The Ontario government has always maintained that getting alternative level of care patients out of hospital is so much more cost-effective than having costly beds tied up with patients who have essentially finished their acute care treatment but are otherwise unable to go home.
The question is, cost-effective for whom?
This week a proposal to set up a 25-bed convalescent unit at a Sudbury retirement home fell through when Health Sciences North (formerly the Sudbury Hospital) learned that standards around convalescent care would actually apply to a convalescent unit. Imagine that?
By applying those standards, the convalescent unit would actually cost $1.4 million – money the hospital says it doesn’t have.
Northern Life says Dave McNeil, Health Sciences North’s vice-president of clinical services, told the newspaper that it was hoped the unit would cost between $300,000 and $800,000 a year to run, depending on the patient’s ability to contribute financially to their care.
In short, they were contemplating patients picking up as much as $500,000 of that tab for what would clearly be substandard care. Assuming the 25 beds were full 365 days a year, that would amount to a levy of about $55 a day. A two week stay would therefore cost about $770 without any extras.
On the other hand, if the patient were medically unable to be discharged from hospital, their care would be ordinarily covered under our Medicare system and guaranteed under the Canada Health Act.
Cuts to nursing positions in Southern Ontario do apparently have a silver lining.
Sudbury’s Health Sciences North says hard times for health care workers in the south are solving some of that hospital’s recruitment problems in the north.
Whereas the hospital normally maintains a vacancy rate for nursing positions of five percent, it has recently dropped to three per cent with new hires. Not only that, but they are having better luck filling allied health positions, including social workers, occupational therapists, physiotherapists, chiropodists, psychologists and speech language pathologists.
Rhonda Watson, VP of Human Resources at the hospital, told Northern Life that the only difficulty they presently have is in recruiting pharmacists.
Sudbury residents may be a little mystified by Health Minister Deb Matthews recent comments on their emergency room problem.
Health Sciences North recently closed 30 transitional beds in March. These beds were occupied by individuals described as alternate level of care (ALC) – patients who have completed their acute care treatment, but are not well enough to go home.
Now the hospital has among the highest waits in the province for access to its ER.
According to the Sudbury Star, a 17-hour wait in February expanded to a 19.7 hour wait in March. The hospital is fingering the rising number of ALC patients as the culprit.
Some would look at this and see some dots connecting.
Remarkably, in an interview with the Sudbury Star, Matthews said “I’ve been enormously impressed with the way the community has come together to find solutions.”
“In Denmark, they started planning for folks getting older in 1986 and they developed a wonderful system of caring in the community. We kind of started three years ago.” – Dr. Peter Zalan, president of the medical staff at Health Sciences North (Sudbury), in response overcrowding and long waits in the ER. (CBC News)
In 1987 Denmark decided to build no new nursing homes, and since then, the number of beds has dropped dramatically.
However, that does not mean there are no residential facilities for seniors that provide around the clock care in the country of 5.5 million. In 2007 about 41,000 Danes received permanent help in either a nursing home or a “nursing dwelling.” By comparison, Ontario with a population of more than 13 million people has about 76,000 people in long-term care homes.
What Denmark does do is provide a lot more home care.
Now that hospitals are subject to Freedom of Information requests, how accessible will this information really be? It all depends on the hospital and how much money you have.
It cost us $1,637.76 to find out what the ratio of staff to management was at 20 hospital corporations. That includes the $5 processing fee it takes to initiate the request.
Hospitals came under the Freedom of Information and Protection of Privacy Act on January 1st of this year, although the Ontario Hospital Association sought and received additional exemption from divulging quality information under specific circumstances.
For years we have heard front line staff complain that their numbers have dwindled while the ranks of management have increased. We decided to test that question with requests to 20 randomly selected hospitals where OPSEU represents members. This includes four mental health centres – Penetanguishene’s Waypoint Centre, Whitby’s Ontario Shores, London’s St. Joseph’s Health Centre (Regional Mental Health), and the Royal Ottawa Health Care Group.
Posted in Health System, Hospitals
Tagged Bluewater Health, Chatham-Kent Health Alliance, FIPPA, Freedom of Information, Grey Bruce Health Services, Hamilton Health Sciences, Hawkesbury and District Hospital, Health Sciences North, Hospital Freedom of Information, Kingston General Hospital, Niagara Health System, Ontario Shores, Peterborough Regional Health Centre, Quinte Health, Rouge Valley Health System, Royal Ottawa Health Group, South Bruce Grey Health Centre, The Ottawa Hospital, Thunder Bay Regional Health Sciences, Waypoint Centre, Windsor Regional Hospital, York Central Hospital