Canada provides least hospital inpatient care

Ontario provides even less hospital care than Canada

Canada is an extreme outlier in terms of hospital services. We provide hospital inpatient services to fewer patients than any other developed nation.

The 34 member "rich nations" club, the Organization for Economic Coordination and Development (OECD) has released its 2013 comparison of health statistics for its member states. For 2011 (or the reported year closest to 2011) the OECD reports that the average number of hospital discharges per 100,000 people is 15,561.

The Canadian rate reported is 8,249.

In other words, we have just over half (53%) the number of discharges as other developed nations. Only Mexico has a lower number -- although many would classify it as a developing nation rather than a rich one. Otherwise, Chile, which has 15% more discharges, is our nearest comparator. The rest range between 24% higher (Spain) to 333% higher (Austria). (You can download the complete 2013 OECD comparison by clicking here.)

Even this may understate the difference between Canada and the rest of the developed world. For some reason, Canada reports data only until 2010. As every previous year in Canada since 1982 (when the data was first reported) saw a significant decline, that probably also occurred in Canada in 2011, increasing the difference more.

Since 1982 we have experienced a reduction of 42% in Canada. Despite the fact that it is much harder to get into a hospital in Canada, the average length of stay is only slightly longer in Canada than in the other 34 OECD nations (7.7 days versus 7.5 days).

Why Canada? The particular focus on cutting hospital services may have to do with the particular nature of public health care in Canada. Under the Canada Health Act, the government is obliged to provide medically necessary services when the care occurs in a hospital. With the exception of medically necessary physician services, no such obligation exists for necessary health care services delivered through other providers. Accordingly, public coverage is much more spotty for drugs, home care, long term care, dental care, physiotherapists, psychotherapists, etc., etc.

So there's a secret incentive in Canada for governments to move services outside of hospital walls. An incentive that exists regardless of the quality of care.

Why Ontario? Ontario appears to have taken this furthest, with the lowest acute inpatient hospitalization rate of any province in Canada.

We are on the edge of the edge, it seems.

Photo: Christiana Care

Comments

More spending on new hospitals and new beds? Nope

Hospital funding: There is something off about the provincial government's Budget claims on hospital capital funding (funding to build and renovate hospital beds and facilities). For what it is worth (which is not that much, given the long time frame the government cites), the province claims it will increase hospital capital spending over the next 10 years from $11 billion to $20 billion – or on average to about $2 billion per year. But, this is just a notional increase from the previous announcement of future hospital capital spending. Moreover, even if we did take this as a serious promise and not just a wisp of smoke, the government's own reports shows they have actually funded hospital infrastructure about $3 billion a year over the 2011/12-2015/16 period. So this “increase” is really a decrease from past actual spending. Even last year's (2016-17) hospital capital funding increase was reported in this Budget at $2.3 billion - i.e. about 15% more th

Ford government fails to respond to 72% increase in COVID inpatient days, deepening the capacity crisis

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data. This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization. Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion. That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year. The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million. In total, there were 60,653 COVID hospitalizations in Ontario in 2022/3, up from 47,543 in 2021/2.

Paramedic Services in Canada: Structure, Privatization, Unionization and other issues

Governance and Funding : While police and fire services are usually municipal services, Emergency Medical Services (EMS) are typically controlled by provincial governments. In Ontario, regional municipal governments have responsibility for delivering and funding EMS. But even in Ontario the province plays a key role, strictly regulating EMS, providing funding for 50% of the approved land ambulance costs, and paying 100% of the approved costs for air ambulance, dispatch, base hospitals, First Nation EMS, and for territories without municipal government. Delivery : Like police and fire services, EMS is predominantly a publicly provided service in Canada. But businesses have now made some significant in-roads into EMS, primarily Medavie, a private corporation based in the Maritimes that describes itself as not-for-profit. Medavie goes back over 70 years, with its roots in health insurance. It still operates Medavie Blue Cross with 1,900 employees. It now a

Defend Public Healthcare

Search This Blog