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HOSPITAL INSURANCE SERVICE, 1963
Sessional Papers of the Province of British Columbia
British Columbia. Legislative Assembly
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PROVINCE OF BRITISH COLUMBIA HOSPITAL INSURANCE ACT Fifteenth Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1963 Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty in right of the Province of British Columbia. 1964 Victoria, B.C., January 23, 1964. To Major-General the Honourable George Randolph Pearkes, V.C., P.C., C.B., D.S.O., M.C., Lieutenant-Governor of the Province of British Columbia. May it please Your Honour: The undersigned has the honour to present the Fifteenth Annual Report of the British Columbia Hospital Insurance Service covering the calendar year 1963. ERIC MARTIN, Minister of Health Services and Hospital Insurance. British Columbia Hospital Insurance Service, Victoria, B.C., January 23, 1964. The Honourable E. C. Martin, Minister of Health Services and Hospital Insurance, Parliament Buildings, Victoria, B.C. Sir,—I have the honour to present herewith the Report of the British Columbia Hospital Insurance Service covering the calendar year 1963. D. M. COX, F.A.C.H.A., Deputy Minister of Hospital Insurance. DEPARTMENT OF HEALTH SERVICES AND HOSPITAL INSURANCE British Columbia Hospital Insurance Service The Honourable Eric Martin, Minister of Health Services and Hospital Insurance. Senior Administrative Staff D. M. Cox, F.A.C.H.A., F.C.I., F.C.I.S., Deputy Minister of Hospital Insurance. W. J. Lyle, F.C.I.S., Manager, Hospital Finance Division. J. W. Mainguy, M.H.A., Manager, Hospital Consultation and Inspection Division. A. W. E. Pitkethley, Esq., Manager, Hospital Construction and Planning Division. W. A. Fraser, O.B.E., E.D., M.D., CM., F.A.C.S., Medical Consultant. K. G. Wiper, Esq., Administrative Officer. W. D. Burrowes, B.A., Director, Research Division. CONTENTS 9 General Introduction British Columbia General Hospitals (Comparisons of Growth) 1 I The Hospital Insurance Act 13 The Hospital Act 13 Persons Entitled to or Excluded from the Benefits under the Hospital Insurance Act 13 Entitled to Benefits 13 Excluded from Benefits 14 Hospital Benefits Available in British Columbia 14 In-patient Benefits 14 Emergency Services and Minor Surgery 15 Application for Hospital Insurance Benefits 15 The Hospital Rate Board and Methods of Payment to Hospitals 15 Organization Chart 17 Organization and Administration 18 Hospital Finance Division 18 Hospital Accounting 1.8 Hospital Claims 20 Hospital Construction and Planning Division 21 Hospital Projects Completed during 1963 24 Hospital Projects under Construction at Year-end 25 Projects in Advanced Stages of Planning 26 Additional Projects Developed through Various Planning Stages 26 Hospital Consultation and Inspection Division 27 Medical Consultation Division 29 Administrative Officer 29 Third Party Liability Section 30 Eligibility Inspectors' Section 30 Research Division 31 Public Information 32 General Office 33 Hospitals as Defined under the Hospital Insurance Act 33 Public Hospitals 3 3 Outpost Hospitals 34 Federal Hospitals 34 Private Hospitals (Providing General Hospital Services) 35 Rehabilitation, Chronic, and Convalescent Hospitals 35 Statistical Data 35 Table I.—Patients Separated (Discharged or Died), Total Patient-days and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public Hospitals Only, 1949-63 (Excluding Federal, Private, and Out-of-Province Hospitalization) 36 Table IIa.—Patients Separated, Total Days' Stay, and Average Length of Stay According to Type and Location of Hospital for B.C.H.I.S. Patients Only, and Days of Care per Thousand of Covered Population, 1949-63 (Including Rehabilitation Hospitals) 37 H 8 BRITISH COLUMBIA Pace Statistical Data—Continued Table IIb.—Summary of the Number of B.C.H.I.S. In-patients (Including Rehabilitation Patients) and Short-stay Patients, 1949-63 38 Table III.—Patients Separated, Total Days' Stay, and Average Length of Stay in British Columbia Public Hospitals for B.C.H.I.S. Patients Only, Grouped According to Bed Capacity, Year 1963 38 Table IV.—Percentage Distribution of Patients Separated and Patient-days for B.C.H.I.S. Patients Only, in British Columbia Public Hospitals, Grouped According to Bed Capacity, Year 1963 38 Charts 39 I.—Percentage Distribution of Days of Care by Major Diagnostic Groups, 1962 40 II.—Percentage Age Distribution of Male and Female Hospital Cases and Days of Care, 1962 41 III.—Percentage Distribution of Hospital Cases by Type of Clinical Service, 1962 42 IV.—Percentage Distribution of Hospital-days by Type of Clinical Service, 1962 43 V.—Average Length of Stay of Cases in Acute-care Hospitals in British Columbia by Major Diagnostic Groups, 1962 (Excluding Newborns) 44 Hospitalization by Diagnoses According to the Canadian List of Diseases and Causes of Death, 1962 45 Statement of Receipts and Disbursements for the Fiscal Year Ended March 31, 1963 48 Fifteenth Annual Report of the British Columbia Hospital Insurance Service GENERAL INTRODUCTION Donald M. Cox, F.A.C.H.A., Deputy Minister of Hospital Insurance On December 31, 1963, the British Columbia Hospital Insurance Service completed its 15th year of service to the residents and hospitals of the Province. It continued to ensure that good and efficient standards of hospital services were maintained, and payments to hospitals were at their highest level since the start of the programme. During the current fiscal year the British Columbia Hospital Insurance Service will pay over $63,000,000 toward hospital expenses incurred by British Columbia residents, the equivalent of approximately $38 for each man, woman, and child living in the Province today. It is of interest to note that early in November the payment of a hospital account brought the amount paid in claims to the $500,- 000,000 mark since January 1, 1949. At the year-end an estimated $510,000,000 in hospital bills will have been paid by the British Columbia Hospital Insurance Service in its 15 years of operation. Daily payments to British Columbia hospitals have increased from an average of $50,000 in 1949 to approximately $170,000 in 1963. The extensive programme of hospital construction, which has been under way throughout the Province for the past decade, continued without let-up, and the number of projects still on the planning boards would indicate that numerous areas will continue to witness the start of new construction for many months to come. During the year 13 major projects were completed, involving 551 beds and gross construction costs of over $9,000,000. These included new hospitals at Nanaimo, McBride, and Grand Forks; new additions at Powell River and the Royal Jubilee at Victoria; new staff residences at Queen Charlotte City, Salmon Arm, and Terrace; and completion of a top floor at Prince George. Major hospital projects still under construction as the year drew to a close involved 600 beds and total costs of over $11,500,000. In addition to construct'on grants-in-aid, representing 50 per cent of the approved costs, the Provincial Government also pays one-third the costs of equipment and furnishings. A detailed summary of hospital construction appears elsewhere in this Report. The continued advice of the medical profession was of great assistance to the British Columbia Hospital Insurance Service during the past year. The progressive development of the rehabilitation programme was the subject of extensive medical study, and advice was given also on many other medical matters affecting the operation of the Service. By arrangement, inquiries are directed to the executive director of the Canadian Medical Association (British Columbia Division), and referred by him to the appropriate committees or sub-committees. I should like to record my appreciation of the assistance rendered by the Canadian Medical Association (British Columbia Division), the College of Physicians and Surgeons of British Columbia, and by the medical profession generally. 9 H 10 BRITISH COLUMBIA The work of the Laboratory Advisory Council and the Radiological Advisory Council continues to be a tremendous help and strength in the programme of assisting hospitals in the improvement of their laboratory and radiological services, and in advising on requests relative to grants in aid of purchases of major equipment. In October the Minister announced the Government's decision to utilize the available beds in Pearson Hospital, Vancouver, for the use of Provincial Infirmary patients. The Infirmary staff is now proceeding with a review and transfer of the patients involved. The British Columbia Hospital Insurance Service was again invited by the executive of the British Columbia Hospitals' Association to exhibit a display during the association's annual conference, held in the Hotel Vancouver in October. Some of the charts appearing in this display are reproduced on the following pages. Reports prepared by the various divisions on work undertaken during 1963 appear under " Organization and Administration." L HOSPITAL INSURANCE SERVICE, 1963 H 11 1949 B.C.H.I.S. Payments to Hospitals 60 55 50 45 o 40 S 35 .0 25 20 15 1951 1954 1957 1960 65 55 50 30 25 20 196.1 (est.) Percentage 340 320 280 260 240 220 200 180 160 140 120 100 80 60 40 20 Hospitals' Growth Rate .0* 6* ^ >05» r^ 7 0T*L 5TAP F PA Tr£NT PAYi ^-_-x" .l.fiiTtON^ 1948 1951 1954 1957 1960 1963 (est.) Percentage Increase over 1948 Per Cent Total gross expenditure (excluding depreciation) 328 Staff (full-time equivalent) 129 Patient-days (adults and children) 86 Population 57 H 12 BRITISH COLUMBIA Total Full-time Staff and Average Number of Patients (Adults and Children) per Day 15 14 13 12 11 ■o 10 c n 3 9 9 H 8 7 6 5 4 ..Cf ^ ill-- TOT^ rf * C^^Jii ., pATtertT-i 15 14 13 12 11 M 10 _r c p 9 5 8 7 6 5 1948 1954 1960 1963 (est.) Gross Salaries and Wages and Other Operating Expenses* 55 50 45 40 m 35 Q O 1 30 25 10 1948 1951 ^s W^ ?*>/ , 5 G*05 .^ ,; fxff^ yS^ 1954 1957 1960 55 40 35 25 20 15 1963 (est.) * Including approximately $2,000,000 in staff fringe benefits. HOSPITAL INSURANCE SERVICE, 1963 H 13 THE HOSPITAL INSURANCE ACT This is the Statute which authorizes British Columbia's hospital insurance plan, and under which the British Columbia Hospital Insurance Service is established. Its main provisions may be summarized as follows:— (1) Generally speaking, every permanent resident who has made his home in British Columbia for at least three consecutive months is entitled to benefits under the Act. (2) Approved hospitals are paid an all-inclusive per diem rate for medically necessary in-patient care rendered to qualified British Columbia residents who are suffering from an acute illness or injury, and those who require active convalescent and rehabilitative care. The payment made to a hospital by the British Columbia Hospital Insurance Service amounts to $1 less than the per diem rate approved for the particular hospital, and the patient is responsible for paying the remaining dollar. The Provincial Government pays the dollar-a-day charge on behalf of Provincial social welfare recipients. (3) The wide range of in-patient benefits and the emergency out-patient and minor surgery services, provided under the Act, are described on the following pages. (4) Qualified persons who are temporarily absent from British Columbia are entided to certain benefits for a maximum period of three months, if they are admitted to an approved hospital within the first three months following their departure from the Province. THE HOSPITAL ACT One of the important functions of the British Columbia Hospital Insurance Service is the administration of the Hospital Act. The Deputy Minister of Hospital Insurance is also the Chief Inspector of Hospitals for British Columbia under this Statute. The Hospital Act controls the organization and operation of hospitals, which are classified as follows:— (1) Public hospitals—non-profit hospitals caring primarily for acutely ill persons. (2) Private hospitals — generally privately owned and profit-making units. This category includes:— (a) Small general hospitals, most of which are operated in remote areas by industrial concerns primarily for their employees. (b) Nursing homes, most of which are operated for profit by private operators or companies. Several are operated as non-profit organizations by religious and other groups. (3) Rehabilitation, chronic, and convalescent hospitals—these are non-profit hospitals approved under Part III of the Hospital Act, primarly for the treatment of persons who will benefit from intensive rehabilitative care. PERSONS ENTITLED TO OR EXCLUDED FROM THE BENEFITS UNDER THE HOSPITAL INSURANCE ACT Entitled to Benefits A person is entitled to benefits if he qualifies as a beneficiary under the Hospital Insurance Act. Generally speaking, a person is a beneficiary if the provision of H 14 BRITISH COLUMBIA hospital care is a medical necessity, and if he proves to the satisfaction of the Deputy Minister of Hospital Insurance that he qualifies under one of the following categories:— (a) He is the head of a family, or a single person, who has made his home in the Province and has lived continuously therein during the preceding three consecutive months; or (b) Having qualified under item (a), he leaves the Province temporarily and returns after an absence of less than 12 months and resumes residence within the Province; or (c) He is living within the Province and is a dependent of a resident of the Province. During the three-month residence qualification period, a person is permitted to be temporarily absent from British Columbia for a total of one month without incurring any postponement of the date on which he becomes a beneficiary. With regard to item (c) above, a dependent is either the spouse of the head of a family or a child under 21 years of age who is mainly supported by the head of a family. Generally speaking, if a man's wife and dependent children arrive in British Columbia after he does, they are entitled to assume his residential status as of the date of their arrival. The foregoing general description may be varied somewhat by the special arrangements that are in effect regarding persons who move to British Columbia from other Provinces. Excluded from Benefits Some of the main classes of persons either permanently or temporarily excluded from benefits are as follows: — (a) A person who works full or part time in British Columbia but who resides outside the Province; or (b) A resident who leaves British Columbia temporarily and fails to return and re-establish residence within 12 months, or who establishes his home elsewhere; or (c) An inmate of a Federal penitentiary; or (d) A resident who receives hospital treatment provided under the Workmen's Compensation Act, or a war veteran who receives treatment for a pensionable disability; or (e) Persons entitled to receive hospital treatment under the Statutes of Canada or any other government; for example, members of the armed forces or Royal Canadian Mounted Police. HOSPITAL BENEFITS AVAILABLE IN BRITISH COLUMBIA In-patient Benefits In addition to standard-ward accommodation with meals and necessary nursing services, a beneficiary may receive any of the other services available in the hospital, which may include:— Laboratory and X-ray services. Drugs, biologicals, and related preparations (with a few exceptions). Use of operating-room and caseroom facilities. Use of anaesthetic equipment, supplies, and routine surgical supplies. Use of radiotherapy and physiotherapy facilities where available. Other approved services rendered by employees of the hospital. HOSPITAL INSURANCE SERVICE, 1963 H 15 (Note.—Private or semi-private rooms cost more to maintain than standard wards, and a patient is required to pay extra for such accommodation, except under special circumstances.) Emergency Services and Minor Surgery The following benefits are also provided in British Columbia public hospitals to beneficiaries who do not require in-patient care:— Emergency treatment within 24 hours of being accidentally injured. Operating-room or emergency-room services for minor surgery, including application and removal of casts. The hospital charges beneficiaries $2 for each visit, and the remainder of the cost is paid by the British Columbia Hospital Insurance Service. However, if the patient received treatment from a private physician, he is responsible for paying the doctor's services, as such charges are not payable by the British Columbia Hospital Insurance Service. Non-beneficiaries are required to pay the full hospital charge for such services. APPLICATION FOR HOSPITAL INSURANCE BENEFITS At the time of admission to hospital, a patient wishing to apply for coverage under the hospital insurance programme is required to make an application for benefits. The hospital is responsible for verifying the patient's statements regarding length of residence, etc., to determine if the patient is a qualified resident as defined in the Hospital Insurance Act and regulations. Payment of the account is then requested by the hospital from the British Columbia Hospital Insurance Service, which may reject any account where either the patient's status as a qualified resident or the medical necessity for his receiving hospital care benefits has not been satisfactorily established. (See Eligibility Section.) THE HOSPITAL RATE BOARD AND METHODS OF PAYMENT TO HOSPITALS The Hospital Rate Board, appointed by Order in Council in January, 1951, is composed of the Deputy Minister of Hospital Insurance, the Hospital Finance Manager, and the Hospital Consultation and Inspection Manager. The purpose of the Board is to advise the Deputy Minister in regard to the rates of payments to hospitals. A system of firm budgets for hospitals, which has been in use since January 1, 1951, provides for a review of hospitals' estimates by the Rate Board. Under the firm-budget procedure, hospitals are required to operate within their approved budgets, with the exception of fluctuation in days' treatment and other similar items. They are further advised that deficits incurred through expenditures in excess of the approved budget will not be met by the Provincial Government. The value of variable supplies used in patient-care has been established. It is generally recognized that the addition of a few more patient-days does not add proportionately to patient- day costs, because certain overhead expenses (such as heating, etc.) are not affected. However, some additional supplies will be consumed, and it is the cost of these variable supplies which has been determined. When the number of days' treatment provided by the hospital differs from the estimated occupancy, the budgets are increased, or decreased, by the number of days' difference multiplied by the patient- day value of the variable supplies. Individual studies and additional budget adjustments are made in those instances where large fluctuations in occupancy involve additions or reductions in stand-by costs. H 16 BRITISH COLUMBIA Over 95 per cent of all hospital accounts incurred in British Columbia are the responsibility of the British Columbia Hospital Insurance Service. Cash advances to hospitals are made on a semi-monthly basis, so that hospitals are not required to wait for payment until patients' accounts are submitted and processed by the British Columbia Hospital Insurance Service. Qualified patients are charged $1 per day, which is deductible when calculating payments to hospitals from the Service. Non-qualifying residents are charged the hospitals' established per diem rates, which are all-inclusive; that is, the daily rate covers the cost of all the regular hospital services, such as X-ray, laboratory, operating-room, etc., provided to patients, in addition to bed, board, and nursing care. HOSPITAL INSURANCE SERVICE, 1963 H 17 H tat. < U rZ o I—t H < N HH z < o o minister of health services and hospital insurance Deputy Minister of Hospital Insurance a o O'r-! •- C. 3 E 3 C o-S C || 5° a on « e O 3 a '-•: o "7. 1 > K T 0 u « H 18 BRITISH COLUMBIA ORGANIZATION AND ADMINISTRATION The British Columbia Hospital Insurance Service is a branch of the Department of Health Services and Hospital Insurance. The administrative head is the Deputy Minister of Hospital Insurance. The following reports give a brief outline of the work carried out during 1963 by the various divisions and offices which comprise the administrative structure of the Branch. Hospital Finance Division W. J. Lyle, F.C.I.S., Manager Hospital accounting and payment of hospital claims are the two main functions of the Hospital Finance Division. The Division is also responsible for the approval of equipment grants, and in 1963, after a review of 3,500 applications received from hospitals, it paid grants of $550,000 on equipment costing approximately $1,700,- 000. During 1963 the Division Manager attended three meetings in Ottawa of the Advisory Council on Hospital Insurance and Diagnostic Services, which is the advisory body to the Minister of National Health and Welfare. The Manager also acted on a sub-committee on finance and accounting which was given the task of studying and making recommendations relative to the sharing of certain costs under the Federal-Provincial Agreement. At the end of 1963 the employees of all public hospitals in British Columbia, except one, were covered under the Municipal Superannuation Act. Additional employees became eligible from April 1, 1963, as a result of an amendment to the Municipal Superannuation Act, which changed the maximum retirement age for females from 60 to 65 years. Close liaison was continued between the Division Manager and the Commissioner of Municipal Superannuation in respect to the application of the Act to hospital personnel, and the postponement of retirement for certain employees who reach maximum retirement age. The Division Manager continued to perform duties as a member and secretary of the Hospital Rate Board, and to represent the British Columbia Hospital Insurance Service on the Radiological Advisory Council, which acts in an advisory capacity on the development of radiology services and the purchase of equipment by public hospitals. He also participated in meetings of the Advisory Committee on Medical Radiography, which was appointed to assist in the development plans for the new Institute of Technology being constructed in Burnaby. The following is an outline of the duties, activities, and responsibilities of the two sections of the Finance Division. Hospital Accounting G. L. Morris, C.A., Supervisor The work of the Hospital Accounting Section falls into two main categories: (a) the detailed inspection, in the field, of the financial records of the hospitals for purposes of verification of annual and other financial statements, and (b) the assembly of relevant information and preparation of tabulations and other data for use by the Hospital Rate Board in its reviews of hospitals' estimates. In carrying out the inspection duties, visits were made at least once during 1963 to 87 public general hospitals and four public rehabilitation hospitals, the individual visits extending from three days to four weeks. The gross expenditures of these public general and rehabilitation hospitals, as approved by the Hospital Rate Board, for the year 1963, amounted to $68,000,000. HOSPITAL INSURANCE SERVICE, 1963 H 19 Other functions performed by the Hospital Accounting staff include:— (a) The tabulation of monthly statistical and financial reports from hospitals, and the correlating of these with the approved budgets. (b) The calculation of the semi-monthly cash advances to be made to hospitals. (c) Checking and amending annual financial and statistical reports prepared by hospitals for the Dominion Bureau of Statistics and the Department of National Health and Welfare. (d) The provision, on request, of accounting assistance and instruction to smaller public hospitals in the Province. (e) The carrying-out of accounting reviews and cost studies of nursing homes, upon the request of the Social Welfare Department, for welfare payment purposes. (/) The auditing of accounts of hospital-construction projects, to determine the amount of construction grants payable by the Province. During 1963, construction projects, involving expenditures of $6,400,000, were audited and the required statements prepared for the Federal Government, in order that Federal construction grants could be claimed on behalf of the hospitals. Experience during the first few years' operation of the British Columbia Hospital Insurance Service indicated that operating costs required serious consideration when planning new hospitals and additions to existing hospitals. In order to ensure that plans for new hospitals or hospital additions are prepared with economical and efficient operation in mind, a system of pre-construction operating budgets is used. The procedure requires a hospital to prepare an estimate of staff and other costs, based upon a reasonable occupancy for the new area. These estimates are submitted to the British Columbia Hospital Insurance Service and are reviewed by the Hospital Rate Board in the same manner as normal operating estimates. It is essential that the estimated operating costs of the new hospital, or new addition, compare favourably with other hospitals actually in operation. Where the hospital's pre-construction operating estimates do not indicate a reasonable operating cost, it is necessary for the hospital board to revise its construction plans to ensure efficient and economical operation. Once a satisfactory pre-construction operating estimate has been agreed upon by the hospital officials and the British Columbia Hospital Insurance Service, the hospital board is required to provide written guarantees relative to the projected operating cost. It is considered that this method of approaching the operating picture for proposed hospital facilities ensures more satisfactory planning, efficient use of hospital personnel, and an economical operation. Under the terms of the Federal Hospital Insurance and Diagnostic Services Act, whereby the Federal Government shares in the costs of in-patient care in this Province, monthly payments are made to the Province by Ottawa, based on advances to hospitals made by the Province during the previous month. These payments are later taken into account when the total amount payable by the Federal Government is determined for the calendar year. The final calculation for the year is based on the annual audited financial reports of each public hospital, after the hospital's records have been inspected by accountants from this Section and approved by Federal Treasury auditors. Compilation of the necesary data required by the Federal authorities for purposes of the final settlement is highly complex, and involves a considerable amount of detailed work before agreement on the amount shareable in respect of each financial year is reached. H 20 BRITISH COLUMBIA The Annual Report on Hospital Statistics, issued by the Department of Health Services and Hospital Insurance and covering the administration of the Hospital Act for the preceding year, is prepared by this office. Hospital Claims W. J. Wade, Supervisor The Hospital Claims Section is responsible for processing Admission/Separation Records (accounts), which hospitals submit for each patient, and approving for payment all acceptable claims. Every claim is checked by this office, whether it is payable by the British Columbia Hospital Insurance Service, by the patient, or other agency. 1963 was another year of active production; approximately 1,350 claims and an average of over 460 emergency-service or minor-surgery account forms were processed during each working-day. In addition to the normal processing of hospital claims, the planning and reviewing of procedures was continued during the year. This was necessary in order to devise methods of meeting the increasing volume and complexity of handling claims. Several pages of the B.C.H.I.S. manual were revised, and some forms were modified to bring them up to date. Discussions with the Bureau of Statistics, when planning the use of the new I.B.M. electronic data-processing machine, resulted in an improvement in the listing of the account cards. A brief outline of the work and duties performed by the various sections of Hospital Claims follows. The Admission Control Section reviews each Application for Benefits made by patients who claim to be qualified for benefits under the Hospital Insurance Act. Details of residence are checked with the verifying documents, and discrepancies referred back to the hospital or the Eligibility Inspectors. Over 5,000 hospital claims, or some 1.4 per cent of the total received from hospitals, were returned for further information. Advice and assistance were given to hospital admitting staffs on the proper methods of obtaining and recording the patient's residence information and employment history. This was carried out by correspondence, by actual visit to the hospital, or by attendance at hospital regional meetings. The Accounts Payment Section verifies the charges made to the British Columbia Hospital Insurance Service, and ensures that all information shown on each claim is completed for statistical purposes, and that it is charged to the correct agency, such as the British Columbia Hospital Insurance Service, Workmen's Compensation Board, Department of Veterans' Affairs, or other Provinces and Territories. During the year an average of 500 queries per month on accounting matters were addressed to British Columbia hospitals. In 1963 a total of 318,804 accounts was paid, compared to 311,543 in 1962 and 308,023 in 1961. The Social Welfare Records Section continues to maintain the alphabetical file of all Health Services Identification Cards issued to welfare recipients in this Province. Over 27,600 hospital accounts incurred by welfare recipients were checked to this file to determine eligibility for hospital benefits. This file is also used by the Department of Social Welfare as a source of information. During the year, Health Services Identification Card duplicates were received for new recipients of social welfare in British Columbia, which increased the number of cards filed to over 85,000. The Voucher and Key-punch Sections are responsible for batching and voucher- ing 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 punched daily to record statistical, financial, and medical data, and are also used to tabulate remittance listings of payments due to hospitals. HOSPITAL INSURANCE SERVICE, 1963 H 21 The Out-of-Province Section handles all claims for hospital accounts incurred by British Columbia residents in hospitals outside the Province. This includes establishing eligibility and the payment of claims. During 1963 a total of 3,364 accounts, amounting to $538,275, was paid on behalf of qualified residents who were hospitalized in the other Provinces and Territories of Canada and the continental United States, including Alaska and Hawaii; Australia; Austria; Bermuda; China; Denmark; England; Finland; France; Holland; Italy; Ireland; Jamaica; Korea; Mexico; New Caledonia Island; New Zealand; Portugal; Scotland; Spain; Sweden; and West Germany. Correspondence arising from all out-of-Province accounts totalled 14,800 letters and forms. This Section also compiles up-to-date hospital rate schedules for every approved hospital in Canada. The Filing Section sorted and filed an average of 3,950 documents and letters daily, an increase of 50 daily over last year. During the year all 1962 hospital accounts were microfilmed by the Central Microfilm Bureau; 597,292 documents were photographed on 19,900 feet of film. In addition, the out-of-province " paid " and " rejected " accounts and general correspondence were microfilmed, totalling 31,378 documents on 1,100 feet of film. This annual microfilming effects a con- s'derable saving in office space, which would normally be taken up with 70 filing- cabinets for documents. Hospital Construction and Planning Division A. W. E. Pitkethley, Manager The main functions of this Division can be briefly described as follows: — (1) Providing hospital boards of management, their architects and planning committees, with a full consultative service on planning hospital- construction projects, which include new hospital facilities, additions to and renovations of existing hospitals, as well as residence accommodation for hospital personnel. Special 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 engineering consultants with basic planning criteria for the logical development of plans. (2) Provincial grants-in-aid toward construction, renovations, and building improvements are processed and recommended for payment by this Division. The Division also initiates applications for Federal construction grants, and processes and submits claims for payment. The Manager of the Hospital Construction and Planning Division serves as secretary of the Advisory Board of Management of the Provincial Infirmaries, and is responsible for general administrative supervision. A great deal of time is spent in reviewing plans of proposed building projects. Special attention is given to the interrelationship of the various departments of the hospital building, to ensure a layout arrangement that can provide a high standard of patient-care, efficient and economical operation, and adequate service and clinical facilities. In planning hospital facilities, attention is also given to the need and method for future expansion. Liaison was maintained with the mechanical engineering profession, and meetings were held with representatives, in recognition of the need to design high-quality mechanical systems that would make a maximum contribution toward an efficient and economical hospital operation. Some of the elements included in designs for mechanical systems for new hospital buildings that H 22 BRITISH COLUMBIA reflect this approach include heat recovery systems, air recirculation, variable-speed motors for air-systems fans, and zoned heating and ventilating controls, including automatic clock control systems. Hospital boards are provided with a complete consultative planning service through this Division and through the co-operation of Health Branch personnel, members of the medical and nursing profession, and other divisions of the British Columbia Hospital Insurance Service. The Provincial Health Branch renders assistance through the Division of Public Health Engineering, the Nutrition Consultant, the Technical Supervisor of Clinical Laboratory Services, and Technical Supervisor of Radiology, and the Provincial Public Health Officers. Hospital plans are also referred for review and comment by the Chief of the Hospital Design Division, Department of National Health and Welfare, Ottawa. The Construction and Planning Division maintained liaison with the Canadian Medical Association (British Columbia Division) and the Faculty of Medicine of the University of British Columbia. During the year the Division continued to benefit through the co-operation of the Public Works Department, which assigned an architect on a full-time basis. The Manager of this Division continued to serve on two working parties established under the chairmanship of the Chief of the Hospital Design Division, Ottawa. One working party studied accommodation problems of hospitals for the chronically ill, with a view to the development of construction standards for this type of hospital, and the other studied the revision and expansion of the general hospital construction standards, originally published in 1948. During the year, liaison was also maintained with the Hospital Committee of the Architectural Institute of British Columbia. The function of this Committee is to review and endeavour to resolve problems arising out of hospital-construction projects which affect members of the Architectural Institute. The Manager of the Hospital Construction and Planning Division was a member of a panel at the British Columbia Hospitals' Association conference at Vancouver on October 24, 1963. The topic under discussion was "A Specific Approach for Regional Planning." HOSPITAL INSURANCE SERVICE, 1963 MAJOR HOSPITAL PROJECTS, 1963 H 23 Boundary Hospital, Grand Forks This new 30-bed hospital was opened by the Minister of Health Services and Hospital Insurance on August 26, 1963. (For details on the hospital-construction programme, please refer to pages 21 to 27.) PROJECTS COMPLETED Nanaimo: New 160-bed hospital. McBride: New 21-bed hospital. Powell River: New additions. Grand Forks: New 30-bed hospital. Victoria (Royal Jubilee): New 195-bed addition plus 20-bed addition to psychiatric unit. Prince George: Completion of 28 beds. Terrace: Completion of 10 beds plus 7-bed addition to staff residence. New Westminster (Royal Columbian): New two-story laundry and maintenance building. Vancouver (St. Paul's): New emergency department facilities. Also new staff residences at Salmon Arm, Queen Charlotte City, and Burns Lake. PROJECTS UNDER CONSTRUCTION AT YEAR-END Mission: New 54-bed hospital. Murrayville: New 81-bed hospital. Kamloops: New 152-bed addition and 107- bed nurses' residence and training-school. Merritt: New 37-bed hospital. Fort Nelson: New 33-bed hospital. Vernon: New laundry and boiler plant. Quesnel: New addition. Sechelt: New 35-bed hospital. Dawson Creek: Completion of unfinished areas. PROJECTS IN ADVANCED STAGES OF PLANNING Duncan: New 125-bed hospital. North Vancouver: Renovation of old hospital building. Tofino: New addition. New Westminster (Royal Columbian): New emergency department. ■J?* (Architects: Gardiner, Thornton, Gathe & Associates, Vancouver.) Holy Family Hospital, Vancouver This proposed addition to the Holy Family Hospital is one of 30 projects at various stages of planning, other than advanced. H 24 BRITISH COLUMBIA (a) Hospital Projects Completed during 1963 Nanaimo Regional General Hospital.—The new 160-bed hospital at Nanaimo was officially opened by the Minister on January 6, 1963. The new building, which has provision for easy expansion in the form of unfinished areas, replaces the old 110-bed hospital building which was constructed in 1929 and added to in 1942. The new building, which is of reinforced-concrete construction, is designed in the form of a " T." The top of the " T " provides five floors of nursing units, which have been structurally designed to take additional floors in future. Royal Jubilee Hospital, Victoria.—The Minister of Health Services and Hospital Insurance officially opened the 20-bed addition to the psychiatric unit on January 18, 1963. The net gain in beds amounted to 18, which brought the total psychiatric beds at the hospital to 42 beds. The addition features a central courtyard and has adequate provision for ambulatory patients. McBride and District Hospital.—An official opening ceremony was performed by the Minister for the new 21-bed hospital at McBride on April 21, 1963. The project also included a residence to accommodate 10 hospital personnel. Due to peculiar subsoil conditions in the McBride district, it was essential to engineer the hospital on a " floating " concrete foundation. The building is constructed as a single story. The new hospital replaces the old hospital building, which was originally a dwelling, taken over for a hospital by the Village of McBride in 1932. Royal Jubilee Hospital, Victoria.—Construction of the new south and west wings. His Honour the Lieutenant-Governor George R. Pearkes officiated at the opening ceremonies on June 22, 1963. The new wings provide a total of 195 beds, 31 of which remain unfinished and can be readily brought into service when required in the future. The radiotherapy and rad'Ography departments are located on the main floor of the new wings. The top floor is devoted to new surgeries. Powell River General Hospital.—The Minister officially opened the additions to the Powell River General Hospital on Friday, July 5, 1963. The new additions include nursing units, an extended administration department, a new laundry, new physiotherapy department, laboratory, and morgue, as well as centralized locker facilities. Thirty-eight new beds are included in the project, and are located in a four-story addition constructed at the front of the existing building. The new accommodation replaces beds that were formerly in overcrowded areas throughout the existing building. In conjunction with the additions, extensive renovations have also been completed in the existing buildings. Boundary Hospital, Grand Forks.—On August 26, 1963, the Minister officially opened the new hospital at Grand Forks, which provides 30 active-treatment beds and 6 bassinets. The buildings is a single-story reinforced-concrete structure with partial basement. It replaces the old hospital which was built in 1914. Prince George Regional Hospital.—Early in 1963, 28 additional beds were brought into service. These beds are located in areas in the existing building which were originally left in a semi-finished state when the hospital build:ng was constructed. Space for a further 12 beds was later fin"shed and brought into service late in the year. Mills Memorial Hospital, Terrace.—Ten additional beds were brought into operation at Terrace. These beds are located in areas which were originally left in a semi-finished state when the new hospital building was constructed in 1961. Addition to Staff Residence: A 7-bed addition to the staff residence at Terrace was completed this year; this addition brings the capacity of the residence at Terrace to a total of 17 beds for hospital personnel. HOSPITAL INSURANCE SERVICE, 1963 H 25 Shuswap Lake General Hospital, Salmon Arm—Nurses' Residence.—A new 7-bed residence at Salmon Arm was completed this year. Accommodation is self- contained in single and double suites. Queen Charlotte Islands General Hospital—Staff Residence.—A new 15-bed residence at Queen Charlotte City was opened in May, 1963. This is a two-story frame building which replaces the inadequate accommodation located in the basement of the hospital. ■ Royal Columbian Hospital, New Westminster—Laundry and Maintenance Building.—In December, 1963, the new laundry and maintenance building came into operation. The building is two stories of reinforced-concrete construction, and is connected to the main building by a tunnel. Burns Lake and District Hospital—Nurses' Residence.—On June 5, 1963, the new 15-bed residence at Burns Lake was completed. The building is of frame construction and has accommodation for 15 nurses in single rooms, including a suite for the matron. The building has a combined lounge and recreation room. St. Paul's Hospital, Vancouver—New Emergency Department Facilities were completed early in 1963. The project involves an area of approximately 6,500 square feet, which was renovated to be used effectively and economically as an emergency department. (b) Hospital Projects under Construction at Year-end Mission Memorial Hospital.—New hospital of 54 beds, with an unfinished area which w'll provide an additional 24 beds when required at a future date. Lan°ley Memorial Hospital, Murravville—New 81-bed Hospital.—The four- story building of reinforced concrete with initial accommodation for 81 beds will have unfinished areas for 24 additional beds, and the fourth floor will be partially completed to provide for 37 beds at a future date, for a total of 61 beds to be left unfinished. Royal Inland Hospital, Kamloops — Addition and Nurses' Residence and Training-school.—The new hospital addition will have 152 beds and will contain a new laundry, kitchen, X-ray department, laboratory, and emergency department, as well as operating theatres. The eighth floor of the new win*, will be initially left in an unfinished state. This floor will provide approximately 34 beds when required in the future. The residence and training-school will have 107 student-nurses' beds and a suite for the resident supervisor. When the new addition is complete, the 1911 wing of 43 beds will be demolished. N'cola Valley General Hospital, Merritt.—The new 3 7-bed reinforced-concrete two-story hospital will replace the existing hospital, which was constructed in 1911. Space for 8 unfinished beds will be left in the building for use when required in the future. A separate frame nurses' residence is being constructed, wh;ch will accommodate 7 hospital staff. Fort Nelson General Hospital.—New 3 3-bed hospital capable of expansion to 60 beds. There is residence accommodation included in the hospital building for 8 nurses. This new building will replace the existing hospital, which was formerly a first-a:d station leased from the Department of Transport. Vernon Jubilee Hospital.—Construction of an addition to provide a new laundry and boiler plant. This is the first phase in an expansion programme planned for the hospital. H 26 BRITISH COLUMBIA G. R. Baker Memorial Hospital, Quesnel.—Additions to the existing building to provide 36 beds plus unfinished space for 22 future beds. The additions also include space for 3 labour beds, an enlarged emergency department, an enlarged laboratory, plus physiotherapy department, pharmacy stores, general storage, etc. The construction is of reinforced concrete steel stud and plaster walls and terrazzo floors. Sunshine Coast Hospital, Sechelt.—The construction of a new 35-bed hospital. The building will be of reinforced-concrete construction, single story with partial basement, structurally designed to take an additional story at a future date. The new hospital at Sechelt will replace the existing St. Mary's Hospital at Garden Bay. St. Joseph General Hospital, Dawson Creek.—Completion of areas on the top floor of the hospital which will provide accommodation to bring the capacity of the hospital up to a total of 100 beds. The hospital presently is listed for a capacity of 71 beds. (c) Projects in Advanced Stages of Planning and for Which Working Drawings and Specifications Are Completed or Are in Process of Preparation Cowichan District Hospital, Duncan.—Construction of a new 125-bed hospital. Royal Columbian Hospital, New Westminster.—Working drawings are under way for the new emergency department addition. Lions Gate Hospital, North Vancouver.—Renovation of old hospital building to provide accommodation for " activation " and psychiatric beds. Tofino General Hospital.—Construction of an addition to contain 6 additional beds, 2 of which will be left unfinished. (d) Additional Projects Developed through Various Planning Stages in 1963 Ladysmith and District General Hospital: Addition and renovations. Vernon Jubilee Hospital: Additions and renovations. St. Joseph's Hospital, Comox: Replacement. 100 Mile House: New facility. Prince Rupert General Hospital: Addition and alterations. Richmond General Hospital: New facility. Gorge Road Hospital, Victoria: Addition. Kelowna General Hospital: Additions and renovations. Creston Valley Hospital: Addition and improvements. Medical Sciences Centre, University of British Columbia: New hospital. St. Vincent's Hospital, Vancouver: Additions and renovations. Vancouver General Hospital: Replacement or renovation of Willow Pavilion and replacement of Laurel Pavilion. White Rock District Hospital: Addition. Cariboo Memorial Hospital, Williams Lake: Nurses' residence. Boundary Hospital, Grand Forks: Nurses' residence. Bulkley Valley District Hospital, Smithers: Addition. Trail-Tadanac Hospital: Laboratory addition and renovations. Summerland General Hospital: New hospital. Holy Family Hospital, Vancouver: Addition. Cranbrook: New hospital. Maple Ridge Hospital, Haney: Expansion programme. Nanaimo Regional General Hospital: Long-term care programme under consideration. Ocean Falls General Hospital: Replacement. Pouce Coupe Community Hospital: Addition for nursing home. HOSPITAL INSURANCE SERVICE, 1963 H 27 Queen Victoria Hospital, Revelstoke: Replacement. Mater Misericordiae, Rossland: Addition. G. F. Strong Rehabilitation Centre, Vancouver: Addition and renovations. Children's Hospital, Vancouver: Planning only. St. John Hospital, Vanderhoof: Addition. Surrey Memorial Hospital, North Surrey: Expansion programme. Hospital Consultation and Inspection Division J. W. Mainguy, M.H.A., Manager The work of this Division is concerned with both public and private hospitals. A consultative service is provided to all hospitals on problems of administration and operation in all aspects of management. The Division is also responsible for the licensing and inspection of private hospitals, includ:ng both private acute hospitals (all but one of which are operated in remote areas of the Province by industrial companies) and private hospitals giving nursing-home care to the aged sick. Most of the latter kind are privately owned and operated for profit. The Division works with the Finance Division in analysing and reviewing hospital estimates, including pre-construction estimates for projects being planned, and the manager is a member of the Hospital Rate Board. Hospital society by-laws are reviewed with the Administrative Officer and advice is given to hospitals on setting up suitable medical staff by-laws, rules, and regulations. Hospitals are encouraged to work toward accreditation by the Canadian Council on Hospital Accreditation, which gives recognition to those hospitals that meet prescribed standards of care and management. During 1963 the consultants in the Division made 47 visits to public hospitals, most visits requiring from one to three days or more in the hospital, and sometimes needing more than one member of the staff. Working with the Provincial Fire Marshal, the Inspector of Electrical Energy of the Department of Public Works, and the Inspector of Elevators, Department of Labour, the staff of the Division checked hospital standards of safety and fire precautions. The Division Manager continued to serve as the B.C.H.I.S. representative on the Laboratory Advisory Council, which advises the Government on the development of laboratory services in public hospitals, including the setting-up of regional pathology services, the appropriate selection of equipment, and the training of laboratory technologists. With the advice of the Council, approval in principle was given during the year to the establishment of a regional pathology service in the north-east region. Seven regional services have now been approved. As in previous years, the Division worked in conjunction with Health Branch personnel on many matters. Contact was maintained with the Medical Health Officers, and with the Technical Supervisor of Clinical Laboratory Services and the Technical Supervisor of Radiology, of the Health Branch, who also visit hospitals to provide advice and assistance in respect to the work of these two departments. The Health Branch Nutrition Consultant assisted the Division in providing advice on dietary problems in public and private hospitals. During the year this Division co-operated with the Director of Emergency Health Services and Provincial Civil Defence authorities in organizing two hospital disaster institutes—one at Kelowna for hospitals in the Okanagan District and one at Victoria for hospitals on Vancouver Island. These were two-day institutes attended by the administrator, director of nursing, and a medical staff representative from each hospital in the district. The purpose of the institutes was to encourage each hospital to prepare a written plan for dealing with an emergency where it might be faced with a large influx of casualties resulting from a local disaster. This Divi- H 28 BRITISH COLUMBIA sion was represented on the Provincial Hospital Disaster Plan Review Committee, along with members from the Health Branch and the Provincial Civil Defence. This Committee is charged with reviewing disaster plans submitted by hospitals and approving them for the issue of the Federal disaster supply kits, which are issued to all hospitals with an approved disaster plan. The Manager of the Division, in addition to being a member of the Working Party on Hospital Standards, was also appointed to the Sub-committee on Quality of Care, Research, and Statistics, both of which committees met in Ottawa during the year. The Division continues to maintain liaison with such groups as the Registered Nurses' Association and the British Columbia Hospitals' Association. During the year, 107 visits for consultation and inspection were made to private hospitals. This figure does not include visits made during the construction of new private hospitals. The following changes took place in the private hospital field:— Richmond Private Hospital, Richmond: Increased capacity from 55 to 75 beds. Royal Oak Private Hospital, Saanich: Increased capacity from 30 to 42 beds. Athlone Private Hospital, Vancouver: Hospital closed (18-bed capacity). North Shore Private Hospital, North Vancouver: Increased capacity from 26 to 57 beds. Braddan Private Hospital, Vancouver: New hospital of 44 beds (old hospital of 18 beds closed in 1962). Kensington Private Hospital, Vancouver: New hospital of 74 beds. Glengarry Private Hospital, Victoria: New hospital of 75 beds. Willowhaven Private Hospital, Nelson: Increased capacity from 27 to 52 beds. These changes brought the total number of private hospital nursing-home beds in the Province to 2,710, an increase of 263 beds over 1962. Altogether there are now 67 hospitals of this kind operating in the Province today. As mentioned in previous Annual Reports, the conversion of buildings such as dwelling-houses to private hospitals is not permitted unless they meet the construction standards for new private hospitals. At the year-end there were six hospitals under construction, involving a total of 450 beds. One hundred and forty persons or groups approached the Division with detailed inquiries into the requirements for obtaining a licence to operate a private hospital. The number of beds in private acute hospitals remained at 76 beds in five hospitals, four of which are operated by industrial concerns. Under the Hospital Act no person may act as superintendent of a private hospital without the approval of the Chief Inspector of Hospitals. In this regard the Registered Nurses' Association assisted the Division in screening the credentials of prospective private hospital superintendents. An associated responsibility of the Division is to arrange for the placement, by the Social Welfare Department, of welfare patients who no longer need to remain in acute general hospitals, but must be admitted to nursing-home facilities because their needs are beyond what can be given in their own homes. The Division is involved only when service is requested by the acute hospital. In 1963 social welfare offices placed 135 cases under this arrangement. HOSPITAL INSURANCE SERVICE, 1963 H 29 Medical Consultation Division W. A. Fraser, O.B.E., E.D., M.D., CM., F.A.C.S., Medical Consultant The processing of all Admission-Separation Records for medical eligibility, length of stay, and assuring correct discharge diagnoses for statistical purposes continued to be a steadily mounting task of this Division. It is essential to ensure the accuracy and adequacy of the separation diagnoses and operations for medical coding based on the Manual of the International Classification of Diseases, Injuries, and Causes of Death. These data are secured for medical research projects and comparative studies on hospital utilization. Considerable interest continues to be shown in studies on tonsillectomies and ade- noidectomies, dental extractions, maternal and newborn morbidity, foetal deaths, and accidents, in relation to incidence, causes, and effects, and hospital costs involved. This year a special study on perinatal mortality in part'cular reference to accredited hospitals was undertaken. To maintain the quality of these data, the outside source—that is, the hospital record department—is visited by the Supervisor and the Medical Consultant as often as possible to assist hospital personnel on mutual problems. The Chief Supervisor of this Division attended the Fourth International Congress on Medical Records at Chicago. At this meeting very informative and interesting papers by key men presented a picture of collaborative studies and medical research projects now being conducted in the United States. Stress was laid on the need for comparative hospital morbidity studies on an international basis, preferably by electronic processing and retrieval of medical data for speed and accuracy. This is in keeping with the rapid progress in the field of medical science. Trends toward out-patient care to include diagnostic follow-up, rehabilitation, and home care, in view of high costs of hospital construction and maintenance and staffing, are on the upward. This is true for the mentally ill as well as the physically incapacitated. Conferences in Regina and Vancouver for the Canadian Association of Medical Record Librarians and the British Columbia Association of Medical Record Librarians respectively were also attended. During the year Dr. Brock Fahrni, Associate Professor, Faculty of Medicine, School of Rehabilitation Medicine, University of British Columbia, and adviser to the British Columbia Hospital Insurance Service, prepared two interesting and widely studied reports titled " Some Observations on Acute' Hospitalization " and " Principles Relating to Continuing ' Chronic' Care," which were submitted to this Division for study. An estimated 92,400 patient-days were covered under the rehabilitation and activation care plan, an increase of approximately 44 per cent over 1961, the first full year of operation. Administrative Officer K. G. Wiper The office of the Administrative Officer is responsible for the drafting of legislation, regulations, and Orders in Council for the British Columbia Hospital Insurance Service. In the performance of these duties a close working relationship exists between this office and the Attorney-General's Department. Hospital societies may apply to the Administrative Officer for assistance in connection with the drafting of hospital constitutions and by-laws, and their application. This work is carried out in conjunction with the Hospital Consultation and Inspection Division. Changes in hospital by-laws are reviewed by this office prior H 30 BRITISH COLUMBIA to their submission for Government approval as required under the Hospital Act. A set of model by-laws has been developed for use by hospitals as a guide in making revisions. Collaborating with the Water Rights Service of the Department of Lands, Forests, and Water Resources and the Chief Electoral Officer of the Provincial Secretary's Department, the Administrative Officer provides guidance to committees in unorganized territory which are establishing hospital improvement districts. Such districts are necessary for the raising of funds by money by-laws, in areas outside cities or municipalities, for the construction of new hospital facilities or the improvement of existing buildings. At the end of 1963 there were 33 hospital improvement districts in operation and a number of others in the process of formation. Material which describes the procedure required for the establishment of a hospital improvement district is available upon request. As in previous years, considerable time was spent in 1963 on matters related to the Federal-Provincial hospital insurance arrangements. Methods of streamlining administrative procedures and improving liaison were discussed with officials of the Federal Government at meetings held in Ottawa and Victoria. The Administrative Officer is also responsible for the over-all supervision of the Third Party Liability and Eligibility Sections. Third Party Liability Section J. W. Brayshaw The hospitalization reports that are completed by hospitals for every patient admitted with accidental injuries are processed by the Third Party Liability Section. This Section also handles the arrangements under which the British Columbia Hospital Insurance Service receives reimbursement from public liability insurance companies and self-insured corporations for hospital expenses paid by this Service on behalf of accident victims. The Senior Eligibility Inspector in Vancouver, Mr. H. E. Drab, is responsible for maintaining a third-party liability clearing-house for the convenience of solicitors and insurance adjusters in the Greater Vancouver area. Up-to-date information regarding the hospitalization of accident victims is available through the Vancouver office, and negotiations may be carried out in person or by telephone, thus avoiding the necessity of corresponding with the head office in Victoria. Eligibility Inspectors' Section P. A. Bacon In order to ensure that only qualified British Columbia residents receive hospital insurance benefits, the staff of the Eligibility Section reviews all applications for benefits made by, or on behalf of, persons admitted to hospital. A detailed check is made of all doubtful applications, resulting in the rejection of a considerable number of claims for hospital insurance benefits made by unqualified persons. Numerous inquiries from the general public with regard to eligibility matters were dealt with by personal interview, telephone, and correspondence. Eligibility Inspectors visit hospitals on a regular schedule to see that the B.C.H.I.S. eligibility procedures are being properly carried out. These Inspectors also assist in the training of hospital admitting staff members. In this regard, regional meetings are held in a number of centres for the purpose of holding panel discussions with hospital personnel, to deal with problems connected with the admission of patients to hospitals, and their status under the Hospital Insurance Act. HOSPITAL INSURANCE SERVICE, 1963 H 31 This Section has provided the great majority of employers in British Columbia with a supply of certificates on which an employee's length of employment can be certified. The Inspectors maintain close liaison with these firms, to ensure their continuing co-operation in providing their employees with this form of proof of residence for hospital insurance purposes. Research Division W. D. Burrowes, B.A., Director The functions of the Division are:— (1) To compile and maintain a body of statistics derived from the processing of Admission-Separation Records, and from other sources, showing the pattern of hospitalization in the individual hospitals and school districts, and to make special compilations as required by other divisions of this Service and by other agencies: (2) To maintain a continuous study of the population and economic growth of all parts of the Province so as to advise the Deputy Minister of the need for new construction of hospital beds, by type of service, in each area: (3) To analyse the patterns and trends of morbidity in the Province as a whole as revealed by statistics derived from Admission-Separation Records and other sources, and to study these data in comparison to corresponding data for other Provinces. During the year, bed-requirement studies were undertaken and reports submitted for the districts of Haney, Ucluelet-Tofino, Tahsis-Zeballos, Prince George, and Prince Rupert. Studies of other localities were in progress at the end of the year. Statistical information and forecasts of hospital bed needs were given for other areas for which full surveys were not required. Research into the methodology of estimating bed requirements in different services continued during the year. As in past years, the preparation of punch cards from Admission-Separation forms was undertaken by the Hospital Claims Section of the Hospital Finance Division of this Service, and the mechanical tabulation of data from these cards was carried out by the Mechanical Tabulation Unit of the Department of Industrial Development, Trade, and Commerce. The preparation of annual statistics of morbidity for 1962 was delayed because of the time required to install and adjust an I.B.M. 1401 electronic computer by the Mechanical Tabulation Unit. It is anticipated that improved timing and increased scope of tabulation will be possible in future from the use of the new machme. The annual bulletin entitled " Statistics of Hospital Cases Discharged in 1962 " was completed at the end of the year, and was enlarged by inclusion of tables showing the regional pattern of hospitalization. With the collaboration of the Bureau of Economics and Statistics, estimates of the 1961 population of each school district in the Province, classified by age-group, sex, and race, were prepared from the detailed census data for enumeration areas, supplied by the Dominion Bureau of Statistics. In preparing these estimates, the number and age distribution of Indians on reserves were not derived from the 1961 Census data, but were synthesized from the most reliable information available on the population of Indian reserves and bands. In this work the co-operation of the Indian Agents in this Province and the Department of Indian Affairs was invaluable. The annual bulletin "Statistics of Hospital Accidents in 1962," prepared by the Division, was issued in November. This edition was enlarged by the inclusion, for the first time, of a series of regional tables. A detailed classification of out- H 32 BRITISH COLUMBIA patient emergency accident cases treated in British Columbia hospitals in 1963 was carried out during the year, and the results will be reflected in the annual bulletin of accident statistics for that year. In order that hospitals might have the benefit of comparative statistics prepared in this office, approval was obtained to commence a series of annual circulars to hospitals giving statistics of their own operations and of comparable groups of hospitals, in terms of well-known hospital indicators. Indicators for the year 1961 were issued in June, 1963, and the corresponding statistics for 1962 were circulated in December. A bulletin of "Current Demographic Trends in British Columbia" was prepared for the benefit of persons concerned with the future demands for hospital beds in the Province as a whole and in specific areas. Miss B. Morrison, B.A., M.S., Statistics Research Officer, resigned in September, 1963, and was replaced by Mr. E. Weekley, B.Sc. Public Information R. H. Thompson The three main areas of responsibility in the continuing development of public information activities include hospitals, the general public, and in-service. The following is a summary of the work undertaken during 1963. A new " General Information " pamphlet was produced and made available to hospitals, industry, "welcome wagon" hostesses, Government Agents, and other interested organizations. The pamphlet outlines the residential requirements for hospital insurance coverage, the benefits provided, the hospital services not covered, and other items of general interest. A stencilled pamphlet entitled "A Welcome to New Employees " was also prepared, for in-service use to assist in the orientation of new staff members. During the year four new 16-mm. films were added to the film library, which is used extensively by hospitals as part of their in-service training programmes. These were " I Dress the Wound," whxh portrays proper post-operative techniques and procedures; "Position of Trust," illustrating the responsibilities of members of the boards of management; " They Called It Fireproof," dealing with fire prevention within a hospital; and " The Role of Nursing in Infection Control." With the co-operation of the offices concerned, several pages of the B.C.H.I.S. Manual of Policy, Procedures, and Organization were revised, and replacements distributed to all hospitals. In some instances entire chapters were affected, as a result of amendments introduced since the Manual was issued in October, 1959. To keep the public aware of various developments in the Provincial plan and the hospital field, numerous press releases were issued during the year. These dealt with the payment of hospital accounts, the grant-in-aid programme for hospital construction, the awarding of contracts, and the opening of new hospitals. Feature articles were written for the British Columbia Government News and national hospital magazines, and revised material on the Service was prepared for city directories, civic pamphlets, and the booklet " Invitation to Industry," which is issued by the Department of Industrial Development, Trade, and Commerce. Through the co-operation of the Photographic Branch of the Department of Recreation and Conservation, numerous photographs were taken of the new hospitals opened during the year. At the request of the executive of the British Columbia Hospitals' Association, a display was developed for use at its annual conference, held in Vancouver in October. Assistance was also given in the preparation of a Departmental display HOSPITAL INSURANCE SERVICE, 1963 H 33 appearing in the Victoria Industrial and Agricultural Exhibition in May, in the Kinsman Fall Fair held in Esquimalt in September, and in alterations made to the Departmental exhibit in the British Columbia Building on the grounds of the Pacific National Exhibition. Regular editions of the B.C.H.I.S. Bulletin were prepared and distributed to over 90 public hospitals and 60 private hospitals. The Bulletin is an administrative aid used to outline policy and procedural changes. The contents also include condensations of published articles dealing with subjects of interest to hospitals, such as safety, laundry management, and geriatric nursing. In November the Public Information Officer was asked to co-ordinate the coverage by news representatives at the Vancouver Island Hospital Disaster Institute, jointly sponsored by Provincial emergency health services and the civil defence organization, and held in Victoria. Other duties included the summarizing of reports, replying to all letters of general inquiry, maintaining the newspaper-clipping file, and editing and preparing the Fifteenth Annual Report. General Office C. R. Leighton The supervision of expenditure continues to be the main function of the General Office. Administrative accounting, personnel, payroll, supplies, infirmary accounting supervision, and assistance in the preparation of estimates are also included in General Office responsibilities. The Supervisor continued as Safety Officer, and it is gratifying to report that during the year the Branch won a Safety Council Bronze Award for nine months of accident-free operation. Due to a decreasing volume in the number of teletype messages being sent to Vancouver and the availability of direct telephone-line service, it was decided to cancel the teletype service. The saving in teletype rental charges of $212 per month was used to offset the cost of acquiring a photostat copying machine. This office continues to act as a liaison between the Mount St. Mary authorities and the Infirmary Superintendent. The change-over from monthly to bi-monthly payment of Government employees' salaries was effected in October. Stenographic assistance was given to various offices during the year, including the typing of all correspondence, stencils, pamphlet drafts, and articles prepared by the Public Information Office. HOSPITALS AS DEFINED UNDER THE HOSPITAL INSURANCE ACT Part I Hospitals defined as such under section 2 of the Hospital Act:— (a) Public Hospitals Armstrong and Spallumcheen Hospital, Armstrong. Arrow Lakes Hospital, Nakusp. Bella Coola General Hospital, Bella Coola. Boundary Hospital, Grand Forks. Bulkley Valley District Hospital, Smithers. Burnaby General Hospital, Burnaby. Burns Lake and District Hospital, Burns Lake. Campbell River and District General Hospital, Campbell River. Cariboo Memorial Hospital, Williams Lake. Castlegar and District Hospital, Castlegar. Chemainus General Hospital, Chemainus. Children's Hospital, Vancouver. Chilliwack General Hospital, Chilliwack. Creston Valley Hospital, Creston. Cumberland General Hospital, Cumberland. Enderby and District Memorial Hospital, Enderby. Esperanza General Hospital, Esperanza. Fernie Memorial Hospital, Fernie. Fort Nelson General Hospital, Fort Nelson. Fraser Canyon Hospital, Hope. H 34 BRITISH COLUMBIA G. R. Baker Memorial Hospital, Quesnel. Golden and District General Hospital. Golden. Grace Hospital, Vancouver. Kelowna General Hospital, Kelowna. Kimberley and District Hospital, Kimberley. King's Daughters' Hospital, Duncan. Kitimat General Hospital, Kitimat. Kootenay Lake General Hospital, Nelson. Lady Minto Hospital, Ashcroft. Lady Minto Gulf Islands Hospital, Ganges. Ladysmith and District General Hospital. Ladysmith. Langley Memorial Hospital, Murrayville. Lillooet District Hospital, Lillooet. Lions Gate Hospital, North Vancouver. McBride and District Hospital, McBride. Maple Ridge Hospital, Haney. Mater Misericordia; Hospital, Rossland. Matsqui, Sumas, and Abbotsford General Hospital, Abbotsford. Michel Hospital, Michel. Mills Memorial Hospital, Terrace. Mission Memorial Hospital, Mission City. Mount St. Joseph's Hospital, Vancouver. Nanaimo Regional General Hospital, Nanaimo. Nicola Valley General Hospital, Merritt. Ocean Falls General Hospital, Ocean Falls. Penticton Hospital, Penticton. Pouce Coupe Community Hospital, Pouce Coupe. Powell River General Hospital, Powell River. Prince George Regional Hospital, Prince George. Prince Rupert General Hospital, Prince Rupert. Princeton General Hospital, Princeton. Providence Hospital, Fort St. John. Queen Alexandra Solarium for Crippled Children, Victoria. Queen Charlotte Islands General Hospital. Queen Charlotte City. Queen Victoria Hospital, Revelstoke. Rest Haven Hospital and Sanitarium, Sidney. Royal Columbian Hospital, New Westminster. Royal Inland Hospital, Kamloops. Royal Jubilee Hospital, Victoria. R. W. Large Memorial Hospital, Bella Bella. St. Bartholomew's Hospital, Lytton. St. Eugene Hospital, Cranbrook. St. George's Hospital, Alert Bay. St. John Hospital, Vanderhoof. St. Joseph General Hospital, Dawson Creek. St. Joseph's General Hospital, Comox. St. Joseph's Hospital, Victoria. St. Martin's Hospital, Oliver. St. Mary's Hospital, Garden Bay P.O. St. Mary's Hospital, New Westminster. St. Paul's Hospital, Vancouver. St. Vincent's Hospital, Vancouver. Shuswap Lake General Hospital, The. Salmon Arm. Slocan Community Hospital, New Denver. Squamish General Hospital, Squamish. Summerland General Hospital, Summerland. Surrey Memorial Hospital, North Surrey. Tofino General Hospital, Tofino. Trail-Tadanac Hospital, Trail. University Health Service Hospital, University of British Columbia, Vancouver. Vancouver General Hospital, Vancouver. Vernon Jubilee Hospital, Vernon. Victorian Hospital, Kaslo. West Coast General Hospital, Port Alberni. White Rock District Hospital, White Rock. Windermere District Hospital, Invermere. Wrinch Memorial Hospital, Hazelton. (b) Outpost Hospitals Red Cross Outpost Nursing Station, Alexis Creek. Red Cross Outpost Nursing Station, Atlin. Red Cross Outpost Nursing Station, Bamfield. Red Cross Outpost Nursing Station, Blue River. Red Cross Outpost Nursing Station, Edge- wood. Red Cross Outpost Nursing Station, Hudson Hope. Red Cross Outpost Nursing Station, Kyuquot. Red Cross Outpost Nursing Station, Masset. Stewart General Hospital, Stewart. (c) Federal Hospitals Veterans' Hospital, Victoria. Shaughnessy Hospital, Vancouver. Coqualeetza Indian Hospital, Sardis. Miller Bay Indian Hospital, Prince Rupert. Nanaimo Indian Hospital, Nanaimo. R.C.A.F. Station Hospital, Holberg. Part II Private hospitals which are defined as such under section 7 of the Hospital Act, and with which the Province has entered into an agreement requiring the hospital to furnish the general hospital services provided under the Hospital Insurance Act:— Bralorne Private Hospital, Bralorne. Cassiar Asbestos Corporation Private Hospital, Cassiar. Gold Quartz Hospital, Wells. Hollywood Hospital Ltd., New Westminster. Medical-Dental Hospital Unit, Vancouver. Port Alice Private Hospital, Port Alice. r HOSPITAL INSURANCE SERVICE, 1963 Part 111 H 35 Rehabilitation, chronic, and convalescent hospitals, as defined under section 25 of the Hospital Act:— G. F. Strong Rehabilitation Centre, Vancouver. The Gorge Road Hospital, Victoria. Holy Family Hospital, Vancouver. Pearson Hospital (Poliomyelitis Pavilion), Vancouver. Queen Alexandra Solarium for Crippled Children, Victoria. Shaughnessy Hospital, Vancouver. Veterans' Hospital, Victoria. STATISTICAL DATA The tables on the following pages represent statistical data compiled by the Hospital Finance Division. The data deal with the volume of hospital insurance coverage provided to the people of British Columbia through the British Columbia Hospital Insurance Service. In 1963 there were 87 public general hospitals approved to accept B.C.H.I.S. patients, the same number as in 1962. In addition, care was provided in eight outpost hospitals, six Federal hospitals, and five private hospitals. Also approved as of September 1, 1960, were four public rehabilitation hospitals, one Provincial rehabilitation hospital, and rehabilitation-care areas in two Federal hospitals which also provide general hospital care. Data for the year 1963 have been estimated from reports submitted by hospitals to October 31st and are subject to revision when actual figures for the year are submitted. Table I shows that a total of 271,911 B.C.H.I.S. adults and children patients were separated (discharged or died) from British Columbia hospitals in 1963, an increase of 7,256 or 2.7 per cent over the previous year. This table also shows that 95.5 per cent of the total patients separated from British Columbia hospitals in 1963 were covered by hospital insurance, compared to 96 per cent in 1961 and 95.7 per cent in 1962. The second part of the table indicates in 1963 that the British Columbia Hospital Insurance Service paid public hospitals in British Columbia for 2,624,026 days of care for adults and children, an increase of 50,392 days or 2 per cent over 1962. As shown in Table IIa, the average length of stay of B.C.H.I.S. adult and children patients in British Columbia public hospitals during 1963 was 9.65 days. The days of care per thousand population decreased from 1,841 in 1962 to 1,830 in 1963, but this incidence of care is a reflection of the number of hospital beds resulting from the continued hospital-construction programme of recent years. H 36 BRITISH COLUMBIA Table I.—Patients Separated (Discharged or Died), Total Patient-days and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public Hospitals Only, 1949-63 (Excluding Federal, Private, and Out-of-Province Hospitalization) (Including Rehabilitation Hospitals). Total Hospitalized in Public Hospitals Covered by B.C.H.I.S. Adults and Children Newborn Total Adults and Children Newborn Total Patients separated— 1949 - 1950 164,964 172.645 26,272 26.205 191,236 198.850 140,168 144,959 150,116 154,336 169,167 189.713 199,774 208,293 209,485 222,046 234,783 249,654 259,953 264,655 271,911 1.430,646 1.476,615 1,467.102 1,569,974 1,712,878 1.954,823 2,005,165 2,041,854 2,076,336 2,169,897 2,275,127 2,451.839 2,546,344 2,573,634 2,624,026 84.9 84.0 82.9 81.9 84.2 91.7 92.2 91.6 91.5 93.7 95.5 95.6 95.7 95.5 95.3 85 0 83.6 81.7 81.9 83.9 90.4 91.2 91.2 91.2 93.4 94.5 95.0 95.2 95.0 94.7 24.640 23,943 24,172 25,023 27,830 29,483 31,515 33,174 34,963 37,045 38,480 38,980 37,558 36,505 36,472 200,585 193,307 187.891 184,160 197,100 213,587 212,514 217,252 223,079 232,390 239,871 241,157 231,043 263,475 258,867 93.8 91.4 89.2 87.3 90.6 92.2 95.0 94.5 93.5 96.5 98.6 98.4 98.3 96.8 96.4 93.8 90.8 87.7 85.8 89.5 94.5 93.3 93.1 92.6 95.1 96.7 96.7 96.1 96.1 95.5 164,808 168,902 174,288 179,359 196.997 219,196 231,289 241,467 244.448 259.091 273.263 288,634 297,511 301,160 308,383 1,631,231 1,669.922 1,654,993 1,754,134 1,909,978 2,168,410 2,217,679 2,259,106 2,299,415 2,402,287 2,514,998 2,692.996 2,777,387 2,837.109 2,882,893 86.2 84.9 83.7 82.6 85.1 91.7 92.5 92.0 91.8 94.1 9*\° 96.0 96.0 95.7 95.5 86.0 84.4 82.3 82.3 84.4 90.8 91.4 91.3 91.3 93.6 94.7 95.1 95.3 95.1 94.8 1951 181,160 | 27,096 | 208,256 188.355 I 28.675 I 217.030 1952 1953 _ 1954 1955 _._. 200,893 206,992 216,743 227,359 228,917 236.859 245,766 261,128 271,609 277,073 285,213 1,682,196 1,766,680 1,795,438 1,916,486 2,041,615 2,162,002 2,198,863 2.239,646 2,277,567 2,322,796 2,407,134 2,581,042 2,675,402 2,708,337 2,771,188 30,712 | 231,605 31,984 | 238,976 33,190 | 249,933 35,118 | 262,477 37,376 1 266,293 38.374 | 275,233 39,039 | 284,805 39,599 [ 300,727 38,226 j 309,835 37,697 | 314,770 37.849 1 323.062 1956 1957... 1958 1959 1960 _ 1961.... 19621 _ 19632 Patient-days— 1949 _. 213,874 212,979 214,285 214,701 220,208 226,031 227,674 233,402 240.872 1,896,070 1,979,659 2,009,723 2,131,187 2,261,823 2,388,033 2,426,537 2,473,048 2.518.439 1950 1951 ... _ ... 1952 _ 1953 1954...., _ - - 1955 __ ..... _ ... 1956 __ 1957 1958 _ 244,429 | 2,567.225 248,074 | 2,655,208 249,273 j 2,830,315 240,207 | 2,915,609 274,032 I 2,982,369 271,186 | 3.042,374 1959 _ 1960 1961 ._ .. 19621 1963 2 Percentage of total, patients separated— 1949 1950 1951 _ 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 _ 19621 _ 19632 _. ._ Percentage of total, patient-days— 1949 1950 1951 1952 1953 1954 1955 1956 1957. 1958 1959 1960 1961 19621... 19632 i Amended as per final reports received from hospitals. 2 Estimated, based on hospital reports to October 31, 1963. HOSPITAL INSURANCE SERVICE, 1963 H 37 Table IIa.—Patients Separated, Total Days' Stay, and Average Length of Stay According to Type and Location of Hospital for B.C.H.I.S. Patients Only, and Days of Care per Thousand of Covered Population, 1949-63 (Including Rehabilitation Hospitals). Total B.C. Public Hospitals Other B.C. Hospitals, Including Federal and Private Institutions Outside B.C. Adults and Children Newborn Adults and Children Newborn Adults and Children Newborn Adults and Children Newborn Patients separated— 1949.. _ _ 1950 149,280 154,643 159,739 164,379 180,149 199,974 209,999 219,218 221,585 236,770 251,393 264,120 273,293 278,021 285,366 1,498,121 1,564,222 1.551.954 1,663,149 1,814,344 2.046,087 7.100,386 2,141,445 2,188,765 2,332,502 . .4-M.974 2,650,129 2,756,665 2,789,355 2,838,881 10.03 10.11 9.71 10.12 10.07 10.23 10.00 9.77 9.88 9.85 9.85 10.03 10.09 10.03 9.95 24,989 24,336 24,587 25,492 28,381 29,761 32,035 33,783 35,813 37,924 39,257 39,488 37,968 36,942 36,913 203,197 196,333 190,948 187,923 200,738 215,507 215,980 221,022 228,875 238,112 244.615 244,480 233,794 266,351 261,727 8.13 8.07 7.76 7.37 7.07 7.24 6.74 6.54 6.39 6.28 6.23 6.19 6.16 7.21 7.09 140,168 144,959 150,116 154,336 169,167 189,713 199,774 208,293 209,485 222,046 234.783 249,654 259,953 264,655 271,911 1, 430,646 1,476,615 1,467,102 1.569,974 1,712,878 1,954,823 2,005,165 2,041,854 2,076,336 2,169,897 2,275,127 2,451,839 2,546,344 2,573,634 2,624,026 10.21 10.19 9.77 10.17 10.13 10.30 10.04 9.80 9.91 9.77 0.69 9.82 9.80 9.72 9.65 24,640 23,943 24,172 25,023 27,830 29,483 31,515 33,174 34,963 37,045 38,480 38,980 37,558 36,505 36,472 200,585 193,307 187,891 184,160 197,100 213,587 212,514 217,252 223,079 232,390 239,871 241,157 231,043 263,475 258,867 8.14 8.07 7.77 7.36 7.08 7.24 6.74 6.55 6.38 6.27 6.23 6.19 6.15 7.22 7.10 7,093 7,617 7,308 7,431 8,173 7,602 8,313 9,473 10,023 12,506 13,908 11,557 10,361 10,226 10,255 45,960 65,326 62,771 68,892 75,518 66,960 75,599 79,428 93,980 141,925 173,343 169,401 182,690 183,042 183,855 6.48 8.58 8.59 9.27 9.24 8.81 9.09 8.38 9.39 11.35 12.46 14.66 17.63 17.90 17.93 151 173 171 161 229 199 361 457 668 665 514 241 151 157 166 1,146 1,288 1,155 974 1,353 1,251 2,271 2,740 4,299 4,113 2.818 1,417 878 850 960 7.59 7.44 6.75 6.05 5.91 6.29 6.29 6.00 6.44 6.19 5.48 5.88 5.81 5.41 5.78 2,019 2,067 2,315 2,612 2,809 2,659 1,912 2,050 2,077 2,218 2,702 2,909 2,979 3,140 3,200 21,515 22,281 22,081 24,283 25,948 24,304 19,622 20,163 18,449 20,680 26,504 28,889 27,631 32,679 31,000 10.66 10.78 9.54 9.29 9.24 9.14 10.26 9.84 8.88 9.45 9.81 9.93 9.27 10.41 9.69 198 220 1951 1952 1953 . 1954. 244 308 322 79 1955 _ 1956 1957 , 159 159 182 1958 1959 .. 214 263 1960 1961.... 267 259 19621 19632. __ Patient-days— 1949 _ 1950 1951 ' 1952 280 275 1,466 1,738 1,902 2,789 1953 2,285 1954 1955 1956.. 669 1,195 1,030 1957 1,497 1958 - 1,609 1959 1,926 1960 1961... 1,906 1,873 19621... 19632...... Average days of stay— 1949 2,026 1,900 7.40 1950 7.90 1951 . 7.79 1952- 9.06 1953 7.10 1954. 8.47 1955. 1956 1957- 1958 1959 7.52 6.48 8.23 7.51 7.32 1960 _ - - 1961 19621 19632 _ 7.14 7.23 7.24 6.91 1 Amended as per final reports received from hospitals. 2 Estimated, based on hospital reports to October 31, 1963. Estimated patient-days (including newborn days) per thousand of population covered by British Columbia Hospital Insurance Service: 1949, 1,528; 1950, 1,548; 1951, 1,496; 1952, 1,527; 1953, 1,600; 1954, 1,733; 1955, 1,720; 1956, 1,688; 1957, 1,626; 1958, 1,665; 1959, 1,724; 1960, 1,804; 1961, 1,806; 1962, 1,841; 1963, 1,830. (1954 and subsequent years based on assumption that total population is covered by British Columbia Hospital Insurance Service. Patient-days include rehabilitation patient-days from September 1, 1960.) Population figures revised according to latest census figures. H 38 BRITISH COLUMBIA Table IIb.—Summary of the Number of B.C.H.I.S. In-patients (Including Rehabilitation Patients) and Short-stay Patients, 1949-63 Total Adults, Children, and Newborn In-patients Estimated Number of Emergency and Minor-surgery Patients Total Receiving Benefits 1949 _ _ 174,269 178,979 184,326 189,871 208,530 229,735 242,034 253,001 257,398 274,694 290,650 303,608 311,261 314,963 322,279 29,000 44,502 47,656 46,767 52,582 63,621 70,553 76,375 83,530 91,883 100,292 107,312 121,000 128,000 135,000 203,269 1950 _ ... 1951 _ _ _ _ 223,481 231,982 1952 _ _ _ 236,638 1953 .. 261,112 1954 _ 293,356 1955 _ 1956 1957 1958... . _ 312,587 329,376 340,928 366,577 1959 _ _ 1960 _ - 1961 — 19622 __ 390,942 410.920 432,261 442.963 19633 __ 457,279 Totals _ _ 3.735,598 1,198,073 4,933,671 i Estimated. 2 Amended as per final reports received from hospitals. 3 Estimated, based on hospital reports to October 31, 1963. Table III.—Patients Separated, Total Days' Stay, and Average Length of Stay in British Columbia Public Hospitals for B.C.H.I.S. Patients Only, Grouped According to Bed Capacity, Year 19631 (Including Rehabilitation Hospitals). Bed Capacity Total 250 and lotal Over 100 to 249 50 to 99 25 to 49 Under 25 Special Hospitals Patients separated— Adults and children Newborn. Patient-days— Adults and children . Newborn ._. Average days of stay— Adults and children Newborn 271,911 j 98,326 36,472 [ 11,213 i 2,624,026 | 1,166,858 258,867 | 90,803 9.65 | 11.87 7.10 | 8.10 78,816 12,057 674,330 79,689 8.56 6.61 36,491 | 41,168 6,142 | 5,196 347,701 [ 308,820 43,852 | 33,363 9.53 [ 7.50 7.14 | 6.42 10.411 j 6,699 1,331 j 533 75,093 j 51,224 8.089 ! 3,071 7.21 j 7.65 6.08 i 5.76 1 Estimated, based on hospital reports to October 31, 1963. Table IV.—Percentage Distribution of Patients Separated and Patient- days for B.C.H.I.S. Patients Only, in British Columbia Public Hospitals, Grouped According to Bed Capacity, Year 19631 (Including Rehabilitation Hospitals). Bed Capacity Total 250 and Over 100 to 249 50 to 99 25 to 49 Under 25 Special Hospitals Patients separated— Adults and children 1 Per Cent | Per Cent 100.00 36.16 100.00 I 30.74 Per Cent 28.99 33.06 25.70 30.78 Per Cent 13.42 16.84 13.25 16.94 Per Cent 15.14 14.25 11.77 12.89 Per Cent 3.83 3.65 2.86 3.12 Per Cent 2.46 1.46 Patient-days— Adults and children — Newborn 100.00 100.00 44.47 35.08 1.95 1.19 i Estimated, based on hospital reports to October 31, 1963. HOSPITAL INSURANCE SERVICE, 1963 H 39 CHARTS The charts on the following pages have been prepared by the Research Division. The statistical data shown in these charts are taken from the annual tabulation of the information shown on Admission-Separation Records submitted to the British Columbia Hospital Insurance Service by all hospitals designated as acute. The charts give a general idea of the relative importance of the various hospital services (medicaJ, surgical, etc.); they also provide some insight into morbidity in British Columbia. It should be noted that the Canadian diagnostic list used for the tables on pages 45 to 47 is a more detailed listing than the diagnostic groups shown on the charts. Both lists are based mainly on the International Statistical Classification of Diseases, Injuries, and Causes of Death, prepared by the World Health Organization (1957 edition). H 40 BRITISH COLUMBIA vo as tn o- D O o u H cn O Z 3 as o >-> < r-H ,--, « A 03 K ft do w « s w 0 g 5 z a u co tt. w oQ £ s 2 w H H I—I 0. H to w o < H Z w o OS w Ph A < X o < HOSPITAL INSURANCE SERVICE, 1963 H 41 tN ON 0j < rj a. o cn < P O z < cn w cn «-. o ►J < jrj Ph cn O & w ►J < « < Q ■*■ C\ "♦ Os y~ SP s «i *ir. o -~ ° "- P "" 5 K K *o vo >~ •o 6S- 6? H 42 BRITISH COLUMBIA <N VO OS y > tc w v, < y z 13 U tt. o tt- r-H CO CO w _2 -1 < H cn O I tt. o z o H D CD 2 H H < u w ►J < rS w Ph o < C/5 H rX) z I-l w < u s w a, -3JS. HOSPITAL INSURANCE SERVICE, 1963 H 43 tN VO On y > Bi m tn < _j U u. o w 0. >■ H 5h aa CO < P < H Or cn O s O z o H s S 2 H cn O < l-H z aa -_> a; PU > H as < X U W r-l H 44 BRITISH COLUMBIA Chart V.—Average Length of Stay of Cases in Acute-care Hospitals in British Columbia, by Major Diagnostic Groups in Descending Order, 1962 (Excluding Newborns). Neoplasms Diseases of the circulatory system Tj Congenital malformations Diseases of the bones and organs of movement Diseases of the blood and blood-forming organs Certain diseases of early infancy Diseases of the nervous system and sense organs Allergic, endocrine system, metabolic, and nutritional diseases Mental, psychoneurotic, and personality disorders Infective and parasitic diseases Accidents, poisonings, and violence Diseases of the skin and cellular tissue Diseases of the digestive system PROVINCIAL AVERAGE LENGTH OF STAY Diseases of the genito-urinary system Diseases of the respiratory system Deliveries and complications of pregnancy, childbirth, and the puerperium Symptoms, senility, and ill- defined conditions Supplementary classification for special admissions iiiiiiiMiiiiiiii/i/mimiiiiiii iiiiiiiiiii-iiiiiiiiiiiiiiii, W//i///M//H//////i/^WM/M£///i//////M wi/iiiiiiiiih-ii/iiiiiiii, Wiiii/ii/r--iii/iii/ii//, wiiiiiiiiiiiiiiiii W////////iiii-<i/i///B//ii///i wiiiiiiMi/iii/iiiih-miii/iiiiii/iiiiii/iiiiiiii ii/Hii- Ullllllllllllllllllllllllh wiiiiiiiiiimiiiiiiiiiiiiiiiiiiiiiiiiiim iiiiiiiiiiiiiiiiiiiiiiiiii wmiimiiiiiiHWiiimiiiiiiiiiiiimi, wiiiiiiiiiiiimiiiiimiiiiiiiiiiiiiiiiiii, msM'-mm^m, «//////////"W/0///////0/M wiiiii " llllllllllllllll w/i/ii • l/lllllllllllll Willi ■ Willi, Will" Ii HOSPITAL INSURANCE SERVICE, 1963 H 45 CN VO ON s < P O co W cn D < u Q Z < cn Ur CO < w co o Z 5 < z < U ui X H O H 0 z 3 Bi O o o < c z o < fcM 05 z o < N' 1—*■ B < E CO O c -O 00 l-H vc (N tj VC r- rJ "fl xr- NC oc a ^1- fN rs t- V-O ST r-> OC c o- ^t C f NC P. 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S u "> =- 5 o o o u u V 3 3 3' 5 3- f.6 .E /-. rt O — -G fl .- u is h -3 rt t-7 *_! x G T3 O O , _- O G 0 g a i -* s *■ - uo E g c. 3 1. a tax: wc »J ^» «; a|w-H£.SH-HH-Oi5SH-ffi5--2 C-0 00 < > 3 X &2 > r. cn fc 1 X 0 «5 'Of. !» 0 —1 fl - ■a & Medical or Mature new Immature n Other speci n 53 i~ 3 E CD O H Oh 3i <3\ ^ C ^ > X H 48 BRITISH COLUMBIA STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE FISCAL YEAR ENDED MARCH 31, 1963 Administration— Salaries $435,443.29 Temporary assistance 1,361.77 $436,805.06 Office expense 35,681.81 Travelling expense 28,664.48 Office furniture and equipment 2,172.77 Printing and publications _____ 1,035.83 Tabulating and rentals _ 2,070.00 Motor-vehicles and accessories , ■ 4,244.19 Incidentals and contingencies 929.16 Construction—consulting fees 300.00 Technical surveys— Travelling expense $385.00 Other expenses __:_j 9,371.31 9,756.31 $521,659.61 Less transfer, Vote 132 (b)—salary adjustments 7,142.00 Payments to hospitals— Claims . $58,388,883.03 Vancouver General Hospital re out-patients (Hospital Insurance Act, see. 29) ——__- 278,962.92 $58,667,845.95 Less collections, third-party liability 284,338.30 $58,383,507.65 Less— Chargeable to Government of Canada $30,049,147.43 Miscellaneous receipts 1,241.58 30,050,389.01 $514,517.61 28,333,118.64 Grants in aid of construction of hospitals 3,566,288.22 Total _-_ $32,413,924.47 Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty in right of the Province of British Columbia. 1964 810-1163-1693
Legislative proceedings
J110.L5 S7
English
Vancouver : University of British Columbia Library
Victoria, BC : Government Printer
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
Original Format: Legislative Assembly of British Columbia. Library. Sessional Papers of the Province of British Columbia
Fifteenth Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1963
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