@prefix ns0: . @prefix edm: . @prefix dcterms: . @prefix dc: . @prefix skos: . ns0:identifierAIP "d0c0cfe9-a02c-4420-b1a0-1f68fdcd53c9"@en ; edm:dataProvider "CONTENTdm"@en ; dcterms:isReferencedBy "http://resolve.library.ubc.ca/cgi-bin/catsearch?bid=1198198"@en ; dcterms:isPartOf "Sessional Papers of the Province of British Columbia"@en ; dcterms:creator "British Columbia. Legislative Assembly"@en ; dcterms:issued "2018-09-19"@en, "[1982]"@en ; edm:aggregatedCHO "https://open.library.ubc.ca/collections/bcsessional/items/1.0372107/source.json"@en ; dc:format "application/pdf"@en ; skos:note """ ]/[iriistry if Health Annual Report 981 I Province of British Columbia l@ffice of the Minister of Health, Parliament Buildings, Victoria, B.C. May 1, 1982 |e Honourable Henry P. Bell-Irving, D.S.O., O.B.E., E.D., Lieutenant-Governor of the Province of British Columbia May it please Your Honour: ■ The Annual Report of the Ministry of Health for the calendar year of 1981 is herewith respectfully submitted. JAMES A. NIELSEN Minister of Health fjBnistry of Health ffioria, B.C. Wy 1, 1982 > Tie Honourable fames A. Nielsen, lKi'sfer of Health, mmoria, B.C. I I have the honour to submit the Annual Report of the Ministry of Health for lie calendar year 1981. PETER BAZOWSKI Deputy Minister of Health all! o • l-l IS • r-l bo u O CD Q|J S a .2fl S *?'&' O tc > S =TJ b g(S | 1 1 ^ c *> D^3 -3* O 2 .- il Qo| O ° — 111 1 Sf'r; BS'g pog 0 && 5 en « «<9 (T tontents ffiemographic Features 1 Iplicy and Resource Allocation Committee 2 Medical Advisory Committee 3 Information Services 4 fecial Care Services 5 Management Operations 7 preventive Services 9 community Care Services 15 Medical Services Commission 15 I Mental Health Services 21 Forensic Psychiatric Services Commission 25 \\ Alcohol and Drug Programs 27 Estitutional Services 29 i Emergency Health Services Commission 29 I Hospital Programs 31 ' Home Care/Long-term Care 41 Enistry of Health Expenditures 51 The Year in Review r e Ministry of Health, the year 1981/82 nrked by a major reorganization de- xo streamline Ministry operations, re- pgrams into more appropriate group- a I improve the managerial capability of distry by addressing areas such as the uy of management controls, manage- rrormation systems and policy analysis ielopment. o the reorganization were the realign- various programs into three major yields — Preventive Services, Corn- it Care Services and Institutional Serv- e h headed by an assistant deputy min- md the addition of a policy planning biy. it Jim Nielsen, Minister, said in an- icg the changes: "By establishing three ms of program policy, we hope to re- 6 hierarchical organizational levels and a gher visibility to lower-cost and cost- tr programs." e ar of reorganization was marked by a b' of other highlights within the stl Inxmjunction with the Health Labour Riitions Association, the Ministry estab- fed a provincial data base, including w;e, benefit and time information for all jo covered by HLRA's certification as b< jaining agent for B. C .'s hospitals. This s):em will provide a modelling ca- piility to project future costs as well as lb ability to monitor certain trends wiin the industry. Ablicy and Resource Allocation Com- mee, chaired by the Deputy Minister ar made up of the program Assistant Diuty Ministers, was set up to co-ordi- ru; the Ministry's policy initiatives as w as maximize senior management in- 13 into decisions affecting the allocation ohsources within the Ministry. Aigh priority in the reorganization has bci the centralization of all financial ac- ti'ies under the Management Opera- CtiiisDivision. The financial services nudate is comprehensive and the new oiinization allows the executive director toirovide direction and support in all *' areas of financial management ffrrol. • An executive information system was designed and implemented providing the Minister and senior executive staff with terminal access to cost and service utilization information on the Ministry's operations. While the system currently provides access to financial data regarding hospitals, it is planned to extend the system in 1982/83 to include information on hospital capital development, Long- Term Care, grants, the Medical Services Plan, and the Dental Care Plan. • A Medical Advisory Committee was also formed during the year. It provides advice on matters requiring a professional background, including funding proposals for new technology and innovations in health-care delivery systems. • Twenty major hospital construction projects were either completed or had reached the final stages of construction. These included four new hospitals — including Children's and Grace in Vancouver — at a total cost of approximately $158 million. • The largest dental health survey of children ever carried out showed that the dental health of the province's young people has steadily improved over the past 20 years. • The Ministry's participation in the International Year of the Disabled saw the Community Vocational Rehabilitation Service assist more disabled persons on their way back to employment. • After many months of negotiation, the 10 provinces and two territories signed reciprocal agreements to standardize the handling of out-of-province hospital inpatient claims. • In Home Care/Long Term Care, 1,435 intermediate-care beds were opened during the year. • New rural services initiated during the year included a health clinic at Dease Lake in northwestern B.C. In co-operation with the provincial chapter of the College of Family Physicians of Canada, the clinic will provide full-time physician services to the area. |iAL Report, 1981 olographic ttures [ 1, British Columbia's population con- m grow at the same fast rate as in 1980. pvince's population in 1981 was ,7. That is 2.9% higher than 1980's fig- [667,200. were 3% more births in 1981 than in te birth rate stood at 15.2 per 1,000 Ion, compared with a rate of 15.1 in re number of illegitimate births in- eby 13% in 1981. They represented j f all births in 1981, compared with 1980. jiarriage rate increased slightly, to 9.1 (0 population. feeath rate was unchanged, continuing : l-time low level of 7.4 per 1,000 first dlin 1980. i te of death from heart disease in 1981 t<>40 per 100,000 population from the rord low of 220. There was no change in it )f death from cancer, the second lead ing cause of death, with 166 deaths per 100,000 population. A slight decline occurred in the rate of deaths from cerebrovascular disease, the third leading cause. There were 66 deaths per 100,000 population from this cause in 1981, slightly below the figure of 68 for the previous year. Mortality from accidents increased in 1981, to 64 per 100,000 population compared with 59 in 1980. More than half the accidental deaths in 1981 resulted from motor vehicle accidents, compared with48% in 1980. In 1971 the proportion was 38% and in 1961,31%. Falls accounted for 16% of accidental deaths in 1981, compared with 19% in 1980. Drowning accounted for 8.7% in 1981 and 8.9% in 1980. Poisonings accounted for 5% of accidental deaths in both years. The suicide rate of 15 deaths per 100,000 population was unchanged from 1980. The number of infant deaths per 1,000 live births was 11, the same as in 1980. MinistryotHeait*, Policy and Resource Allocation Committee The Ministry announced in July that a policy and resource allocation committee — to consider questions having major policy implications — was to be formed. It was part of the initial phase of the reorganization of the Ministry. The committee is headed by the Deputy Minister and supported by the Ministry's Assistant Deputy Ministers and the Senior Medical Adviser. Its role will be to investigate, review and evaluate programs and policies, taking into account needs and resource requirements. Ival Report, 1981 Medical Advisory iimmittee It during 1981, in April, a committee of S.nistry's senior medical staff was 11. p vides professional opinions on matters 1 uire a medical background. For exam- lexarnines proposals for funding new tilogy; reviews Ministry budgets in tf medical needs; and examines innova- hlth-care delivery systems. |:ommittee is also the Ministry's main ic of communication with physicians on (nssional matters, i Ministry's Senior Medical Adviser le 5 committee chairman. The committee v ts other members from Hospital Pro- a the Vancouver Bureau, the Medical HjCorrjimission, the Forensic Psychiatric ll'S Commission, and Public Health inistry of Health Information Services A heavy demand from the public and media for information on the Ministry's services continued through 1981. The preparation of press releases, background material for speeches, supervision of audio-visual scripting and the publication of brochures, pamphlets and other printed materials were among the division's activities. The division researched and wrote approximately 180 press releases and prepared material for 58 speeches. The complexity of many of the Ministry's programs required extensive research on most topics. Information Services also had responsibility for the Ministry's photographic and art services, a displays unit and the Ministry's reference library. The displays service had an unusually busy year, adding to its services a tractor-trailer unit which travelled to several centres with displays illustrating the Ministry's programs and objectives, on a pilot project basis. ual Report, 1981 ecial Care irvices Ministry continued to provide grants satiety of community-based agencies, Sin turn provide a wide spectrum of (services province-wide. 8 racts were implemented for the 1981/82 ear. The Ministry negotiated the pur- f specific health services with individ- incies. In addition, performance-based ging was introduced for the 1982/83 ap- sm process. AH agencies completed g estimates which established an opera- ardnimum, with increases built in on an Ssntal basis. ji al Care Services is also responsible for ong primary health care to isolated rural inities. e rural services in 1981/82 included a tclinic at Dease Lake in northwestern id, in conjunction with the B.C. chap- Clege of Family Physicians of Canada, jroduction of full-time physician serv- t hat area. In addition, full-time nursing jes and visiting physicians were Jhd to the Zeballos area on Vancouver west coast. Management Operations Ministry of HealtiI Management Operations Management Operations was formed in 1981 as part of the reorganization of the Ministry. Headed by the Senior Assistant Deputy Minister, it consists of Financial Services, Personnel Services, Planning, Policy and Legislation, Management Services, Central Services, Management Information Systems and Legal Services. During 1981, the Planning, Policy and Legislation Division directed, co-ordinated or was extensively involved in, for example, a hospital role study. An addendum to the original Phase I discussion paper was produced, completing Phase I. Work began on Phase II, which will develop a methodology for applying the results of the hospital role classification scheme developed in Phase I. Other involvements of the division included: completion of the provincial study of severely handicapped children; Phase I or the provincial rehabilitation study; and pilot nospice projects in Vancouver and Victoria, including evaluation of these projects. A high priority in the reorganization of the Ministry has been the centralization of all fi nancial activities under the Management C erations Division. A review of the organization of the finant services of the Ministry had concluded th; realignment of reporting relationships am much more centralized organization structi were essential to the efficient management the Ministry's financial resources. The financial services mandate ism prehensive and the new organization gRjl the executive director to provide direct onl support in all key areas of financial m*ffii| ment and control. The division is organii into three sections: financial analysis«M ning and budgets; accounting operations!!] financial policy and procedures. At thelsM time, a number of functions of the firum] offices of the various headquarter diflm were amalgamated to provide a co-ordSy support group for more effective plannii budgeting and expenditure control.■ For Personnel Services, the latter part of year was marked by a major reorganizatj with increased emphasis on labour relanrJ and classification. The reorganization alsos the introduction of a regional concept for delivery of personnel services. Table 1 Registrations, certificates, and other documents processed by Division of Vital Statistics, 1980 and 1981 Registrations accepted under Vital Statistics Act— Birth registrations Death registrations Marriage registrations Stillbirth registrations Adoption orders Divorce orders Delayed registrations of birth Registrations of wills notices accepted under Wills Act Total registrations accepted Legitimations of birth effected under Vital Statistics Act Alterations of given names effected under Vital Statistics Act Change of Name applications granted under Change of Name Act Materials issued by the Central Office— Birth certificates , Death certificates Marriage certificates Baptismal certificates Change of Name certificates Divorce certificates Photographic copies Wills Notice cerhfication Total items issued , Non-revenue searches for government ministries by the Central Officer TOTAL REVENUE 1 Preliminary. 39,143 40,480' 19,616 21,380' 23,718 24,620' 294 330' 2,176 1,690' 9,586 9,490' 255 210' 53,750 57,702 148,538 155,902' 206 220 377 372 3,844 3,563 96,663 89,461 8,443 7,626 10,684 10,273 15 11 3,681 2,863 243 232 14,850 14,176 13,066 13,3581 147,645 142,155] 26,588 27,119 S968.049 Sl,257g Preventive Services 10 Ministry of HeaI^h Preventive Services Preventive Services consists of the following programs: Public Health Inspection; Public Health Nursing; Speech and Hearing; Dental Health Services; Epidemiology; Nutrition; Occupational Health; and the Vancouver Bureau. The latter includes the Medical Supply Service; the Division of Venereal Disease Control; the Division of Tuberculosis Control; Community Vocational Rehabilitation Services; and Health Laboratory Services. The dental health survey of children in 1980, the largest dental health research project ever carried out, showed the improvement in dental health of children in B.C. over the past 20 years. The average number of teeth lost through extraction in 15-year-olds fell from 1.1 in 1958-60 to 0.1 in 1980. Vision Services produced a 16 mm film, Sight-Seeing Eyes, for elementary school children. The public health nursing project, At Risk; Early Pregnancy Profile, involving nutritionists and physicians, led to more effective monitoring of pregnancy outcomes. Special prenatal classes involving teenage and single mothers and others with special needs, increased by 36.7%. Perinatal deaths (infants up to seven days and stillbirths) decreased from 15 per 1,000 births in 1978 to 12.6 per 1,000 births in 1980. The province-wide demand for hearing services resulted in the continued extension of audiology services. The Speech and Hearing Division worked closely with the Ministries of Education, Human Resources, the federal departments of Veterans' Affairs and Health and Welfare C ada to provide standardized serviceHF There was a continued decline in the ir dence of measles, rubella, diphtheria, a pertussis. Vaccination coverage rates i proved with an over-all rate of approxiinat 89% assessed during Grade 1. (Tables $3) While the gonorrhea rate remained un ceptably high, and the division of verier disease control has been vigilant in its cont program for syphilis, several other conditio were being treated by VD clinics in 191 These include non-gonococcal genital infi tions, herpes, genitalis, and two parasitic testations—pubic lice and scabies. (Table In 1981, a new core program for the Nul tion Division greatly assisted in the plannir implementation, and evaluation of nutriti services. On-going programs, as well as sj cial projects, were designed to meet sped needs of the population during the prenat infant, early childhood, childhood and ac lescent, adult and elderly stages of life, Nutrition Week 1981 proved to be a succe ful awareness program. More members of I public took part than in previous years. As expected, 1981 was a busy year for Co munity Vocational Rehabilitation Services. The International Year of The Disabled p duced a dramatic increase in the number referrals of disabled persons for vocational habilitation. (Table 5) For example, as of November 1981, th were about 100 more disabled persons spi sored in a variety of employment preparat programs, compared with 1980. I|nual Report, 1981 11 School Health Program II ■ Area of activity ranked according to time spent Percent of total time in elementary schools per student enrolled Percent of total time in secondary schools per student enrolled i cation and follow-up of health problems (vision, hearing and other). K g support and guidance for students and families with chronic or acute 45.28 27.42 15.94 6.90 4.46 28.5 34.1 15.2 12.8 9.2 3 Stuucable disease control and immunizatioi 3 2 100.00 100.00 Reported Communicable Diseases, 1977-1981 1, (Rate per 100,000 population) 1977 1978 19 '9 1980 1981 Number of Cases Rate Number of Cases Rate Number of Cases Rate Number of Cases Rate Number of Cases Rate 1 2 57 7 70 307 1 884 15 40 14 45 78 310 101 539 1 9 0.1 0.1 2.3 0.3 2.8 12.3 0.1 35.4 0.6 1.6 0.6 1.8 3.1 12.4 4.0 21.6 0.1 0.4 15 35 17 58 908 3 1 794 12 43 15 104 1 90 129 105 1,297 16 0.6 1.4 0.7 2.3 35.9 0.1 0.1 31.4 0.5 1.7 0.6 4.1 0.1 3.6 5.1 4.2 51.3 0.6 21 23 9 56 810 459 7 76 14 286 1 237 1,801 163 1,784 4 1 18 0.8 0.9 0.4 2.2 31.6 17.9 0.3 3.0 0.5 11.1 0.1 9.2 70.2 6.3 69.5 0.1 0.1 0.7 77 29 11 67 857 29 3432 17 2 37 37 534 102 242 1582 1,808 9 2.9 1.1 0.4 2.5 32.5 1.1 13.- 0.6 0.1 1.4 1.4 2-.3 3.9 9.2 6.0 68.6 0.3 79 1 43 3 68 881 280 25 1 38 35 283 52 50 265 1,252 13 as 1 1.6 0.1 2.5 32.6 10.4 0.9 W 1.4 1.3 10.5 1.9 1.9 9.8 46.4 siea of the newborn Ifflf lery, type unspecified Direction— jibxication— !:ulism lis— matis— mm o/elitis H Bmccal throat infection BSarlet fever Spi and paratyphoid fever Total 0.5 2,482 99.4 3,643 144.0 5,769 244.7 4,359 165.3 3,369 124.7 1 ss than 0.05. wwected figures. 12 Ministry of Health Rates Per 100,000 Population of New Notifications1 of Venereal Infection2 1946-1981 500 400 300 & 200 100 *-H nffECTIOUS SYPHILIS3 '**•*•*■ ■*..*•*' 'i I-*-*-** 125 75 . 1 1 Excludes transfers and transients. 1 Excludes gonorrhoea epidemiological, syphilis epidemiological, and non-gonococcal urethritis. 3 Primary, secondary, and early — latent syphilis. nual Report, 1981 13 I Caseload for Community Vocational Rehabilitation Services January 1 to December 31,1981 currently under assessment or receiving services—January 1,1982 1,176 ■New cases referred to C. V. R. S. Committees in Vancouver Metropolitan ■Region (7 committees) 423 New cases referred to C.V.R.S. Committees outside Vancouver Metro- ■politan Region (44 committees) 616 Cases re-opened (all regions) 276 new referrals considered for services January 1,1981 to December 31,1981 (includ- i re-opened) 1,315 icases provided with service in 1981 ._„ 2,491 Community Care Services: Community Care Services comprises the Medical Services Plan (including the Dental Care Plan), Mental Health Services, Forensic Psychiatric Services, and Alcohol and Drug Programs Medical Services Commission 16 Ministry of Health Medical Services Plan The Medical Services Plan provides prepaid medical coverage on uniform terms and conditions for all residents of the province and their dependents. Insured services under the plan are paid for insured persons regardless of age, state of health, or financial circumstances, provided the premiums fixed by the commission are paid. Payment for the services provided is made, according to a scale of fees approved or prescribed by the commission, or on a salaried, sessional or contract basis at levels approved by the commission. During the year the commission continued to provide service with emphasis on prompt payment of practitioners, and improved relations with the public and health professions. The taxable income ceiling for premium assistance was raised during the year from $1,770 to $2,740. Effective July 1, 1981, those subscribers whose taxable income for 1980 was $1,810 or less qualified for 90% premium assistance. Those subscribers whose taxable income for 1980 was over $1,810, but not more than $2,740, will qualify for 50% premium assistance. The total expenditure for insured benefits under the Medical Services Plan rose 16.5% to $502,670,042 in 1980/81, from $431,471,022 in 1979/80. The increased costs to the Medical Services Plan were a result of upward revisions to the fee schedule, increased utilization of benefits, changes in the practitioner/population ratio, and increased population. On January 1,1981, the Dental Care Plan of British Columbia was established, under the supervision of the Medical Services Commission. During the first three months, to the end of the 1980/81 fiscal year, the plan was fully operational, with enrolment of beneficiaries and the payment of dental claims on schedule. The plan provides coverage of basic dent try and removable prostheses. There are i premiums. It will pay up to $700 a year for each perst in a number of categories. The beneficiaries include some clients of tl Ministry of Human Resources; people wl receive premium assistance from the Medic Services Plan and their dependents; people I years and older who do not receive premiu. assistance from the Medical Services Plan; ar children 14 years and younger. Table 6 Subscriber Statistics J Registrations and persons covered1 by premiu subsidy level at March 31,1981 Subsidy (per cent) 90.. 50.. Nil. Total.. 272,496 972,952 1,245,448 Persons 421,715 2,227,810 2,649,525 1 Coverage data do not include members of the Canadi Armed Forces, RCMP and inmates of Federal penitentiaries. Tabic 7 Persons covered by age group at March 31,1981 Age group Perse ....33,6 MSU 401,6 462,3 791,5 ....»« ...JI03,4 ...JJ25,S .....47,5 ..10,3 ...5,7 ....... 2,649,5 wal Report, 1981 17 Coverage by Family Size at March 31,1981 567,014 Coverage by Age Group at March 31,1981 pi i ■ ■ I ■ ■ I ■ ■ ! I I I Under 1 1-4 5-14 15-24 25-44 45-64 65 & Unknown w Ministry of He alth Medical Services Commission Fee-for-service Payments Medical Practitioners and Dental Surgery in Hospital Distribution of Fee-for-service Payments for Medical Services (Shareable) Table 10 Specialty AMOUNT PAID' 1979/80 1980/81 PERCENTAGE OF TOTAL 1979/80 1980/81 COST PER PERSON' 1979/80 1980/81 General Practice Dermatology Neurology Psychiatry Neuropsychiatry Obstetrics and Gynaecology.. Ophthalmology Otolaryngology Eye, Ear, Nose, Throat General Surgery Neurosurgery Orthopaedic Surgery Plastic Surgery Thoracic Surgery Urology Paediatrics Internal Medicine ~ Radiology Pathology Anesthesiology Physical Medicine Public Health Microbiology Dental Surgery in Hospital ... Osteopathy Nuclear Medicine Unclassified 158, 4, 3, 10, 13, 13, 6, 21, 2, 10, 2, 2, 5, 7, 25, 27, 37, 14, 141,797 298,941 043;580 328,785 304,089 513,293 933,539 242,783 147,775 353,556 028,378 267,676 821,731 404,774 724,521 687,211 ,440,626 760,750 ,725,287 ,722,177 545,440 99,686 15,575 ,467,182 259,830 684,686 ,595,621 TOTAL 378,559,289 181,570,921 5,085,560 3,679,085 12,290,280 338,217 14,915,234 16,036,623 7,072,221 172,923 23,645,362 2,372,111 11,766,863 3,160,303 2,760,411 6,623,708 8,571,490 29,836,114 33,017,927 47,444,889 16,824,633 598,511 67,280 162,751 1,853,099 236,904 885,573 7,172,032 41.77 1.14 .80 2.73 .08 3.57 3.68 1.65 .04 5.64 .54 2.71 .75 .64 1.51 2.03 6.72 7.33 9.96 3.89 .14 .03 .00 .39 .07 .18 2.01 438,161,025 41.44 1.16 .84 2.80 .08 3.40 3.66 1.61 .04 5.40 .54 2.69 .72 .63 1.51 1.96 6.81 7.53 10.83 3.84 .14 .02 .04 .42 .05 .20 1.64 61.0929 1.6608 1.1758 3.9902 .1175 5.2204 5.3828 2.4117 .0571 8.2492 .7836 3.9666 1.0901 .9290 2.2115 2.9697 9.8281 10.7244 14.5739 5.6874 .2107 .0385 .0060 .5668 .1004 .2645 2.9343 100.00 69.07. 1.93. 1.39! 4.67! .121 5.67< 6.101 2.691 .06! 8.99! .90! 4.471 1.20: 1.051 2.51! 3.261 11.351 12.561 18.04' 6.40i .22' .02 .06 .70 .09 .33 2.72 166.68 1 Includes only those payments which have been made during the respective fiscal periods. 2 Based on insured population as at October 1, as derived from Statistics Canada Data (October 1,1979 = 2,588,548; October 1,1980 2,628,662. New population statistics received April 1, 1980. \\toal Report, 1981 Distribution of Medical Fee-for-service Payments and Services by Type of Service 19 ' Type of Service General Practitioner fcjt«examination iiXamination aent office visit BluBSav, Holiday or emergency t use visit jenf house visit.. IflEisit Subtotals Specialists ration i:/isit.. fcisit ^il visit Subtotals tiesia.. tics. -Procedures.. 100 im office procedures.. dherapy tliagnosis nary function oineous I Other Medical Subtotals TOTALS Number of Services 1979/80 1980/81 1,078,055 5,902,427 1,675,979 604,699 119,771 46,655 1,513,018 10,940,604 981,533 12,598 509,275 671,237 2,174,643 2,173,584 59,459 490,450 801,200 1,199,295 8,359,432 1,229,612 207,926 64,978 32,788 17,071 14,635,795 27,751,042 1,166,743 7,956,753 12,891< 637,221 118,601 44,395 1,490,946 11,428,550 1,036,243 14,157 560,292 685,004 2,295,696 2,244,219 61,364 497,119 816,627 1,229,786 9,115,288 1,211,857 224,016 83,822 36,236 17,405 15,537,739 29,261,985 Amount Paid 1979/80 1980/81 26,210,066 70,792,448 11,376,595 16,289,734 2,492,821 760,773 10,643,113 138,565,550 42,947,843 508,702 5,165,087 6,944,880 55,566,512 17,786,592 10,461,167 45,414,345 15,713,190 24,326,058 45,133,839 8,926,498 8,148,875 3,557,226 403,099 4,556,338 184,427,227 378,559,289 160,215,201 50,534,367 614,477 7,516,401 7,640,766 66,306,011 20,290,844 11,447,487 48,401,688 18,130,734 28,088,694 57,402,980 9,156,119 9,528,320 5,002,345 461,598 3,729,004 211,639,813 438,161,025 29,713,903 98,214,759 177,372' 17,769,342 2,563,758 750,652 11,025,415 r.; schedule item 0107 in service code 51 as of April 1,1980. Additional Benefits Fee-for-service li2 Distribution of fee-for-service payments for insured services, additional benefits Type of service Amoun 1979/80 paid1, < 1980/81 Percentage of total 1979/80 1980/81 Cost per person3 1979/80 1980/81 710 322 4,242 9,970,672 430,704 4,770,381 1,926 2,497,322 5,420,004 134,133 4,392 11,905,995 421,703 5,928,442 3,310 2,770,107 6,412,064 125,995 2,710 .00 .00 .02 42.91 1.85 20.53 .01 10.75 23.33 .58 .02 43.18 1.53 21.50 .01 10.05 23.26 .46 .01 .0003 .0001 .0016 3.8519 .1664 1.8429 .0007 .9648 2.0938 .0518 .0017 4.5293 upathic .1604 E^Kpy (office) 2.2553 final. .0013 IB. 1.0538 ttetric. 2.4393 hontic .0479 :l;ified .0010 Totals 23,234,808 27,570,326 . 100.00 100.00 8.9760 10.4883 — :ludes only those payments which have been made during the respective fiscal periods, -iwe amounts are fee-for-service payments made under the plan only, and in no way reflect the total for the services of these £ners. sed on insured population as at October 1, as derived from Statistics Canada Data 1979 = 2,588,548; 1980 = 2,628,662. New 'U on statistics received April 1,1980. "1 20 Ministry of Health Summary of Expenditures 1970/71 to 1980/81 Medical Fee-for-servii Salaried and Sessional Additional Benefits Administration 1970/71 1971/72 1972/73 1973/74 1974/75 1975/76 1976/77 1977/78 1978/79 1979/80 1980/81 122,818,267 127,000,505 139,532,341 159,614,356 190,452,494 250,026,093 268,496,749 298,900,495 337,513,465 384,735,825 445,734,331 4,375,798 4,788,365 6,022,920 7,991,062 10,424,602 15,437,520 14,880,410 17,749,957 19,484,932 23,200,389 28,368,006 $ 6,611,815 5,534,520 7,897,244 8,963,080 11,089,892 15,045,516 17,090,707 17,436,161 21,132,210 23,534,808 28,567,705 $ 6,030,059 6,567,847 7,320,137 8,581,794 12,501,015 12,659,521 13,040,063 13,207,188 16,856,376 19,883,088 21,435,615 S 139,835,» 143,891,237 160,7721*81 185,150,292 224,468,111 293,168,650 313,507,929 347,293,801 394,986,9® 451,354,110 524,105;j|l Whereas preceding statistical tables are prepared on a cash basis, the above summary is compiled on an accrual bas Dental Care Plan costs in 1980/81: claims payments $10,843,578, administration costs $2,927,527. On Page 80, Table 109, figures listed under "Neglect' should appear under "Sexual Abuse" and vice versa. 22 Ministry of Health Mental Health Services During 1981 Mental Health Services continued its direct responsibility for administering Riverview Hospital, Burnaby Psychiatric Services, Integrated Services for Child and Family Development (Victoria), and the Mental Health Centres. The Delta sub-office was made a full centre, and the Maples adolescent unit was temporarily transferred to the Forensic Psychiatric Services Commission. The Greater Vancouver Mental Health Service (GVMHS), funded completely by the Ministry, maintained a very close liaison with Mental Health Services. Other divisions of the Ministry which had a close working relationship included Hospital Programs; Long Term Care; Forensic Psychiatric Services Commission; Medical Services Commission, which pays private psychiatrists; and Preventive Services. In housing, a vital support for many patients, an acting co-ordinator of residential services was appointed; more than 50 group home places were obtained through the Ministry of Lands, Parks and Housing; and 10 staff positions were transferred from Riverview to serve patients in the community. At Riverview, consolidation of wards and the development of rehabilitation programs continued. The hospital received one-year accreditation from the Canadian Council on Accreditation. The Riverview Volunteer Society developed a boarding home proposal, and; sisted in the implementation of the patien council. Programs including pre-vocational activi centres, lithium groups, and life skills groir were developed at various Mental Heal Centres. The construction of the Maples' 26 secu beds and expansion of servicesfw continued. Vancouver General Hospital opened a 1 bed adolescent unit; planning started on tl construction of a 25-bed unit in Victoria; anc day program for adolescents was opened Kelowna. For staff education, the electives progra provided approximately 200 workshops mental health centres and other agencies. Br ish Columbia hosted the western.'jrite provincial conference on rural mental healt Statistics showed that mental health ce tres, including Burnaby, saw approximate 15,390 out-patients. Burnaby admitted 334 i patients and Riverview admitted 1,285 i patients. Riverview's in-patient populatic stayed stable at about 1,100 patients. GVM1 saw approximately 3,000 patients^ Total expenditures for the service, indudii a grant to GVMHS, were $70,624,01M sOal Report, 1981 23 Patient movement trends for mental health facilities 1979-1981 MENTAL HEALTH FACILITIES YEARLY SUM OF ENTRIES1 Oct. 1979 to Sept. 1980 Oct. 1980 to Sept. 1981 RESIDENT OR CASELOAD End of Sept. 1980 End of Sept. 1981 ntal health facilities al programs, Riverview.. ic Facilities yview j^[ - nj^MW Health services2 -patient units Me7ZZ!Z"!"!!"" nt-patients ntal health centres... jfia&d aby—Central ^m Children's I Day program.. I North South ISike- Vanderhoof.. sffil River ivvack tenav brook son Creek an...... |||Sparwood Melson 5t. John d Forks loops •vna . iat.. ley- leRi. itt.. limo... dge. Westminster.. h Delta roos cton Alberni Coquitlam Hardy 11 River asSeorge ie Rupert :n Charlottes .. ;nel ich... BBErm grjf. archers. mish if |e (ley.. ams Lake amunity care teams. lejm House away Clinic lano. nt Pleasant riond mm- Ouiyoi)3 h Vancouver Keona End Side. 3.C. (out-patient) 12,831 1,314 175 98 65 12 9,634 394 326 68 10,948 9,062 354 220 94 112 152 140 42 14 137 146 187 211 230 81 6 264 97 445 341 125 165 169 37 291 358 98 281 98 350 331 334 86 127 97 141 38 44 234 112 127 73 58 67 258 148 244 425 223 419 208 96 1,708 42 240 188 190 161 147 211 269 13,111 1,201 145 104 16 25 10,092 388 334 54 11,377 9,536 269 203 196 114 170 158 12 91 187 189 209 164 333 6 81 191 102 345 237 134 209 208 41 333 417 122 184 85 273 469 295 92 117 74 149 40 410 154 124 64 127 65 296 181 215 434 357 484 102 24 1,673 66 225 158 149 165 67 195 203 277 168 135 19,523 1,113 687 452 139 96 14,712 52 17 35 17,671 14,573 341 366 176 28 518 292 46 22 177 198 235 335 187 59 6 400 87 1,117 438 161 409 531 39 330 460 329 259 134 721 457 461 83 177 374 38 25 47 233 109 239 87 66 131 800 161 505 925 394 472 344 131 3,011 78 686 256 325 306 247 317 357 352 87 21,102 1,097 527 367 72 88 16,489 53 23 30 19,425 16,350 291 405 242 22 538 255 31 60 275 264 224 267 363 12 39 530 62 1,288 429 198 423 536 67 493 622 264 349 218 600 803 398 171 174 396 85 32 31 323 130 284 75 56 159 629 225 554 952 528 544 351 83 2,989 110 645 248 324 324 66 266 338 334 334 86 rthe residential facilities, this includes permanent transfers tb£otal does not include community care teams. PSj^community care team commenced reporting. admissions from the community, returns from leaves and escapes. 24 Ministry of HeaiIh Patient movement data1 for mental health facilities, 1981 MENTAL HEALTH FACILITIES Direct Returns Permanent Admissions from leave .transfers- Discharges Permaneng am transfers Ueatl AH mental health facilities Hospital programs, Riverview. Geriatric facilities Valleyview Dellview Skeenaview Mental health services2 Total in-patients Burnaby B.C.Y.D.C Total out-patients «**•>■' All mental health centres Abbotsford Bumaby—Central Children's Day program North South Bums Lake-Vanderhoof Campbell River Chilli wack Courtenay .... i.Y. CranbroOK Dawson Creek Duncan Fernie-Sparwood Fort Nelson Fort St. John Grand Forks Kamloops Kelowna Kitimat Langley Maple Ridge Merritt Nanaimo Nelson New Westminster North Delta Osoyoos Penticton Port AJberni Port Coquitlam Port Hardy Powell River Prince George Prince Rupert Queen Charlottes Quesnel Saanich Salmon Arm Sechelt Se Cure; Smithers Squamish Surrey Terrace Trail Vernon V.I.S.C... Victoria Whalley Williams Lake All community care teams Blenheim House....'.1. Broadway Clinic Kitsilano Mount Pleasant Richmond S.A.F.E.R. (July81)3 South Vancouver Strathcona West End West Side :,637 ,182 135 105 5 25 1,866 387 341 46 B.C.Y.D.C. (out-patient).. 12,341 892 135 105 5 25 9,860 381 336 45 10,933 9,155 235 193 183 109 195 151 13 107 173 209 196 124 324 1 76 173 108 320 219 145 209 197 31 316 445 131 196 81 228 423 279 85 105 52 159 48 425 195 125 51 115 71 251 181 192 387 321 495 84 23 1,647 63 223 149 151 148 89 177 197 277 173 131 253 253 43 37 11,450 1,184 235 131 75 29 8,472 388 332 56 10,543 433 100 52 • 35 13 8,451 367 312 55 9,643 7,955 296 160 157 113 144 233 3 71 71 141 204 307 155 55 44 59 77 199 203 107 185 85 1 139 252 121 91 1 479 119 373 3 132 65 133 48 21 348 171 96 81 87 48 519 100 191 440 201 463 87 76 1,559 29 291 160 152 143 1 177 180 263 163 129 705 695 1 1 Table compiled from actual data through September 1981 and proj< opened in 1981, table compiled on basis of available data. 2 Sub-total does not include community care teams. 3 Month community care team commenced reporting. cted for the remainder of the year. NOTE: For community care teal I Forensic Psychiatric Services Commission 26 MlNISTI °f Health Forensic Psychiatric Services Commission To meet its obligations under the Forensic Psychiatry Act, the commission operates a 140 bed in-patient secure mental health facility; two out-patient clinics; and travelling clinics at Prince George and Kamloops. Psychiatric assessment services are provided to provincial adult and youth detention centres and to local lock-ups in the Lower Mainland. Consultative and educational services are offered to persons involved in the mental health and justice systems. The secure hospital is in Coquitlam near Riverview Hospital. Men and women charged with offences are admitted by court remand order for assessment of mental disorders, for a period of up to 30 days. Those persons whom the courts have found unfit to stand trial, or not guilty of an offence because of insanity, are admitted by court order for treatment until the pleasure of the Lieutenant Governor is made known. The hospital also accepts transfers of prisoners serving sentences in provincial correctional centres, who have been certified as mentally ill under the Mental Health Act of British Columbia. During 1981, approximately 85% of all admissions were accused persons remanded for psychiatric assessment. Mental status evaluations were completed as quickly as thoroughness allowed. Over 80% of persons assessed for fitness to stand trial were considered to meet the legal criteria. Persons admitted as unfit to stand trial accounted for 7% of admissions. An average length of stay in hospital was three months. Court finding of "not guilty by reason of insanity" accounted for 2% of admissions, a reduction from previous years. The Canadian Criminal Code provision for detention at the pleasure of the Lieutenant Governor is for indeterminate detention. While hospitalization time for these patients is longer than required to modify the acute stage of illness, the vast majority are conditionally discharged by cab net order to the community, under corrunii sion supervision. Adjusting to life outside tri ^institution has always presented special pro! lems for many of these persons, due in part t an absence of transitional housing to compk ment the individual's community rehaMtei tion program. In 1981, the commission took possession c three homes on Riverview Hospital grounds Seventeen patients have been transferrei from hospital to these transition homes where they are experiencing the challenges c more independent living while being guidet and monitored by institute treatment stafl This was considered the most important ad junct to prevention achieved in 1981. Changes were made to the Mental Health Ac during the year, which directly affected thi institute. Previously, an order-in-council was re quired before a certified mentally ill prisone could be transferred from prison to a menta health facility for treatment. The legislate! changes provided for immediate transfer an treatment of those persons, permitting mor prompt intervention in the illness. The Vancouver forensic clinic accepts courl ordered referrals of adults and juveniles; fol lows up the maj ority of persons on conditio™ discharge from the Forensic Psychiatric In stitute; co-ordinates services to lock-ups an detention centres in the Lower Mainland; an organizes travelling clinics to the Interior. Case activations continued to increase i 1981. Approximately 950 persons were re ferred by the courts, an increase of 7% ovd 1980. Persons receiving counselling at year's en numbered 127. Of these, 58 were con ditionally discharged persons from the ill stitute. The rest were clients on bail, on recos nizance, or probation. The Victoria forensic clinic provides service to Vancouver Island similar to those of m clinic in Vancouver. A highlight of activities during the year vd the further implementation of psychiatri services to the Vancouver Island Regional Cod rectional Centre (VIRCC). Accused persori requiring a remand in custody for psychiatnj assessment were seen in VIRCC by the clirucl psychiatrist, often making it necessary to e-j cort and admit the accused, to the F°ri*sj Psychiatric Institute, with disruption of live and public expense. Alcohol and Drug Programs 28 Ministry of H ealth Alcohol and Drug Programs The role of the Alcohol and Drug Commission was significantly changed during 1981. The commission, which was expanded in light of its new functions, will act as an advisory body coordinating the alcohol and drug services developed over the past eight years with other government services. In 1981, several initiatives to provide more effective service were developed, with a greater emphasis being placed on preventive services. Program evaluation and treatment services were reorganized by integrating services for alcohol and other drugs. This resulted in the more efficient use of treatment staff and a better geographical distribution of treatment clinics. Services to more communities will 1 provided in the next phase of progra development. Northern Way Detoxication Centre, whii will replace the City of Vancouver drunk tan was completed. Staff for this program we being recruited at the year-end and the pr gram was operating early in 1982. j Alcohol and Drug Programs funded 55 vc untary societies to operate programs in tl alcohol and drug field in the 1981/82 rise year, at a cost of $7,850,785. In addition, directly administered out-patient clinics i seven communities outside Vancouver, thn detoxication centres, and four out-plmei services in Vancouver. Institutional Services: Institutional Services consists of the Emergency Health Services Commission, Hospital Programs, and Home Care/ Long-Term Care. Emergency Health Services Commission in 30 Ministry of Health Emergency Health Services Commission While the primary concern of the commission since its inception has been to provide ambulance service throughout the province, it also has the powers and authority: • to provide emergency health services; • to establish, equip, and operate emergency health centres and stations in areas the commission considers advisable; • to assist hospitals, other health institutions and agencies, municipalities and other organizations and persons in providing emergency health services, and to train personnel to provide services, and to enter into agreements or arrangements for that purpose; • to establish or improve communications systems for emergency health services in the province; • to make available the services of medically trained persons on a continuous, or temporary basis, to those residents of B.C. who are not, in the opinion of the commission, adequately served; • to recruit, examine, train, register and license emergency medical assistants; • to perform any other function related to emergency health services as the Lieutenant Governor in Council may order. The commission is also responsible for the medical aspects of disaster planning, as well as the maintenance, inspection, replacement and storage of federal emergency medical supplies stored throughout the province. In 1981, 10 full-time crew members were posted to Kelowna and immediately started training as an advanced life support team. Eight full-time crew members were posted to Vernon, some of whom will be trained as trauma attendants. Two full-time crew mei bers were posted to Sidney. A second full-tin crew member was added in Cresto Hazelton, Sparwood, and Port McNeill we each allocated a full-time crew member/a ministrator. In addition, six crew membe and one dispatcher were added in the Vanco ver area, which now has 228 crew positioi and 18 dispatchers. New services operated 1 part-time personnel were opened at Cassi; Zeballos and Peachland. The vehicle modification depot in Victor manufactured 31 standard ambulances ar two 4-wheel drive ambulances at a substanti cost-saving per unit. They replace older, unr liable vehicles beyond maintenances All aspects of training ambulance crew both full-time and part-time, are contracted ■ the Justice Institute of British Columbia. Tl utilization of training days in 1981 was 7,31 for new personnel, and 20,510 for advanca training and development of existing staff. The areas of training included programs f emergency medical assistants, advanced 11 support, trauma attendants, infant transpoj training community instructors, and pr grams for public awareness and knowledge cardio-pulmonary resuscitation, basic \\i support. In 1981 the air ambulance service contimd to be extensively used to transport patient involving 4,050 flights and 4,100 patients, i 18% increase in flights over 1980. Road ambulance call volume of 226,034 1981 represented an increase of 11% over 198 During the year, the upgrading of an bulance stations continued for the improv ment of crew and equipment accommodarioi 32 Ministry of Health Hospital Programs Under the Hospital Insurance Act, Hospital Programs pays the cost of in-patient services at various levels of care, and the costs of certain out-patient services, including emergency treatment and day-care surgery. In addition to patient benefits, Hospital Programs also provides consulting and inspection services to the province's public hospitals and licensed private hospitals. Hospital Programs pays at least 60 per cent of the approved net costs of major hospital construction and renovation for acute, rehabilitation and extended-care facilities built by public hospitals and other non-profit organizations. It also provides grants for the purchase of hospital equipment. In Hospital Programs during 1981, 20 major hospital projects were completed, or had reached the final stages of construction, including four new hospitals, at a total cost of approximately $158 million. The largest of these new hospitals were the new Children's and Grace Hospitals in Vancouver, designed to provide a total of 200 pediatric and 122 obstetrical beds respectively. The total cost of this combined project, including the provision of teaching facilities was originally funded under the Ministry of Education but was subsequently handled by the Ministry of Universities, Science and Communication. The two hospitals, while keeping their separate identities, will share many service facilities with each other and the adjacent Shaughnessy Hospital. The other two new facilities were quite distinctive. One was a new unit built in Burnaby, which combined 40 extended-care bedswi 40 beds for intermediate care, each unitusii common lounge, dining and activitmre under one management. The other was t New Denver Health Centre, built adjacent an intermediate-care unit called the Pavilio The health centre, besides providing diagnc tic and treatment facilities, contains 10 be which can be used for short-term acute extended-care patients, depending on nee Substantial progress was made on a ne and enlarged emergency department and 27-bed coronary care unit at Vancouver Gei| eral Hospital, as part of the new Laurel Stre complex. Besides providing a major erne gency and crisis centre, the Emergency f> partment also provides teaching and clinic research facilities, in cooperation with th University of British Columbia. The openin of these facilities is expected in 1982. During 1981, after many months of negoti tions, the 10 provinces and two territoria agreed to enter into agreements for the rJ ciprocal processing of out-of-province hospj tal in-patient claims. The new process will n lieve hospitals from having to deal with ti hospital plans in other jurisdictions. Insteai each provincial or territorial plan will indue in operating payments to their hospitals, tl cost of care for qualified beneficiaries fro: other areas of Canada, and the host plan recover their costs by direct bulk billings to tl other plans. The new process began in Briti: Columbia on October 1, 1981, and it is ei pected that all participants will benef through the reduction in individual billing i*iuAL Report, 1981 33 ts separated and proportion covered by Hospital Programs, British Columbia public ;neral hospitals1 only (excluding federal, private, extended care and out-of-province hospi- aKtion), 1976-1981/82. TabIe 16 T ital hospitalized public hospitals ■ Covered by lospital programs Adults and children Newborn Total Adults and children Newborn Total e l separated: 408,278 406,180 408,606 410,648 409,216 423,394 36,117 36,980 37,938 39,880 41,514 43,198 444,395 443,160 446,544 450,528 451,252 466,592 390,641 386,872 389,922 390,513 389,573 402,139 95.7 95.2 95.4 95.1 95.2 94.9 35,292 36,119 37,293 39,125 40,767 42,515 97.7 97.7 98.3 98.1 98.2 98.4 422,991 427,215 429,638 430 340 179 180' I81!. 1823.. 444,654 :i age of total is separated: Mi. 95.8 I..;. 95.4 179.. 95.7 HI 95.4 m 95.2 I823.. 95.3 dudes rehabilitation and long term care statistics, nended as per final report received from hospitals. 3 test 1981/82 hospital reports available. ipatient days and proportion covered by Hospital Programs, British Columbia public eneral hospitals1 only (excluding federal, private, extended care and out-of-province hospi- Ijffation), 1976-1981/82. Table 17 Total hospitalized in public hospitals Covered by hospital programs Adults and children Adults and children edays 179... *sp.. *823.. 3,488,179 3,473,838 3,565,659 3,603,701 3,648,247 3,741,171 207,316 208,574 208,969 232,226 234,094 236,522 3,695,495 3,682,412 3,744,659 3,835,927 3,881,341 3,977,693 §i»of total Edays '79.. i812.. '823.. 3,343,172 3,337,330 3,428,709 3,460,477 3,505,965 3,614,613 95.8 96.1 96.2 96.0 96.1 96.6 201,111 202,751 203,299 225,992 228,476 230,949 97.0 97.2 97.3 97.3 97.6 97.6 3,544,283 3,540,081 3,632,008 3,686,469 3,734,441 3,845,562 95.9 96.1 96.2 96.1 96.2 96.7 JCMjes rehabilitation and long term care statistics. friended as per final report received from hospitals. 3 timated, based on latest 1981/82 hospital reports available. 34 Ministry of Hffl M.TH Table 18 Patients separated, total patient-days, and average length of stay according to type and location of hosoii for Hospital Programs patients only, and days of care per 1,000 of covered population, 1976-1981/82 Total (excluding extended care) Adults and children Newborn public hospitals Adults and children Newborn Other B.C. hospitals including federal and private Adults and children New- bom institutions outside British Columbia1 Adults and children New- bom Extendet care hospital: Patients separated— 1976 1977 1978/79 1979/80 1980/811 1981/822 ; Patient days— 1976 1977 1978/79 1979/80 1980/811 1981/822 Average days of stay- 1976 1977 1978/79 1979/80 1980/811 1981/822 400,675 394,727 397,273 398,457 396,753 408,514 3,424,979 3,397,729 3,488,887 3,521,692 3,558,391 3,663,074 35,832 36,496 37,636 39,516 41,124 42,877 204,156 205,059 205,431 228,587 230,739 233,233 5.70 5.62 5.46 5.78 5.61 5.44 390,641 386,872 389,922 390,513 389,573 402,139 3,343,172 3,337,330 3,428,709 3,460,377 3,505,965 3,614,613 35,292 36,119 37,293 39,125 40,767 42,515 201,111 202,751 203,299 225,992 228,476 230,949 5.70 5.61 5.45 5.78 5.60 5.43 475 350 213 256 519 5003 1,647 1,615 718 892 1,795 1,7003 3.47 4.61 3.37 3.48 3.46 3.40 65 31 24 59 503 390 250 130 94 279 2353 4.88 3.85 4.19 3.92 4.73 4.70 9,559 7,505 7,138 7,688 6,661 5,875 80,160 60,784 59,460 60,323 50,631 46,761 8.39 8.10 8.33 7.85 7.60 7.96 460 312 312 367 298 312 2,655 2,058 2,002 2,501 1,984 2,049 5.77 6.60 6.42 6.81 6.66 6.57 3,59. 4,02 3, 3,55: 3, 3,671 1,498,79: 1,734,22: 1,841,08' 1,886*56 1,963,02 1,960,70 417.26 430.76 528.59 530.! 533.43 533.52 1 Amended as per final report from hospitals. 2 Estimated, based on latest 1981/82 hospital reports. Estimated patient-days (including new-born) per 1,000 of population covered hospital programs: 1976—1,474; 1977—1,432; 1978/79—1,460; 1979/80—1,459; 1980/81—1,350; 1981/82—1,337 (because the armed lora Royal Canadian Mounted Police, and some other groups are not insured under the Provincial Plan, the actual incidence of days would somewhat higher than shown). In addition, estimated patient-days per 1,000 population for extended care amounted to 603 in 1976,639 1977, 728 in 1978/79, 734 in 1979/80, 745 in 1980/81, and 756 in 1981/82. Population figures according to latest census figures. M 3 Including hospitals at Cassiar, Holberg and Masset. Patients separated, total days' stay and average length of stay in British Columbia publ hospitals for Hospital Programs patients only, grouped according to bed capacity, 1981/8! (excluding extended care hospitals). Table 19 Total 250 & over Bed capacity 100 to 249 50 to 99 25 to 49 Undei Patients separated Adults and children.. Newborn Patient days Adults and children- Newborn Average days' stay Adults and children.. Newborn 402,139 42,515 3,614,613 230,949 8.99 5.43 202,476 20,641 1,982,615 124,227 9.79 6.02 133,229 16,185 1,168,966 83,511 8.77 5.16 36,675 2,903 266,397 11,572 7.26 3.99 19,183] 1,717 136,632 7,390 7.12 4.30 1 Estimated, based on latest available hospital reports for 1981/82. J ual Report, 1981 itage distribution of patients separated and patient-days for Hospital Programs patients fly, in British Columbia public hospitals, grouped according to bed capacity, 1981/821 I ccluding extended care hospitals). Bed capacity 100 to 249 50 to 99 25 to 49 Under 25 lays ii and children.. orn separated i and children.. arn Per cent 100.0 100.0 100.0 100.0 Per cent 50.35 48.55 54.85 53.79 33.13 38.07 32.34 36.16 Per cent 9.12 6.83 7.37 5.01 Per cent 4.77 4.04 3.78 3.20 Per cent 2.63 2.51 1.66 1.84 mated; based on latest available hospital reports for 1981/82. |Summary of the number of Hospital Programs in-patients and out-patients 1976-1981/82 Total adults Children and newborn in-patients Estimated number of emergency minor surgery day care and out-patients receivmg benefits 440,099 435,249 438,392 441,526 441,557 455,066 1,228,723 1,303,679 1,464,799 1,678,768 1,931,548 1,933,027 1,668,822 1,738,928 1,903,191 2,120,294 2,373,105 2,388,093 [ended as per final report received from hospitals. imated, based on latest available hospital reports for 1981/82. Summary of Hospital Programs out-patient treatments, by category 1976-1981/82 iry itient jmS.-. 'id emergency... surgery day care erapy (counselling fib/sis day care1 22,352 40,392 542,223 66,663 3,426 368,867 10,218 10,481 164,101 23,974 46,323 575,000 76,405 4,126 387,993 12,942 18,351 158,565 26,222 53,725 645,634 82,979 4,515 454,697 18,189 19,717 159,121 24,481 57,209 814,317 89,312 4,949 484,110 22,077 20,253 162,060 29,972 63,529 1,019,628 93,445 6,595 507,233 23,649 22,177 165,320 34,800 66,948 934,800 100,862 8,670 572,176 27,525 21,006 166,240 TOTALS.. 1,228,723 1,303,679 1,464,799 1,678,768 1,931,548 1,933,027 nmenced June 1, 1976. erindudes (a) cancer out-patients and (b) rehabUitiation day care. mated. r ' 36 Ministry of Healti Charts The statistical data shoWn in the following charts prepared by the Research Division are derived from admission/separation forms submitted to Hospital Programs. Note that the figures given are for fiscal year 1980/81. Readers interested in the more detailed statistics hospitalization in British Columbia may wish to refer Statistics of Hospital Cases Discharged During 1980/j and Statistics of Hospitalized Accident Cases, 1980/8 available from the Research Division. Percentage distribution of days of care* by major diagnostic groups, Hospital Programs, 1980/8 Table 23 Infective and parasitic diseases 1.3% Skin 1.3* Congenital anomalies 1.3%. Metabolic diseases 2.3% Other 3.8% Nervous system 4.1% Genito-urinary system 5.7% Mental disorders 6.9% Respiratory system 8.6% Neoplasms 11.2% Skin 1.1 Infective and parasitic diseases 1.0% Dl-defined conditions 2.1% Metabolic disorders 2.6% Other 3.1% Nervous system 3.4% Respiratory system 5.4% Genito-urinary system 6.6' Bones 7.2%. Mental disorders 7.4% Neoplasms 9.5% Males Circulatory system 18.2W Females Accidents 17.39m Digestive system 11.6% Circulatory system 14.3*3 Bones 6.9% Deliveries 14.3*9 Accidents 12.99B Digestive system 10.0% Administration and payments to hospitals —1977/78-1981/82 Administration Grants to hosptials.. Total 1977-78 $ 3,856,217 573,896,901 577,753,118 1978-79 $ 4,237,158 627,145,613 631,382,771 1979-80 $ 4,459,302 696,184,526 700,643,828 5 5,317,086 959,961,923 965,279,009 1981-82 $ 7,256,765 1,078,601,170' 1,085,857,9352 1 Also includes special warrant for $42,682,000. ! Source: Estimate of Revenue and Expenditure, Fiscal Year Ending March 31,1982. k ual Report, 1981 37 ■ length of stay of cases* in hospitals in British Columbia, by major diagnostic groups in descending order, 1980/81 (excluding newborns) Mental disorders Certain conditions originating in the perinatal period Endocrine, nutritional and metabolic diseases Diseases of the circulatory system Neoplasms Diseases of the musculoskeletal system and connective tissue Injury and poisoning Congenital anomalies Diseases of the skin and subcutaneous tissue Provincial average length of stay Diseases of the blood and blood-forming organs Diseases of the digestive system Diseases of the nervous system and sense organs Infective and parasitic diseases Diseases of the genito-urinary system Diseases of the respiratory system Supplementary classification 'ffijgjnplications of pregnancy, childbirth, and the puerperium Symptoms, signs and ill-defined conditions * Including rehabilitative c 38 Ministry op h| U.TH Percentage distribution of hospital cases* by type of clinical service, Hospital Programs, 1980/1 Table 26 Males Psychiatric 5.3% Pediatric surgical 7.3% Pediatric medical 9.5C, Adult medical 31.5 Psychiatric 4.8% Pediatric surgical 4.0' Pediatric medical 5.6 Maternity 20.3% Females Rehabilitative care 0.7% Adult surgical 45.7% Rehabilitative care 0.6% Adult surgical 39Ht Adult medical 25.3% i Including rehabilitative care. Lual Report, 1981 39 sage distribution of hospital days* by type of clinical service, Hospital Programs, 1980/81 fcdt medical 36.59! atnc surgica 13.6% k atric medical 6.2% |i hifflric 7.0% Giabilitative care 3.3% iliatric medical 3.9% Jchiatric7.9% jfternity 12.8% ultpiedical 31.5% I eluding rehabilitative care. Males Females Rehabilitative care 3.4% Adult surgical 43.3% Pediatric surgical 2.1% Adult surgical 38.5% Home Corel Long-Term Care 42 Ministry of HealtIJ Home Care/ Long-Term Care The Long-term Care program provides in- home and institutional care to persons who can no longer function independently as the result of health-related problems. Home support services include homemaker services, community physiotherapy, home care nursing services, and adult day care. Residential care is provided in community care facilities, mental health boarding homes, licensed private hospitals, family care homes, group homes for independent living, and government institutions. During 1981 a review of the level of home- maker hours purchased was undertaken throughout the province to keep expenditures within approved budget limits. This review was initiated to identify and eliminate those services which fall outside service boundaries felt appropriate for home- makers, and which would not affect the care requirements of those receiving services. This review was successful in maintaining the overall number of services and clients within budgetary allocations. An internal working committee within the Long-term Care program initiated and drafted revised facility standards, which would sure a minimum standard of care through all facilities in the province. Work was c touing on a final draft of these standai which could then be implemented in.Bier fiscal year. Preliminary discussions for a revised fu ing system were initiated between the Mil- try and the B.C. Association of Private G Facilities (PRICARE). Although the details revised system were not finalized, it is anl pated that such a system could be imp mented in the next fiscal year. An outside consultant was retained to a duct a feasibility study on the needs of behaviourally-disturbed elderly. A propo was then developed for the establishment short stay assessment and treatment cent and special care units for the specific need; the psychiogeriatric or behaviourally-d turbed elderly. This proposal was being viewed by senior Ministry staff at year-ei Since January 1980, the construction of additional 2,600 intermediate-care beds v approved, with 1,435 opening in 1981. Al: an additional 12 adult day centres wt opened in 1981. fjAL Report, 1981 «] Long-Term Care Program services provided Homemaker agencies Adult day care Assessment and treatment centres Family care homes Group homes Non-profit facilities Proprietary faculties Mental health boarding homes Private hospitals 23 106 129 175 32 | 111 159 17 11 211 222 Nonprofit Propria. 36 No. of clients 26,573 1,253 1,995 43,876 ■utilization 30 Bte(%) Age-specific utilization rates by source of care (March 31,1981) Average utilization over 65: forility clients (includes extended care) 6.6% Homemaker services 7.7% FAC = Facility HMKR = Homemakei 44 Ministry of Health Number of Long-Term Care clients Table M November 1979-September 1981 Facility Homemaker clients clients 27,000. 26,573 26,000; . 25,000. 24,322 24,000. IISE 22,000 i 20,000. Mumber 18,137 i )f 18,000, :IientS 16,000. 16,570 HW£|1 15,096 15'757 nK»|» ■ 14,000. - j I 12,000. j 10,000, 1 8,000 i . i w 6,000. ! 4,000. • ! i ffl 2,000. ■ f il !■ 11 ML Nov./79 Sept./80 Sept./81 Nov./79 Sept./80 Sept./81 rable 31 Number of Long-Term Care clients Facilities Homemaker Nov./79 Sept./80 Sept./81 Nov./79 Sept./80 Sept./ Personal can 5,391 5,057 4,573 3,975 4,218 4,734 2,656 3,047 3,485 2,029 2,423 2,739 1,045' 1,012' 1,039' 10,811 14,231 15,3i 3,531 5,035 5,9: 2,038 2,843 2,9! 823 1,081 m 934 1,132 1,K Extended ca -e Tote 1 15,096 15,757 16,570 18.1372 24,322' 26,551 1 Does no 2 Figures i include extended care clients in public extendec efer to clients approved for service. This may be care units. 10-15% higher than the figure for cli ;nts actually receiving service. [JAL ; cent Report, 1981 Facility utilization rates for persons 65 and over 65-69 70-74 75-79 80-84 Facility utilization rates for persons 65 and over (figures are percentages of the general population) 75-79 85-89 901 egional District ancouver Regional District.. ;rof British Columbia I Average 0.83% 1.36% 0.93% 1.12% :.82 !.50 1.94 '.18 4.08 5.30 4.86 4.96 8.98 11.63 12.21 11.37 18.42 20.66 23.72 21.20 '41.25 40.71 40.75 40.81 Homemaker utilization rates for persons 65 and over UiU 65-69 70-74 75-79 80-84 85-89 90 + Homemaker utilization rates for persons 65 and over (figures are percentages of the general population) 65-69 ' egional District... 'ancouver Regional District. 'er of British Columbia "1 Average 1.62% 2.88% 3.23% 2.86% 3.27 5.63 6.44 5.63 6.34 9.44 12.14 9.96 11.24 14.45 18.29 15.16 17.76 16.59 21.52 18.30 18.59 18.24 20.78 19.05 Fi 46 Ministry of Healti Composition of the provincial facility population by care level Per cent 25 j 20 | 15 10 5 Ul ■ ■ ■ PC IC1 IC2 IC3 EC Composition of the provincial facility population by care level (rows total 100%) Table 37 (includes extended care units).; PC Under 65 65-69 70-74 80-84 V..J§ 85-89 90+ All clients 30.0% 26.2% 25.1% 25.2% 25.2% 18.0% 25.0 23.9 24.0 23.6 21.0 21.0 17.1 17.6 16.7 16.8 16.9 16.0 14.5 14.5 14.0 12.8 11.6 13.0 13.4 17.8 20.2 21.6 25.3 32.0 24.5 22.6 16.8 13.2 Table 38 Composition of the provincial Homemaker population by age group and care lev Per cent 60 ■ 50 ■ 40 30 ■ 20 10 ■ ■ L^ PC ici IC2 IC3 EC Composition of the provincial Homemaker population by age group care level Table 39 (rows total 100%) PC ICI IC2 IC3 EC Under 65 48.1% 61.2% 62.1% 62.9% 60.9% 55.1% 42.4% 22.0 20.9 20.7 20.9 21.5 22.0 23.8 14.7 10.8 10.3 10.1 11.0 13.5 14.1 6.0 3.4 3.7 3.4 4.1 5.5 9.6 9.2 3.7 3.2 2.7 2.5 3.9 10.1 4.5 65-69 70-74 j 75-79 80-84 85-89 90+ ..<:.: ;'.::...- All clients 57.6 21.5 11.8 4.6 tjal Report, 1981 Home Nursing Care Program S^ distribution by age groups or patients admitted to the Home Nursing Care Program April 1,1979-March 31,1980 Home Nursing Care Program age distribution by age group and category of patients admitted to the Home Nursing Care Program April 1,1979 to March 31,1980 lerl year.. Jagears SM years.... IS4 years... '74 years... '34 years... ^ears I TOTAL... Age Percentage hospital replacement 11 6 6 4 Percentage non-hospital replacement 7 9 20 19 10 Total percentage 3 4 18 15 26 23 48 Ministry of Heaiti- Home Nursing Care Program Percentage distribution and number of Home Nursing Care patients by diagnostic groups in descendi order April 1,1979 to March 31,1980 Table 42 Diagnosis Number of patients Percentage of total patients 1. Circulatory 2. Malignant neoplasms 3. Accidents 4. Gastrointestinal 5. Musculoskeletal 6. Endocrine .jf...... 7. Skin 8. Childbirth 9. Symptoms undiagnosed 10. Respiratory 11. Nervous system 12. Gynecology 13. Blood disorders 14. Perinatal 15. Genitourinary 16. Mental disorders 17. Sense organs 18. Nonmalignant neoplasm i9. Infective 20. Congenital TOTAL ..... 9,083 5,647 5,628 5,289 3,484 2,851 2,829 2,760 2,292 2,032 1,803 1,779 1,210 1,025 965 921 865 727 486 242 51,918 17.51 10.9 10.8 10.2 6.7 4.4] 3.9 3.5 3.4 2.3 2.0 1.9 1.8 1.7 1.4 0.9 0.5 1 permits.. BlOs INTERMEDIATE CARE 13 815 382 Licences 17 Capacities 1,007 Licences Capacities., 10 y/4 irically Disabled 1 -im permits.. jacities l8— ikot permits.. icities i' Retarded <- i:im permits., HBnes ,:im permits., iaaties , and Drugs •- a rim permits.. tadties sig— irim permits.. acities SPECIALIZED RESIDENTIAL CARE 10 104 15 245 10 105 2 10 Licences Capacities.. Licences Capacities.. Licences Capacities.. Licences Capacities.. Licences Capacities. Licences Capacities I 13 123 4 36 7 86 1 15 2 26 Closures Table 44 PERSONAL CARE Licences 16 Capacities 273 INTERMEDIATE CARE Licences Capacities.. SPECIALIZED RESIDENTIAL CARE Psychiatrically Disabled Licences 8 Capacities 78 Mentally Retarded Licences 6 Capacities 37 Alcohol and Drugs Licences 4 Capacities 144 Total of 34 facilities, with a capacity of 532, were closed. ^»~l 50 Ministry of HeaIM Table 45 The Provincial Child Care Facilities Licensing Board 1981 statistics == Child Out of Nursery Kinder Group Family Specialized Residence for children Specialized minding school garten day care day care day care residence Amendme Interim permits.. 12 73 39 0 37 75 1 12 6 Capacities.. 216 418 601 0 657 345 12 76 60 Licences.... 16 108 41 0 43 138 6 16 1 45 Capacities. 292 660 740 0 870 606 70 98 30 120 669 new interim permits and licences with a total capacity of 5,871 in 1981 Table 46 Closures in 1981 Child minding Out of school Nursery Group daycare Family day care Specialize daycare Facilities Capacities.. 6 77 36 468 29 408 102 44 181 facilities, with a total capacity of 1,537, were closed. Ministry of Health Expenditures 52 Ministry of Health Expenditures by Principal Categories in the Ministry of Health \\ e47 for the Fiscal Year 1980/81 Total Expenditure Fiscal Year Ended March 31,1981 $ 1 Minister's Office 204,244 Administration and Support Services 23,872,360 Preventive Services 39,733,614 Direct Care Community Services 261,536,823 Hospital Programs 965,276,999 Medical Services Commission 537,876,762' Emergency Health Services Commission 37,154,274 Forensic Psychiatric Services Commission 4,935,300 Alcohol and Drug Commission 12,805,505 Building Occupancy Charges 29,850,614 Computer and Consulting Charges 2,317,000 1,915,563,495 Statutory Interest on Overdue Accounts 5,101 1,915,568,596 1 The expenditure of $537,876,762 shown for Medical Services Commission is the gross operating cost as shown in the detai statements of the Public Accounts. The actual charge to Vote 119 was $352,335,891 and covered the subsidy by the province for low-inco residents and the estimated deficits not covered by premiums and other revenue. Also included in the Medical Services Commission w charge of $13,501,609 for Dental Care Services which will be shown separately in the Public Accounts. .Report, 1981 ^^KikL-i.' 53 failed Expenditure by Principal Categories in the Ministry of Health for the Fiscal Year 1980/81 Total Expenditure Fiscal Year Ended March 31, 1981 $ jet's Office 204,224 i istration and Support Services 23,872,360 ■i tive Services: $ Hentive Programs ^ 36,284,203 lints—Health Services 3,449,411 39,733,614 p Care Community Services: ilg Term Care 168,199,777 fee Care 12,164,818 nnrnunity Physiotherapy Lj 516,836 Rising Boards 537,906 Stal Health 55,645,968 Kernment Hospitals 24,471,518 j:al Programs: ministration 5,317,086 yments to Hospitals: ■paims 916,179,454 »jrants in Aid of Equipment 8,754,673 KCapital and Debt Service 35,025,786 lal Services Commission: Baits: ^Medical Care 484,945,915 ■Additional Benefits JMW 28,567,705 Administration 24,363,142 261,536,823 965,276,999 537,876,762 ;ency Health Services Commission 37,154,274 ic Psychiatric Services Commission 4,935,300 nil and Drug Commission 12,805,505 Ing Occupancy Charges ... 29,850,614 ruter and Consulting Charges 2,317,000 ury: terest on Overdue Accounts 5,101 Bbtal, Ministry of Health 1,915,568,596 ' 54 Ministry of Health Medical Services Plan Financial Statement Auditor's Report To the Chairman oi the Medical Services Commission of British Columbia, and To the Minister of Health Province of British Columbia: I have examined the statement of financial position of the Medical Services Commissron British Columbia as at 31 March 1981 and the statement of operations and working capita deficiency for the year then ended. My examination was made in accordance with generall accepted auditing standards, and accordingly included such tests and other procedures as considered necessary in the circumstances. In my opinion, these financial statements present fairly the financial position of the Commis sion as at 31 March 1981 and the results of its operations for the year then ended in accordance witl generally accepted accounting principles, as modified by Note 1 to the financial statements applied on a basis consistent with that of the preceding year. ERMA MORRISON, C.A. Auditor General Victoria, B. C. 29 May 1981 Exhibit Medical Services Commission of British Columbia Statement of Financial Position Table 49 March 31,1981 1981 1980 $ $ Assets Cash 5,120,829 4,197,35! Accounts receivable 1,534,395 1,588,64( Due from the Province of British Columbia 20,000,000 26,655,224 5,785,99: Liabilities Bank overdraft 1,419,622 Accounts payable 1,566,977 527,50: Premiums received in advance 18,104,034 15,923,52.1 Estimated liability for unpresented and unprocessed benefit claims 61,500,000 52,500,0Utl 82,590,633 68,951,02:| Working Capital Deficiency—Exhibit B 55,935,409 26,655,224 The accompanying notes are an integral part of these financial statements. Approved by the Commission: Dr. D. M. Bolton, Chairman • i Report, 1981 Medical Services Commission of British Columbia Statement of Operations and Working Capital Deficiency for the Year Ended March 31,1981 kbers' premiums (Note 1) t e of British Columbia premium assistance.. Ore is ;cal care Immal benefits.. titration lies and employee benefits I (processing expenses leal office expenses i pancy expenses a operating expenditure over revenue.. ttions p:e of British Columbia j...„ icapital def iciency- ■mg of year i capital def iciency- jyear—Exhibit A 1981 1980 $ $ 179,862,707 155,217,061 34,903,114 31,456,261 214,765,821 186,673,322 484,945,915 407,936,214 28,567,705 23,534,808 513,513,620 431,471,022 11,912,554 10,750,191 8,472,953 6,356,216 2,773,558 1,723,919 1,204,077 1,052,762 24,363,142 19,883,088 537,876,762 451,354,110 323,110,941 264,680,788 330,340,564 258,032,994 (7,229,623) 6,647,794 63,165,032 56,517,238 55,935,409 63,165,032 Medical Services Commission of British Columbia Notes to Financial Statements March 31,1981 I fit accounting policies K financial statements have been prepared in accordance with generally accepted ac- ■Brinciples except that: Iffiemiums from individual subscribers are included in revenue only when cash is re- jceived. Premiums from other sources are recognized as revenue on an accrual basis. irhe cost of furniture and equipment is charged to administration expenses in the year of Inquisition. iNo accrual for holiday pay is provided for salaried employees. BIyears' statements were headed Medical Services Plan of British Columbia Operated by ■er the Medical Services Commission of British Columbia. 56 Ministry of HealtI Forensic Psychiatric Services Commission Statement of Expenditure for the Period April 1,1980 to March 31,1981 Table 51 Vote 121 Expenditure by Standard Classification $ Salaries 3,767, Temporary salaries 280^ 47047; Travel expense 43 Professional and special services 709 Office expense..... 25, Office furniture and equipment Materials and supplies 286, Acquisitions—machinery and equipment Grants, contributions and subsidies ,,,„ 53 5,179 Less transfers: Vote 100—salary adjustment 227,387 Vote 178—employee 6,147 Vote 185—pre-retirement leave 10,744 Total transfers ^.al-,..i.g.,^.,J 244 4,935, Alcohol and Drug Commission Financial Statement of Expenditures Table 52 April 1,1980 to March 31,1981 By Activity $ $ Alcoholism treatment and rehabilitation program 8,270, Heroin treatment program (net of recoveries) 4,535, 12,805, By standard expenditure classification Salaries—permanent lT^n..L^..^„r 6,534, Salaries—temporary assistance 1/374, Travel 157, Professional and special services 460, Office expense 1"°' Office furniture and equipment "■* Materials and supplies &*> Acquisition—machinery and equipment •*■ Grants *S *£. 5,617, Sub-total , i.U.. 14<933- Less Salary and employee benefit transfers from Votes 100 and 178 101,961 Subsidy from drug, alcohol and cigarette education prevention and rehabilitation fund «** »K,4isM«,.:i'.,».,. 2,021,989 Other fcu i:aaa.fetfe.M..tefo.s9 4,312 JJ28J 12,805,! [Report, 1981 Expenditure by Principal Categories in the Ministry of Health for Fiscal Year 1980/81 [Table 53 Other: Forensic $4.9 million Alcohol and Drug $12.8 million Administration $56.2 million Preventive Services $39.7 million Emergency Health Services $37.2 million Total Health Services in 1980/81 — $1,915.6 million """@en ; edm:hasType "Legislative proceedings"@en ; dcterms:identifier "J110.L5 S7"@en, "1982_V01_16_001_057"@en ; edm:isShownAt "10.14288/1.0372107"@en ; dcterms:language "English"@en ; edm:provider "Vancouver : University of British Columbia Library"@en ; dcterms:publisher "Victoria, BC : Government Printer"@en ; dcterms:rights "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"@en ; dcterms:source "Original Format: Legislative Assembly of British Columbia. Library. Sessional Papers of the Province of British Columbia"@en ; dcterms:title "Ministry of Health Annual Report 1981"@en ; dcterms:type "Text"@en ; dcterms:description ""@en .