,600\n1,430,646\n2,005,165\n2,451,839\n2,546,344\n2,573,634\n2,631,671\n2,670,176\n2,747,232\n2,861,260\n2,946,000\n3,074,959\n3,141,100\n10.21\n10.04\n9.82\n9.80\n9.72\n9.65\n9.60\n9.57\n9.55\n9.45\n9.47\n9.25\n24,640\n31,515\n38,980\n37,558\n36,505\n35,878\n34,196\n31,863\n30,814\n30,377\n31,635\n33,300\n200,585\n212,514\n| 241,157\n| 231,043\n| 263,475\n| 257,736\n| 246,813\n| 230,096\n220,270\n222,543\n226,633\n232,300\n8.14\n6.74\n6.19\n6.15\n7.22\n7.18\n7.22\n7.22\n7.15\n7.32\n7.16\n6.98\n7,093\n8,313 |\n11,557 |\n10,361 |\n10,226 |\n10,895\n11,605\n11,417\n11,459\n9,436\n9,310\n8,986\n45,960\n75,599\n169,401\n182,690\n183,042\n187,714\n199,164\n205,488\n212,413\n195,564\n188,152\n204,238\n6.48\n9.09\n14.66\n17.63\n17.90\n17.23\n17.16\n18.00\n18.53\n20.72\n20.21\n22.73\nI\nI\n151\n361\n241\n151\n157\n169\n149\n114\n101\n83\n80\n83\n1,146\n2,271\n1,417\n878\n850\n1,018\n878\n619\n541\n451\n434\n397\n7.59\n6.29\n5.88\n5.81\n5.41\n6.02\n5.89\n5.43\n5.36\n5.43\n5.42\n4.78\n2,019\n1,912\n2,909\n2,979\n3,140\n3,261\n3,516\n3,306\n3,414\n4,707\n4,627\n5,160\n21,515\n19,622\n28,889\n27,631\n198\n159\n267 I\n259\n280\n279\n307\n263\n237\n344\n316\n300\n1,466\n1,195\n1,906\n1,873\n32,679 I 2,026\n31,174 | 2,017\n36,204 1 2,136\n32,372\n1,723\n37,028\n1,664\n47,648\n2,485\n46,422\n1,986\n53,500\n1,800\n10.66\n7.40\n10.26\n7.52\n9.93\n7.14\n9.27\n7.23\n10.41\n7.24\n9.56\n7.23\n10.30\n9.79 |\n10.84\n10.12\n10.03\n10.37\n I\n6.96\n6.55\n7.02\n7.22\n6.28\n6.00\n699\n873\n990\n1,120\n305,940\n358,675\n409,514\n500,000\n437.68\n410.85\n413.64\n446.43\ni Amended as per final reports from hospitals.\n2 Estimated, based on hospital reports to October 31, 1969. Estimated patient-days (including newborn\ndays) per thousand of population covered by British Columbia Hospital Insurance Service: 1949, 1,528; 1950,\n1,548; 1951, 1,496; 1952, 1,527; 1953, 1,600; 1954, 1,733; 1955, 1,720; 1956, 1,688; 1957, 1,626; 1958, 1,665;\n1959, 1,724; 1960, 1,804; 1961, 1,806; 1962, 1,841; 1963, 1,835; 1964, 1,815; 1965, 1,799; 1966, 1,779; 1967,\n1,754; 1968, 1,774; 1969, 1,769. (1954 and subsequent years are based on total population. Because the Armed\nForces, Royal Canadian Mounted Police, and some other groups are not insured under the Provincial plan, the\nactual incidence of days would be somewhat higher than shown.) In addition, estimated patient-days per\nthousand population for extended care amounted to 205 in 1968 and 243 in 1969. Population figures are\nrevised according to latest census figures.\n L 46\nBRITISH COLUMBIA\nTable 2b.\u2014Summary of the Number of B.C.H.I.S. In-patients (Including\nExtended Hospital Care Patients) and Short-stay Patients\nTotal Adults,\nChildren, and\nNewborn\nIn-patients\nEstimated\nNumber of\nEmergency and\nMinor-surgery\nPatients i\nTotal\nReceiving\nBenefits\n1<M9\n174,269\n242,034\n303,608\n311,261\n314,963\n323,079\n327,796\n333,762\n346,242\n357,538\n371,727\n388,549\n29,000\n70,553\n107,312\n121,000\n128,000\n135,000\nMl ,000\n160,000\n175,000\n195,000\n210,000\n220,000\n203,269\n312,587\n410,920\n1955\n1Q\u00ab1\n1961              ... .                              .   ..\n19ft?\n432,261\n442,963\n458,079\n468,796\n1963\n1964                   - ..\n1965                                                    \t\n1966      ...\n1967    \t\n19682         _ ,\t\n19693                               \t\n493,762\n521,242\n552,538\n581,727\n608,549\nTotals  \t\n5,862,012                 2,299,073\n1\n8,161,085\n1 Years 1962 to 1969 estimated, includes day-care surgery.\n2 Amended as per final reports received from hospitals.\ns Estimated, based on hospital reports to October 31, 1969.\nTable 3.\u2014Patients Separated, Total Days' Stay, and Average Length of\nStay in British Columbia Public Hospitals for B.C.H.I.S. Patients\nOnly, Grouped According to Bed Capacity, Year 19691 (Excluding\nExtended-care Hospitals) .\nBed Capacity\nTotal\n250 and\nOver\n100 to 249\n50 to 99\nUnder 25\nPatients separated\u2014\nAdults and children\nNewborn .\t\nPatient-days\u2014\nAdults and children\nNewborn\t\nAverage days of stay-\nAdults and children\nNewborn\t\n339,600\n33,300\n3,141,100\n232,300\n9.25\n6.98\n149,100\n13,300\n1,506,800\n99,500\n10.10\n7.48\n93,400\n10,300\n793,300\n68,800\n8.49\n6.68\n54,200\n6,400\n519,000\n43,200\n9.58\n6.75\n34,300\n2,650\n256,500\n16,100\n7.48\n6.08\n8,600\n650\n65,500\n4,700\n7.62\n7.23\n1 Estimated, based on hospital reports to October 31, 1969.\nTable 4.\u2014Percentage Distribution of Patients Separated and Patient-\ndays for B.C.H.I.S. Patients Only, in British Columbia Public Hospitals, Grouped According to Bed Capacity, Year 19691 (Excluding\nExtended-care Hospitals) .\nBed Capacity\nTotal\n250 and\nOver\n100 to 249\n50 to 99\n25 to 49\nUnder 25\nPatients separated\u2014\nAdults and children\nNewborn  .\nPatient-days\u2014\nAdults and children\nNewborn\t\nPer Cent\n100.00\n100.00\n100.00\n100.00\nPer Cent\n43.91\n39.94\n47.97\n42.83\nPer Cent\n27.50\n30.93\n25.26\n29.62\nPer Cent\n15.96\n19.22\n16.52\n18.60\nPer Cent\n10.10\n7.96\n8.17\n6.93\nPer Cent\n2.53\n1.95\n2.08\n2.02\n1 Estimated, based on hospital reports to October 31, 1969.\n HOSPITAL INSURANCE SERVICE, 1969\nL 47\nCHARTS\nThe statistical data shown in the following charts prepared by the Research\nDivision are derived from Admission\/Separation forms submitted to the British\nColumbia Hospital Insurance Service.\nThe major diagnostic categories used for the table on pages 53 to 56 are more\ndetailed than the diagnostic groups shown on the charts. Both lists are based on\nthe International Classification of Diseases, Adapted, prepared by the Public Health\nService of the United States Department of Health, Education, and Welfare.\nReaders who are interested in more detailed statistics of hospitalization in this\nProvince may wish to refer to \" Statistics of Hospital Cases Discharged during 1968 \"\nand \" Statistics of Hospitalized Accident Cases, 1968 \" available from the Research\nDivision.\n L 48\nBRITISH COLUMBIA\noo\nsO\nOs\nVi\ntu\nO\nO\nH\nO\nz\no\n<\noJ\nO\n<\nX\nM\ns\ntt,\n*    S\nu\nPh\no\n<\nQ\nh\no\nz\n2\nH\nM\ns\nH\nW\nO\n<\nz\nW\nu\nBJ\nW\nOh\n<\nu\no\nz\n3\nz\nw\no\nto\nw\nQ\n<\n6?\n>rt m 23\ns?\nu \u2014\ni=S\nS?\neo 3\nKtt\n\\. \/\n<\ns\nu\nw\no\nM**4\" XSCffr\u2014\u2014\u2014\u2014v\n'l\nVIhmj,\n^n_\nt\n HOSPITAL INSURANCE SERVICE, 1969\nL 49\noo\nsC\nas\na\n<\nu\na,\no\nQ\nQ\nZ\n<\ntn\nBJ\n<\nU\n\u25baJ\n<\n\u00a3\ntn\nO\n*\nUJ\ni-l\n<\ns\nBJ\nPh\na\nz\n<\nBJ\nhJ\n<\nBh\no\nz\no\nH\nP\n\u00a3\n5\ntn\nUJ\nO\n<\nBJ\na\n<\nH\nz\nBJ\nu\nBJ\n0-\nH\nPh\n<\n0\n L 50\nBRITISH COLUMBIA\noo\ns\u00a3>\nBJ\nu\nt\u2014i\n>\na!\nBJ\nC\/>\n<\n-I\nU\nBh\nO\nBJ\nPh\nH\n!x\nB5\ncn\nBJ\ncn\n<C\nU\n\u25baJ\n<\nH\ni\u2014i\nPh\ncn\no\nX\nBh\no\nz\no\nH\nD\n2\nH\nBJ\na\n<\nz\nBJ\nu\nBJ\nBJ\nOh\nH\nBJ\n<\no\n<\ns\nBJ\ns,\n<\n r\nHOSPITAL INSURANCE SERVICE, 1969\nL 51\n00\nOs.\nw\no\ntt\n%.\nBJ\n-J\n<\nhJ\nO\no\nBJ\nPh\nH\nx-\n\u00ab\n* i\ncn\n>*\nUJ\ni\nS\n\u25baJ\n<\nH\ni\u2014i\nPh\ncn\nI\nO\nZ\no\nH\nP\nP3\nl-H\nPJ\nH\ncn\nBJ\nH\nz\nBJ\nO\nUJ\nX\nU\nUJ\n L 52\nBRITISH COLUMBIA\nChart V.\u2014Average Length of Stay of Cases* in Hospitals in British\nColumbia, by Major Diagnostic Groups in Descending Order, 1968\n(Excluding Newborns).\nDiseases of the circulatory system\nDiseases of the bones and\norgans of movement\nNeoplasms\nDiseases of the blood and\nblood-forming organs\nDiseases of the nervous system\nand sense organs\nCongenital malformations\nMental, psychoneurotic, and\npersonality disorders\nAllergic, endocrine system,\nmetabolic, and nutritional diseases\nInfective and parasitic diseases\nInjuries and adverse effects\nCertain diseases of early infancy\nDiseases of the skin and\ncellular tissue\nPROVINCIAL AVERAGE\nLENGTH OF STAY\nDiseases of the digestive system\nDiseases of the genito-urinary\nsystem\nDiseases of the respiratory system\nDeliveries and complications of\npregnancy, childbirth, and the\npuerperium\nSymptoms, senility, and ill-\ndefined conditions\nSupplementary classification for\nspecial admissions\n* Including rehabilitative care.\nK\n HOSPITAL INSURANCE SERVICE,  1969\nL 53\nQ\n^;N(simmH;mr4^;t^viwo\\viH.N^ir)Noo\n-Hooo'ooosoooo\" OOOOO ooo^J\nO o'       O cn o O d hH d O d O Ht .J rn\" \u00a9\nCJ ^ ~ ^ ^ **. ^ -NmMfl; *fr \u00abo-H-.rnrt\u2014; os\n^Hdoddo'sDo'ddoo'do'odooo'o\nhn      NMOf^rtO-NVj'nMHvoin\n\u00bb-* d      THfirtdd-ddd6rJ--d\ntn\nZ\nBJ\no\nUJ\nO\nz\n3\n5\no\nX\nW\noo\nsO\nOs\nBJ\nO\nO\nBJ\nH\n<\nH\ncn\n0\nz\no\n<\nBJ\no\n<\n><\nm\nz\no\nH\n<\nN\n<\no\n0) O\nCD\nW43 >>\n\u00ab5\noor~\"s-j-oooor-iri\"^>\n^MTm^OOOOOMiI\noo N\np- od\nso O CA in to tn CAOs Os Os c\\Os Os in\nsocAos^Osinto'intotociini^oo\ntn \\t\n>i ra\nOr^r^^crnr--aoo\\r--o\\r--oor-oo(N-H;'H-rn'rt;\nOLoco^ti*ir-Tti>TtrtTtl^H<^'^rNOwNi\/i\no^ \u00ab r>^ o_ a o> >n m n n u, rt ^ w r^ in t> -- [~> \u25a0*\nr>\" in h -- a m m m' n\" is in oo d m* ^f vd \u2022\u2014' oo\" t> *h\n\u2022Iff l-H ,-t   l-H THfs|H(S(fl'H (SfH VO\nrim       r\u2014 c~cAtntntocAC>rorosoto<~}co\ni-h O O\\\u00abs0O0\\n^00HHOOCst\nor-      (Ni-r-vo^-coo^r-r-or-Troo\n0(S\\DMNM\u00abrt\u00bbD\\0\"tOr-<ri\u00abf,iN(Nr--t\nin a\\ o co r- o\\ r- <N'*r-Tj-om>nr-'-H'*rgmo\\\nONf)MNrnowiflWinfi|n's,twOrJTj'0\\\nCOM        sOrt-rtcACAtOt-tOtOtOCAOsC~sO\nco Os      ooOsinr^ossoo>^sosoc^coc^tn\nt-'O CAC~-rtC~Os-rttoaQintnCAO\\-*t-Q0\nz\nQ\ntj\ncn O\nm    -H    t\u00bb\n\u00bb o\n7??Ss\nNNOC\nO O oo\nc\\ r-\nOOO\nft\noo r~i\nO O\nOs to v\u00a9 \u201e\nQ \u2014\u25a0 ,-. co f>\nI  r\u00bb Q\nQ\\  CO <*) tj- \u2014I inrHOtm\nco -rt \\\u00a3> r- co      i^        i  rt\n(N'H-rnit'-'0'-H'r'nr-''-l'trHsf)0tN\\D\ni    I  in in in       \u00bb\u25a0- r*.   i \u2022\u2014 r~.    _ r*i       .^\" *\u2014.       \u2014,\nO O -\n\u201er- r-   I  t- r-\nTj- -t\nSO\n~ O     . r\u00a3 O * \"- 55\nONnhINH;^\nCO\nt> Os CA Tf r~-OyOsOs\\OOsOO\\D\n-oo Im r-ooo\\oMso-(N\nfNtN-HfNnoncNrJtNmmmfn\n.IITf       |sfll | I I I I I I\nmor^nofspooooopo\n\u2014 tn\u00a3cA\n*\\o &<\n1\n9\"\" \"0\nrt  rt  rt\n3    QJ\n3 g\nrt J=\n,3 \u00a7\ni \u00a3  C\n53 fi *\n5 R & .2 \u00ab J=\na js\n11\n8 \"\n\u2014    4\u00bb    O\nK   5      \u00ab\nii 5 I'\no So \u00b0 v C\nw .* <u y w <o\n, ^ xi o 3 o\nj2 a\nO \"U\n6.2\n\u00ab 3 \u00a3 6 -3 \u00ab\nOOOOOOOOOOOi\nE \u00ab\nS > A\nra o *\u25a0>\ns a a s a s\nrt  rt\nD.D.\nO\nIII\nS   S3\ncn   ca   cu\na a a a a a a r\no o o o o o o r\ngggcgggcg\nra\n-    -    . _   O  O \"2   Q\nuuuuuuuuuuiuCj;\n   ~    \"   \"  \" a C\nrt \u00ab\n\u00a3gs\nCCCRCCCCCCC\nft ft\no o\na s g-H\n!  S^  &  \u00bb\nra  ra\ng 5j 5j HI S ci, Sij EL d\/j Sj\nC   C   C   :\nrt rt ra w cO g cj\nC    C    G    C    =\nc ^ ri to -=t m \u25ba\nCJ;  0(l|   [j\ntt ra\nj-a\nS3\n.2 o\n\u25a0o g,\nofj\nSo\ni a\nEf 8\nII\nco ra\n00 00 O\n.sl.$\n131\nP 2 5\no <u\n\u25a0S fj\n\u25a0 rt  ra  rt\nra rt ra ra ra <\n^\"CQPQ\n|4a\nEC\"     <\u00ab\no o\nW   cU   c\nb      a r; \u2122 ?i fl ra\n2 .y 6 .S \u00a3 \u25a0\u00a7 \u00a3 =\ng ff<55SS<\n.odosd \u2014 cNrn^tindc--od\n11   -\n13 o .a\nos I\nS6 g\ntu \u00abw o\n45   \u00b04=   (\nIH   cu   Sj j\n\u00b0 ra ft4\ncfl   <u\ntU   cfl \u00ab\n\u00abS 2\nSt?\nlH(N<(\n L 54\nBRITISH COLUMBIA\n-sS\ncu\n3\n\u2022S\nK\n0\nO\nz\nPh\no\n05\nBJ\no\nz\n3\n&\ni-i\no\nX\noo\nsO\nBJ\nO\nO\nBJ\nH\n<\nH\ncn\n\u00a7\nO\nOS\nO\nhi\n<\nn\nz\no\nH\n\u2022<\nN\n<:\nH\ni\u2014i\nCh\ncn\nO\n\u00abCJ\no\nwm*mH(>it^N(NcoNN\u00abm^wa(Noo*^N^N\nhmHo\u00abdNd\u00abrIo'HHd6o'c>d6mHf-HNd(N\nOO'-'OOOOm'\nVO ^ t- vo\nl> O \u00a9 \u00a9\n'tncomsOrtNMinoovDin'HvotN'tcoin'tTt'-\u25a0 \u00a9 in in o in\nInHOdrtHOOOrtddOHOod^^dcnNVOHNrlrH\nSOCArt-r}--rt^CASOrt-TtrMGIOQO\ndiHNOrtddN^'drtdd\n\u00a9 o\nra45 >\u00bb\n\u2022h tt ra\ntu B0\u00ab\n> CM\n>\u00bbrt\nrtU\noqr*ift^n\\ONqa-H\\oh^s\u00bbo>N\\qinoNwoo>H n ^ ^ m n ts m t q h \u00bb n h\nov cn r- ov tN ^t  r~-i>od-HvovO\"-Hr^C\\r-cno\\oo\n, \u25a0) id- co o' vd vd -^t Ov l> rn (N\\ rt  \u00a9 \u25a0> cn co so tn  m -\u2014'\nTH   tN   !H   CM t-I   t-   T-H   -H   tH   (^   t-I rH th\nT-, HtNW\ncoo^r^MrnOTtvooor^irir-l^r^0^^t^w^r^inO\\coTtc?\\\n^^^VOC^O\\f^t^mO\\in^rr)COVOVO'-HVOOv(SrOfSr-COc3NVCi\n^r^pr^^covo^r^t^m^MOC>o>r^Tfr^ot^cococSfnin\nSO\" tO   tn   rt   CO   CO   CO   rt   OSOS\\Ort0\\^GtOC^0600OsinSOr^Ost^rt\nTtHIAHfnrMHfJOfntNH\/^HHHfNtN (S)    v\u00a3>   -(J.    Tt    tH IT-\ncNm'-Hvovor-O'rtr-mtN'^J-Tt\nrtOsSOSOSOtnrtlnOsrt-rt-rfsO\nmr~-Ttmvovoi-Hr-r-vo\u00ab-HOco\nTf ov \u00a9\" Tt* t-f r-\" \u00abn \u00a9\" <n r? u-T \u00abt( *-*\nHtN>OrtnNHH(rndHts)M.\nr-l fS\nQ\nu\nQ\n\u25a0d\n3\nz\n^o\u00abvo-llnH^Nln^c^mN^s*l(N'^t^oo^lnmo^'lln^\nmvortt~-vo--r--0'-Hvoovor--voovvornr--'-HT-i\\ooocoor-oo\ncomc^ovovom'-HcriooTH|-^\\\u00a3)rHr^mmomr--'-Hs\u00a3)cri'^t^H-o\ncO^NHini\nXrHCslr^fvlHffltN\ni rt m rt th r- o m <\n\"\"tvor-'-HoONiN'-H'-ioJ'nrHr-\nCOO(NCMNO\"(NM*l\\0(Na\ncj\\ 0(N (NO r-C-0>0\"\\i'-^ONvDiVO\nrt Tf  t> rtin rt OO to so CO CA CA\no o m\nco\nvo\n\u25a0 \"* r- m to co ci       t-~ c~ m cA\n)    I  r-l r- oo o\\ \u00a9       CA oo to -rt\n-min-Tj-Ttttinommmm\n- \u2014  . y? j j      1   i \u2014 i  j   ii\nooooooooo't^i-m,*\u00a9oooom'-iooo\nvor-ONOOrNrnTtm so    .. r- r- oo o\\ o       nmn^\ncomrot'strtxi-^H; -\u25a0*\/ tN \u25a0<* \u25a0\"*\u25a0\"* tt in       innmio\nvo\nI777T1TT7T3;\nin to rt to T~~ tO C~ -rf        ,t\nTtmvo t\u00bboohmo\\      o\nmmmo'-|cS\u00bbntnmvomovo\nI I .. r- r- r- I _l - T lo -\nmoommmO^ovoovocN\nTtmvo cc CO p\"> C?\\ ON        o\nmmm mminmm       vo\nVD\nS o\nc\nu\n5\nrt\no\nra\nOJ\nd)\n45\nft\nii\nft\nu\nG\n'So'\nB 6\nv a\nja -b\n3 \"5   <u\n\u201e   B   >\nI  rt  3        M '\nii.No\n: \u00ab .s > co\n> <3 JS.:\njOOO\u00a3\u00bb\na o\ni 3  w w\n1  B  rt  rt\n3  \u00b0 \u00a7\nrt       3\no-o 2 S\nsat;\nca 5 u\n43   a)   5 H\nfl 4= S ra\n8 *\u25a0* \u00ab .G\na o a \u00ab\n+:      cA <u\nM   rt    tU <U\nra cu jg ft\ntg \u00ab9 *\u2022 ft ra\na a\nu_, O q>\nO cfl M\n>^ cfl    T\nO .S3 *-\n*Z  0\n!   rj   Ih   u   O   <u\n3 \u00ab 2 a \u00a7 g\n3 \u2014\u25a0 J5   \u00a3U   g it-,\n|>\u00a3Q531S<cDMQ>iB.o|<5\u00a3mKOS\na \u25a0\u00a7\ng   3   X\n3 'a? u\nt> '^\"O\ns-o =\nB S I\n\u00ab, rt.-\n.3   3   B\n! a \u00a7 -o\n?\u00ab w d\n\u20220 \"\u00b0   -\n' a 9 S\n\u00ab \u00ab a\ns: j: a\n3u v\n\u25a0u ca -a\n\u00bb jo\n-H S-o   !\n\u00b0\" .a\nCfl   \u00ab4H      Cfl      G\n\u2022use\n\u00ab >h h \u25a0%\n.53 ii rt f\nflPO-i\n\u00bb.Jo\u00bb\u00abS\ni   tn\" S3  *   rt   ^   >.\n\u25a0a \u00bb s * s .s\n.  o -d\n\u25a0o 9 S 2 J.\n.   rt C3   3   3   K\u00bb\n-3  rt \u2014 -ri\nuc1.3 -a ^\n' S 2 B rt\n\u2022a oo S\nG 52\nG \"h \u00ab\n45   iu\nO   ft G   >.\n\"5  c \u2014\u25a0  ra\nSi *o .. . T.\n2 - .S3  G  0\n3 '\u00abm \u00b12 o \u2014\n' \u00a7 B J= 5-S S S\nH  X  H  '-   H\ncSuupo lz\u00a3u\n HOSPITAL INSURANCE SERVICE, 1969\nL 55\ntO   m   rt   SO   OS   Tt   OS\n-H-    TH   \u00a9   \u00a9   \u00a9   \u00a9   O\noq^Nm^iriincjviNMinTf       r** l> W      cvj *\u25a0{ *-r \u00a9       *\u25a0 in oo ^t fj      nror;0\\\noo\"--H1\u00a9Ttr4o--^\u00a9OvdtN'-HtN        t-ht-h*\u00a9'        Ohhw        iHrldrin        >-h O* <\u00a9' (N\nvq o\\ tN o r- Tt o\\\nrH \u00a9 O\" rH \u00a9 w h\norotN'-HvqtNmr-r-^H'-Hpp       m m in       tN \u00a9 p i>      in r^ n h q      o tN \u25a0* in\nMlNHhlNdrldd^rt'rlrJ th  rH  \u00a9 \u00a9  tN  tN   ri r-3  \u00a9  ri  \u00a9  (H t-J  O  \u00a9  Tf\"\no in q -* vo oca\nco in to vd cn\" tN Tt\novfNvDoovqouotNr-vqvo^ON      ov ov r-;\ntr,i Tf cn m1 oo' ini O co tN Tt ov Tt ri      tN in d\nr-_ m m co\n\u00a9 \u00abn tn \u00a9\nov co co rn m\n\\6  ri  in  \\t   CO\np \u00a9 \u00a9; cn\n00 cn tn vd\nih co vo m ov vo co\noo ov cn tN \u00a9 ov th\no r- CN Tt f- vo vd\nm\u00a9mr-'^tO\\vorN->tTtcoin'-'\noo\\incncNOvr--ovco\u00a9cor-Tt\n\u00a9 \u25a0*  IN  VO^ \u00a9 \u00a9_ *-* Tt_ SO CT^ OS r* l>\ntN n !* --<o\\tnovcooovr-'\"H\u00a9\nl> <n t-i t* r-      ^t HmOMnoo\nri\nr-i\nvo vo vo m\nm oo co r-\nCN  00 CO VD\nr- t> oo\nOO OO 00 ON\nVO OV fN 00\nm m\ncn cn cn\nm  -.-j-   fN   rt   Tt\ntn        CN OV\ncn o\\ cn in in in o\\\n^t vo m m cn oo rt\nvo cN r- cn m r- m\nTtOsOSCASO00rtCTtTt\\OC~>00\nCA0000a0Ttrt00sO-tc0t~~sOOs\ncn ov_ \u00a9^ Tt^ <-< vo vo oj Tt cn ov^ in r*\nvo\" f* Tt\" Tt\" os       rt\" cn\" CN Tf\" cn\" cn\" vd\"\nr- r- ov\ntN (N VD\nTt Tt r-\nOV 00 CO OV\nVO OV OV tN\nr- \u00a9 pm\ni> l> \u00a9\n(SHiriHH- r- \u00a9 in Tt\n\u00a9r-CN\u00a9Tt CNCN\"-HCN\nco tN vo^ vq^ cn m r* -* r*\nm\" cN Tt rf cn Tt\"      r+ in\n)   *T1   Tt   \\0   S\nx cn m\nj VD vo ,-j. ,\nr-ovovcN ooo\\vocovoo\\r\u2014 voovovovvd\n.rncoTtm r-co'-'OV'-HTttN cn Tt in in r-\n,\\Dvovovp\u00a9\\DvDt>vpr--r--r-mr-i>r--i>t--\n.TTTTvoTTtTi i icn .1 1 1 1\n\u25a0-o\u00a9ovo\u00a9ocspo\u00a9\u00a9r~Tt\u00a9\u00a9\u00a9o\nTtTtm       r~-coOv0j\\pcNcN       cnTtmmvo\n\u201e ro ^ ~ ~ m        r~ go j\\ ui u n n\nj ^ VO \\D vo vO        vovo^voot^t-\nvo m m ov\nr~- ov ov ov\nr- r- r- ov\n0006\nvo 00 00 o\nr~ r- r- 00\ncn 00 r- -h vo\nm   \u00a9   rt   CA fN\nCO CO 00 00 CO\n* J   I   .. I\nm m \u00a9 o fN\n\u00a9   \u00a9   rt   (VJ fN\nCO CO 00 00 00\nJ CT\\ Os O\n- vo Tt r-\nj 00 ov CO\nI    I     \u201e\n)    \u00a9    O    TH\n> vo Tt m\n! 00 OV 00\nOs CO OV\n0 0 r- ov\n00 Ov Ov    1\n00 Os Os 7_\n00 Os Os\nR\n>\nG\n>\n-n\nC\nra\na\nX>\nG\nG\nra\na\n0\nra\nx\nra\nG\na\n>\nF\na\nG\nr\/l\n>\n>\ns\n45\nD\nc\nra\n00\nM\n0\n53\nC  ra\nG   0 <U\nre\nra\n'5\nG\nC\nV\nra\n0-\nCJ\ni   G V\n<u  rt\nI I s\n\u00ab \u00b0 I\nra .2 hh\ntu ^ g\n.2 \u00ab ra\n*0   ft \"^\nS3 \u00a3 \u00a7\nokpjjh5(5o\n\u00ab a a\n> g J -o\ni 2 o S\nIs\no  o\no a 3 \u25a0\nC4H     ft'C\nO G <u\n5 a *\n\u00a78ss\\\n\u00abeg <u -o\na leas\ns 3 j5 a\ntn O   G 1,\n2 <u u\na g 42\n2 45\na^ \u00ab\n\u00a7m is^^\no -O\n\u20222 c\n3 rt\nD.  o\nu c i;\nS3 o^\n^ >>. ra -t-.\n\u25a0 H   .H      C     <\u00bb\nhQu 2\n00     -  \u00ab   0\ns.l g 3\na \"Si S31\n3 \u00a9 a 2 H\nI \u00a3 w S \u00ab\n3 <m -H S ;''*\nG  ra    -\n9*e\n3 ?\nID r3\n^\u20220.\na .a m a a\nJ  i. S? rt \"M\n~-5 t= -o\n52-2\n.3 S\n13 a-.a 1 ??\u25a0!\n\u2022t=-0\n9 u\nSO\n. o -o\n' si\ng 3  H\n|<S5\n& a\n**H     \u00ab L.     .\nG    H U     H\ni 3 1 3\nc ts rt 3f\n-. a s .s\n\u00a7 8 Jg 1\nootj ra pq\n>     >\n5      rS\n1 >\u00bb\" a \u00ab\nr *c !>, a ss\nj rt \u00ab q tu\n>   cu 45   cfl >\n? b M I \"o\nH   rt   J- 2 G\na. B.rn u\nI   . .3,\n,5? \u00a3 B\ncn 00 >H\n\"H    JJ  ^  ^\no-S o o\nCD   O   tu   tu\n3^33\no P \"S ti\nra 3 ra ra\nit 'G\u00bb  Ih   h\nS   cfl-\ntu  \u00abj\n3 ^ h \" 0\n\u25a0W   M   Q  \u00ab\u00bb  C\nrt c\na g\ns u\nrt  \u201e-\nU\n\u2022ie\nrt u\na c\n>\nrt 45\nO 0   ^ d  5\n\u25a0h 01 u n \u00ab\n<u g\n\u25a0r>   S    G    ft   00\nB kS pq O u\nr- 00 <\n00 00 c\n%\n L 56\nBRITISH COLUMBIA\nTS\na\n\u2022S\ns\no\ncn\nZ\nBJ\no\n03\nUJ\nz,\no\nz\nQ\n5\nhJ\nCJ\nX\nm\n00\nSO\nOV\nCO\nw\n5\no\no\nUJ\nH\n\u2022<\nu\nu\nl-H\nH\nCO\nO\nz\no\n<\nPh\no\n1-5\n<\nZ\no\nH\n<\nN\n<\nH\nHH\nPh\nCO\nO\nX\nS\n0\nt;\n3\nto H\n(N \u00a9 \u00a9 \u00a9 CN\n\u00a9\nJ3\n>^\n\u00a9 d o' d d\n\u00a9\nrtCJ\no\n<u\n00\nra\nOD\nc\nCU\ntu\nm \u00a9 \u00a9 \u00a9 in\n\u00a9\na\n\u00a9odd\u00a9\nd\nUl\n<u\nU\n\u00a9\nPh\n-^t-H\nK.0\n00\nra45 >,\nin p \u00a9 i> m\ni\u2014\nuoo\u00a3\nTt ri ov r-^ Tt\nOv\n> cw\nCN\n\u00abl3\nl+H\nm Tt co cn o\nfN\n\u00b0 u\n13\ncn       i\u2014I co cn\nTt\nOv                  t\u00bb\nnn\nrn\"\n\u00abCJ\n00\n0\nen\nto\nCfl\nto CA CA tO SO\nVO\nU\nm                 Tt\nVO\nw\nr-^               r^\nu\nr-\nTt\ncn\nc~ ov\nCN tN\no\"\nVO CO\nT?\n\u00bb      ^^w\n<:\n^ o cn\"m\"'7\n^OCNCN H\nG\nJ\"-1       fN cn J*\nu\n\u00a9  rH\nCA CN\n0\n-C\n!H\n<u\n>\neo\nc\n\u25a03\n3\nu ^*-\nS !\u00ab\ntn   G\nG\nCfl\nG 5\no\n\"cn\n.2 \u25a0-\n43\nG\nm *j\no\nCU\n00\nra\n1 \u00a7\n\u201e\nG\n3\n\"il\nG\n0\nfill\na\n\u2022o\n\u2022a \"5\nhQ\n\u2022a\nc\nra\ns\nrt\n\"u W\ntu   cfl\nc\n\"o\ntn\nU\na c\ntfl   o\n1\nra\n(U\na\nO   rt\ntu\n_\n\u25a0*- c\nz\n11\nc\n>\n.a\n0 rt\n\"hH      X\n.2 X\nj\nra u\nCfl     o\nU     TH\njg ra\n5\n1    M\nM   tu   G\nC\n43\ni\nCJ\n12 *\nra   ca\n13 5\n&  \u00b0   E   \u00ab\nrt       c  f\ng ra <u r\n8 .2 \u00a7 \u00ab\n\u25a03 [2\nft\ntu\n45\n0\n& . . . .\n3 in so t-> oo\nCOOSOS SSOS\n\u00a35\n>\nX\n HOSPITAL INSURANCE SERVICE, 1969 L 57\nSTATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE\nFISCAL YEAR ENDED MARCH 31, 1969\nAdministration\u2014\nSalaries \t\nTemporary assistance\nOffice expense \t\nTravelling expense\t\nOffice furniture and equipment\t\nPrinting and publications \t\nTabulating and rentals \t\nMotor-vehicles and accessories\t\nIncidentals and contingencies \t\nConstruction and consultation fees\nTechnical surveys \t\nPayments to hospitals\nGrants in aid of construction\nTotal\n$769,020.00\n5,528.00\n$774,548.00\n50,081.00\n49,163.00\n6,661.00\n3,739.00\n4,034.00\n2,153.00\n1,905.00\n71.00\n38,843.00\n$931,198.00\n134,679,028.00\n3,251,920.00\n$138,862,146.00\nPrinted by A. Sutton, Printer to the Queen's Most Excellent Majesty\nin right of the Province of British Columbia.\n1970\n750-1169-9458\n ","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":"1970_V01_14_L1_L57","type":"literal","lang":"en"}],"http:\/\/www.europeana.eu\/schemas\/edm\/isShownAt":[{"value":"10.14288\/1.0373686","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":"Twenty-first Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1969","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"}]}}