Ontario eliminated enough beds last year to fill a regional hospital

Some interesting notes from this week’s auditor’s report:

Ontario eliminated the equivalent of a regional hospital in beds cut last year.

According to information provided by the Ministry of Health and Long-Term Care, 400 fewer beds existed in the province’s hospitals from 2008/09 to 2009/10 (from 18,800 beds to 18,400 beds). Despite all the new construction, our bed capacity is the same as it was five years ago.

The province may be both increasing and aging, but the number of hospital discharges has also remained relatively static. In 2005/06 there were 1,095,000 discharges. In 2009/10 there were 1,092,000. The average length of stay has remained the same – six days.

While other countries are looking at managing their occupancy rates to build surge capacity, some Ontario hospitals are trying to build capacity by discharging patients earlier in the day to make more beds available during peak emergency room times. The Auditor General of Ontario commends this activity, but it is indicative of the level of micromanaging necessary to accommodate patient demand in these overloaded facilities.

About one in five patients discharged will need to be sent to another health care setting. That could be home with visiting care (10%), a long term care home (4%), a complex continuing care facility (2%), or palliative and other care settings (4%). Given these settings are also stretched to capacity, something has to give.

While home care has been the focus of the auditor’s comments, there are also long waits to access other forms of care. In theory, if patients cannot access this care, they remain in hospital longer. This issue has been the focus for government in recent years. The question is, if “alternate level of care” (ALC) patients are taking up more beds in the hospital, why has the average length of stay not increased over the last five years?

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