Numbers don’t lie: Cuts to hospital allied health professionals not showing up in community visits

Over the last number of weeks we have been debunking the myth that hospital cuts somehow represent service transfers to the community.

The data for 2012/13 is not yet available, but if we look at the volume of home care services delivered in 2011/12 we can see that for most clinical services, fewer visits –- not more — were delivered than in preceding years.

If hospital cuts truly represented a transfer to community-based services, shouldn’t these CCAC visits be rising, not declining?

The most obvious is physiotherapy. While Ontario hospitals are making significant cuts to outpatient physiotherapy, the actual number of physiotherapy visits delivered in the community by Community Care Access Centres (CCACs) and their agencies has dropped dramatically.

According to the Ontario Home Care Association, in 2005/06 there were 541,101 community physiotherapy visits. By 2011/12 that number had dropped by almost 100,000 visits to 444,054.

The story is the same for speech language therapy. In 2007/08 the CCACs delivered a record 461,484 visits. By 2011/12 it was down to 245,782 visits.

Almost 12,000 fewer community visits were made by CCAC dietitians between 2007/08 and 2011/12 — from 59,690 visits to 47,954 visits.

Occupational therapists? No increase here either. The high water mark for community-based delivery was 2007/08 when 736,134 visits were made. In 2011/12 it was down by more than 200,000 visits to 513,290.

The only clinical visits that are up are nursing visits, which set a new high in 2011/12 at 8.1 million visits, up from 7.6 million visits the year before. However, nursing visits have gone up and down over the preceding five years. There were fewer nursing visits in 2010/11 than 2009/10, for example. It will be interesting to see the final numbers for 2012/13.

Are we really transferring clinical services? At the very least the disappearance of allied health professions from hospitals is clearly not being answered in the community. The numbers simply don’t lie.

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