CONTENTdm
HOSPITAL INSURANCE SERVICE, 1972
Sessional Papers of the Province of British Columbia
British Columbia. Legislative Assembly
application/pdf
PROVINCE OF BRITISH COLUMBIA HOSPITAL INSURANCE ACT Twenty-fourth Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1972 Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty in right of the Province of British Columbia. 1973 Victoria, B.C., January 20, 1973. To Colonel the Honourable John R. Nicholson, P.C., O.B.E., Q.C., LL.D., Lieutenant-Governor of the Province of British Columbia. May it please Your Honour: The undersigned has the honour to present the Twenty-fourth Annual Report of the British Columbia Hospital Insurance Service covering the calendar year 1972. DENNIS G. COCKE Minister of Health Services and Hospital Insurance British Columbia Hospital Insurance Service, Victoria, B.C., January 20, 1973. The Honourable Dennis G. Cocke, 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 1972. WILLIAM J. LYLE, F.C.I.S. Deputy Minister of Hospital Insurance The Honourable Dennis G. Cocke, Minister of Health Services and Hospital Insurance. DEPARTMENT OF HEALTH SERVICES AND HOSPITAL INSURANCE BRITISH COLUMBIA HOSPITAL INSURANCE SERVICE The Honourable Dennis G. Cocke, Minister of Health Services and Hospital Insurance. Senior Administrative Staff W. J. Lyle, F.C.I.S., Deputy Minister of Hospital Insurance. J. W. Mainguy, B.A., M.H.A., Assistant Deputy Minister of Hospital Insurance. C. F. Ballam, M.D., Senior Medical Consultant. N. S. Wallace, C.G.A., Manager, Hospital Finance Division. K. G. Wiper, Senior Administrative Officer. P. Breel, Manager, Hospital Consultation and Inspection Division. D. S. Thomson, B.A., M.P.A., Director, Research Division. J. G. Glenwright, Manager, Hospital Construction and Planning Division. D. M. N. Longridge, M.A., B.Ch., F.R.C.S., Medical Consultant. CONTENTS General Introduction British Columbia Regional Hospital Districts Act British Columbia Regional Hospital Districts Financing Authority Act The Hospital Insurance Act The Hospital Act Persons Entitled to or Excluded From the Benefits Under the Hospital Insurance Act Entitled to Benefits Excluded From Benefits Hospital Benefits Available in British Columbia In-patient Benefits Other Benefits Application for Hospital Insurance Benefits The Hospital Rate Board and Methods of Payment to Hospitals BCHIS Planning Group Organization and Administration Assistant Deputy Minister- Hospital Consultation and Inspection Division . Research Division Hospital Finance Division Hospital Accounting Hospital Claims Section Hospital Construction and Planning Division. Page . 13 . 15 . 16 . 16 . 17 17 17 17 18 18 18 19 19 20 21 21 21 23 24 25 26 28 Hospital Projects Completed During 1972 30 Hospital Projects Under Construction at Year-end 31 Projects for Which Tenders Have Been Called but no Contract yet Awarded 35 Projects in Advanced Stages of Planning 35 Additional Projects Approved and in Various Planning Stages in 1972 35 Medical Consultation Division- Administration Division 37 39 Eligibility Representatives' Section 39 Third-party Liability Section 40 General Office 40 Information Office_ .. 41 11 P 12 BRITISH COLUMBIA Approved Hospitals. Page . 42 . 42 . 43 . 43 Public Hospitals Outpost Hospitals Federal Hospitals Private Hospitals (Providing General Hospital Services) 43 Rehabilitation Hospitals 43 Extended-care Hospitals 43 Statistical Data. 44 Table Ia—Patients Separated and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public General Hospitals Only (Excluding Federal, Private, Extended-care, and Out-of- Province Hospitalization) 45 Table 1b—Total Patient-days and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public General Hospitals Only (Excluding Federal, Private, Extended-care, and Out-of- Province Hospitalization) 46 Table 2a—Patients Separated, Total Days' Stay, and Average Length of Stay According to Type and Location of Hospital for BCHIS Patients Only, and Days of Care per Thousand of Covered Population 47 Table 2b—Summary of the Number of BCHIS In-patients and Outpatients 48 Table 3—Patients Separated, Total Days' Stay, and Average Length of Stay in British Columbia Public Hospitals for BCHIS Patients Only, Grouped According to Bed Capacity, Year 1972 (Excluding Extended-care Hospitals) 48 Table 4—Percentage Distribution of Patients Separated and Patient-days for BCHIS Patients Only, in British Columbia Public Hospitals. Grouped According to Bed Capacity, Year 1972 (Excluding Extended-care Hospitals) 4 8 Charts 49 I—Percentage Distribution of Days of Care by Major Diagnostic Groups, 1971 50 II—Percentage Age Distribution of Male and Female Hospital Cases and Days of Care, 1971 51 III—Percentage Distribution of Hospital Cases by Type of Clinical Service, 1971 52 IV—Percentage Distribution of Hospital Days by Type of Clinical Service, 1971 53 V—Average Length of Stay of Cases in Hospitals in British Columbia by Major Diagnostic Groups, 1971 (Excluding Newborns) 54 Hospitalization by Major Diagnostic Categories, 1971 (Excluding Newborns)— 55 Statement of Receipts and Disbursements for the Fiscal Year Ended March 31, 1972. 61 Twenty-fourth Annual Report of the British Columbia Hospital Insurance Service GENERAL INTRODUCTION Wm. J. Lyle, F.C.I.S., Deputy Minister On December 31, 1972, the British Columbia Hospital Insurance Service completed 24 years of operation, nearly a quarter of a century of continuous and vital development in the provision of expanded hospital facilities and improved services for residents of British Columbia. This development could not have been achieved without the co-operation and joint effort of the boards and staff of hospitals, the medical profession, regional hospital districts, and the Provincial Government. I would like, at this point, to pay special tribute to Donald M. Cox, who retired as Deputy Minister during the past year, and who guided this Service from its infancy and placed the planning and operation of hospitals on a sound basis. Mr. Cox has been an outstanding administrator and deserves much credit for the tremendous development in the hospital field which exists today in British Columbia. During 1972, payments to hospitals, toward expenses incurred by residents, totalled $220,000,000, which is the equivalent of $97.38 being paid on behalf of each man, woman, and child residing in British Columbia. Hospital insurance daily payments to hospitals amounted to $602,740 as compared with $534,247 in the 1971 calendar year, an increase of 12 per cent. A number of hospitals has encountered operating difficulties since 1970, due in part to policy which did not allow acceptance of the total wage-rate increases negotiated between hospitals and their employees in that year. During the last months of 1972 the Government agreed to restore the 30 per cent of wage increases not previously accepted. This was retroactive to January 1, 1972, and provided the hospitals with more than $3,000,000 in additional funds. The average length of stay of in-patients continued to decrease, and for 1972 is estimated to be 8.78 days compared with 8.94 days for public hospitals in British Columbia during 1971. While this further reduction of about one-sixth of a day may not seem significant, it does mean that the total days of in-patient care provided by the public hospitals in British Columbia would have been 60,505 more than the estimated 3,320,087 for 1972 if the decrease in average stay had not taken place. Of greater significance is the trend recorded during the past 10 years, since in 1963 the average length of stay of adult and child patients was 9.65 days compared with the estimated 8.78 days for 1972, a reduction of 0.87 of a day. If this reduction had not been achieved, the 378,154 patients admitted by public hospitals in British Columbia in 1972 would have recorded an additional 328,000 patient-days of care, or 10 per cent more than the number estimated for the year. To provide an additional 328,000 patient-days of care would call for more than 1,000 hospital beds. 13 P 14 BRITISH COLUMBIA There are many reasons for the continuing decrease in the average length of stay of in-patients apart from improvements in medical treatment, new techniques, and medications, and one of the most important is the control of patient stay by the medical staff of hospitals. Another contributing factor is the development of extended hospital care units to which long-term patients are transferred. Hospital construction projects under way at year-end, many due for completion early in 1973, will cost an estimated $20,546,560. Major projects completed during the year involved construction of space and services for a total of 950 new beds, of which 586 were for extended care. In addition, 1,164 beds were under construction at year-end, with 679 of these for extended care. Details of construction projects are shown commencing with page 30. There has been a dramatic increase in open-heart surgery in British Columbia over the past four years, as indicated by the following comparisons: Operations 1969 252 1970 348 197L ..476 1972 600 (estimated) Surgery for correction of congenital defects and valve replacements has remained relatively constant. The great increase has been in coronary artery bypass procedures, and there are strong indications there will be a similar rate of increase over the next few years. In accordance with recommendations of the Third Heart Surgery Review Committee, approval was given for construction and renovation programmes at the Vancouver General Hospital; St. Paul's Hospital, Vancouver; and the Royal Jubilee Hospital, Victoria. The Vancouver General Hospital has been given the use of the second floor of the east wing in the Willow Chest Centre. Renovations are now well under way, with the enlarged unit scheduled for opening in February 1973. Upon completion, there will be 27 beds, including recovery and intensive-care beds, and the unit will have the full use of two operating-rooms and related facilities, with a third operating- room being available for emergency and other use not normally requiring a "heart lung pump." The capacity of the new unit will be 20 operations a week. St. Paul's Hospital proposed to place its chapel elsewhere in the hospital and construct in the existing chapel area a 15-bed unit for open-heart surgery patients. This was approved as was a later proposal to construct, on the second floor of the chapel space, a respiratory treatment unit to serve the entire hospital. Construction on the combined project commenced on December 11, 1972, with completion planned for May 1973. The new unit can provide for up to six operations a week. The open-heart surgery unit of the Royal Jubilee Hospital, Victoria, will have a capacity of two operations a week. The hospital is completing its plans and is placing orders for equipment. Because of the time required for staff training and perfecting team techniques in an entirely new unit, the hospital does not anticipate that it will be ready to admit patients until the summer of 1973. Earlier in the year, Shaughnessy Hospital looked into the possibility of developing an open-heart surgery unit for veterans whose hospitalization will, in most instances, be chargeable to the British Columbia Hospital Insurance Service. In view of the number of patients awaiting open-heart surgery, the Hospital Insurance Service gave strong support to the project, and the hospital was urged to proceed as quickly as possible. The first open-heart operation was performed there on December 5, 1972. HOSPITAL INSURANCE SERVICE, 1972 P 15 The four hospitals will have a combined capacity of more than 1,500 open- heart surgery procedures a year. During the past year, hospital insurance coverage was made available to cover diabetic day-care services at four selected hospitals in the Province. The Methadone Treatment Programme, provided by the Narcotic Addiction Foundation in Vancouver, was extended to cover treatment in centres established in Victoria, Prince George, Nanaimo, Trail, Coquitlam, and Kamloops. Costs of pharmacy and laboratory service is provided by the Service, as well as social service work for the Vancouver unit. Assistance continued to be given by Hospital Insurance personnel in the devel- opement of programmes for personal care units in Vancouver, Victoria, and Kamloops being constructed by the Provincial Government. During the year a ways and means committee was set up to assist in the implementation of recommendations contained in a report, prepared for the former Minister, on cancer services in British Columbia. The Hospital Insurance Service is represented on this committee. The Service is also represented on such committees as the B.C. Medical Association's Hospitals Committee, the Advisory Sub-committee for Chronic Renal Failure, and other committees involved in the development of special services. Throughout the year, helpful advice and guidance were provided by the medical profession, and I should like to thank the College of Physicians and Surgeons and the B.C. Medical Association for their co-operation. The continuing assistance of the B.C. Hospitals' Association, the Registered Nurses' Association, and the Architectural Institute of British Columbia is appreciated. My appreciation also to the laboratory and radiological advisory councils for helping hospitals to improve laboratory and radiological services and in advising this Service regarding the approval of Provincial grants-in-aid for purchasing major hospital equipment. Also, I would like to express my appreciation and thanks to the staff of the Hospital Insurance Service for the conscientious way in which they performed their varied roles over the past year. Reports by the various divisions which comprise the administrative structure of this Service commence on page 21 under the heading "Organization and Administration." BRITISH COLUMBIA REGIONAL HOSPITAL DISTRICTS ACT The Act provides for the division of the Province into large districts to enable regional planning, development, and financing of hospital projects to be carried out under a formula which provides substantial financial assistance from the Provincial Government toward the capital cost of hospital projects. The Province was divided into 29 areas, and 28 of them have been incorporated as regional hospital districts. The district not incorporated is located in an area without hospitals in the northern part of the Province. As is the case with school construction, each regional hospital district, subject to the requirements of the Act, is able to pass money by-laws authorizing debentures to be issued covering the total cost of one or more hospital projects. When approval has been obtained from the Minister of Health Services and Hospital Insurance, the district is able to raise any funds immediately required by temporary bank borrowing on a uniform basis. The Regional Hospital Districts Financing Authority (see page 16) in due course issues and sells its own debentures. At that time the districts are able to sell their long-term debentures to the Authority. Following this, a district can repay any sum which has been temporarily borrowed from a bank. P 16 BRITISH COLUMBIA Each year the Provincial Government pays through the Hospital Insurance Service its share of the amortization cost in accordance with section 22 of the Act. Each district in turn raises, by taxation, the remainder of the annual amortization cost required to retire its debentures which are held by the Authority. Under the formula the Province pays annually to each district 60 per cent of the net cost of amortizing the district's borrowings for an approved hospital project, after deduction of any items which are the district's responsibility, such as provision of working funds for hospital operation, etc. If a 4-mill tax levy by the district is inadequate to discharge its responsibility in regard to annual charges on old debt for hospital projects, as well as the remaining 40 per cent of the charges on the new debt resulting from hospital projects, the Province will provide 80 per cent of the funds required in excess of the 4-mill levy. The affairs of each regional hospital district are managed by a board comprised of the same representatives of the municipalities and unorganized areas who comprise the board of the regional district (incorporated under the Municipal Act) which has the same boundaries as the regional hospital district. The board of the regional hospital district is responsible for co-ordinating and evaluating the requests for funds from hospitals within the district, and for presenting money by-laws to the taxpayers in respect of either single projects or an over-all programme of hospital projects for the district. A hospital society or corporation is not compelled to seek financing under this Act if the cost of the project, over and above the amount of the Provincial Government grant, can be raised by other means. BRITISH COLUMBIA REGIONAL HOSPITAL DISTRICTS FINANCING AUTHORITY ACT This Act established a Provincial Government authority similar to the one set up to assist school districts in financing their projects. The functions of the Authority are referred to briefly in the second paragraph of the preceding commentary regarding the Regional Hospital Districts Act. THE HOSPITAL INSURANCE ACT This is the statute which authorizes British Columbia's hospital insurance plan, and under which the British Columbia Hospital Insurance Service is established. The main provisions of this Act and the regulations may be summarized as follows: (1) Generally speaking, every permanent resident who has made his home in British Columbia during the statutory waiting-period is entitled to benefits under the Act. (2) Approved hospitals are paid an all-inclusive per diem rate for medically necessary in-patient care rendered to qualified British Columbia residents who are suffering from an acute illness or injury, and those who require active convalescent, rehabilitative, and extended hospital care. The payment made to a hospital by the British Columbia Hospital Insurance Service amounts to $1 less than the per diem rate approved for the particular hospital, and the patient is responsible for paying the remaining dollar. The Provincial Government pays the dollar-a-day charge on behalf of Provincial social welfare recipients. (3) The wide range of in-patient and out-patient benefits provided under the Act are described on the following pages. HOSPITAL INSURANCE SERVICE, 1972 P 17 (4) Qualified persons who are temporarily absent from British Columbia are entitled to certain benefits for a period of 12 months following their departure from the Province. THE HOSPITAL ACT One of the important functions of the British Columbia Hospital Insurance Service is the administration of the Hospital Act. The Deputy Minister of Hospital Insurance is also the Chief Inspector of Hospitals for British Columbia under the Act. The Hospital Act controls the organization and operation of hospitals, which are classified as follows: (1) Public hospitals—nonprofit hospitals caring primarily for acutely ill persons. (2) Private hospitals. This category includes (a) small public hospitals, most of which are operated in remote areas by industrial concerns primarily for their employees, and (b) licensed nursing-homes which are not under hospital insurance coverage. (3) Rehabilitation and extended-care hospitals. These nonprofit hospitals are primarily for the treatment of persons who require intensive rehabilitative and extended hospital care. PERSONS ENTITLED TO OR EXCLUDED FROM THE BENEFITS UNDER THE HOSPITAL INSURANCE ACT Entitled to Benefits A person is entitled to benefits if he qualifies as a beneficiary under the Hospital Insurance Act. Generally speaking, a person is a beneficiary if the provision of hospital care is a medical necessity, and if he establishes that he qualifies under one of the following categories: (a) He is the head of a family, or a single person, who has made his home in the Province and has lived continuously therein during the statutory waiting-period (which expires at midnight of the last day of the second month following the month in which the person moved to the Province); or (b) Having qualified under item (a), he leaves the Province temporarily and returns after an absence of less than 12 months and resumes residence within the Province; or (c) He is living within the Province and is a dependent of a resident of the Province. During the statutory waiting-period, a person is permitted to be temporarily absent from British Columbia for a brief period without incurring any postponement of the date on which he becomes a beneficiary. With regard to item (c) above, a dependent is either the spouse of the head of a family or a child under 21 years of age who is mainly supported by the head of a family. Excluded From Benefits Some of the main classes of persons either permanently or temporarily excluded from benefits are as follows: (a) A person who works full or part time in British Columbia but resides outside the Province; or 2 P 18 BRITISH COLUMBIA (b) A qualified person who leaves British Columbia temporarily and fails to return and re-establish residence within 12 months; or (c) A qualified person who leaves British Columbia and who establishes residence elsewhere; or (d) An inmate of a Federal penitentiary; or (e) A resident who receives hospital treatment provided under the Workmen's Compensation Act, or a war veteran who receives treatment for a pensionable disability; or (f) Persons entitled to receive hospital treatment under the Statutes of Canada or any other government; for example, members of the armed forces or Royal Canadian Mounted Police, and consular officials of other countries. HOSPITAL BENEFITS AVAILABLE IN BRITISH COLUMBIA In-patient Benefits In addition to standard-ward accommodation with meals and necessary nursing services, a beneficiary may receive any of the other services available in the hospital, which may include laboratory and X-ray services; drugs, biologicals, and related preparations (with a few exceptions); use of operating-room and caseroom facilities; use of anaesthetic equipment, supplies, and routine surgical supplies; use of radiotherapy and physiotherapy facilities where available; other approved services rendered by employees of the hospital. (Note—Private or semiprivate rooms cost more to maintain than standard wards, and the patient is required to pay extra for such accommodation if it is requested by or on behalf of the patient.) Other Benefits The following services and treatments are also provided in British Columbia public hospitals to beneficiaries who do not require in-patient care: Emergency treatment within 24 hours of being accidentally injured. Operating-room or emergency-room services for minor surgery, including application and removal of casts. Day-care surgical services are available to patients who require operating room or other specialized-treatment facilities, but who can be discharged within 24 hours. Out-patient cancer therapy is provided by the branches of the B.C. Cancer Institute in Vancouver and Victoria. Day-care and night-care psychiatric services are available to patients who come to a designated hospital for an organized programme of treatment which requires that they remain for a minimum of seven hours, but does not necessitate formal admission as in-patients. Out-patient psychiatric care is available to patients who come to a designated hospital for a particular psychiatric service. (During 1972 the number of hospitals authorized to provide day-care and outpatient psychiatric services as insured benefits was increased.) HOSPITAL INSURANCE SERVICE, 1972 P 19 A cytology service provides for examination of cervical smears for the early detection of cancer in women. The service is operated by the B.C. Cancer Institute and is universally available for residents of the Province. Day-care rehabilitative services at the G. F. Strong Rehabilitation Centre in Vancouver apply to patients requiring an organized and comprehensive programme of treatment which would require that they remain at the centre for at least a half day. A methadone substitution programme established by the Narcotic Addiction Foundation of British Columbia is available at six centres in the Province. Coverage for diabetic day-care services is now available in a number of the larger hospitals in the Province. Day-care services at The Arthritis Centre of British Columbia, Vancouver, which is operated by the Canadian Arthritis and Rheumatism Society, British Columbia Division, is now under hospital insurance coverage. This centre provides physiotherapy and other services on an out-patient basis to persons suffering from arthritis and rheumatism. A beneficiary is required to pay a nominal sum for each visit to the hospital for these services, and the remainder of the cost is paid by the British Columbia Hospital Insurance Service. Charges for medical services incurred at the hospital are payable by the British Columbia Hospital Insurance Service, and nonbenefici- aries are required to pay the full charge for the hospital services and treatment received. APPLICATION FOR HOSPITAL INSURANCE BENEFITS At the time of admission to hospital, a patient wishing to apply for coverage under the hospital insurance programme is required to make an Application for Benefits. The hospital is responsible for verifying the patient's statements regarding length of residence, etc., to determine if the patient is a qualified resident as defined in the Hospital Insurance Act and regulations. Payment is then requested by the hospital from the British Columbia Hospital Insurance Service, which may reject any account if either the patient's status as a qualified resident or the medical necessity for his receiving hospital-care benefits has not been satisfactorily established. THE HOSPITAL RATE BOARD AND METHODS OF PAYMENT TO HOSPITALS The Hospital Rate Board, appointed by Order in Council, is responsible for advising the Deputy Minister in regard to the rates of payments to hospitals for both in-patient and out-patient benefits. A system of firm budgets for hospitals, which, with modifications, has been in use since January 1, 1951, provides for a review of hospitals' estimates by the Rate Board. Under the firm-budget procedure, hospitals are required to operate within the total of their approved budgets, with the exception of fluctuation in days' treatment and other similar items. They are further advised that deficits incurred through expenditures in excess of the approved budget will not be met by the Provincial Government. However, hospitals retain surplus funds earned as a result of keeping expenditures within the total amount approved. The value of variable P 20 BRITISH COLUMBIA supplies used in patient-care has been established. It is generally recognized that the addition of a few more patient-days does not add proportionately to patient- day costs because certain overhead expenses (such as heating, etc.) are not affected. However, some additional supplies will be consumed, and it is the cost of these variable supplies which has been determined. When the number of days' treatment provided by the hospital differs from the estimated occupancy, the budgets are increased or decreased by the number of days' difference multiplied by the patient- day value of the variable supplies. Individual studies and additional budget adjustments are made in those instances where large fluctuations in occupancy involve additions or reductions in stand-by costs. Policies to be used in the allocation of the total funds provided are approved by the Government. The Hospital Rate Board reviews the detailed revenue and expenditure estimates forwarded by each hospital and applies the policies in establishing approved budgets. Approximately 96 per cent of all in-patient hospital accounts incurred in British Columbia are the responsibility of the British Columbia Hospital Insurance Service. Cash advances to hospitals are made on a semimonthly basis, so that hospitals are not required to wait for payment until patients' accounts are submitted and processed by the British Columbia Hospital Insurance Service. Qualified patients are charged $1 per day, which is deductible when calculating payments to hospitals from the Service. Nonqualifying residents are charged the hospitals' established per diem rates, which are all-inclusive; that is, the daily rate 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. BCHIS PLANNING GROUP The Planning Group co-ordinates and expedites planning for hospital facilities. Its functions are to review research reports on hospital bed needs, study submissions from hospitals and regional hospital districts for increases in beds or services, consider other problems related to orderly planning and provision of facilities and services to meet the needs of the Province, and to consider other matters referred to it by the Deputy Minister. The Planning Group is responsible for making recommendations on these matters to the Deputy Minister. It is composed of six senior members of the service. Planning Group held 20 full meetings during the year, in addition to which members of Planning Group held a number of meetings with regional hospital district boards or committees and with representatives of hospitals. Detailed discussions were held with the advisory committee of the Greater Vancouver Regional Hospital District in connection with the programme set out in the $95 million bylaw presented to and passed by the rate-payers in December. Planning Group reviewed the contents of programmes proposed by four other regional hospital districts, of which two were placed before the ratepayers in December. The money vote of the Kitimat-Stikine Regional Hospital District, involving a comprehensive programme, was passed and so was the more limited one placed before the ratepayers by the Kootenay Boundary Regional Hospital District. Several special studies were undertaken. One of these involved diabetic day care. This resulted in hospital insurance coverage being extended to programmes in five hospitals. A comprehensive review of day-care psychiatry was also undertaken, which included a review by the programme consultant to the Mental Health Branch and a literature survey under his direction. The results of the study and recommendations were being finalized at the year-end. HOSPITAL INSURANCE SERVICE, 1972 P 21 ORGANIZATION AND ADMINISTRATION The British Columbia Hospital Insurance Service is a branch of the Department of Health Services and Hospital Insurance, the other branches being Health, Mental Health, and the Overall Medical Services Plan. During the year the Assistant Deputy Minister, W. J. Lyle, advanced to the position of Deputy Minister, and the Director, Hospital Consultation, Development and Research, J. W. Mainguy, was appointed Assistant Deputy Minister. The following reports provide a brief outline of the work carried out during 1972 by the various divisions and offices which comprise the administrative structure of this branch: ASSISTANT DEPUTY MINISTER J. W. Mainguy, B.A., M.H.A. The Assistant Deputy Minister is responsible for the operation of the Service in the absence of the Deputy Minister. He is directly responsible for the Hospital Consultation and Inspection Division and the Research Division. He is a member of both the Hospital Rate Board and Planning Group, and represents the Service on a number of committees of government and community agencies, including the Liaison Committee between the Service and the B.C. Hospitals' Association and the Sub-Committee on Quality of Care and Research, Ottawa. Hospital Consultation and Inspection Division P. M. Breel, Manager The resources of this Division are available to public and private hospitals for consultative services in all matters of hospital operation and administration, with emphasis on quality of care, utilization, and operational efficiency. The Division is responsible for an inspec- tional programme to ensure that basic standards are met, and for the licensing of private hospitals. Its staff is composed of administrative, nursing, dietary, and management engineering consultants. The Division co-operates with all other divisions of the Service in achieving aims of mutual interest and responsibility. It is responsible for the analysis, and makes recommendations, relative to hospital staffing patterns which are considered in establishing approved operating budgets. The Division is represented on the Hospital Rate Board, the Planning Group, the Functional Programme Review Committee, and the Equipment Committee. Staff members also participate in the hospital planning functions of the British Columbia Hospital Insurance Service, including the review of the operational implications of construction projects, and the setting of standards. Programmes and plans for construction are analysed and assessed in conjunction with the Medical Consultation and Hospital Construction and Planning Divisions. The Division represents the Service on a large number of councils, committees, and working parties associated with hospitals and the health field, and works with Federal, Provincial, and municipal representatives on related matters. P 22 BRITISH COLUMBIA Throughout the year, 256 visits were made to acute, rehabilitation, chronic, convalescent, and extended-care hospitals and 294 to private hospitals giving nursing-home care, with inspection reports recommending ways and means of improvement being made both to government and hospitals. With salaries and wages forming the largest portion of hospitals' budgets, administrative consultants again this year concentrated their efforts on staffing requests and allowances, coupled with a continuing evaluation and validation of standards used, and on actual utilization of staff by hospitals. Another major area of concentration was the evaluation of the effectiveness of the board, medical staff, and administration of a sizeable number of the Province's hospitals. Almost all hospitals received the normal annual visit and inspection. Liaison was maintained by membership on the Radiological Advisory Council, Laboratory Advisory Council, the Community Care Facilities Licensing Board, the Provincial Youth Resources Panel, the B.C. Hospitals' Association's Education Committee, and many other ad hoc boards and committees. One administrative consultant accepted the position of interim administrator of a hospital, and, prior to the arrival of a new administrator, was able to measurably assist that hospital to improve its operating and financial status. The same consultant, additionally qualified as a graduate pharmacist, represented the Service on both Federal and Provincial pharmacy committees. Several members participated in presentations to the B.C. Institute of Technology courses and programmes sponsored by the B.C. Hospitals' Association. The Hospitals' Management Engineering Unit carried out 18 studies of projects during the year, 14 of which were undertaken for individual hospitals or groups of hospitals. The unit continued its involvement with the Federally sponsored hospital dietetic project at Penticton. Three hundred and forty copies of study reports, in addition to those distributed on behalf of the two Regional Management Engineering Units, were provided to interested parties, including 45 to other provinces and 51 to other countries. A close liaison was maintained with the Regional Management Engineering Units in Victoria and Vancouver. Unit personnel participated in the B.C. Hospitals' Association's education programmes. The unit continued to sponsor the "Idea of the Month" feature of the Service's bulletin. The nursing consultants continue to participate in National and Provincial nursing organizations. Visits to hospitals and private hospitals were less frequent but of longer duration, with emphasis being placed on the quality of patient care. Two large hospitals with schools of nursing were reviewed during the year, with resultant reports and recommendations being made in depth. Advice on matters related to staffing, nursing procedures and techniques, patient-care programmes, construction plans, and hospital equipment demanded increased nursing consultants' time. The Senior Nursing Consultant participated in the Federal-Provincial Hospital Nursing Consultants' Conference and was a member of the Nursing Advisory Committee of the B.C. Institute of Technology, the Council of Practical Nurses, and of the working group responsible for the production of the Glossary on Canadian Hospital Terminology and Definitions. In addition to the routine visits and inspections of hospital dietary facilities, the Consultant in Dietetics participated in the courses for Supervisors and Senior Cooks in Small Hospitals held in Vernon and Kitimat and acted as an adviser to students taking the Canadian Hospitals' Association's Food Service Supervisory Course. Many new facility plans were evaluated and consultation given, along with advice on equipment and renovation layouts. In collaboration with a member of the Management Engineering Unit, the total planning of the dietetic department of the pro- HOSPITAL INSURANCE SERVICE, 1972 P 23 posed Saanich Peninsula Hospital was undertaken, in addition to continued involvement with the research project at the Penticton Hospital which is designed to evaluate chilled and frozen food production with point-of-service reheating. The Consultant in Dietetics maintained participation in both National and Provincial dietetic affairs throughout the year. The Division's Administrative Consultant based in Vancouver kept in close contact with the private hospital field through more than 200 visits and inspections. Five private hospitals, totalling 128 beds, closed down during the year. At present there are 57 private hospitals providing 2,969 patient beds. Special visits, encompassing an all-inclusive sanitation inspection of each private hospital visited, were carried out during the year in Vancouver and Victoria, in co-operation with the Vancouver City Health Department and the Victoria Metropolitan Health Unit. Special weekly visits to ensure continued safe patient care were made by both administrative and nursing consultants to a private hospital experiencing management/labour difficulties. Special investigatory studies were undertaken by members of the Division on the quality of care being provided in the Vancouver General Hospital's Annex accommodating extended-care patients, and on the efficiency and personnel relations of the department of dietetics of the Royal Columbian Hospital with reports and recommendations being submitted for the Minister's and hospital's guidance. All extended-care hospitals and hospitals with extended-care units were provided with copies and were counselled in the application of the Extended Care Programme Guide completed last year. Two university students were employed during the summer on research studies. One student completed a review of the work-load statistics of British Columbia hospitals which provided indicators allowing the identification and subsequent investigation of atypical production rates in the various hospitals and departments. The other student assisted Management Engineering Unit personnel in the collection, collation, and analysis of data pertaining to current studies. Members of the Division once again attended a number of in-service and other educational and informative sessions, including a seminar on Community Health Centres presented in October at the University of British Columbia. The manager of the Division also attended the Advanced Program in Health Services Organization and Administration (Part 1) presented by the University of Toronto, School of Hygiene. Research Division D. S. Thomson, B.A., M.P.A., Director The Research Division is responsible for assessing the need for additional hospital beds and services. In order to determine the need for new facilities, the Division carries out studies both on an individual hospital and regional basis. These studies involve a comprehensive analaysis of hospitalization data as well as economic and demographic information. The formation of regional hospital districts has brought about a greater need for planning hospital services on a regional scale, and this Division co-operates with other divisions of the Service for the purpose of providing guidelines for hospital development on a regional basis. During the year the Division continued to update five-year projections of bed requirements by region. vmm P 24 BRITISH COLUMBIA This Division is also responsible for compiling and maintaining statistical data relating to hospitalization and morbidity in the Province. The admission/separation records submitted by the hospitals for each patient form the basis of this information. All diagnoses and operations are coded according to the International Classification of Diseases Adapted (8th revision). By use of this classification system it is possible to analyse the incidence of disease by age, sex, and geographical location as well as other variables. In connection with morbidity reporting, the Division publishes a number of annual reports. Statistics of Hospital Cases Discharged includes the standard morbidity tables which all provinces have agreed to publish in order that national health statistics can be developed. Statistics of Hospitalized Accident Cases, which also is prepared annually, provides a broad analytical coverage of hospitalized cases by circumstance, by type of accident, and by nature of injury. A report of the Day Care Surgery British Columbia Hospitals is prepared in conjunction with the Medical Consultation Division for the purpose of showing the potential of this type of service. In addition to these reports the Division supplies data to many agencies both inside and outside of the Government. The demand for hospital morbidity data continues to grow and has become particularly useful in planning of specialized hospital services. Every attempt is made to provide information for worth-while projects. Since the change in the Criminal Code in 1969 permitting therapeutic abortions, the Division has maintained a reporting system for all therapeutic abortions performed in hospitals in the Province. The current interest in this subject has stimulated an increasing demand for information relating to therapeutic abortions. Hospital Finance Division N. S. Wallace, C.G.A., Manager Hospital accounting, the payment of hospital claims, and financing of hospital capital projects are the three main functions of the Hospital Finance Division. At the 1967 Session of the Legislature, two Acts were passed which changed the method of financing hospital capital projects—the Regional Hospital Districts Act and the British Columbia Regional Hospital Districts Financing Authority Act. The Finance Division is responsible for reviewing the annual budgets prepared by each regional hospital district as required by the legislation, and works closely with the Hospital Financing Authority and the regional hospital districts in the financing of hospital capital projects and repayment of debentures. During 1972 the Finance Division assisted the regional hospital districts in debenture sales to the British Columbia Regional Hospital Districts Financing Authority amounting to $21,428,000. The Finance Division is also responsible for the approval of grants to assist hospitals in the purchase of equipment. In 1972, after a review of approximately 6,100 applications received from hospitals, grants estimated at $2,700,000 were approved on movable and fixed technical equipment costing $8,200,000. As a means of assisting hospital employees to maintain high working standards, the Hospital Insurance Service provided over $150,000 during the year to enable hospital employees to attend or participate in short-term training programmes. This was additional to the longer-term educational training courses sponsored for certain hospital employees. HOSPITAL INSURANCE SERVICE, 1972 P 25 Close liaison was continued with the Commissioner of Municipal Superannuation in respect to the application of the Act to hospital personnel and the postponement of retirement for certain employees who reach maximum retirement age. The Division Manager continued to perform duties as a member and Secretary of the Hospital Rate Board and a member of the following committees: Subcommittee on Hospital Finance and Accounting (a subcommittee appointed by the Federal Government to advise on the administration of the Hospital Insurance and Diagnostic Services Act), the Radiological Advisory Council, the B.C. Hospitals' Association Computer Committee, the Health Sciences Centre Computer Advisory Committee, and as an adviser to the Cancer Control Ways and Means Committee. Experience during the first few years' operation of the British Columbia Hospital Insurance indicated that operating costs required serious consideration when planning new hospitals and additions to existing hospitals. In order to ensure that plans for new hospitals or hospital additions are prepared with economical and efficient operation in mind, a system of pre-construction operating budgets is used. The procedure requires a hospital to prepare an estimate of staff and other costs, based upon a reasonable occupancy for the new area. These estimates are submitted to the British Columbia Hospital Insurance Service and are reviewed by the Hospital Rate Board in the same manner as normal operating estimates. It is essential that the estimated operating costs of the new hospital, or new addition, compare favourably with other hospitals actually in operation. Where the hospital's pre-construction operating estimates do not indicate a reasonable operating cost, it is necessary for the hospital board to revise its construction plans to ensure efficient and economical operation. Once a satisfactory pre-construction operating estimate has been agreed upon by the hospital officials and the British Columbia Hospital Insurance Service, the hospital board is required to provide written guarantees relative to the projected operating cost. It is considered that this method of approaching the operating picture for proposed hospital facilities ensures more satisfactory planning, efficient use of hospital personnel, and an economical operation. Hospital Accounting H. G. Benjamin, C.G.A., Supervisor The five main functions of the Hospital Accounting Section are as follows: (a) The assembling of relevant information and preparation of data for the use of the Hospital Rate Board in its review of hospitals' annual and pre-construction estimates. During this process, estimated revenues and expenditures are examined in detail, and adjustments to estimated amounts are recommended. The gross expenditure approved by the Hospital Rate Board for public general, rehabilitation, and extended-care hospitals for the year 1972 amounted to $226,000,000. (b) The detailed annual inspecting of each budget-review hospital for purposes of verification of annual and other financial statements. Final settlement with each hospital for that year is based on inspection and review results. (c) The assembling of relevant information and preparation of data for the Deputy Minister in the review of the annual budgets of regional hospital districts. (d) The auditing of hospital construction projects, in the field, to determine the amount shareable by the Province and the regional hospital district. P 26 BRITISH COLUMBIA (e) The tabulating of monthly statistical and financial reports from hospitals, correlating these with approved budgets, and the calculation of semimonthly cash advances to be made to hospitals. Other functions performed by the Hospital Accounting Section include: (a) The review and amendment of annual financial and statistical reports prepared by hospitals for submission to the Dominion Bureau of Statistics and the Department of National Health and Welfare. (b) The preparation of monthly and annual claims on the Federal Government under the Hospital Insurance and Diagnostic Services Act. (c) The tabulation of temporary borrowing for construction projects by regional hospital districts, and the calculation of the Provincial share to be paid to the district. The preparation and issue of debentures to replace short-term borrowing and the calculation of the Provincial share of repayment. (d) The provision of accounting and financial assistance and instruction to public hospitals in the Province. (e) The review of annual operating results and recommendations of year-end adjustments to the hospitals' approved budgets. (f ) The preparation of the Annual Report on Hospital Statistics covering the administration of the Hospital Act. One hundred and sixty hospital-operating, pre-construction, and regional hospital district budgets were reviewed and processed in 1972. Inspection visits were made to each of 105 public general, rehabilitation, and extended-care hospitals during the year. Construction projects involving approved expenditures of $20,024,000 were audited, and cost reports involving approved expenditures of $781,600 for minor construction projects were prepared for regional hospital districts. Hospital Claims Section W. J. Wade, Supervisor The staff of Hospital Claims is responsible for processing the Admission- Separation Records (accounts), which hospitals submit for each patient, and approving the payment of all acceptable claims. Assistance is provided to hospitals by this Section in the proper method of submitting the individual accounts. This is accomplished by correspondence, telephone, and personal visits. During the year the Supervisor of Hospital Claims attended an Admitting and Eligibility Seminar held at Kimberley, which was attended by hospitals in the region. The Supervisor also visited hospitals in the Greater Vancouver area as well as hospitals on Vancouver Island. In September the Supervisor of Hospital Claims attended a seminar for Vancouver Island hospital accountants held at Parksville. In November the Assistant Supervisor of Hospital Claims attended a Workshop on Admitting Procedures sponsored by the B.C. Hospitals' Association. Approximately 60 people from 26 hospitals attended. Research and adjustment to accounts showed an increase in volume, due primarily to changes in responsibility for payment. In addition to the required accounting amendments, it was necessary to direct over 1,000 queries to the hospital concerning claims. Accounts processed were in excess of 1,900 per working-day, and over 900 emergency-service and minor-surgery account forms were handled per working-day. HOSPITAL INSURANCE SERVICE, 1972 P 27 Discussions with the Data Processing Centre were continued during the year regarding the efficient use of IBM electronic data processing equipment in order to refine statistical procedures. A brief outline of the work and duties performed by the various offices of the Hospital Claims Section follows. The staff of Admission Control reviews each application for benefits made by patients who claim to be qualified for benefits under the Hospital Insurance Act. Details of residence are also checked with the verifying documents, and as a result over 3,900 claims had to be returned to hospitals during the year because they were incomplete or unacceptable, and over 1,800 letters were written on eligibility, verification, and related matters. Advice and assistance were given to hospital admitting staffs on the proper method of obtaining and recording the patient's residence information and employment history. In order to assist further in the co-operation between the British Columbia Hospital Insurance Service and hospitals, the Supervisor of Admission Control visited hospitals for discussions of procedures being used for verification of residence of patients. He also attended Admitting and Eligibility Regional Seminars held at Terrace and Kimberley. These seminars were well attended by the hospitals of the areas. The Accounts Payment staff pre-audits the charges made to the British Columbia Hospital Insurance Service, and ensures that all information shown on each claim is completed so that it can be coded for statistical purposes, also that it is charged to the correct agency, such as the British Columbia Hospital Insurance Service, Workmen's Compensation Board, the Department of Veterans' Affairs, or other provinces and territories. During the year over 6,000 queries were addressed to British Columbia hospitals on such matters. Preliminary figures for 1972 show that more than 445,000 accounts (excluding out-of-Province) were processed. The Day-care Surgical Services, Day-care/Night-care Psychiatric Services, and Out-patient Psychiatric accounts increased in volume from 4,403 per month in 1971 to over 5,000 per month in 1972. During the year the quarterly statistical run of Day-care Surgical Services was continued as it has proven to be very useful to the hospitals of the Province. The Voucher and Key-punch staff are responsible for batching and vouchering the checked accounts, in order to determine the amounts payable to each hospital and the punching of the data processing cards for each account. The cards are punched daily to record statistical, financial, and medical data, and are used to tabulate remittance listings of payments due to hospitals and for morbidity statistics for the Research Division. This procedure includes punching cards for out-of-Prov- ince accounts and Day-care Surgical Services accounts. During the year the Hospital Claims Section completed compiling statistics for a linkage study of congenital anomalies being carried on by Atomic Energy of Canada Limited. Over 250,000 statistical cards were punched and verified by this Section. The out-of-Province personnel process all claims for hospital accounts incurred by British Columbia residents in hospitals outside the Province. This requires establishing eligibility and the payment of claims. During 1972 over 5,800 accounts amounting to an estimated $2,250,000 were paid on behalf of qualified residents hospitalized in other provinces and territories of Canada, the continental United States (including Alaska and Hawaii), Algiers, Australia, Austria, Bahamas, Bar- P 28 BRITISH COLUMBIA bados, Belgium, Brazil, British Honduras, Canary Islands, Chile, Denmark, El Salvador, England, France, Germany, Greece, Guatemala, Holland, Hong Kong, Hungary, India, Ireland, Israel, Italy, Japan, Kenya, Mexico, New Zealand, Norway, Rhodesia, Scotland, Senegal, Singapore, South Africa, Spain, Sweden, Switzerland, Trinidad, Tunisia, Uganda, Wales, and Yugoslavia. An up-to-date Hospital Rate Schedule is maintained for every hospital in Canada. All claims are coded for statistical purposes and a data processing card is punched for each account. The Filing and Mail Unit sorted and filed over 9,500 documents and letters daily. In order to handle increased volume, new procedures were instituted. Hospital Construction and Planning Division John Glenwright, Manager The main functions of the Construction and Planning Division can be briefly described as follows: The Division provides hospital boards of management, their architects and planning committees, with a consultative service in the planning of hospital construction projects, including new hospital facilities as well as additions and renovations to existing hospitals. Special emphasis is given to the need for the development of master programmes which contain a clear definition of the hospital's role supported by written functional programmes for construction projects related to the proposed new or expanded facilities. During the year a great deal of time was spent in reviewing programmes and plans of proposed hospital projects, both at the sketch- plan stage and the working-drawing stage. Drawings and architectural programmes which evolved from the hospital's functional programme were reviewed with the various professions represented in the Consultation and Medical Consultation Divisions as well as other allied organizations including the Radiology Advisory Council and the Laboratory Advisory Council. Reviews are made with several objectives in mind, but basically the intent is to ensure that in terms of the capital funds available the greatest benefit consistent with economical operation is derived from the construction projects. In planning hospital facilities, attention is also given to the need and method of future expansion in conjunction with the most logical and the best use of the hospital site. Proposed hospital sites are approved by this Division and direction and guidance are given in site selection. Wherever possible, potential sites are inspected by a member of the Division. Over 300 sets of plans were received by the Division during the year. These drawings covered many phases of planning, including small-scale schematic drawings and final working drawings and specifications, including the architectural, mechanical, electrical, and plumbing drawings. During 1972, 23 hospital construction projects were completed throughout the Province. These projects resulted in a total of 950 new and replacement beds coming into service, together with supporting improved and expanded diagnostic, treatment, and service facilities. The Division is responsible for processing, and recommending for approval, applications for Provincial grant assistance, either by direct grants-in-aid or by funds provided through regional hospital districts, for major expansion and improvement projects as well as minor renovations for all public hospitals throughout the Province. HOSPITAL INSURANCE SERVICE, 1972 P 29 The Division works with representatives of hospitals and regional hospital districts in the review and processing for consideration of Government those programmes of proposed capital expenditures to be included in money by-laws and made the subject of regional hospital district referendums. Continuing benefit was derived during 1972 from the co-operation of the Department of Public Works in the assignment of architects to the Division. In September, 1972, Lome Macdonald, architect, Department of Public Works, joined the planning staff of the Division, which brings the number of architects on staff in the Division to three. The Manager of the Division is a member of the BCHIS Planning Group, which has the responsibility of reviewing and making recommendations to the Deputy Minister on matters concerning the development of hospital facilities throughout the Province. He is Chairman of the Functional Programme Review Committee; also, the Division has representation on the Equipment Committee. These committees are subcommittees of Planning Group. C. N. Beattie, formerly of the Veterans' Affairs Treatment Division and most recently Administrator of the Col. Belcher Hospital, Calgary, joined the staff of the Construction and Planning Division early in 1972 as a planning consultant. The members of the medical and nursing professions and the staff of the Provincial Health Branch, through the Technical Supervisor of Clinical Laboratory Services and Technical Supervisor of Radiology, contributed materially to the provision of consultative services to hospitals. Also, through the co-operation of the Provincial Department of Labour, the office of the Inspector of Factories provided a consultative service to this Division related to proposals for elevators and dumbwaiter installations in hospitals. During the year, liaison was maintained with the mechanical engineering profession in recognition of the need to design high-quality mechanical systems which would make a maximum contribution toward an efficient and economical hospital operation. Some of the elements included in designs for mechanical systems for new hospital buildings, reflecting this approach, included air recirculation and zoned heating and ventilating controls. W. H. Cox, Engineer in the Division, was also actively engaged in studies undertaken by a Committee on Electrical Safety in Hospitals. The primary aim of the committee was to develop recommendations to provide minimum standards designed to obtain a more consistent pattern of electrical installation in hospitals in conjunction with a high level of patient safety. These studies are being carried out in liaison with the Health Facilities Design Division of the Department of National Health and Welfare, Ottawa. Members of the Division are also involved in the Systems Advisory Committee which acts as an advisory subcommittee of the Equipment Committee. A simplified system of preventive maintenance (known as the COM AC system) developed by members of the Engineering staff of the Division is now in use or is being incorporated in many hospitals throughout the Province. Consultative advice is provided in the field of plant operation and maintenance and equipment selection. During the year visits were made to hospitals for inspection and advice pertaining to mechanical plants and electrical installations. Liaison was maintained with the Hospital's 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. An architect on the Division's staff is a member of this committee. P 30 BRITISH COLUMBIA During 1972 the Manager, as well as the architects and engineers, made a number of inspectional, advisory, and educational visits to hospitals throughout the Province. (a) Hospital Projects Completed During 1972 Ashcroft and District General Hospital—The new 41-bed acute hospital was officially opened by D. M. Cox, Deputy Minister, on April 29, 1972. This new hospital replaces the old 29-bed Lady Minto Hospital. Chilliwack General Hospital—Phase II of the current expansion programme was completed with its official opening on February 27, 1972, by Hon. Kenneth Kiernan. The project entailed the addition of a 77-bed extended-care unit, as well as 20-bed psychiatric and 16-bed activation/rehabilitation units. Dr. Helmcken Memorial Hospital, Clearwater—This new facility of 10 beds was officially opened by Dr. John Helmcken, great-grandson of Dr. John Sebastian Helmcken, on September 23, 1972. Cranbrook and District Hospital—The 15-bed addition to the extended-care unit came into use on January 22, 1972, bringing the total number of extended-care beds at this hospital to 50. Stuart Lake Hospital, Fort St. James —■ This new 25-bed facility came into operation on May 23, 1972. The then Minister of Health Services and Hospital Insurance, Hon. Ralph R. Loffmark, presided at the official opening ceremonies held on July 15, 1972. Lady Minto Gulf Islands Hospital, Ganges ■— A new wing containing 15 extended-care beds was officially opened by Hon. W. A. C. Bennett on May 19, 1972. Fraser Canyon Hospital, Hope—Hon. Ralph R. Loffmark officially opened the expanded hospital on March 25, 1972. The hospital now has 38 acute beds and enlarged service departments. Windermere District Hospital, Invermere—An additions and alterations project was recently completed at this hospital, which now has 31 acute beds. J. W. Mainguy, Assistant Deputy Minister of Hospital Insurance, presided at the official opening on November 26, 1972. Royal Inland Hospital, Kamloops—In order to provide additional acute beds, the psychiatric unit was moved into the school of nursing, thus providing an additional 30 medical and surgical beds. Nicola Valley General Hospital, Merritt—The remaining two unfinished wards were completed at this hospital at the end of the year. The hospital's capacity was, therefore, increased by four acute beds. Nanaimo Regional General Hospital—Mayor Frank Ney officially opened the new Reactivation Wing on April 23, 1972. This project involved the construction of a two-storey addition providing 24 psychiatric and 25 activation/rehabilitation beds, and an 85-bed extended-care unit built round an open court. Existing areas adjoining the new wing were altered to provide an enlarged dietary department, pharmacy, etc. Royal Columbian Hospital, New Westminster—By the end of the year the renovations and demolition of most of the 1912 wing, included as part of Phase I of the expansion programme at this hospital, was completed. South Okanagan General Hospital, Oliver—This new 45-bed acute hospital, replacing St. Martin's hospital, which had 37 beds, was completed by the end of the year. HOSPITAL INSURANCE SERVICE, 1972 P 31 Penticton Hospital—Hon. F. X. Richter, Minister of Mines and Petroleum Resources, officially opened the expanded hospital on April 15, 1972. This marked the completion of the expansion programme which resulted in an increase in capacity to 159 acute beds, a new 63-bed extended-care unit, and enlarged service departments. West Coast General Hospital, Port Alberni—Although 38 additional acute beds were brought into use last October, the renovations were not completed until this year. The project, which provided a 30-bed extended-care unit as well as the acute beds, and expanded service departments, was officially opened on April 8, 1972, by Hon. Wesley Black. Port Alice Hospital—-This new 10-bed facility was brought into operation on September 17, 1972. Port Hardy Hospital—This new 10-bed facility was brought into operation on April 24,1972. Richmond General Hospital—The 75-bed extended-care unit, built adjacent to the acute hospital, was officially opened by Ernie LeCours, M.L.A., on February 13, 1972. Shuswap Lake General Hospital, Salmon Arm—The additions and renovation project at this hospital, which has provided a 25-bed extended-care unit and an additional 12 acute beds as well as enlarged service departments, was recently completed. The Minister of Health Services and Hospital Insurance, Hon. Dennis G. Cocke, opened the new wing on December 16, 1972. Stewart General Hospital—The addition and renovation project was completed, which added one more acute bed to the hospital for a total of 10, and provided enlarged diagnostic and treatment facilities and a doctors' clinic. Tatla Lake—This outpost nursing station, operated by the Red Cross, was completed recently. The new facility has three holding beds, clinic room, etc., and a house for the nurse. Vancouver General Hospital—Ceremonies were held on December 1, 1972, to mark the official opening by Hon. Dennis G. Cocke of the new 201-bed extended- care unit built on property owned by the hospital between Heather and Ash Streets. This unit, as well as providing the facilities usual to extended-care units, is also designed to care for patients requiring extra nursing. Victoria General Hospital — The ambulatory care unit for day-care surgery patients was officially opened on February 25,1972. (b) Hospital Projects Under Construction at Year-end Armstrong and Spallumcheen Hospital, Armstrong—Alterations and renovations to upgrade diagnostic, treatment, and service facilities. R. W. Large Memorial Hospital, Bella Bella—Replacement of existing building with a new hospital of 19 acute and four extended-care beds. Burnaby General Hospital—A 150-bed extended-care unit is being constructed adjacent to the acute hospital. Chemainus General Hospital—Alterations and renovations to upgrade diagnostic, treatment, and service facilities. Chilliwack General Hospital—Third phase of expansion programme—the renovation of existing areas of the hospital, including a new emergency department, enlarged operating suite, central sterilizing room, etc. Major Hospital Projects, 1972 Completed—Ashcroft, Chilliwack, Clearwater, Cranbrook, Fort St. James, Ganges, Hope, Invermere, Kamloops, Merritt, Nanaimo, New Westminster (Royal Columbian), Penticton, Port Alberni, Port Alice, Port Hardy, Richmond, Salmon Arm, Stewart, Tatla Lake, Vancouver General, and Victoria General Hospital. Under construction—Armstrong, Bella Bella, Burnaby, Chemainus, Chilliwack, Duncan, Enderby, Fernie, Gold River, Kelowna, Maple Ridge, Nelson (Mount St. Francis), New Westminster (Royal Columbian), Prince George, Quesnel, Squamish, Tahsis, Vancouver (Vancouver General) (St. Paul's) (St. Vincent's) (G. F. Strong Rehabilitation Centre), Vanderhoof, Victoria (Royal Jubilee). For details, see pages 30, 31, and 34. «- West Coast General Hospital, Port Alberni, with the new Extended-care Unit showing at right. (Architects: The Gardiner Thornton Partnership.) Architect's conception of the new 41-bed Ashcroft and District General Hospital. (Architects: Thompson, Berwick, Pratt & Partners.) ■■:■■:■■ ••■■?-.■.■..;,■ ''■:::,«■:-: ■■-::*:■■ The new extended-care addition at Lady Minto Hospital, Ganges. (Architects: Wagg & Hambleton.) Architect's conception of Penticton Hospital, showing the new addition for acute beds and extended- care unit. (Architects: Thompson, Berwick, Pratt & Partners.) Richmond General extended-care unit. (Architects: Thompson, Berwick, Pratt & Partners.) Exterior view (north exposure) of Vancouver General's new extended-care unit. (Architects: Paul Smith Associates.) Nanaimo General, showing the new extended-care, rehabilitation, and psychiatric unit. (Architects: The Gardiner Thornton Partnership.) P 34 BRITISH COLUMBIA Cowichan District Hospital, Duncan—A 100-bed extended-care unit (75 beds to be finished initially) being built on the old King's Daughters' Hospital site. Enderby and District Memorial Hospital—Alterations and additions to improve diagnostic, treatment, and service facilities. Fernie Memorial Hospital—Replacement of existing building with a new hospital of 66 beds to serve Fernie, Michel, and surrounding areas. Gold River—Diagnostic and treatment centre. Kelowna General Hospital—Final phase of the expansion programme, consisting of the renovation of the old hospital building, now known as Block A. The project will provide 74 acute beds (for a combined total of 250 acute beds), including a 23-bed psychiatric unit, a 21-bed activation/rehabilitation unit, new physiotherapy and occupational-therapy departments, and five beds for future use. A new regional laboratory, also part of this project, is already in use. Maple Ridge Hospital—A 75-bed extended-care unit is being constructed adjacent to the acute hospital. Mount St. Francis Hospital, Nelson-—Renovations and improvements to upgrade the facilities to provide 84 extended-care beds. Royal Columbian Hospital, New Westminster—A new power plant, including two new water-tube boilers and related mechanical and electrical services, is under construction. Fringe George Regional Hospital—Construction of the West Wing Addition to provide a net gain of 135 beds, an enlarged power plant, dietary, central sterilizing, and laundry departments, storage, etc. (35 beds in the existing hospital will be allocated to extended care once the project has been completed). G. R. Baker Memorial Hospital, Quesnel — A 40-bed extended-care unit is being constructed adjacent to the existing hospital. The project also includes the expansion of the radiological and dietary departments. Squamish General Hospital ■— An addition to provide new operating, post- ana.sthetic recovery/labour rooms; conversion of the old operating-room to a case room; improvement of services. Tahsis Hospital—A new 10-bed hospital to replace Esperanza General Hospital. Vancouver General Hospital—(1) Phase I of the programme to expand the Pathology Department, consisting of the relocation of the Personnel Department in the Women's Residence; (2) a 15-bed psychiatric assessment unit; (3) (Willow Chest) provision of 21 beds for open-heart surgery. St. Paul's Hospital, Vancouver—Conversion of the old chapel to provide 15 cardiac surgical nursing beds and a pulmonary unit. St. Vincent's Hospital, Vancouver—Expansion of the hospital to provide a 75- bed extended-care unit; 20 psychiatric beds; 10 day-care psychiatric spaces; occupational-therapy facilities, personnel lockers, storage and dietary facilities. G. F. Strong Rehabilitation Centre, Vancouver—Construction of an addition containing 100 activation/rehabilitation beds as well as the renovation of the existing building. St. John Hospital, Vanderhoof—A new 45-bed acute hospital to replace the existing building. Gorge Road Hospital, Victoria—The 300-bed extended-care unit, being constructed as a wing onto the existing activation/rehabilitation hospital, is expected to be completed early in 1973. Royal Jubilee Hospital, Victoria—Facilities for open-heart surgery. HOSPITAL INSURANCE SERVICE, 1972 P 35 (c) Projects for Which Tenders Have Been Called but no Contract yet Awarded Campbell River and District General Hospital—An addition containing 30 acute beds; expansion of services. St. Joseph's General Hospital, Comox—Completion of the unfinished top floor to provide approximately 50 acute beds, construction of an addition for 20 psychiatric beds; day-care facilities; expansion of services. Kootenay Lake District Hospital, Nelson—The first phase of an expansion and renovation programme, including the upgrading of the electrical service; a four-bed intensive care/coronary care unit, and second X-ray room. Vernon Jubilee Hospital—A new extended-care unit is planned for construction adjacent to the existing acute hospital which will provide 75 adult beds on the main floor and 26 pa.dia.ric beds on the lower floor. Cariboo Memorial Hospital, Williams Lake—Completion of unfinished areas to provide 98 acute beds and a three-bed intensive care/coronary care unit; plus an addition to house a new emergency department, laboratory, and central storage. (d) Projects in Advanced Stages of Planning Saanich Peninsula Hospital, Central Saanich—A 75-bed extended-care unit. Chilliwack General Hospital—Phase IV of expansion programme: six-bed intensive-care unit; finishing of 20-bed acute area for 10 extended-care beds; improvement of pa.dia.ric department and services. Langley Memorial Hospital—Expansion programme—finishing of 35 acute beds now in "shell," 15 additional acute beds on fourth floor; services expansion. Lillooet District Hospital—Expansion of acute hospital, plus three extended- care beds; alterations to improve diagnostic, treatment, and service facilities. Arrow Lakes Hospital, Nakusp—A new hospital to replace existing 15-bed hospital. Kootenay Lake District Hospital, Nelson—Phase II of expansion and renovation programme—additional acute beds and improvement of services. Bulkley Valley District Hospital, Smithers—Eight additional acute beds plus seven extended-care beds. Richmond General Hospital—Emergency department. Children's Hospital, Vancouver—Care-by-parent unit; classroom space and activity areas, etc. Holy Family Hospital, Vancouver—Expansion to 80 activation and rehabilitation beds, plus-day-care facilities; 150-bed extended-care unit. Mount Saint Joseph Hospital, Vancouver—Conversion of existing extended- care beds to acute, upgrading services, and 150-bed extended-care unit. Royal Jubilee Hospital, Victoria—Renovation of the Bay Pavilion for paediatrics and renal dialysis. (e) Additional Projects Approved and in Various Planning Stages in 1972 Matsqui-Sumas-Abbotsford General Hospital, Abbotsford—Expansion programme to include extended-care beds. St. George's Hospital, Alert Bay—Improvements to buildings and grounds. P 36 BRITISH COLUMBIA St. Joseph General, Dawson Creek—Expansion and improvement of services. Fort Nelson General Hospital—Expansion. Providence Hospital, Fort St. John—Expansion and improvement of services. Boundary Hospital, Grand Forks—Addition for extended-care beds. Wrinch Memorial Hospital, Hazelton—Replacement of existing building with a new acute hospital to include extended-care beds. Royal Inland Hospital, Kamloops—Expansion of acute hospital, including activation/rehabilitation beds and extended-care unit. Kitimat General Hospital—Extended-care unit. Maple Ridge Hospital—Expansion of acute hospital. Mount Waddington Regional Hospital District—Approval to select and acquire a site and plan a central regional hospital facility. 100 Mile District General Hospital, 100 Mile House—Expansion of acute hospital. Mills Memorial Hospital, Terrace—Expansion of acute beds and services. Trail Regional Hospital—Construction of a nine-bed intensive/coronary care and renal dialysis unit. Burnaby General Hospital—Expansion of acute beds and services. Delta Centennial Hospital—Acquisition of site and construction of health facilities. Royal Columbian Hospital, New Westminster—Expansion of acute beds and services. Queen's Park Hospital Society, New Westminster—Extended-care unit. Lions Gate Hospital, North Vancouver—Expansion of services. Coquitlam and District Hospital, Port Moody—New acute facility. Richmond General Hospital—Expansion of acute beds and services. B.C. Cancer Institute, Vancouver—Expansion of acute beds. Children's Hospital, Vancouver—Continuation of planning and development of pediatric facilities in the area of the Vancouver General Hospital. Louis Brier Hospital, Vancouver—Expansion of extended-care unit. St. Paul's Hospital, Vancouver—Services expansion. Sunny Hill Hospital, Vancouver—Expansion and renovations. Vancouver General Hospital—Activation unit; renovations. Health Sciences Centre, Vancouver—350-bed acute hospital. Vernon Jubilee Hospital—Conversion of existing extended-care unit for acute care; expansion of services, renovations. Royal Jubilee Hospital, Victoria—Expansion and renovations. HOSPITAL INSURANCE SERVICE, 1972 P 37 7t -w MEDICAL CONSULTATION DIVISION Charles F. Ballam, M.D., Senior Medical Consultant Dr. Ballam returned to the British Columbia Hospital Insurance Service as Senior Medical Consultant, October 1, 1972, consequent upon the resignation in June of Dr. D. G. Adams. Dr. Ballam held the post of Medical and Educational Director at the Royal Jubilee Hospital in Victoria prior to resumption of his duties at the Service. Dr. David M. Longridge continues as Medical Consultant, acting as principal Administrative Assistant to the Senior Medical Consultant and having in addition to these duties prime responsibility for the supervision, advice, and administration of the Medical Coding Section and for all questions of a medical nature arising out of the review by the Medical Coders and by the Claims Division of the Admission- Separation Records. During the year, Dr. Doris E. Mackay was appointed full-time Medical Consultant, Extended Care and Rehabilitation. Dr. Mackay had been employed on a part-time basis by the Service since the inception of the Extended-care Programme in 1965/66, and continues to have principal responsibility for consultative advice concerning this programme, as well as in the field of rehabilitation. These two medical consultants work in the Division under the general direction and supervision of the Senior Medical Consultant. This Division is responsible for medical consultation within the Hospital Insurance Service, between the Service and other departments of Government, with hospitals at all levels of care, and with regional hospital districts. Other responsibilities include liaison with other health agencies such as the B.C. Medical Association, the B.C. Hospitals' Association, and the University of British Columbia; the medical coding and assessing of all discharge records received from hospitals; the initial medical assessment and continuing quarterly review of patients to determine their eligibility for coverage by the Hospital Insurance Service under the Extended-care Programme; and medical record consultation to hospitals and related organizations. The staff of the Division is composed of physician medical consultants, physiotherapy and medical record librarian consultants, and nurses who are trained to undertake the assessment and coding of claims received from hospitals. The medical consultants assist in the planning and implementation of new services in hospitals by representation on the Planning Group, the Equipment Committee, and the Functional Programme Review Committee at the Hospital Insurance Service. The medical consultants provide continuing and active liaison with all health agencies, through visits to hospitals, special disease groups, societies, regional hospital districts, and professional bodies, and represent the Service as members of committees developed by these organizations. Liaison with the B.C. Medical Association has become particularly important, and active participation on its Hospitals P 38 BRITISH COLUMBIA Committee and the Advisory Subcommittees on Chronic Renal Failure, Intensive Cardiac Care, Nuclear Medicine, and Cancer Therapy Services continued during the year. The Admission-Separation Record, which is completed for each patient admitted to a hospital either in British Columbia or outside the Province, is assessed with regard to medical eligibility for coverage, and is then coded in accordance with the "International Classification of Diseases, Adapted for Indexing Hospital Records by Diseases and Operations." Graduate nurses undertake the review and coding functions, and in areas of difficulty receive the assistance of a medical consultant. The coded records are then utilized by the Research Division for compiling and maintaining statistical data relating to hospitalization and morbidity in British Columbia. Day-care surgical services, approved as a hospital insurance benefit in 1968, have improved the utilization of the Province's health facilities, and the Senior Medical Consultant continues to advise the Service in its planning for an expanded role in ambulatory patient care. As is the case with the in-patient admission records, all day-care surgical services records are assessed and coded according to the International Classification of Diseases, so that this data may be tabulated in preparation for statistical reviews. Applications for admission to the Extended-care Programme, submitted on behalf of patients, were assessed for medical eligibility by the Medical Consultation Division. At the end of 1972, extended-care coverage was being provided in some 2,535 beds in the Province. During the year, approximately 4,500 applications for admission to this programme were assessed for medical eligibility by the Medical Consultation Division. Additionally, 89 reviews of extended-care hospitals were undertaken to ensure that the hospitals' extended-care population continued to remain medically eligible for this benefit. During many of these audit reviews the hospital's programme was also assessed to ensure that the care which the patient received was commensurate with current thinking in the management of chronically disabled individuals. The Medical Record Consultant provided consultative advice to the Service, to hospitals visited in the Province, and participated as a member of the Provincial Education Committee of the British Columbia Association of Medical Record Librarians. The encouragement of hospitals to achieve accreditation standards imposes certain pressures to conform to the requirements of accreditation, and when these pressures produce problems for the medical staff of the hospital, the Senior Medical Consultant is able to render assistance with the help of the Hospital Consultation and Inspection Division and the Hospitals Committee of the B.C. Medical Association, together with representation from the College of Physicians and Surgeons of British Columbia. The medical consultants participate in postgraduate continuing medical education programmes sponsored through the university and the Provincial and local medical societies, as well as special and pertinent continuing medical education seminars or courses offered outside British Columbia. HOSPITAL INSURANCE SERVICE, 1972 P 39 ADMINISTRATION DIVISION K. G. Wiper, Senior Administrative Officer The Senior 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. This officer provides advice and information on a wide range of matters to the Minister, Deputy Minister, and other officials of the Department. Hospital societies and corporations are provided with assistance in connection with the drafting of hospital constitutions and by-laws, and their interpretation and application. Changes in hospital by-laws are reviewed by this office prior to their submission for Government approval, as required under the Hospital Act. A set of model by-laws has been developed for use by hospitals as a guide in making revisions. Under the Regional Hospital Districts Act, described earlier in this Report, the staff of this Division worked closely with the officials of other divisions, Government departments, and the various districts in arranging for money by-laws, temporary borrowing, and related matters. In collaboration with the Hospital Consultation and Inspection Division, this Division processes, for approval under section 14 of the Hospital Act, transfers of private-hospital property and transfers of shares in the capital stock of private- hospital corporations. The Division is also involved in the acquisition and disposal of hospital sites. In addition, close liaison is maintained with the Land Registry Office to ensure that the property records of both general hospitals and private hospitals are suitably endorsed so that land transfers are not made until they are approved under sections 14 (2) and 41 (1) (c) of the Hospital Act. As in previous years, considerable time was spent in 1972 on matters related to the Federal-Provincial hospital insurance arrangements. Methods of streamlining administrative procedures and improving liaison were discussed with officials of the Federal Government. This Division handles pay and personnel matters concerning the staff of the Hospital Insurance Service and works closely with the Civil Service Commission and the Finance Department in this regard. The Senior Administrative Officer is also responsible for the over-all supervision of the Eligibility Representatives' and the Third-party Liability Sections and the General Office. Eligibility Section P. A. Bacon, Supervisor In order to ensure that only qualified British Columbia residents receive hospital insurance benefits, the staff of the Eligibility Section review the Applications for Benefits made by, or on behalf of, persons admitted to hospital. A detailed check is made of all doubtful applications, resulting in the rejection of a considerable number of claims for hospital insurance benefits made by unqualified persons. Numerous inquiries from the general public with regard to eligibility matters are dealt with by personal interview, telephone, and correspondence. P 40 BRITISH COLUMBIA Eligibility representatives visit hospitals on a regular schedule to see that the British Columbia Hospital Insurance Service eligibility procedures are being properly carried out. The representatives also assist in the training of hospital admitting personnel to deal with problems connected with the admission of patients to hospitals and the determination of their status under the Hospital Insurance Act. This training assistance is provided by means of visits to hospitals and by regional meetings. During 1972, regional meetings were held in Terrace and Kimberley and this Section also participated in a workshop on admitting procedures held by the B.C. Hospitals' Association in Vancouver. In all, 96 persons attended, representing 37 hospitals. This Section keeps the great majority of employers in British Columbia supplied with certificates on which an employee's length of employment can be certified. The representatives maintain close liaison with these firms to ensure their continuing cooperation in providing their employees with this form of proof of residence for hospital insurance purposes. Close liaison is maintained with the British Columbia Medical Plan, and eligibility representatives supply Medical Plan applications and information to the general public in many communities throughout the Province. Eligibility representatives are located in Prince George, Kamloops, Nelson, Kelowna, Vancouver, and Victoria. Third-party Liability Section J. W. Brayshaw, Supervisor The hospitalization reports that are completed by hospitals for every patient admitted with accidental injuries are processed by the Third-party Liability Section. This Section also handles the arrangements under which the British Columbia Hospital Insurance Service receives reimbursement from public liability insurance companies and self-insured corporations for hospital expenses paid by this Service on behalf of accident victims. The Senior Eligibility Representative in Vancouver, H. E. Drab, is responsible for maintaining a third-party liability clearing-house for the convenience of solicitors and insurance adjusters in the Greater Vancouver area. Up-to-date information regarding the hospitalization of accident victims in the Lower Mainland area is available through the Vancouver office, and negotiations may be carried out in person or by telephone, thus avoiding the necessity of corresponding with the head office in Victoria, which deals with cases arising elsewhere in British Columbia. General Office C. R. Leighton, Supervisor One of the main responsibilities of the General Office is the handling of funds and the review of requisitions and vouchers submitted by other divisions. These include travel expenses, requisitions for supplies and equipment, grant payments to hospitals, and administrative vouchers. These are then forwarded to the appropriate branch of Government for further action. The Supervisor is responsible for gathering information from all divisions and co-ordinating this material in the preparation of the annual estimates of the Hospital Insurance Service which are submitted to Treasury Board for inclusion in the Provincial Budget. The General Office also handles the storage and dispatch of the various forms supplied by this Department to hospitals. Mail is opened, sorted, and distributed in this office, and stenographic services to other offices are provided on an occasional basis. HOSPITAL INSURANCE SERVICE, 1972 P 41 INFORMATION OFFICE C. N. Shave The Information Officer is responsible for providing a basic programme of general information and public relations. His three main areas of involvement are general public, approved hospitals, and in-service requirements. To keep the public informed during the year, numerous press releases were prepared for the news media, dealing with hospital construction programmes, policy changes, and other items of interest. Regular editions of the BCHIS Bulletin were published every two months for distribution to public and private hospitals, as well as interested members of the public. (A total of 10,800 was sent out during 1972.) The Bulletin is an administrative aid providing detailed explanation of policy and procedures with items of interest for hospitals and our own staff. (Circulation at the present time is 1,800.) The General Information pamphlet was again revised and reprinted and over 20,000 copies were distributed to hospitals, business and industry, civic organizations, welcome-wagon agencies, and other services which come in regular contact with new residents of the Province. Visits were made to the Pacific National Exhibition in July for the purpose of having our Departmental exhibit updated. A pamphlet containing statistical data and other information of interest to administrative personnel of hospitals was prepared for distribution at the B.C. Hospitals' Association Convention in October, and an information booth was set up and manned for the convenience of delegates meeting with Departmental personnel. British Columbia Hospital Insurance Service films, located in the Health Branch Film Library, which are maintained for the free use of hospitals for in-service training purposes, were used fairly extensively throughout 1972. In all, 55 screenings were made by hospitals. A map was prepared for the Radiological Advisory Council, and in consultation with a member of the Council, details for graphic illustration were worked out to denote (a) number of radiologists at each hospital in British Columbia, (b) size of the hospital, and (c) number of procedures and sophistication of equipment. Assistance was rendered to Camosun College for a resource programme sponsored by the college to provide information on benefits to senior citizens, people about to retire, and persons who have senior citizens in their charge at home. Other duties included summarizing reports for the Deputy Minister, maintaining newspaper and photograph files, writing news and feature items for the Bulletin, answering telephone and written requests for information, also the compiling and initial editing of this 24th Annual Report. P 42 BRITISH COLUMBIA APPROVED HOSPITALS Public Hospitals Armstrong and Spallumcheen Hospital, Armstrong. Arrow Lakes Hospital, Nakusp. Ashcroft and District General Hospital, Ashcroft. Bella Coola General Hospital, Bella Coola. Boundary Hospital, Grand Forks. British Columbia Cancer Institute, Vancouver. Bulkley Valley District Hospital, Smithers. Burnaby General Hospital, Burnaby. *Burns Lake and District Hospital, Burns Lake. *Campbell River and District General Hospital, Campbell River. Cariboo Memorial Hospital, Williams Lake. Castlegar and District Hospital, Castlegar. Chemainus General Hospital, Chemainus. Chetwynd General Hospital, Chetwynd. Children's Hospital, Vancouver. *Chilliwack General Hospital, Chilliwack. *Cowichan District Hospital, Duncan. *Cranbrook and District Hospital, Cranbrook. Creston Valley Hospital, Creston. Cumberland General Hospital, Cumberland. Dr. Helmcken Memorial Hospital, Clearwater. Enderby and District Memorial Hospital, Enderby. Esperanza General Hospital, Esperanza. Fernie Memorial Hospital, Fernie. Fort Nelson General Hospital, Fort Nelson. Fraser Canyon Hospital, Hope. G. R. Baker Memorial Hospital, Quesnel. * Golden and District General Hospital, Golden. Grace Hospital, Vancouver. * Kelowna General Hospital, Kelowna. Kimberley and District Hospital, Kimberley. Kitimat General Hospital, Kitimat. *Kootenay Lake District Hospital, Nelson. Lady Minto Gulf Islands Hospital, Ganges. Ladysmith and District General Hospital, Ladysmith. *Langley Memorial Hospital, Langley. Lillooet District Hospital, Lillooet. *Lions Gate Hospital, North Vancouver. McBride and District Hospital, McBride. Mackenzie and District Hospital, Mackenzie. Maple Ridge Hospital, Maple Ridge. Mater Misericordia. Hospital, Rossland. Matsqui-Sumas-Abbotsford General Hospital, Abbotsford. Michel-Natal District Hospital, Sparwood. Mills Memorial Hospital, Terrace. Mission Memorial Hospital, Mission City. * Mount Saint Joseph Hospital, Vancouver. Nanaimo Regional General Hospital, Nanaimo. Nicola Valley General Hospital, Merritt. Ocean Falls General Hospital, Ocean Falls. 100 Mile District General Hospital, 100 Mile House. *Peace Arch District Hospital, White Rock. *Penticton Hospital, Penticton. Port Alice Hospital, Port Alice. Port Hardy Hospital, Port Hardy. *Pouce Coupe Community Hospital, Pouce Coupe. * Powell River General Hospital, Powell River. Prince George Regional Hospital, Prince George. *Prince Rupert Regional Hospital, Prince Rupert. Princeton General Hospital, Princeton. 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 General Hospital, Sidney. *Richmond General Hospital, Richmond. 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. George's Hospital, Alert Bay. St. John Hospital, Vanderhoof. St. Joseph General Hospital, Dawson Creek. *St. Joseph's General Hospital, Comox. St. Martin's Hospital, Oliver. St. Mary's Hospital, New Westminster. *St. Mary's Hospital, Sechelt. St. Paul's Hospital, Vancouver. St. Vincent's Hospital, Vancouver. *Shuswap Lake General Hospital, Salmon Arm. Slocan Community Hospital, New Denver. South Okanagan General Hospital, Oliver. Squamish General Hospital, Squamish. Stewart General Hospital, Stewart. Stuart Lake Hospital, Fort St. James. Summerland General Hospital, Summer- land. *Surrey Memorial Hospital, North Surrey. Tofino General Hospital, Tofino. * Hospitals with extended-care units. HOSPITAL INSURANCE SERVICE, 1972 P 43 Public Hospitals—Continued *Trail Regional Hospital, Trail. University Health Service Hospital, University of British Columbia, Vancouver. University of British Columbia Health Sciences Centre Hospital, Vancouver. *Vancouver General Hospital, Vancouver. *Vernon Jubilee Hospital, Vernon. Victoria General Hospital, Victoria. Victorian Hospital, Kaslo. *West Coast General Hospital, Port Alberni. Windermere District Hospital, Invermere. Wrinch Memorial Hospital, Hazelton. Outpost Hospitals Red Cross Outpost Nursing Station, Alexis Creek. Red Cross Outpost Nursing Station, Atlin. Red Cross Outpost Nursing Station, Bam- field. Red Cross Outpost Nursing Station, Blue River. Red Cross Outpost Nursing Station, Edge- wood. Red Cross Outpost Nursing Station, Kyu- quot. Red Cross Outpost Nursing Station, Masset. Red Cross Outpost Nursing Station, Tatla Lake. Federal Hospitals Veterans' Hospital, Victoria. Shaughnessy Hospital, Vancouver. Canadian Forces Station Hospital Holberg, San Josef. Canadian Forces Station Hospital Masset, Masset. Licensed Private Hospitals Industrial Hospitals in Remote Areas With Which the Province Has Entered Into an Agreement Requiring Them to Furnish the General Hospital Services Provided Under the Hospital Insurance Act. Cassiar Asbestos Corporation Private Hospital, Cassiar. Mica Creek Private Hospital, Mica Creek. Port Alice Private Hospital, Port Alice. Rehabilitation Hospitals G. F. Strong Rehabilitation Centre, 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. * Sunny Hill Hospital for Children, Vancouver. *Veterans' Hospital, Victoria. (A number of the larger public hospitals also have rehabilitation units.) Other Hollywood Hospital Ltd., New Westminster (licensed under the Mental Health Act). Extended-care Hospitals (See also Public Hospitals marked *.) The Louis Brier Hospital, Vancouver. Menno Hospital, Abbotsford. Mount St. Francis Hospital, Nelson. Mount St. Mary Hospital, Victoria (excluding top floor). Pearson Hospital, Vancouver (excluding facilities for tuberculosis patients). Priory Hospital, Colwood (24-bed unit and 71-bed unit). Glendale Lodge, Victoria. Out-patient Clinics Houston Hospital, Houston. The Arthritis Centre of British Columbia, Vancouver. * Hospitals with extended-care units. P 44 BRITISH COLUMBIA 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 1972 there were 98 public general hospitals, including four diagnostic and treatment centres, approved to accept British Columbia Hospital Insurance Service patients. Care was also provided in eight Red Cross outpost hospitals, three Federal hospitals, four contract hospitals, five public rehabilitation hospitals, one rehabilitation hospital operated by the Provincial Government, and two specialized out-patient facilities—the Canadian Arthritic Society Vancouver Centre and the Narcotic Addiction Foundation in various centres throughout the Province. Hospital insurance coverage for patients in nonprofit extended-care hospitals and units commenced December 1, 1965. At the end of 1972 there were 38 hospitals, including two Federal and two Provincial hospitals providing extended care. Data for the year 1972 have been estimated from reports submitted by hospitals to October 31, 1972, and are subject to minor revision when actual figures for the year are submitted. Table 1a shows that 378,154 BCHIS adult and children patients were discharged (separated) from British Columbia hospitals in 1972, an increase of 13,072 or 3.6 per cent over 1971. This table also shows that 95.9 per cent of the total patients discharged (separated) from British Columbia public hospitals were covered by hospital insurance, compared to 95.7 in 1970 and 1971. Table 1b indicates that in 1972 the British Columbia Hospital Insurance Service paid public hospitals in British Columbia for 3,320,087 days of care for adults and children, an increase of 60,990 days or 1.9 per cent over 1971. As shown in Table 2a, the average length of stay for British Columbia adult and child patients in public hospitals during 1972 was 8.78 days, and the days of care per thousand population were 1,671. For comparison purposes, the data for extended-care hospitals are not included in the above observations, but it should be noted that an additional 372 days of care per thousand population were provided for these patients. Table 2b, under "Minor Surgery Patients," includes an estimated 60,000 surgery and psychiatric patients handled on a day-care basis. An additional estimated 31,000 out-patient cancer treatments were covered by the British Columbia Hospital Insurance Service, which were not included in this table, as well as patients treated on an out-patient basis by the Canadian Arthritic Society Centre, the Narcotic Addiction Foundation, and the Houston Diagnostic and Treatment Centre. HOSPITAL INSURANCE SERVICE, 1972 P 45 Table 1a—Patients Separated and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public General Hospitals1 Only (Excluding Federal, Private, Extended-care, and Out-of-Province Hospitalization). Total Hospitalized Hospitals in Public Covered by BCHIS Adults and Children Newborn Total Adults and Children Newborn Total Patients separated— 1949 .... .... 164,964 216,743 261,128 271,609 277,073 285,998 292,119 301,510 314,585 326,793 338,923 354,766 371,266 380,651 394,471 26,272 33,190 39,599 38,226 37,697 37,231 35,688 33,555 32,488 32,014 33,529 36,550 36,931 35,101 34,434 191,236 249,933 300,727 309,835 314,770 323,229 327,807 335,065 347,073 358,807 372,452 391,316 408,197 415,752 428,905 140,168 199,774 249,654 259,953 264,655 272,597 278,023 286,799 299,518 311,718 324,769 339,409 355,449 364,452 378,154 84.9 92.2 95.6 95.7 95.5 95.3 95.2 95.1 95.2 95.4 95.8 95.7 95.7 95.7 95.9 24,640 31,515 38,980 37,558 36,505 35,878 34,196 31,863 30,814 30,377 31,635 34,576 35,047 33,732 33,389 93.8 95.0 98.4 98.3 96.8 96.4 95.8 95.0 94.8 94.9 94.4 94.6 94.9 96.1 97.0 164,808 19. . 231,289 I960 288,634 1961 297,511 1962 301,160 1963 308,475 1964 .. . 312,219 1965 1966 - - 1967 318,662 330,332 342,095 1968 356,404 1969 373,985 1970 390,496 19712 398,184 19723 411,543 Percentage of total, patients separated—■ 1949 .... .... 86.2 1955 92.5 1960 96.0 1961. 96.0 196?. 95.7 1963.. . .. .. .. 95.4 1964 95.2 196S 95.0 1966 _____ 95.2 1967 95.3 1968. _ - .. 95.7 1969 95.6 1970 — — 95.7 19712 95.8 19773 95.9 1 Includes rehabilitation hospitals. 2 Amended as per final reports received from hospitals. 3 Estimated, based on hospital reports to October 31, 1972. P 46 BRITISH COLUMBIA Table 1b—Total Patient-days and Proportion Covered by British Columbia Hospital Insurance Service, British Columbia Public General Hospitals1 Only (Excluding Federal, Private, Extended-care, and Out-of-Province Hospitalization) . Total Hospitalized Hospitals in Public Covered by BCHIS Adults and Children Newborn Total Adults and Children Newborn Total Patient-days— 1949 1955 . 1,682,196 2,198,863 2,581,042 2,675,402 2,708,337 2,778,668 2.820,122 2,895,476 3,008,632 3,093,372 3,225,333 3,315,760 3,384,586 3,400,366 3,458,168 213,874 227,674 249,273 240,207 274,032 270,298 260,979 245,756 235,796 239,972 244,715 248,324 253,081 227,372 219,127 1,896,070 2,426,537 2,830,315 2,915,609 2,982,369 3,048,966 3,081,101 3,141,232 3,244,428 3,333,344 3,470,048 3,564,084 3,637,667 3,627,738 3,677,295 1,430,646 2,005,165 2,451,839 2,546,344 2,573,634 2,631,671 2,670,176 2,747,232 2,861,260 2,946,000 3,074,959 3,156 171 3,233,553 3,259,097 3,320,087 85.0 91.2 95.0 95.2 95.0 94.7 94.7 94.0 95.1 95.2 95.3 95.2 94.5 95.8 96.0 200,585 212,514 241,157 231,043 263,475 257,736 246,813 230,096 220,270 222,543 226,633 231,803 238,049 216,305 210,979 93.8 93.3 96.7 96.1 96.1 95.4 94.6 93.0 93.4 92.7 92.6 93.3 94.1 95.1 96.3 1,631,231 2,217,679 I960 2,692,996 1961 - - 1962... 1963 2,777,387 2,837,109 2,889,407 1964- - 1965 _ 1966 2,916,989 2,977,328 3,081,530 1967 1968.. - — — - 1969 - 3,168,543 3,301,592 3,387,974 1070 3,471,602 19712 3,475,402 19723 .. _ _ 3,531,066 Percentage of total, patient-days— 1949 - 86.0 1955 .. - . 91.4 1060 95.1 1961 95.3 1962 95.1 1963 - 94.8 1964 94.7 1965 94.0 1966 95.0 1967 95.0 1968 _ 95.1 1969 .. - 95.1 1970 . . . — 95.4 19712 95.8 19723 96.0 i Includes rehabilitation hospitals. 2 Amended as per final reports received from hospitals. 3 Estimated, based on hospital reports to October 31, 1972. HOSPITAL INSURANCE SERVICE, 1972 P 47 Table 2a—Patients Separated, Total Patient-days, and Average Length of Stay According to Type and Location of Hospital for BCHIS Patients Only, and Days of Care per Thousand of Covered Population. Total (Excluding Extended Care) B.C. Public Hospitals Other B.C. Hospitals, Including Federal and Private Institutions Outside British Columbia Extended- Adults and Children Newborn Adults and Children Newborn Adults and Children Newborn Adults and Children Newborn Hospitals (Including Federal) Patients separated— 1949- 1955- 149,280 209,999 264,120 273,293 278,021 286,753 293,144 301,522 314,391 325,861 338,706 353,457 369,210 379,144 391,834 1,491,121 2,100,386 2,650,129 2,756,665 2,789,355 2,850,559 2,905,544 2,985,092 3,110,701 3,189,212 3,309,533 3,397,005 3,465,504 3,486,671 3,540,826 10.03 10.00 10.03 10.09 10.03 9.94 9.91 9.90 9.89 9.79 9.77 9.61 9.39 9.20 9.04 24,989 32,035 39,488 37,968 36,942 36,326 34,652 32,240 31,152 30,804 32,031 34,974 35,431 34,192 33,694 203,197 215,980 244,480 233,794 266,351 260,771 249,827 232,438 222,475 225,479 229,053 234,098 240,657 218,971 212,986 8.13 6.74 6.19 6.16 7.21 7.18 7.21 7.21 7.14 7.32 7.15 6.69 6.79 6.40 6.32 140,168 199,774 249,654 259,953 264,655 272,597 278,023 286,799 299.518 311,718 324,769 339,409 355,449 364,452 378,154 1,430,646 2,005,165 2,451,839 2,546,344 2,573,634 2,631,671 2,670,176 2,747,232 2,861,260 2,946,000 3,074,959 3,156,171 3,233,553 3,259,097 3,320,087 10.21 10.04 9.82 9.80 9.72 9.65 9.60 9.57 9.55 9.45 9.47 9.30 9.10 8.94 8.78 24,640 31,515 38,980 37,558 36,505 35,878 34,196 31,863 30,814 30,377 31,635 34,576 35,047 33,732 33,389 200,585 212,514 241,157 231,043 263,475 257,736 246,813 230,096 220,270 222,543 226,633 231,803 238,049 216,305 210,979 8.14 6.74 6.19 6.15 7.22 7.18 7.22 7.22 7.15 7.32 7.16 6.70 6.79 6.41 6.32 7,093 8,313 11,557 10,361 10,226 10,895 11,605 11,417 11,459 9,436 9,310 8,867 8,307 8,654 8,280 45,960 75,599 169,401 182,690 183,042 187,714 199,164 205,488 212,413 195,564 188,152 186,565 176,086 167,339 167,739 6.48 9.09 14.66 17.63 17.90 17.23 17.16 18.00 18.53 20.72 20.21 21.04 21.20 19.34 20.26 151 361 241 151 157 169 149 114 101 83 80 94 87 109 70 1,146 2,271 1,417 878 850 1,018 878 619 541 451 434 463 450 442 407 7.59 6.29 5.88 5.81 5.41 6.02 5.89 5.43 5.36 5.43 5.42 4.92 5.34 4.06 5.81 2,019 1,912 2,909 2,979 3,140 3,261 3,516 3,306 3,414 4,707 4,627 5,181 5,454 6,038 5,400 21,515 19,622 28,889 27,631 32,679 31,174 36,204 32,372 37,028 47,648 46,422 54,269 55,865 60,235 53,000 10.66 10.26 9.93 9.27 10.41 9.56 10.30 9.79 10.84 10.12 10.03 10.47 10.24 9.98 9.81 198 159 267 259 280 279 307 263 237 344 316 304 297 351 235 1,466 1,195 1,906 1,873 2,026 2,017 2,136 1,723 1,664 2,485 1,986 1,832 2,158 3,224 1,600 7.40 7.52 7.14 7.23 7.24 7.23 6.96 6.55 7.02 7.22 6.28 6.03 7.27 6.34 6.81 . -. 1960 1961 1962... 1963... 1964 1965 - .. .. 1966. 1967 _ 1968- 1969- 1970 699 873 990 1,100 1,022 19711 1,495 19722—.- Patient days— 1949 1,840 1955 - 1960 1961 1962 1963 1964 1965 1966 1967 . 1968- — 1969 1970 305,940 358,675 409,514 502,365 531,808 197U 672,099 19722 Average days of stay—■ 1949 837,000 1955 — 1960 1961 1962 1963 1964 1965 1966 1967- - 1968 437.68 410.85 413.64 1969 456.70 1970 520.36 19711 449.56 19722 . . ... 454.89 1 Amended as per final reports from hospitals. 2 Estimated, based on hospital reports to October 31, 1972. Estimated patient-days (including newborn days) per thousand of population covered by British Columbia Hospital Insurance Service: 1949, 1,528; 1950, 1,548; 1951, 1,496; 1952, 1,527; 1953, 1,600; 1954, 1,733; 1955, 1,720; 1956, 1,688; 1957, 1,626; 1958, 1,665; 1959, 1,724; 1960, 1,804; 1961, 1,806; 1962, 1,841; 1963, 1,835; 1964, 1,815; 1965, 1,799; 1966, 1,779; 1967, 1,754; 1968, 1,774; 1969, 1,757; 1970, 1,734; 1971, 1,696; 1972, 1,671. (1954 and subsequent years are based on total population. Because the Armed Forces, Royal Canadian Mounted Police, and some other groups are not insured under the Provincial plan, the actual incidence of days would be somewhat higher than shown.) In addition, estimated patient-days per thousand population for extended care amounted to 308 in 1971 and 372 in 1972. Population figures are revised according to latest census figures. P 48 BRITISH COLUMBIA Table 2b—Summary of the Number of BCHIS In-patients and Out-patients Total Adults, Children, and Newborn In-patients Estimated Number of Emergency, Minor Surgery, Day Care, and Out-patients Total Receiving Benefits 1949 174,269 242,034 303,608 311,261 314,963 323,079 327,796 333,762 346,242 357,538 371,727 389,531 405,663 414,831 427,368 29,000 70,553 107,312 121,000 128,000 135,000 141,000 160,000 175,000 195,000 210,000 220,000 235,000 265,000 300,000 203,269 1955 312,587 1960 - 1961 1962.. ... 410,920 432,261 442,963 1963. - . 1964 458,079 468,796 1965 - - - 493,762 1966 521,242 1967 ... 552,538 1968 581,727 1969 — 1970 197H. _ 19722 609,531 640,663 679,831 727,368 Totals (1949 to 1972, inclusive) 7,110,856 3,099,073 10,209,929 1 Amended, as per final reports received from hospitals. 2 Estimated, based on hospital reports to October 31, 1972. Table 3—Patients Separated, Total Days' Stay, and Average Length of Stay in British Columbia Public Hospitals for BCHIS Patients Only, Grouped According to Bed Capacity, Year 19721 (Excluding Extended-care Hospitals). Bed Capacity Total 250 and Over 100 to 249 50 to 99 25 to 49 Under 25 Patients separated— Adults and children Newborn _. Patient-days— Adults and children 378,154 33,389 3,320,087 210,979 8.78 6.32 195,834 15,618 1,812,754 104,248 9.26 6.67 90,938 8,848 724,123 52,931 7.96 5.98 49,376 5,796 487,620 36,330 9.88 6.27 32,916 2,378 234,365 13,719 7.12 5.77 9,090 749 61,225 3,751 Average day's stay— Adults and children 6.74 5.01 1 Estimated, based on hospital reports to October 31, 1972. Table 4—Percentage Distribution of Patients Separated and Patient-days for BCHIS Patients Only, in British Columbia Public Hospitals, Grouped According to Bed Capacity, Year 19721 (Excluding Extended-care Hospitals). Bed Capacity Total 250 and Over 100 to 249 50 to 99 25 to 49 Under 25 Patients separated— Adults and children Newborn Patient-days— Adults and children . Newborn... . Per Cent 100.00 100.00 100.00 100.00 Per Cent 51.79 46.78 54.60 49.41 Per Cent 24.05 26.50 21.81 25.09 Per Cent 13.06 17.36 14.69 17.22 Per Cent 8.70 7.12 7.06 6.50 Per Cent 2.40 2.24 1.84 1.78 i Estimated, based on hospital reports to October 31, 1972. HOSPITAL INSURANCE SERVICE, 1972 P 49 CHARTS The statistical data shown in the following charts prepared by the Research Division are derived from Admission/Separation forms submitted to the British Columbia Hospital Insurance Service. The major diagnostic categories used for the table on pages 55 to 60 are more detailed than the diagnostic groups shown on the charts. Both lists are based on the 9th revision, International Classification of Diseases, Adapted, prepared by the Public Health Service of the United States Department of Health, Education, and Welfare. Readers interested in more detailed statistics of hospitalization in this Province may wish to refer to Statistics of Hospital Cases Discharged During 1971 and Statistics of Hospitalized Accident Cases, 1971, available from the Research Division. P 50 BRITISH COLUMBIA <o < 7. W0? *r\ i Oh .1 U , V... $4^ ym\_ ■ \ i J3 .0 C '■5 3 HOSPITAL INSURANCE SERVICE, 1972 P 51 o _c U P 52 BRITISH COLUMBIA H w H-I < P. SS £ V. , ~ r= ii - " V-;/ VJ ' — vo t. .— '-_. tsgw<<c/ Vnc- Hi r-t^w ^ \2" 2 ^->^/2K i //}W/^ o X PJ I-I < HOSPITAL INSURANCE SERVICE, 1972 P 53 w_ I w p. s 2 - Q w i. :- Z Ph a P 54 BRITISH COLUMBIA Chart V—Avf.ragf. Length of Stay of Cases" in Hospitals in British Columbia, by Major Diagnostic Groups in Descending Order, 1971 (Excluding Newborns) Diseases of the circulatory system Certain causes of perinatal morbidity and mortality Neoplasms Endocrine, nutritional, and metabolic diseases Mental disorders Diseases of the musculoskeletal system and connective tissue Congenital anomalies Diseases of the digestive system Diseases of the skin and subcutaneous tissue Accidents, poisonings, and violence PROVINCIAL AVERAGE LENGTH OF STAY Diseases of the nervous system and sense organs Diseases of the blood and blood-forming organs Infective and parasitic diseases Diseases of the genito-urinary system Diseases of the respiratory system Complications of pregnancy, childbirth, and the puerperium Symptoms and ill-defined conditions /////////////////////////// -■» limi. W/////////////////M, « #/###/« w///////////////////// - //////////////mm, W//////////////M - w/m/m/m/ ■////////////////////// ■» mm///////////// w/mm/m - /mm/mm /////////mm ■» WW/////////////// ///////////////////« WWWW/i, m/mm«w/ww/ww W////////////Z » WWWWW WmmX 9'2 llll»j WW//////// «w////////// w///m,»v/mm//, w/m •■» mm wm« www w/m - //////// www" m. W/M - « * Including rehabilitative care. HOSPITAL INSURANCE SERVICE, 1972 P 55 w 2. « o z o z Q P ►J U X W a. co w s o o w H H O Z o p. o hi S5 O H < H S to O X «0 p rn «n d o d ^^^^t^^^°H<M^NNqvq^^r;mn^qqhH coodddoodddodddddddo'dddodd© ooor-wo ri © *-* d d ! © ts m i d d d do in d d o'ddo'o'do'dddo'o'dddddddodod a> o <3 «0 < 0 NO O CO 00 00 Tf ND Tf in -* rn on ri © nd m oo i> m" TtNo^'-rf'^Tta.vDo i-"T-H(Nr.r.<N'-''-1r. im^Ttin<j;^n<0'-;^;r.vD-~;v.i-;(s - no" On rn o. od oo -*' r^ r- 06 rf nd cn ri 00" t-~" f-t--r.v0MOf.vDH VOO in th tf n oo 00 © On cn no comwnO o»no C-Oi vo ts 00" <n t-T t-T o" NO rH OS r.ovofnooo\ONNOt^vor-.r--a-Tf-©r-^oot^-tSOfSvoinrtov t-~rnt-Hr.oovocornvocn»n^trnr.vovOrnr^ONa\r~-coNoinr.c c-^no t-h c-l rn on m rH cS oooo-^-NOoopoooo^-^t ■<* rn t- -tf cnO\ON< o^^r^t^tninrimri^oosou^t^r^r^^sS^rAOstr^ cn" - O rH <S rH rH cn C-( N ^ ,-, ,_h fs| OlN^riinONOHH NO -"d" f'-O-^rH't'-i,tC0'-(ONa,y5i-iv0f."t'HNDM0\T)-00'-.|3sfn 00 in o no 00 no on --1 n- no no on vo r-icnNovooo\o(Nf~-ooo»noo'^-r-Nor~-ooinoNcocnin corH»nm'-> r- 00 cs r- r-Mwr-vo^oNDH Ttr-[^>tTt »-< © ^ ,-h no no o m On m vo cn On On <n cn O o r- rn 7 2 3 3 °. © O rf- © rf O O O rH m o o o o o r> NO 0 2 1 NO ON ON © r'i f 71= 0 YY 0 rn *;' ... —( O .1. rt NC ■— 4 0 O O 0 2 O O ! ■ 0 ^HH^inr. CS f- OO On On o O *1 h h (sj nyo r-rl o tmNHOH^o^jmwoor-HH^rmof-f-O <n »n no no r- _.r-oo .^oooooocooi -.1 ., rH rn „r. Hrir.rtH(SHHrH22'HHHHHOTt(fir.f.Mr- P •a «.a ■ i- - . ra B -SS 1>' ! o — ■__ *I3 B S -.5 b s — C B 0,3 » 2 a* « ya « „ 3 o ° 2 a h oftg.2> : o -a c i S IS * 0. B ™ J(J > c ° < -S I 2 2 : § .§>-°. § •2--S" 00 u__ u—1 v— r-—1 ;—1 o &3 " > +: u,,__;; i - -a OJ3C IHIH 0 ooooooooooooooooooh rt cd sssssssseesss _■_ s K > S 43 -° ' 1 !T-.cscnrt>nNoir-cd JH Z >o 0000000000000 & Oh Ph OOO u u u rt -<_ cd c cu ft ft ' O o ; <u <u fit.t.pfiCBCCflflE:c.!3CC.flfi« B1 c « rf a 5 .^ «-" -m > _£> M xj p o ^ <4H lH-H t4H IH o o O O O _3 9 fl fi C a d C H rt c3 n3 cd cd ca cd fififififififififififi! O0O0O0MbD01)ti0OI)fcI)W.O0. g§ ::si4 2 2 a B I _0 _D tO B. 1. .. .J rt B B B B B B B B — b a* a xi a a a a OpqfBP.P. P 56 BRITISH COLUMBIA s •S K O g co Z p. o p. w Z a z 3 5 o X W ON CO w 2 o G pa H d o o z o <- P4 O i-. < PQ rH z o H -J < H P. co O w cdU Q <D O M rt.fl >. S_?w B(J Q Z < 8 © rH co odd CS rH © d IHHHTt, r-) i-i r< r- -^r rn <n ,-< (v. NO rHI ,-J *fr © *<* CSt OS ■«* OV rn rH r- fs. 90 H iH ^ N rn \0 CO H r.dddrH©©'odddddNodr-.ddrHodddrnddddddd© rH © TJ- O © O cn rH d d VOF--"JHO\HNOH^HOUlf^M^^f^V.^H\000\r.Or;HfOcnnfl .H"d©'©©©d©©© ©©©■«*©©©©'T-*©d©©fn©o©©" ©©do ts t— i-hi ON<n Tt^o\NONoavr.t^©ONrnr^cnot^oovovq-^[>tsONun©ONrn^c»rirH\q© ■^ l> t*- no© rnNO©r.Trornin^'odr-r^t^rn©dvD©rHint^r-.\oo-C>dcd I-H T-H rH ,-t T-H ,-H T-H 1-H ^H T-H T-lrH HH(V|H(SH HM H m O. ft rH rHttm rH(S rHTl-r- oooor. O-^J- —*.__.____ rH OO tS rH CO ts cn cn r. m oo no m m r- tS rH r- © co 00rnwO\r.Unr.©NOC0NOrHrHln0NrHt^tSrHln©NO^-'tONr--OV0©0N'ri-'-' ©ONfnovTtov-^vo^oNOONOrn^r^tSt-^t^-OvCONtnOcnrHrHcorHONOvo r^flfNiHTtcnt-HinnTtr- OJ^rO fn ON CM ^ CN \D V. Wr. w rs h t(- (S th h w \d no' cn tS*" rH* NO" rH i-T t-T ITi'h rf -* th rt-H r. <s © CS (S I ^t . I On th . irS t» ** -m ri ts . ts I i „© O ND 00 Os m On On ■■* in no r- r- oo oo *-h r.tS©tScSr.r.r.©'-HcNcn **>__-. I I -9-- rtts ts tsfstscsr. tScSr.r.r.©rHcs<mrHinvO'^l-Om'^-rncnmcncnotS I | | I I COM IIOnOnOnOn©©© -III l-rf^f rH©©^or.r^rs©tstStSr-cncncnts©©©©cncn invo r~r-co coon j © th cn cs tn rj im m m N r-Jr^ rsl f. fl ffi m m rn CO Ov .-•n vo 1 »n *f cn cn "* 3: J i i cn cn © © -m no cn cn m .ss rt S s .5 ■a ° s-g £ a tH fi 0.0 I t4H t4H Cd ■a ° 0& 1 S1S •3 u_ (/) S C rt rt 0 | a a* J, 00 0C In Bill u. y o +-< rtpqpao ft . , . o ND t-- 00 <u cn cn rn J s OJ " +J OJ P tS X o a w C ft O *+H S ° ■? a -3.2 .a to !.'3 b 9 a .£ a S x> -O t3 t3 -O rt i: si o a c * 5 __ ^ o 9 B O rt 2 __ _* ■s a .5 ° a a [ J^.o5 :»S_£5.'S2J'-S«* !..■-?_ H "o y b -; a, n ~t sSSSob - .O o f (J S S 5 S J= Ill lis S.ot.S. /■•5<6o ijSiSo3 O •a J3 § Pi - ||.|a| <tn<OZ a = & ™ o u J? « D. _! a Sj +J B P" O B'O - caw 8 b » o > sS& 0, rt a rt > c a her disea seases of flammato a HH W OQ5 m NO VO m NO vo r- co NO NO NO HOSPITAL INSURANCE SERVICE, 1972 P 57 dddddddrfdddNVddH'Hddddddd!}.H'dmH,dH'ddddddHddH, ddddH TtTjHri9iHMqof)'tr-0\Tt „ cici£<o<oci<£os'<d>dc>' Os r^^ ih m co vo h NO»nr^vocnoN©fSin-^©p'n©ooriON>n'd;cnr-oo ddo'dddddcn'tsdri'-.o^cidddddrH'© d © ©'©©■<-. r-. Cn-HrSO\<nrH©pT~HprHr--rH ri on tr- no vi!r* in* in t> ri *-I oo* m* T-Hts©©oocnrncooNO\rHinr.tSNo^vots^^ootnpcnr^ts-^©ONcncnoort --HNo'r-^odcov^r^o.Nd'^'vo'vDr^doNco'ri^cncnca^rHo.c^ HHr.f.r-HHH T-H tH CS*-<T-H T-H t-, t-H N^Nv0HWr^00iHONDWMtHNr^'nM^^nTfrJ-0.l>V0^^v0rHOnM ^tn©r-OvNO-*<n-TfNOcnr-~vocnrnONt»tncoON.^r4rHtMvoinaNONOO\vor--ocNfSrHc^ 1h- * *1, "1. ^ *"! ^ t,H- ^1 "t ^ °i ° ** °°* **L °°„ **1 ^ **! ^ ov ^r cn«n m ov^r^in oo rn irr;"o Q0^riTt,,~l,(N„ol',;:C^.'rl'r enr-rnNO00rHNOorts"ts co"Tfinvoin<n"r^vo^"^tn"ts"vorn"ddoo"co"ov"rH"^cs"t^ On t-h no cn m" •<* on t-h © r —H -~< — -_-. — fV. t-#- —- #*-. .Vs —■ _%J —j rr\ i tH- vr. —i .r% ^rt- .-P. (-n. ^H .—; Hr rsj t-h m Ii vl^^a^O\com^n^coHHOO\NOcolOOO^^novllnoc^\o^ow^o^H^mNnNv.^oONvo ^ino\cocoHiriinrfHT4-HO\\ooOvOi^^Tf(^hinNOinhOOOi/iroHin^n^M^^Own Tf^o^'ctcor^r-r^r~-'-H©NO in ot mmvonomroc^N n nti >DNOfH o^ND^vO^^D w tj ^ m. °i, ^ ^, "^ ""i. °_ "*, - ih n rn *-HTfr ,-h t-T ^ t-T t-T r-Tcn rn r-ro'ri ts" oC rf © in" rn m" »-. r-T rH d (vf ro h h h tj- 'c no cnmootsoo"* ■* on th-"? oo cn G 90 I m ov O- © hn ^ I .tt„|2 r-t-t- -co .« 1 | i IrHlTenTcn^'TinT cnrncnr.cnrirn©©rnOTtrH©T+cs'^-rj-'H^rrH r- co ». on on o. o t-h <n m „ 3 m cn tnocnmcn-^t •^■•^f ^ O ~ ^ 00 os so "^t vo n m t-h vo r- 00 on ^m-^-intd-rf-^-rtmOrn ^"nl lIlTlOvo© ■'TTNOOOOOO'Jinin m no 10 r~- co on ^t -^ ■* -^J- ^J- -^ 1/- m m V. T-H r- fN »N f> rn m m in ■^r m m r) m m in m © in in © © ■sO t-h" A © ". T U 1 in m rs m V) m 60S BS: S.S-3 w -a '-a ) 4> « «M • > a) rt g **= £ fi t: „ O cd rt rt ■jh o h o aj ^ M -2 rfl -fl p -a *p o «m ^ f CD 01. +-1 HH ►* (11 rt cu "O ■« <u f 01 U S ie : g ""a "§ .y *fl ! fl qj cd fi u 5 qj > u « S2 a *■* c ^ o *■" ! a j- u v. t, »uoooSo8<ok<oo b .3 §=3S: U i_ to fl o ■-3 • rt j_3 •- w -H J-3 B-2! g £J3 5 B xi 0 qj .a <D _. __, JH CJ W B B £ JP 1 * ft o O -H J--1 HH S ° J.S3 T^. OJ 1 > 2 .<_ ,<. m X ri *s X u o o ■a g OP. s-5 b8a -Sc 3 « (-1 •3 2.§ *4H cd "q. (D « |H W QJ Ih rt Ih OJ .22 r- ft rt •flS fl N >o< -fi w* ■:, p->a 0 -a & a •S c : t- o ra SuSg ■S n _S^2 f. a S. 9 3"S 2 S &'S S S a,g i. OT W ° aggss O ♦_ TH C 3 OO 00 CO 00 C a a,g g, o i Tf" in no r-^ 00* c n On Os os Os On C in u fi O g^Wfi « vv rt O T3 w fi u "Sees OOBp, c±™& ■a B a .3 o«h cj 3 O rt *fl M rt *a ■ ' «_ u -; ^ cfl OT J3 1 rt 3 O fi ctj -j -t; V <D Tt TZ rt fl> "-H T" O <U -O to rt u ■-! j2 1/1 .Sh «h T3 ^ «J TJ o ■H "S rt *H Ih iu o g o « . . oj •irn cGTtmNor-ooONOrH .OqOOOOOO-hh to .J5 -3 f ■-J -O 13 " ■rH ^ fi 5 1 *h in h* Jr. *fl 1 OJ *i oj y fi ■ — rt -M o. QJ P 58 BRITISH COLUMBIA 13 5. a .s s o U CO Z P< O PQ O z M Q D h. U W f- a. w l-H 5 o o w H < U o Z o < ft o I") M z g < N < O S3 rtU Q rtfl >? M r„rt OJ CD+-J > flW <__ d©"drH©ocs©'©dt-*dddddr-.©o©dddddr-" rn d-) ts Tt r- T-H © d d 0" © ■**■' <?\ HH d d H-Of^(SnON^r^f-)vDr-lO_0'd-HMr^lrilnVDTt00l>0\r; HlOfOi S<£Sricicic^SSdS^ddSridSScidci<dcSSm odd. I rH |> ' ri vo rH CN rn' ©' oqNqi£icOrHvDt^min^O\ONNq-Hq(>3^m^^^^^tn oDrHcdo"oNNo"rH"oNricn^ricoi>vdod^riinrnr^NodcnN^ © © in on © no in in m' ri cn <n t-; -* ran Q o Z < e z rHT-Htn©rnrH©inincninrHT-HrS'rj-©ini>rnT)-i>©ini>avin co cn cn rn ts r- m rn 00 t- co'^i-tsovr-rHNOmONOinr-Notsco©in^foo©'-HcsicoON©T-H -<t Tt r- 0 cn no vo 00 corn C»ONr-CnrHrHcnNDr.CONDNOrHinr~Tr'*©inrH^OfN.ONONrHcn tSrtNDNOC-rH m © OOrH trTtinrHtsvooof-Of-mO- HiHTtr. CJNrH rH^OtSrH ts H OS cn m" ts" rn' no" I> rH rf ' 0 cn Tt rH ... ts" © no" ts" rt" NO ih —' tS -d" rH •*OM»>HMHOf.00Klr-O00H00loO*Hhfn*r--t-- viinoo©NOtn©rnNO©T-Hrn'd'OocntnovrnooNoc-OrnrnNOOor- f> in r-r^q^H n a^ ts 00 * o ^ cjwo th o r-o^oo^cn^r^rH tjinw t-H rJ-rH w"h doOts"tS*rHTtcn T-HrHCS"rHCn*'cn'cnrH o o no 00 ts n m © t-h 00 rj- vo ■^l- r- ts cn ts o m © m in -_H -so .r. r^ r^ n j 1/, i/i m CN Tt ts 00 in no r- vo t~~ r* r- m m in Cn »n I NO fl On -On NO rH ND fS Tf cjn OH Hflr. CM r- m©invoNONONONONONovo ictn -on _. © o „ „ I . „r. _. J ©Oinr.mmNONOTt©r.©mNom© oooo on on ©T-HT-Hoir. tsm •n >n m m ^5 vo no no no no nd On O tS vd n no m no © -. m I cn T £ © VO NO no © vD r. oo nc t— NO NO O "fl rt > u fl !|S. o u fi ,~j 5" * tn il rt J-3 fl rt1 « .2;fl -a .-fl fl ° c rt « a n £ ft '3 rt cm rt '7; 51.1 a — ■* _■ .a .2 .a 3 'a.^S QJ r* W ° fl .S3 C cn ~-fl P fl .13 QJ fl I qj cn C qj rt 1 O ftT3 - lM d rt '£5 _i\fl O - ... ■ QJ . *2 fl CO ft fl OJ a ^2 TJ CO 5 G <U rt cd Ih CO ft •h _r O -5 60 5fl'C c2t§ fl +-, - rt " fl i Ih CO O ft ft O fi ■o ft) fl QJ ft rt OJ " a_ '..H -•S"3 O b o ; CO <D ■ 8K> 3«-i p. 2 a a--, . ° a a * 1 s & •§ -a 0 -2 S.S E . .2 > s ■S S^i ^23 I O ft fi i-h Cd rt G *> fl ?.§ o ■ S S a a a. <u *z! g o S.2 E3 o tw '^ b OD o a. &-S B I a h ■_; H "--•5 >-£____£" X !) « a £c K_'S.35*!.aS u * ^UOUOOUOQlZfioooap.OQOPlPQOi.S jrin^inior-Mf os.. «. Svo 5u2 SKhO< ,2£"S^ a •a 5 -a a rt % b S a. °-S O d, rt ft «a a a ■fi o oj o ? o o u <U QJ -7-1 QJ .£ -£ O •-- d> *QJ -S "QJ 0Q2Q oa a " & o oa u _ 3 .a >: a n.S B a BOftU X HOSPITAL INSURANCE SERVICE, 1972 P 59 TtNot,^tovONONcnoomNor.r~-NOr-r r- r o- -t c © c ©t © c "* c rl <r r- r- m no CT- cn nOOOWOOOOHOOOHOOOOOOO © c c doc rH © rH -3- r- ■hON-h ri © ^t^<n^rlcnincnfnrHt^cnr--cn©r-rH^Hcncncn © © c © © c ■* rn rn Tt r- r- rl tr-t rn m cn H'ddo,to'dd6"dddrio,6dQOO,d d © © © © © ri © ri tj-' rn Oridr. ri © rt©inooovovooNOmO|nr- r^oo^inr.vOr.in ri o r. r^ ^ oo cn r~; cn tn os 00 cn ON r-H ND ON 0\o6rHONricnt^ONrHcn"co*in0. rHOOcn'©Ttt~-inod t' cc NC in cn cn ■n rj* >n os no rn in rt m r- t-h rH HNrl {NrH (3> H W rH th h i-h cn rH ts cn rH ,-h CT-©a\©cncnrs-NDoortONrtooO.O\inrt©rtrtcn © *!t 00 oo r- cn OOOvOH On in © r- rf rn r4r-NDir/NNDrHii-lovcocn'S-rHrHr-oooNin'*Trcnr- cni-Hcnr-inOcomcnooo\r-r.C-»nON©cn-rtONOv n m r © NO NO © Tt ND OO rH rt NO ON © rH OO cn rn r- © rt t-h r- i-l rH O cn rt co cn rt ON©incn©rHtNrHr^mr.mininint-~r.inON'rtON r. 0\ t-h (-• m rt rt ^h*} m O rt On r- m n ^r-rtrinnrnHNinr. cS»n rn n NO rl OO in rt rH rHr-rir.^tooONONcn©oONOrHcsiTtooinininrHTtt On c^- m on in t- r- m n no m cn nd rt no cn cn vOrH"Ttovoov-rtor-cnON©©T-HrtONONr^"^-oor~- -3- -^t r-i t- O © © cn rH no so r- rt tr- n rlVltTl',:t,rlrl00 r^ C^ r-^ N£^ T-HOO^r-rnm rn cn CN ONrn m cn © rt rt r^ m >n cn on © in" rf t-T rH" VO" rn" r-i t-T ,-h" rt (sf ^ fsf ^jT __J __," On On in no rJ rt rl rt m — tn fl On rH <N * C* oo" fl c,£ 'l r- CA i r- o. cc t- m"2 n tn Tt Sf* OnnoooOnoo 't m r- r- on cn r- n (fuc ^ » ON ON *S ""6 \£> CO J» "To ^ SPvo 4-g© tr- -on on i^1 SS „co r- tn tr- -Z rt ON On rn Os 00 on •n © t-h r. r) "^ vo CO CO 00 00 00 00 00 680-70 680-68 690-69 700-7C 710-73 712 713 711,71 720-72 725 4, 726- 731 0, 732- 740-75 741,74 747.0- 749 750, 75 752, 75 754-75 ), 743- 3-747.S m r- •-- it ZZZZZ -5.5 ^ i CO ::; DC On l> 1 ON „On "T - c- © t> (N On A © in © © (S © © m NO NO ' NO HH» t- +j ,00 On On X if, c^ •^ ri rt fn no r- r~~ r~r "fl t"T •fl. cn 1> t^ *7 oo cc OC oo 00 oo °o 00 o r- r- £ t-.gr 4 ■■-.'.. .S4 "d no .9*"" S zzzzzz zz P c- r- r~ r- © 5 ^« NO "* S5 fi QJ rt u Q -S .9 "o fl O QJ a. ? o =M o fl <u .3 s ei s u fl <0 > +3 E E 1 > c t b £ (B P 3 NJ TJ £ £ CJ QJ C p rt = a If 1 1 rt p o .£ G a n .fl 4 C c E c fl flj .■ *rt ^ t c E c E •a c •5 (U E c 1 CO a. i ft u. 3 U S. B 0} c fl 'u QJ oj o£ > c fl rt .5 ft TJ u a c 4 a X c r z £ onditions of ski and subcutane ■■Ietal system an* c c ~ p c t. | E - fl t+H ,i- O " o. tj 8.- rt £ t3 -g Ih 0. QJ > > c S > c fi Q 13 "rt *q3 3 CJ C c C '- > *c "c r 1 t eg & c .£ •J?'c ■o a •si w c QJ QJ fl 01 rt «_ E c aS Se 3 QJ fl ei fl S «M C o <-> -a p « •5 a c E .5 "P c c > | . 1 : a •c > •5 ? c E rt c C c 0/ ■£_ = 1 a Q c c ° -a 4. c I •a •fl fl fl I 'rt ft fl u rt fl rt c aj s o •a a - ■c c R (. 41 X. c a — C J NO 7. Other inflammatory c 8. Other diseases of skin seases of the musculoske 3* si || B " o t- 8,= OC O r- 5..E M O •- B fl ■a oj « oj a i OOC ri cn rt A 3 *g .-. •— -fl o ^ g S.s fl S_« fl rt F r ° C .fl ^3 cc E t-r- O QJ B C fl! .fl WO £ c «n" no" E 00 « *_ c C 2 oo *- .Sat i ■0. Other congenital ano 1. Congenital anomalies 2. Congenital anomalies d fl u ft o £ t_ a Se a — P 2 c c c. ct: > fl < tr o!E li N£3 t- .s i- *+- C ^ I fl c: u i- I c Symptoms and ill-defined c 169. Observation, without 170. Symptoms, senility, ai Accidents, poisonings, and ■a £ c .fl rt — QJ fc .9 * ft £ IH »(- O C V 0- (H t- B 5 tj t Ih 1- feU- ri c*" E u- C c "t r i- (X rl 5 fl £ ° o 5 0) ? 2e y o S 3 <S B w- Sou 5.3_ OO E in NO a •s <HH o t 3 3 1 QJ 3 tri QT.-.^fQTtmi^inmw.u.m.1- in in in *° no vo ^O NC NO NO NC r- r- r- r- r- r^ rH t-h r- f__4 tH rH t-H rH tH III. IV. fe t-i r-< > -t X X X 5c P 60 BRITISH COLUMBIA rs •S K O z PS o m w 55 o z ►J o CO w 3 o a w H < o z p. o < >H « z o < s. C/J o 3. c o •a a •M „?j. tr rn ND © r- rH S d d <6 S cn n on © © © g 'S tn Q — 5 . cm rt m g O NhtJOtHN iHt-jO j j o o CS u ri © © d *-. © »-* d ri j 8 QJ PL. «H <D O 00 _ rtJn >• <Htl rt aj w.+- ^ 'I *n ^ o\ r* *-h \q *-* | rs in rt m" On >n cn ri Os rt \ Os > CM <X mNOrtmoon m m on © o „ © tn On m t— Ov t-voNO m B0 NO rH rH f- (N CO tn ut CA rt r-r.rHrHrtr4 min—. rt CS IN rj- cn rt »n cn cn r- r- m m o\ © "nO\a j rt W rt r.O\ oo o ov r- r- no 1 rt in on t-< ,— r- ©invo ! U 00 t-h -rt rt t— 1 NO CO cn t- Ov rt r. On On On On Ov Ov ON NO no 0C r. <n rt in [— oo ONOv ro r-j 0v On On Ov On ON On On in d Z ZZzzzz Z£ 7min 333333 gS^rjS < 8 r~ cn rt m no oo Ov On v. r. rt 00 On Ov On o\ On O\0\rr.tN zzzzzz zz 0-„- n r. >^> fl fl "S'S O It rt e -9 ft L C O QJ tH O OJ o § B -J -■o « s uT 4> a-l a a V t_ a a •« QJ b -a u ° fl. — a o o — O w M p SI'S o a S. 2 3 O a rt a a S o .a. a.a u ft "rt « T QJ E c c c & a as O fl ■o 1 Ih U 1 a Z 3 ft—t fl* o ... 4> © a | M O TJ :§ T3 o §*« .9 o a 3 _ " o a c Ih *- 1 c •s fl > X '- G U 0 ! s "** fl ih „ u« a c o rt fl B o M fl 00 .9 a 8 ■& O fl fl .Str -rt C c w •fl Q_ £ QJ fl 0 > ait, ."a u v s»a 2 6 a ■a "• y <m o " ° a £ o -a _ SiSg_,»3e w H a - t3 a £ rt B "c. 1 on" V U HW O C O fl -H V- fl^Xfiwflaj-flt -H »—l "H o d "fl1 ^ w Ou_,+h cljz c H oo o\OHNJ2it m no r- oo P t- r- co oo oo co oo OOOOO0OO t-i § HOSPITAL INSURANCE SERVICE, 1972 STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR THE FISCAL YEAR ENDED MARCH 31, 1972 Administration— $ Salaries 1,145,942 Temporary assistance 29,570 1,175,512 Office expense 60,185 Travelling expense 67,502 Office furniture and equipment 15,037 Printing and publications 4,925 Tabulating and rentals 6,587 Educational material Motor-vehicles and accessories 6,067 Incidentals and contingencies 1,674 Construction and consultation fees 13,998 Technical surveys and new service development 48,608 1,400,095 Payments to hospitals— Claims 199,531,437 Grants in aid of equipment 2,536,434 Grants in aid of construction 4,599,383 Total 208,067,349 P 61 Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty in right of the Province of British Columbia. 1973 1,030-1172-9174
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
Twenty-fourth Annual Report British Columbia Hospital Insurance Service JANUARY 1 TO DECEMBER 31 1972
Text