Acute Care Utilization Report
|
|
- Lorena Patrick
- 5 years ago
- Views:
Transcription
1 Information Management A System We Can Count On Acute Care Utilization Report South East LHIN Health System Intelligence Project March 2006
2
3 Table of Contents About HSIP ii Introduction iii Section 1 Total Separations and Level of Care South East Hospitals South East Residents Section 2 Acute Separations South East Hospitals South East Residents Section 3 Mental Health South East Hospitals South East Residents Section 4 Alternate Level of Care (ALC) South East Hospitals South East Residents Glossary References Page i
4 About HSIP The Health System Intelligence Project (HSIP) This report is produced by the Health System Intelligence Project. HSIP consists of a team of health system experts retained by the Ministry of Health and Long- Term Care s (MOHLTC) Health Results Team for Information Management (HRT-IM) to provide the Local Health Integration Networks (LHINs) with: Sophisticated data analysis; Interpretation of results; Orientation of new staff to health system data analysis issues; and Training on new techniques and technologies pertaining to health system analysis. Report Authors: Linda Baigent, HSIP Stephanie Loomer, HSIP Jennifer Sarkella, HSIP (Project Lead) Dave Zago, HSIP Contributors: Carley Hay, HSIP Paul Lee, HSIP Marc Lefebvre, HSIP For further information, please contact: hrtim@moh.gov.on.ca HSIP was created as part of the Ontario government's Information Management Strategy. HSIP is designed to complement and augment the existing analytical capacity within the MOHLTC. The project team is working in concert with MOHLTC analysts to ensure that the LHINs are provided with the analytical supports they need for their local health system planning activities. Page ii
5 Introduction Identification and understanding of patterns of health care utilization are essential for health care planning. There are two aspects of utilization that should be considered for local planning. The first is the activity of local providers, which gives a measure of local capacity what do local hospitals or agencies provide and to whom? The second aspect is utilization of provincial services by local residents where do residents go to obtain care? Although residents are generally served by local facilities, they can and are sometimes required to seek health care services outside their area of residence. Knowledge of both perspectives allows for the development of local strategies to meet the health service needs of area residents. The examination of acute care hospital use is a key component in the analysis of health care utilization patterns. Acute care refers to short-term, intensive inpatient care for serious health problems involving a variety of medical and surgical services. Patterns of acute inpatient utilization are influenced by a broad range of factors including system capacity, the availability of physicians and community services, and the age structure, health and socio-economic status of the population. These factors should all be considered when interpreting utilization patterns and planning for services. Methods This report describes key aspects of acute care hospitalization in fiscal year 2004/05 for both hospitals and residents within the South East Local Health Integration Network (LHIN), hereafter referred to as South East. This information will be valuable for those involved in planning within the health care system, as well as for those monitoring the health service needs of the population. The analysis is divided into four sections: 1. Total separations and level of care (primary, secondary, tertiary/quaternary). 2. Acute care excluding mental health. 3. Acute mental health care. 4. Alternate level of care stays. A separation is a completed case treated in a hospital resulting in any of the following: discharge home, transfer to another facility, death, or patient sign out. Separations refer to the activity completed per facility so patients transferred for further care to other acute facilities will result in multiple separations. Days of stay within acute care beds are classified as either acute or Highlights South East hospitals primarily served South East residents (93.9% of separations), and the majority of separations for South East residents were from South East hospitals (89.1%). The proportion of non-residents served by South East hospitals increased as complexity of care increased. Non-residents represented 3.8% of primary, 7.1% of secondary, and 11.2% of tertiary/quaternary separations from South East hospitals. Relative to Ontario residents, South East residents had significantly higher age-standardized separation rates for acute care (excluding mental health) and the tertiary/quaternary level of care category. The average length of stay in alternate level of care in South East hospitals was 8.5 days longer than such stays in Ontario hospitals. Introduction Page iii
6 alternate level of care (ALC), the latter of which refers to patients who have completed the acute care phase of their treatment but remain in an acute care facility while awaiting placement elsewhere 1. Each section in this report describes the activity in South East hospitals with comparisons to Ontario hospitals, followed by the hospital utilization of South East residents (regardless of where they were hospitalized within Ontario) with comparisons to that of Ontario residents. These data exclude newborns and stillborns, so as to avoid double counting of mothers and babies. Figures for Ontario residents include those with an unknown LHIN of residence, where assignment to a LHIN was not possible due to insufficient geographic information. Ontario numbers are included to provide context but should not necessarily be considered the ideal or target. report primarily reflect those provided by this database. It should be noted that some multi-site hospital corporations report their inpatient data by individual site while others report their data together. The South East LHIN South East is home to 481,092 people, which accounts for 3.9% of the population of the province of Ontario as a whole 3. South East consists of the Counties of Hastings, Prince Edward, Frontenac, and Lennox & Addington, as well as portions of Lanark County, Leeds & Grenville United Counties, and Northumberland County. Geographic names that appear in the tables refer only to the portions of the particular areas that are contained within the South East LHIN. At the end of the 2004/05 fiscal year, there were 913 acute care beds in operation in South East facilities; of these 70 were psychiatry beds 4. The data included in this report were obtained from the Inpatient Discharges section of the Ontario Ministry of Health and Long-Term Care s (MOHLTC) Provincial Health Planning Database 2. As this database only includes data for Ontario facilities, hospitalizations of South East residents that occurred in other provinces or countries are not included. Hospital names in this Page iv Introduction
7 Section 1 Total Separations and Level of Care This section describes the total separations and days from acute care facilities along with the complexity or level of care provided during these stays. Level of care is a method of categorizing acute inpatient hospital activity based on the degree of medical and technological specialization required. Acute hospital separations can be grouped into Case Mix Groups (CMG TM ), a methodology that aggregates hospital inpatients with similar diagnoses and treatment requirements 5. Levels of care are aggregations of CMGs and CMG complexity age category combinations. Assignment of level of care in this report is based on the Hay Level of Care Methodology 2002/03 version 6, which has been adopted by the Joint Policy and Planning Committee (JPPC) for use in the acute care portion of the hospital funding model. In the development of this methodology, the Hay Group considered issues including the number and distribution of cases, inflow/outflow patterns, the critical mass necessary for optimal outcomes, and the relative cost of providing care for each CMG and age category. The levels reflect differences in the acute average length of stay (ALOS) and the cost and complexity of treatment 5,7. There are three categories that define level of care 7,8. Primary care can be provided in any hospital setting by general practitioners or specialists. Secondary care includes surgical and other procedures provided by medical specialists, usually in larger community hospitals. Tertiary and quaternary separations involve highly specialized, costly care provided to seriously ill patients, most often in larger regional referral centres or teaching hospitals. Table 1: Total Separations by Level of Care, South East & Ontario Hospitals, 2004/05 Hospitals Primary Secondary Tertiary/Quaternary Total # % # % # % # Frontenac Hotel Dieu Kingston General 5, , , ,187 Hastings Quinte Healthcare (QHC)-Belleville General 4, , ,861 QHC-North Hastings QHC-Trenton Memorial 1, ,849 Lanark Perth & Smiths Falls District-Perth Site ,397 Perth & Smiths Falls District-Smiths Falls Site 1, ,830 Leeds & Grenville Brockville General 2, , ,529 Lennox & Addington Lennox & Addington County General ,267 Prince Edward QHC-Prince Edward County Memorial 1, ,483 Total South East 18, , , ,701 Ontario 459, , , ,002,333 Cell count suppressed due to small numbers (<5 separations). Section 1: Total Separations and Level of Care Page 1
8 1.1 South East Hospitals There were 39,701 total separations and 280,237 total patient days from acute hospitals in South East in 2004/05. These numbers represented 4.0% of the total separations and 4.4% of the total days from acute care beds within all Ontario hospitals. In South East hospitals, 45.5% of separations were primary, 42.6% were secondary, and 11.9% were tertiary/quaternary (see Table 1). On average, South East hospitals had a greater proportion of tertiary/ quaternary separations compared to Ontario hospitals (10.8%). Volumes from South East hospitals represented 3.9% of primary, 3.9% of secondary, and 4.4% of tertiary/ quaternary separations from Ontario hospitals. The vast majority of separations from South East hospitals (93.9%) were by South East residents. The next most common areas of patient origin for separations from South East hospitals were the Central East (2.9%) and Champlain (1.8%) LHINs. The proportion of nonresidents served by South East hospitals increased as complexity of care increased. Non-residents represented 3.8% of primary, 7.1% of secondary, and 11.2% of tertiary/ quaternary separations from South East hospitals. Following South East, the next most common areas of patient origin for tertiary/quaternary separations from South East hospitals were the Central East (7.5%) and Champlain (2.0%) LHINs. Program Cluster Categories (PCCs) consist of CMGs aggregated into 30 broad programs and provide a means to analyze groups of patients by the types of services received 9. Figure 1 shows the top ten PCCs (based on separations) in South East hospitals. Although obstetrics accounted for the largest proportion of separations (12.1%), it had the shortest ALOS (2.6 days) among the top ten categories in South East hospitals. This category also represented a smaller proportion of separations in South East hospitals compared to Ontario hospitals (15.6%). Psychiatry accounted for only 5.2% of separations yet had the longest ALOS (12.3 days) within the leading categories in South East hospitals. Figure 1: Leading Program Cluster Categories (PCCs) as a Proportion of Separations, South East & Ontario Hospitals, 2004/05 Obstetrics Cardiology Program Cluster Category Pulmonary Gastro/Hepatobiliary Orthopaedics General Surgery General Medicine Cardio/Thoracic South East Hospitals Ontario Hospitals Trauma Psychiatry % of Separations Page 2 Section 1: Total Separations and Level of Care
9 1.2 South East Residents South East residents had 41,847 total separations (from all Ontario hospitals) which accounted for 294,194 total days. These figures represented 4.2% of total separations and 4.6% of total days for Ontario residents. For South East residents, 44.4% of separations were primary, 42.8% were secondary, and 12.7% were tertiary/quaternary, as shown in Table 2. South East residents had a greater proportion of tertiary/quaternary separations compared to Ontario residents (10.7%). Table 2: Total Separations by Level of Care, by Area of Residence, South East & Ontario Residents, 2004/05 Area of Residence Primary Secondary Tertiary/Quaternary Total # % # % # % # Frontenac 4, , , ,780 Hastings 5, , , ,346 Lanark 1, , ,143 Leeds & Grenville 3, , ,175 Lennox & Addington 1, , ,374 Northumberland Prince Edward 1, , ,051 Total South East 18, , , ,847 Ontario 455, , , ,951 Figure 2: Age-Standardized Total Separation Rates by LHIN of Residence, Ontario, 2004/05 Manitoba 14 Quebec Local Health Integration Networks 1 Erie St. Clair 2 South West 3 Waterloo Wellington 4 Hamilton Niagara Haldimand Brant 5 Central West 6 Mississauga Halton 7 Toronto Central 8 Central 9 Central East 10 South East 11 Champlain 12 North Simcoe Muskoka 13 North East 14 North West Age- Standardized Total Acute Care Separation Rates per 1,000 Population U.S.A U.S.A. 2 4 U.S.A km km Statistics Canada 2001 Cartographic Boundary Files. Section 1: Total Separations and Level of Care Page 3
10 South East residents accounted for 4.1% of primary, 4.2% of secondary and 5.0% of tertiary/quaternary separations for Ontario residents. The distribution of age-standardized total separation rates by LHIN of residence is shown in Figure 2. The overall age-standardized rate for South East residents was similar to that for Ontario residents, as were the rates for the primary and secondary level of care categories, see Table 3. However, the age-standardized rate for the tertiary/quaternary level of care category was significantly higher for South East residents compared to Ontario residents. Slightly more than 89% of South East residents separations were from South East hospitals. The next most common locations for South East residents separations were hospitals in the Champlain (5.2%) and Central East (2.2%) LHINs. As complexity of care increased, the proportion of South East residents separations that were provided in South East hospitals decreased. South East hospitals served 93.4% of South Table 3: Age-Standardized Total Separation Rates (95% Confidence Intervals) per 1,000 Population by Level of Care, South East & Ontario Residents, 2004/05 Level of Care South East Residents Ontario Residents Primary 36.8 ( ) 36.7 ( ) Secondary 31.8 ( ) 32.4 ( ) Tertiary/Quaternary 9.2 ( )* 7.9 ( ) Total Separations 77.8 ( ) 77.0 ( ) *Significantly different from provincial average based on assessment of 95% confidence intervals. Page 4 Section 1: Total Separations and Level of Care
11 East residents primary, 87.8% of secondary, and 78.5% of tertiary/quaternary separations. Hospitals in the Champlain LHIN provided care to 11.4% of South East residents tertiary/quaternary separations, while hospitals in the Toronto Central LHIN provided care to 7.0%. smaller proportion of separations for South East residents compared to Ontario residents (15.6%). Psychiatry accounted for only 5.1% of South East residents separations but had the longest ALOS (12.6 days) among the top ten categories. The top ten PCCs for South East residents (based on separations) are shown in Figure 3. Within these categories, obstetrics accounted for 12.0% of separations yet had the shortest ALOS (2.6 days) for South East residents. This category also represented a Figure 3: Leading Program Cluster Categories (PCCs) as a Proportion of Separations, South East & Ontario Residents, 2004/05 Obstetrics Cardiology Pulmonary Program Cluster Category Gastro/Hepatobiliary General Surgery Orthopaedics General Medicine Cardio/Thoracic South East Residents Ontario Residents Trauma Psychiatry % of Separations Section 1: Total Separations and Level of Care Page 5
12 Page 6 Section 1: Total Separations and Level of Care
13 Section 2 Acute Separations This section focuses on the active treatment of conditions involving medical and/or surgical services provided during the acute care portion of the hospital stay, thus ALC days are not included. Mental health separations (psychiatry PCC) have also been excluded and will be covered in the following section. 2.1 South East Hospitals In 2004/05, there were 37,651 acute separations and 218,610 acute days from hospitals in South East, as shown in Table 4. These figures accounted for 4.0% of the acute separations and 4.2% of the acute days from Ontario hospitals. Overall, the acute ALOS in South East hospitals (5.8 days) was slightly longer than the acute ALOS in Ontario hospitals (5.5 days). The majority of acute separations from hospitals in South East (93.8%) were by South East residents. The Central East LHIN (2.9%) and Champlain LHIN (1.9%) were the next most common areas of patient origin for separations from South East hospitals. As previously mentioned, acute hospital separations can be grouped into CMGs. Each CMG is identified as either surgical or medical, based on the presence or absence of a surgical procedure during the hospital stay 5,10. South East hospitals had a similar proportion of medical separations (65.9%) and surgical separations (34.1%) compared to Ontario hospitals (65.8% and 34.2%, respectively). Separations from South East hospitals represented 4.0% of the medical as well as 4.0% of the surgical separations from Ontario hospitals. Table 4: Acute Separations, Days, & Average Length of Stay (ALOS), South East & Ontario Hospitals, 2004/05 Hospitals Acute Separations Days ALOS Frontenac Hotel Dieu Kingston General 17, , Hastings Quinte Healthcare (QHC)-Belleville General 8,198 34, QHC-North Hastings 330 1, QHC-Trenton Memorial 1,791 8, Lanark Perth & Smiths Falls District-Perth Site 1,352 9, Perth & Smiths Falls District-Smiths Falls Site 1,779 11, Leeds & Grenville Brockville General 4,468 24, Lennox & Addington Lennox & Addington County General 1,226 8, Prince Edward QHC-Prince Edward County Memorial 1,419 5, Total South East 37, , Ontario 944,650 5,200, Section 2: Acute Separations Page 7
14 2.2 South East Residents In 2004/05, there were 39,722 acute separations and 230,718 acute days for South East residents (from all Ontario hospitals), as shown in Table 5. These separations accounted for 4.2% of the acute separations and 4.5% of the acute days for Ontario residents. The acute ALOS for South East residents (5.8 days) was slightly longer than the acute ALOS for Ontario residents (5.5 days). The age-standardized acute separation rate for South East residents was significantly higher than the rate for Ontario residents, as shown in Table 6. In addition, the crude acute day rate was 15.6% higher than the rate for Ontario residents. The majority of acute separations for residents of South East (88.9%) were from South East hospitals. The Champlain LHIN was the next most common location for residents hospitalizations (5.3%), followed by the Toronto Central and Central East LHINs (both at 2.2%). South East residents had a smaller proportion of medical (64.9%) and accordingly, a greater proportion of surgical (35.1%) separations compared to Ontario residents (65.8% and 34.2%, respectively). Separations for South East residents represented 4.2% of the medical and 4.4% of the surgical separations for Ontario residents. Table 5: Acute Separations, Days, & Average Length of Stay (ALOS), by Area of Residence, South East & Ontario Residents, 2004/05 Area of Residence Acute Separations Days ALOS Frontenac 9,970 64, Hastings 11,691 58, Lanark 3,035 22, Leeds & Grenville 8,001 47, Lennox & Addington 3,197 20, Northumberland 927 5, Prince Edward 2,901 13, Total South East 39, , Ontario 934,669 5,142, Table 6: Age-Standardized Acute Separation Rates (95% Confidence Intervals) per 1,000 Population & Crude Acute Day Rates per 1,000 Population, South East & Ontario Residents, 2004/05 South East Residents Ontario Residents Age-Standardized Acute Separation Rate 73.4 ( )* 72.5 ( ) Crude Acute Day Rate *Significantly different from provincial average based on assessment of 95% confidence intervals. Page 8 Section 2: Acute Separations
15 Section 3 Mental Health Acute mental health separations are based on the psychiatry PCC. Although there are acute beds in some facilities that are specifically for psychiatric care, patients with such conditions can also be cared for in other acute beds. As this report focuses on acute utilization, hospitalizations in specialized mental health facilities (the former provincial psychiatric hospitals) are not included. This section will provide information on both the acute and total (i.e. including ALC) hospital stay. 3.1 South East Hospitals Acute mental health separations represented 5.2% of all separations from South East hospitals and 9.0% of total days, smaller proportions compared to those for Ontario hospitals (5.8% and 10.9%, respectively). In 2004/05, there were 2,050 acute mental health separations and 25,152 total mental health days from hospitals in South East, as shown in Table 7. These numbers accounted for 3.6% of mental health separations as well as 3.6% of mental health days from Ontario hospitals. In South East hospitals, the total Table 7: Acute Mental Health Separations, Days, & Average Length of Stay (ALOS), South East & Ontario Hospitals, 2004/05 Hospitals Separations Acute Total Days ALOS Days ALOS Frontenac Hotel Dieu , , Kingston General 108 1, , Hastings Quinte Healthcare (QHC)-Belleville General 663 5, , QHC-North Hastings QHC-Trenton Memorial Lanark Perth & Smiths Falls District-Perth Site Perth & Smiths Falls District-Smiths Falls Site Leeds & Grenville Brockville General , Lennox & Addington Lennox & Addington County General Prince Edward QHC-Prince Edward County Memorial Total South East 2,050 21, , Ontario 57, , , Had acute psychiatry beds as at March 31, Section 3: Mental Health Page 9
16 ALOS was 1.9 days longer than the acute ALOS, which reflects the impact of ALC stays. Overall, the total ALOS for mental health in South East hospitals (12.3 days) was similar to the total ALOS in Ontario hospitals (12.1 days). The majority of mental health separations from hospitals in South East (97.1%) were by South East residents. The Central East LHIN (1.3%) was the next most common area of patient origin for mental health separations from South East hospitals. 3.2 South East Residents Acute mental health separations represented 5.1% of all separations and 9.1% of total days for South East residents, smaller proportions compared to those for Ontario residents (5.8% and 10.9%, respectively). In 2004/05, there were 2,125 mental health separations and 26,726 total mental health days for South East residents (from all Ontario hospitals), as shown in Table 8. South East residents accounted for 3.7% of the mental health separations and 3.9% of the total mental health days for Ontario residents. For South East residents, the total ALOS was 1.9 days longer than the acute ALOS, which reflects the added impact of ALC stays. The total ALOS for mental health for South East residents was 12.6 days, slightly longer than the total ALOS for Ontario residents (12.1 days). The age-standardized acute mental health separation rate for South East residents was similar to the rate for Ontario residents, as was the crude total day rate, as shown in Table 9. The majority of mental health separations for residents of South East (93.6%) were from South East hospitals. The Champlain LHIN (3.3%) and the Central East LHIN (1.8%) were the next most common locations for residents hospitalizations. Table 8: Acute Mental Health Separations, Days, & Average Length of Stay (ALOS), by Area of Residence, South East & Ontario Residents, 2004/05 Area of Residence Separations Acute Total Days ALOS Days ALOS Frontenac 810 9, , Hastings 655 6, , Lanark 108 1, , Leeds & Grenville 174 2, , Lennox & Addington 177 2, , Northumberland Prince Edward 150 1, , Total South East 2,125 22, , Ontario 57, , , Table 9: Age-Standardized Acute Mental Health Separation Rates (95% Confidence Intervals) per 1,000 Population & Crude Total Mental Health Day Rates per 1,000 Population, South East & Ontario Residents, 2004/05 South East Residents Ontario Residents Age-Standardized Separation Rate 4.4 ( ) 4.5 ( ) Crude Total Day Rate Page 10 Section 3: Mental Health
17 Section 4 Alternate Level of Care (ALC) ALC refers to cases where patients have completed the acute care phase of treatment but remain in acute care beds while awaiting placement elsewhere 1. The patient is classified as ALC when the attending physician or authorized designate indicates that acute care is no longer required and requests a transfer to another setting. Coding of ALC days began in 1989 in order to differentiate non-acute use of acute care beds from typical acute care 1. ALC days are considered an inefficient use of acute care resources and reflect problems with access to postacute services such as rehabilitation, long-term care homes, home care, etc. 11. This section includes individuals with at least one ALC day during their hospital stay, including those with mental health diagnoses. The ALC days and ALC ALOS refer to the length of the ALC stay only and exclude the acute care portion of the stay. 4.1 South East Hospitals ALC separations accounted for 4.4% of total separations while ALC days represented 14.4% of the total days in South East hospitals, larger proportions compared to those for Ontario hospitals (3.9% and 8.9%, respectively). There were 1,752 ALC separations and 40,252 ALC days from South East hospitals in 2004/05, as shown in Table 10. This represented 4.5% of the ALC separations and 7.1% of the ALC days from Ontario hospitals. Although there was variation among the hospitals, overall, the ALC ALOS in South East hospitals was 8.5 days longer than the ALC ALOS in Ontario hospitals (23.0 days and 14.5 days, respectively). Bed equivalents estimate the number of beds used based on ALC days at benchmark levels of occupancy (95% for these calculations). In 2004/05, there were approximately 116 acute care beds in South East hospitals filled by ALC patients who were more suited for service elsewhere. This represented 7.1% of the 1,637 ALC patient bed equivalents in Ontario hospitals. Table 10: Alternate Level of Care (ALC) Separations, Days, & Average Length of Stay (ALOS), South East & Ontario Hospitals, 2004/05 Hospitals ALC Separations Days ALOS Frontenac Hotel Dieu Kingston General , Hastings Quinte Healthcare (QHC)-Belleville General 629 6, QHC-North Hastings QHC-Trenton Memorial 243 2, Lanark Perth & Smiths Falls District-Perth Site Perth & Smiths Falls District-Smiths Falls Site 58 1, Leeds & Grenville Brockville General 138 3, Lennox & Addington Lennox & Addington County General Prince Edward QHC-Prince Edward County Memorial Total South East 1,752 40, Ontario 39, , Section 4: Alternate Level of Care Page 11
18 Approximately 98% of ALC separations from South East hospitals were by South East residents. The next most common area of patient origin for ALC separations from South East hospitals was the Central East LHIN (1.0%). The five PCCs associated with the largest proportion of ALC days for South East hospitals appear in Figure 4. Compared to Ontario hospitals, larger proportions of South East hospitals ALC days were associated with neurology, general surgery and trauma, while general medicine and psychiatry contributed a smaller proportion of ALC days. The transfer destinations associated with the largest number of ALC separations and days in South East hospitals were complex continuing care facilities, no transfer/unknown location (discharged home, death, etc.), and long-term care homes, as shown in Table 11. Figure 4: Leading Program Cluster Categories (PCCs) as a Proportion of Alternate Level of Care (ALC) Days, South East & Ontario Hospitals, 2004/05 Neurology Program Cluster Category General Surgery Trauma General Medicine South East Hospitals Ontario Hospitals 12.8 Psychiatry % of ALC Days Page 12 Section 4: Alternate Level of Care
19 In South East hospitals, the ALC ALOS was shortest for patients who were transferred to home care (9.7 days). The longest ALC ALOS in South East hospitals was associated with transfers to psychiatric facilities (64.0 days, although the number of separations was small), and to long-term care homes (48.3 days). 4.2 South East Residents There were 1,804 ALC separations and 40,792 ALC days for South East residents (from all Ontario hospitals), as shown in Table 12. South East residents separations represented 4.6% of the ALC separations and 7.2% of the ALC days for all Ontario residents. The ALC ALOS varied by area of residence in the South East but Table 11: Alternate Level of Care (ALC) Separations, Days & Average Length of Stay (ALOS) for Specific Transfer Locations, South East & Ontario Hospitals, 2004/05 Transfer Locations South East Hospitals Ontario Hospitals ALC Separations Days ALOS Separations Days ALOS Complex Continuing Care 442 4, , , No Transfer/Unknown 428 8, , , Long-Term Care Home , , , Home Care 180 1, ,320 48, General Rehabilitation 159 1, ,358 57, Unclassified/Other Facility 73 2, , Acute Care Facility ,080 12, Psychiatric Facility , Ambulatory Care/Outpatient Dept Special Rehabilitation , Total 1,752 40, , , Cell count suppressed due to small numbers (<5 separations). Table 12: Alternate Level of Care (ALC) Separations, Days, & Average Length of Stay (ALOS) by Area of Residence, South East & Ontario Residents, 2004/05 Area of Residence ALC Separations Days ALOS Frontenac , Hastings , Lanark 99 1, Leeds & Grenville 241 6, Lennox & Addington 75 1, Northumberland Prince Edward Total South East 1,804 40, Ontario 38, , Section 4: Alternate Level of Care Page 13
20 overall, was 8.1 days longer than the ALC ALOS for Ontario residents (22.6 days and 14.5 days, respectively). The longest ALC ALOS for South East residents was for those who were transferred to psychiatric facilities (56.9 days, although the number of separations was small), and to long-term care homes (48.3 days). This represented 7.2% of the approximately 1,631 acute care bed equivalents filled by Ontario resident ALC patients. The age-standardized ALC separation rate for South East residents was similar to the Ontario rate, but the crude day rate was 85.7% greater than the Ontario rate, as shown in Table 13. South East hospitals accounted for 95.3% of South East residents ALC separations. Hospitals in the Champlain LHIN provided care to 2.5% of South East residents ALC separations, while hospitals in the Toronto Central LHIN provided care to 1.2%. Figure 5 shows the PCCs associated with the largest proportion of ALC days for South East residents. Compared to Ontario residents, a larger proportion of South East residents ALC days were related to neurology, general surgery and trauma, while smaller proportions were related to general medicine and psychiatry. Table 13: Age-Standardized Alternate Level of Care (ALC) Separation Rates (95% Confidence Intervals) per 1,000 Population and Crude ALC Day Rates per 1,000 Population, South East & Ontario Residents, 2004/05 South East Residents Ontario Residents Age-Standardized ALC Separation Rate 2.5 ( ) 2.6 ( ) Crude ALC Day Rate Figure 5: Leading Program Cluster Categories (PCCs) as a Proportion of Alternate Level of Care (ALC) Days, South East & Ontario Residents, 2004/05 Neurology Program Cluster Category General Medicine General Surgery Trauma South East Residents Psychiatry 10.0 Ontario Residents % of ALC Days Page 14 Section 4: Alternate Level of Care
21 The transfer destinations associated with the largest number of ALC separations and days for South East residents were complex continuing care facilities, no transfer/unknown location (discharged home, death, etc.), and long-term care homes, as shown in Table 14. The ALC ALOS was shortest for South East residents who were transferred to home care (9.7 days). The longest ALC ALOS for South East residents was for those who were transferred to psychiatric facilities, (56.9 days, although the number of separations was small), and to long-term care homes (48.3 days). Compared to Ontario residents, the ALC ALOS was longer for South East residents for all transfer locations with the exception of complex continuing care and home care. Table 14: Alternate Level of Care (ALC) Separations, Days & Average Length of Stay (ALOS) for Specific Transfer Locations, South East & Ontario Residents, 2004/05 Transfer Locations South East Residents Ontario Residents ALC Separations Days ALOS Separations Days ALOS Complex Continuing Care 448 4, , , No Transfer/Unknown 437 8, , , Long-Term Care Home , , , General Rehabilitation 180 2, ,322 56, Home Care 177 1, ,316 48, Unclassified/Other Facility 72 2, , Acute Care Facility ,061 12, Psychiatric Facility , Ambulatory Care/Outpatient Dept Special Rehabilitation , Total 1,804 40, , , Cell count suppressed due to small numbers (<5 separations). Section 4: Alternate Level of Care Page 15
22 Glossary Age-Standardized Rate: A summary rate which adjusts for variations in population age distributions over time and place. Hospitalization rates have been adjusted using the direct method and the 1991 Canadian population as the standard. Alternate Level of Care (ALC): When a patient who has completed the acute care phase of treatment occupies an acute care bed while awaiting placement elsewhere (long-term care home, rehabilitation, complex continuing care, home care, etc.). Average Length of Stay: The number of patient days divided by the number of separations, reported in days. Bed Equivalents: The approximate number of beds used annually based on patient days (ALC or other types) at benchmark occupancy rates (95% for these calculations). Bed Equivalents = days/(occupancy * days/year) Case Mix Group (CMG TM ): A methodology designed to aggregate hospital inpatients with similar diagnoses and treatment requirements. CMG is a registered trademark of the Canadian Institute for Health Information. Case Mix Group Complexity Age Category: Categories refer to broad age groupings (<17 years, years, 70+ years) that are associated with differing levels of treatment complexity and lengths of stay for specific CMGs. Crude Rate: The number of events occurring in a specific time period, expressed per population. A crude rate is not adjusted for differences in population structure. Primary Level of Care: Procedures or treatments that can be provided in any hospital setting by general practitioners or specialists. Program Cluster Category (PCC): Consists of Case Mix Groups (CMGs) aggregated into broad programs and reflects the main types of services received. Secondary Level of Care: Surgical and other procedures provided by medical specialists, usually in larger community hospitals. Separation: A completed case treated in a hospital resulting in any of the following: discharge home, transfer to another facility, death or sign out. Statistical Significance: The probability that a result is not likely to have occurred due to chance alone. Tertiary/Quaternary Level of Care: Procedures or treatments provided to seriously ill patients that involve highly specialized, costly care most often provided in larger regional referral centres or teaching hospitals. Total Days of Stay: Includes the acute and ALC portions of a hospital stay. Confidence Interval: The interval with a given probability (here 95%) that the true value of a rate is contained within the interval. Page 16 Glossary
23 References 1. Canadian Institute for Health Information. DAD abstracting manual Edition, Ottawa, ON; Ontario Ministry of Health and Long-Term Care. Provincial Health Planning Database, Inpatient Discharges. Version 16.03; December Ontario Ministry of Health and Long-Term Care. Provincial Health Planning Database, Population Estimates [2004]. Version 16.03; December Ontario Ministry of Health and Long-Term Care, Finance and Information Management Branch. Daily census summary, acute beds staffed and in operation 2004/05 (March). Retrieved November 16, 2005, from 05&pMTH=March 5. Campbell L. CIHI case mix tools. In: Johnson L, Richards J, Pink G, & Campbell L (Eds.). Case mix tools for decision making in health care. Ottawa, ON: Canadian Institute for Health Information; p Hay Health Care Consulting Group and JPPC. The Hay Group level of care methodology: CMG Retrieved September 1, 2005, from 8. Baigent L, Shaw R, & Chalmers F. Health system monitoring report 2004/05. Windsor, ON: Essex Kent Lambton District Health Council; Joint Committee of the Ministry of Health and the Ontario Hospital Association. Rural and Northern Health: Parameters and Benchmarks; Canadian Institute for Health Information. CMG TM /PLX TM Directory ICD-10-CA/CCI. Ottawa, ON; Damba C, Vahabi M, & Zon L. First annual Toronto s health system report card November Toronto, ON: Toronto District Health Council; Hay Health Care Consulting Group. Hay level of care methodology: 02/03 version using AARV weights Retrieved September 1, 2005, from References Page 17
24 Notes
25
26
27
28 2006, Queen s Printer for Ontario
2015 Ontario Hospitals Maternal-Child Services Report LHIN-level Indicators
215 Ontario Hospitals Maternal-Child Services Report LHIN-level Indicators TAB Intro Population IP ED MH OBS LHIN map, the list of acronyms, and key definitions 1. Paediatric Population Overview Ontario
More information2016 Ontario Hospitals Maternal-Child Services Report LHIN-level Indicators
216 Ontario Hospitals Maternal-Child Services Report LHIN-level Indicators TAB Intro Population IP ED MH OBS LHIN map, the list of acronyms, and key definitions 1. Paediatric Population Overview Ontario
More informationInfrastructure of Rural Vitality:
Infrastructure of Rural Vitality: The Future of Rural Health Services Jim Whaley Rural Vitality Conference (May 23, 2008) Presentation Overview Rural Health Reality Hard Infrastructure: E-health Soft Infrastructure:
More informationSouth East Local Health Integration Network Integrated Health Services Plan EXECUTIVE SUMMARY
South East Local Health Integration Network Integrated Health Services Plan DISCUSSION DRAFT July, 2006 1.0 Background and Objectives The Government of Ontario has established the South East Local Health
More informationFrontenac, Lennox and Addington Health Services Restructuring. Report
Frontenac, Lennox and Addington Health Services Restructuring Report Restructuring Report 1 Table of Contents INTRODUCTION AND BACKGROUND...1 SECTION I: REGIONAL AND COMMUNITY PROFILE...12 GEOGRAPHIC PROFILE...12
More informationExecutive Compensation Policy and Framework BLUEWATER HEALTH
Executive Compensation Policy and Framework BLUEWATER HEALTH 1. Background The Province of Ontario introduced The Broader Public Sector Accountability Act in 2010 (BPSAA), which introduced controls on
More information2006 SURVEY OF ORTHOPAEDIC SURGEONS IN ONTARIO
ARTHRITIS COMMUNITY RESEARCH & EVALUATION UNIT (ACREU) University Health Network 2006 SURVEY OF ORTHOPAEDIC SURGEONS IN ONTARIO MARCH 2007 Prepared by: Elizabeth Badley Paula Veinot Jeanette Tyas Mayilee
More informationAssessing Value in Ontario Health Links. Part 3: Measures of System Performance in Ontario s Health Links
Assessing Value in Ontario Health Links. Part 3: Measures of System Performance in Ontario s Health Links Applied Health Research Question Series Volume 4.3 Health System Performance Research Network Report
More informationNursing Practice In Rural and Remote Ontario: An Analysis of CIHI s Nursing Database
Nursing Practice In Rural and Remote Ontario: An Analysis of CIHI s Nursing Database www.ruralnursing.unbc.ca Highlights In the period between 2003 and 2010, the regulated nursing workforce in Ontario
More informationONTARIO COMMUNITY REHABILITATION: A PROFILE OF DEMAND AND PROVISION
ARTHRITIS COMMUNITY RESEARCH & EVALUATION UNIT (ACREU) University Health Network ONTARIO COMMUNITY REHABILITATION: A PROFILE OF DEMAND AND PROVISION March 2007 Prepared by: Laura Passalent Emily Borsy
More informationKingston Health Sciences Centre EXECUTIVE COMPENSATION PROGRAM
Kingston Health Sciences Centre EXECUTIVE COMPENSATION PROGRAM Background In 2010, the Province of Ontario legislated a two-year compensation freeze for all non-unionized employees in the Broader Public
More informationLHIN Regional Summaries 2016
College of Nurses of Ontario LHIN Regional Summaries 2016 Mississauga Halton VISION Leading in regulatory excellence MISSION Regulating nursing in the public interest LHIN Regional Summary 2016 Mississauga
More informationSupporting Best Practice for COPD Care Across the System
Supporting Best Practice for COPD Care Across the System May 3, 2017 Health Quality Ontario The provincial advisor on the quality of health care in Ontario Overview Health Quality Ontario background QBP
More informationLHIN Regional Summaries 2016
College of Nurses of Ontario LHIN Regional Summaries 2016 Central West VISION Leading in regulatory excellence MISSION Regulating nursing in the public interest LHIN Regional Summary 2016 Central West
More informationApproved Executive Compensation Policy and Framework Feb. 28, 2018 Executive Compensation Policy and Framework WOODSTOCK HOSPITAL
Approved Executive Compensation Policy and Framework Feb. 28, 2018 Executive Compensation Policy and Framework WOODSTOCK HOSPITAL Organization (Full Name): Woodstock Hospital General Trust Last Name: Ziegler
More informationChronic Obstructive Pulmonary Disease in Ontario
Chronic Obstructive Pulmonary Disease in Ontario 1996/97 to 2014/15 October 2017 ii Chronic Obstructive Pulmonary Disease in Ontario, 1996/97 to 2014/15 Authors Andrea S. Gershon Graham Mecredy Sujitha
More informationKemptville District Hospital
Kemptville District Ontario Broader Public Sector Executive Compensation Framework Public Consultation March 1, 2018 Table of Contents A. Compensation Philosophy... 1 Kemptville District... 1 Executive
More informationUpdate for Ontario s Modernized Food Premises Regulation. For Industry Stakeholders Modernized Safe Food and Water Regulations May 7, 2018
Update for Ontario s Modernized Food Premises Regulation For Industry Stakeholders Modernized Safe Food and Water Regulations May 7, 2018 Purpose: To update stakeholders on the regulatory changes and implementation
More informationHospital Report. A joint initiative of the Ontario Hospital Association and the Government of Ontario
Hospital Report A C U T E C A R E A joint initiative of the Ontario Hospital Association and the Government of Ontario CONTENTS PAGE This report is brought to you by the Government of Ontario in partnership
More informationHealth Quality Ontario
Health Quality Ontario The provincial advisor on the quality of health care in Ontario November 15, 2016 Under Pressure: Emergency department performance in Ontario Technical Appendix Table of Contents
More informationSub-Acute Care Capacity Plan
Sub-Acute Care Capacity Plan Final Report Submitted to: Champlain LHIN Sub-Acute Capacity Planning Steering Committee Hay Group Health Care Consulting 121 King Street West Suite 700 Toronto, Ontario M5H
More informationWaterloo Wellington Community Care Access Centre. Community Needs Assessment
Waterloo Wellington Community Care Access Centre Community Needs Assessment Table of Contents 1. Geography & Demographics 2. Socio-Economic Status & Population Health Community Needs Assessment 3. Community
More informationQUALIFICATIONS AND EXPERIENCE
2016 QUALIFICATIONS AND EXPERIENCE Hay Group Health Care Consulting 2016 QUALIFICATIONS AND EXPERIENCE Health Care Consulting HAY GROUP HEALTH CARE CONSULTING Hay Group Health Care Consulting is part of
More informationTelemedicine in Central East LHIN
Telemedicine in Central East LHIN Status Report May 28, 2014 Jeanne Thomas, Lead System Design Shelley Morris, Regional Coordinator, OTN What is OTN Telemedicine? OTN is one of the largest Telemedicine
More informationHealth human resources forecasting: Understanding the current and future requirements of PSW s and nurses in Ontario s LTC sector
Health human resources forecasting: Understanding the current and future requirements of PSW s and nurses in Ontario s LTC sector Presented by: Adrian Rohit Dass, MA IHPME, University of Toronto Canadian
More informationFOCUS on Emergency Departments DATA DICTIONARY
FOCUS on Emergency Departments DATA DICTIONARY Table of Contents Contents Patient time to see an emergency doctor... 1 Patient emergency department total length of stay (LOS)... 3 Length of time emergency
More informationNew Members in the General Class 2014
New Members in the General Class 2014 New Members in the General Class 2014 ISBN 978-1-77116-039-1 Copyright College of Nurses of Ontario, 2016. Commercial or for-profit redistribution of this document
More informationWhat does the Patients First Act mean for Rural Communities?
What does the Patients First Act mean for Rural Communities? Michael Barrett, CEO South West Local Health Integration Network (LHIN) ROMA Conference January 30, 017 Overview of Today s Presentation 1.
More informationUnderstanding and Identifying Target Populations for Integrated Care
Understanding and Identifying Target Populations for Integrated Care W.Wodchis, X.Camacho, I. Dhalla, A. Guttman, B.Lin, G.Anderson Leveraging the Culture of Performance Excellence in Ontario s Health
More informationEnvironmental Scan of Ontario s Behavioural Support Transition Units (BSTUs)
Environmental Scan of Ontario s Behavioural Support Transition Units (BSTUs) Report Created by the Behavioural Support Transition Unit (BSTU) Collaborative Part of Ontario s Best Practice Exchange June
More informationMethodology Notes. Cost of a Standard Hospital Stay: Appendices to Indicator Library
Methodology Notes Cost of a Standard Hospital Stay: Appendices to Indicator Library February 2018 Production of this document is made possible by financial contributions from Health Canada and provincial
More informationNational. British Columbia. LEADS Across Canada
LEADS Across Canada National Accreditation Canada Canadian College of Health Leaders Canadian Institute of Health Information Canadian Agency for Drugs and Technology in Health Canada Health Infoway Canadian
More informationCollege of Nurses of Ontario. Membership Statistics Report 2017
College of Nurses of Ontario Membership Statistics Report 2017 VISION Leading in regulatory excellence MISSION Regulating nursing in the public interest Membership Statistics Report 2017 Pub. No. 43069
More information4.09. Hospitals Management and Use of Surgical Facilities. Chapter 4 Section. Background. Follow-up on VFM Section 3.09, 2007 Annual Report
Chapter 4 Section 4.09 Hospitals Management and Use of Surgical Facilities Follow-up on VFM Section 3.09, 2007 Annual Report Background Ontario s public hospitals are generally governed by a board of directors
More informationMINISTRY OF HEALTH AND LONG-TERM CARE
THE ESTIMATES, 1 The Ministry provides for a health system that promotes wellness and improves health outcomes through accessible, integrated and quality services at every stage of life for all Ontarians.
More information2017/18 PERSONAL SUPPORT WORKER (PSW) TRAINING FUND FOR HOME AND COMMUNITY CARE PROGRAM DESCRIPTION
2017/18 PERSONAL SUPPORT WORKER (PSW) TRAINING FUND FOR HOME AND COMMUNITY CARE PROGRAM DESCRIPTION 1 Table of Contents 1. Introduction and Background... 3 a) Introduction b) Eligible Organizations c)
More informationCanadian MIS Database Hospital Financial Performance Indicators, to Methodological Notes
Canadian MIS Database Hospital Financial Performance Indicators, 1999 2000 to 2008 2009 Methodological Notes Revised July 2010 Who We Are Established in 1994, CIHI is an independent, not-for-profit corporation
More informationCMG + Highlights Overview of the new acute care inpatient grouping methodology
CMG + Highlights Overview of the new acute care inpatient grouping methodology Presentation to CCHSE Leadership Conference June 12, 2007 - Toronto Sandra Mitchell Manager, Grouper Redevelopment Project
More informationJanuary 18, Mike Horrobin Board Chair
January 18, 2018 Dear Community Member, In 2014, the Government of Ontario began the process of developing public sector compensation frameworks to ensure a transparent and consistent approach to executive
More informationFrequently Asked Questions (FAQ) Updated September 2007
Frequently Asked Questions (FAQ) Updated September 2007 This document answers the most frequently asked questions posed by participating organizations since the first HSMR reports were sent. The questions
More informationTransforming Health Care For Seniors in the Mississauga Halton LHIN Right care, right time, right setting, right cost
Transforming Health Care For Seniors in the Mississauga Halton LHIN Right care, right time, right setting, right cost Narendra Shah COO MH LHIN September 29, 2010 1 Implications of Alternate Level of Care
More informationThis profile provides an overview of the services provided at the Royal Inland Hospital in the areas of:
Facility Profile This profile provides an overview of the services provided at the in the areas of: Inpatient Cases & Days Inpatient Surgery & Surgical Day Care Emergency Department The information provided
More informationProvincial Dialysis Capacity Assessment Executive Summary. April 2012
Provincial Dialysis Capacity Assessment 2011-2020 Executive Summary April 2012 Table of Contents Introduction... 2 Planning Process... 2 Methodology... 3 Dialysis Planning Support Model... 3 Data... 3
More informationA locally driven collaborative project (LDCP) Quarterly Update. June 2017
A locally driven collaborative project (LDCP) Quarterly Update June 2017 Overview The use of CQI is relatively new in public health units in Ontario. There are no general standards and everyone is doing
More informationExecutive Compensation Policy and Framework ALEXANDRA HOSPITAL INGERSOLL / TILLSONBURG DISTRICT MEMORIAL HOSPITAL
Executive Compensation Policy and Framework ALEXANDRA HOSPITAL INGERSOLL / TILLSONBURG DISTRICT MEMORIAL HOSPITAL Front Page for Ministry Submission: Organization (Full Name): Last Name: Job Title: Address:
More informationExploring the Hip Fracture and Joint Replacement Landscape in a Changing Context: Implications and Recommendations GTA REHAB NETWORK
Exploring the Hip Fracture and Joint Replacement Landscape in a Changing Context: Implications and Recommendations GTA REHAB NETWORK MARCH 2006 TABLE OF CONTENTS EXECUTIVE SUMMARY 7 1.0 BACKGROUND AND
More informationThousand Islands Region The Francophones A community to discover. French-Language Health Services for the local francophone population
Thousand Islands Region The Francophones A community to discover French-Language Health Services for the local francophone population 1 Summary Slide French speaking population in the Thousand Islands
More informationDeaths by care setting
Deaths by care setting Resource for Indicator Standards (RIS) Health Analytics Branch, Ministry of Health and Long-Term Care Indicator description RIS indicator name Deaths by care setting Other names
More informationHay Group Health Care Consulting
2011 Qualifications and Experience Health Care Consulting Hay Group Health Care Consulting Hay Group Health Care Consulting is part of Hay Group, one of the world s preeminent consulting firms focusing
More informationHealth System Performance and Accountability Division MOHLTC. Transitional Care Program Framework
Transitional Care Program Framework August, 2010 1 Table of Contents 1. Context... 3 2. Transitional Care Program Framework... 4 3. Transitional Care Program in the Hospital Setting... 5 4. Summary of
More informationHospitalizations for Ambulatory Care Sensitive Conditions (ACSC)
Hospitalizations for Ambulatory Care Sensitive Conditions (ACSC) Resource for Indicator Standards (RIS) Health Analytics Branch, Ministry of Health and Long-Term Care Indicator description RIS indicator
More informationFederal Economic Development Agency for Southern Ontario
Federal Economic Development Agency for Southern Ontario 2012-13 Report on Plans and Priorities The Honourable Christian Paradis Minister of Industry Minister of State (Agriculture) The Honourable Gary
More informationAccess to Health Care Services in Canada, 2003
Access to Health Care Services in Canada, 2003 by Claudia Sanmartin, François Gendron, Jean-Marie Berthelot and Kellie Murphy Health Analysis and Measurement Group Statistics Canada Statistics Canada Health
More informationBenchmarking variation in coding across hospitals in Canada: A data surveillance approach
Benchmarking variation in coding across hospitals in Canada: A data surveillance approach Lori Kirby Canadian Institute for Health Information October 11, 2017 lkirby@cihi.ca cihi.ca @cihi_icis Outline
More informationSub-Acute Care Capacity Plan
Sub-Acute Care Capacity Plan Final Report Submitted to: Champlain LHIN Sub-Acute Capacity Planning Steering Committee Hay Group Health Care Consulting 121 King Street West Suite 700 Toronto, Ontario M5H
More informationTelemedicine in Central East LHIN Opportunities to Strengthen the System. Central East LHIN Board February 2015
Telemedicine in Central East LHIN Opportunities to Strengthen the System Central East LHIN Board February 2015 OTN and Telemedicine Enabled Organizations BACKGROUND 2 What is OTN Telemedicine? OTN is one
More informationCentral East LHIN/ Entité 4: Building Engaged and Healthy Communities Together
LOGO Entité LOGO Central East / Entité 4: Building Engaged and Healthy Communities Together Central East Board of Directors February 26, 2014 Creation of French Language Health Planning Entities (FLHPEs)
More informationFull-time Equivalents and Financial Costs Associated with Absenteeism, Overtime, and Involuntary Part-time Employment in the Nursing Profession
Full-time Equivalents and Financial Costs Associated with Absenteeism, Overtime, and Involuntary Part-time Employment in the Nursing Profession A Report prepared for the Canadian Nursing Advisory Committee
More informationFocused Organizational Analysis of Hôtel- Dieu Grace Hospital, Windsor & Windsor Regional Hospital
Focused Organizational Analysis of Hôtel- Dieu Grace Hospital, Windsor & Windsor Regional Hospital Final Report June 2002 HayGroup Table of Contents Section Page EXECUTIVE SUMMARY...I 1.0 INTRODUCTION...1
More informationDo-not-Resuscitate/Do-not- Hospitalize Orders in Nursing Homes: Are they being done and do they make a Difference?
Do-not-Resuscitate/Do-not- Hospitalize Orders in Nursing Homes: Are they being done and do they make a Difference? Peter Tanuseputro MHSc (CH&E), MD, CCFP, FRCPC (PHPM) Mathieu Chalifoux MSc Acknowledgements
More informationEXECUTIVE COMPENSATION PROGRAM
EXECUTIVE COMPENSATION PROGRAM 2 Background In 2010, the Province legislated a two-year compensation freeze for all non-unionized employees in the Broader Public Sector (BPS) which prohibited increases
More informationImproving Outcomes in Dual Diagnosis Specialized Care. December 5, 2016
Improving Outcomes in Dual Diagnosis Specialized Care December 5, 2016 cfhi-fcass.ca @cfhi_fcass Welcome With us today: Host Erin Leith Director, Education and Training, CFHI Dr. Susan Farrell Clinical
More informationEastern Ontario Development Fund. Ontario Ministry of Economic Development and Innovation
Eastern Ontario Development Fund Ontario Ministry of Economic Development and Innovation 1 Presentation Overview Background - Attracting Investment and Creating Jobs Act, 2012 Fund Objectives Eligible
More informationHamilton Niagara Haldimand Brant LHIN. Appendix XII: Strategic Health System Plan: Current State Synopsis
Hamilton Niagara Haldimand Brant LHIN Appendix XII: Strategic Health System Plan: Current State Synopsis Table of Contents Introduction... 4 Environmental Scan Summary... 5 Provider Survey Summary...
More informationAMENDING AGREEMENT THIS AMENDING AGREEMENT (the Agreement ) is made as of the 1 st day of April, 2010 B E T W E E N: NORTH SIMCOE MUSKOKA LOCAL HEALTH INTEGRATION NETWORK (the LHIN ) - and - MUSKOKA ALGONQUIN
More informationHow to Calculate CIHI s Cost of a Standard Hospital Stay Indicator
Job Aid December 2016 How to Calculate CIHI s Cost of a Standard Hospital Stay Indicator This handout is intended as a quick reference. For more detailed information on the Cost of a Standard Hospital
More informationRecommendations for Adoption: Major Depression. Recommendations to enable widespread adoption of this quality standard
Recommendations for Adoption: Major Depression Recommendations to enable widespread adoption of this quality standard About this Document This document summarizes recommendations at local practice and
More informationCase-mix Analysis Across Patient Populations and Boundaries: A Refined Classification System
Case-mix Analysis Across Patient Populations and Boundaries: A Refined Classification System Designed Specifically for International Quality and Performance Use A white paper by: Marc Berlinguet, MD, MPH
More informationQuick Facts Prepared for the Canadian Federation of Nurses Unions by Jacobson Consulting Inc.
Trends in Own Illness- or Disability-Related Absenteeism and Overtime among Publicly-Employed Registered Nurses: Quick Facts 2017 Prepared for the Canadian Federation of Nurses Unions by Jacobson Consulting
More informationIndicator description
Patients with a primary care visit within 7 days of acute discharge for Quality Improvement Plans - Primary Care Resource for Indicator Standards (RIS) Health Analytics Branch, Ministry of Health and Long-Term
More information3.12. Specialty Psychiatric Hospital Services. Chapter 3 Section. 1.0 Summary. Ministry of Health and Long-Term Care
Chapter 3 Section 3.12 Ministry of Health and Long-Term Care Specialty Psychiatric Hospital Services 1.0 Summary There are about 2,760 long-term psychiatric beds in 35 facilities (primarily hospitals)
More informationScottish Hospital Standardised Mortality Ratio (HSMR)
` 2016 Scottish Hospital Standardised Mortality Ratio (HSMR) Methodology & Specification Document Page 1 of 14 Document Control Version 0.1 Date Issued July 2016 Author(s) Quality Indicators Team Comments
More informationCommunity Performance Report
: Wenatchee Current Year: Q1 217 through Q4 217 Qualis Health Communities for Safer Transitions of Care Performance Report : Wenatchee Includes Data Through: Q4 217 Report Created: May 3, 218 Purpose of
More informationMEDICATION SAFETY SELF-ASSESSMENT FOR LONG-TERM CARE ONTARIO SUMMARY. April 2009 September 2012
MEDICATION SAFETY SELF-ASSESSMENT FOR LONG-TERM CARE ONTARIO SUMMARY April 2009 September 2012 Institute for Safe Medication Practices Canada Institut pour l utilisation sécuritaire des médicaments du
More informationLooking Back and Looking Forward. A Sneak Peek for the 2018/19 Home Care quality improvement plans (QIPs)
Looking Back and Looking Forward A Sneak Peek for the 2018/19 Home Care quality improvement plans (QIPs) DANYAL MARTIN LAURIE DUNN NOVEMBER 20, 2017 Learning Objectives Share learnings from the 2017/18
More information2009/2010 Benchmarking Comparison of Canadian Hospitals
2009/2010 Benchmarking Comparison of Canadian Hospitals 2009/10 Annual Benchmarking Comparison of Canadian Hospitals 2009/2010 Annual Benchmarking Comparison of Canadian Hospitals For the fourteenth year,
More informationMeeting Future Need Through Specialization in LTC Homes
Meeting Future Need Through Specialization in LTC Homes CLRI Conference November 9, 2015 Presenters: Amy Porteous and Zsófia Orosz Presenter Disclosure 2 Research Team: Amy Porteous, Bruyère Continuing
More informationOutstanding Care No Exceptions! Zero Based Budgeting Project Summary
Outstanding Care No Exceptions! Zero Based Budgeting Project Summary Contents 1.0 INTRODUCTION... 2 1.1 EARLY ADOPTER OF CHANGE AND WORKING CAPITAL DEFICIT... 2 1.2 UNPRECEDENTED GROWTH... 2 1.3 ACCOUNTABILITY
More informationRECOMMENDATION STATUS OVERVIEW
Chapter 2 Section 2.01 Community Care Access Centres Financial Operations and Service Delivery Follow-Up on September 2015 Special Report RECOMMENDATION STATUS OVERVIEW # of Status of Actions Recommended
More informationAbout the Data: Adult Health and Disease - Chronic Illness 2016/17, 2014/15 (archived) Last Updated: August 29, 2018
About the Data: Adult Health and Disease - Chronic Illness 2016/17, 2014/15 (archived) Last Updated: August 29, 2018 Adult Health and Disease: 2016/17 Denominator: Ontario Ministry of Health and Long-Term
More informationRapid Response Nursing Program: Supporting Chronic Disease Management through Transitions in Care
Rapid Response Nursing Program: Supporting Chronic Disease Management through Transitions in Care Geriatric Day Hospitals Institute Sunnybrook Health Science Centre November 25, 2013 Liana Sikharulidze,
More informationFrom Clinician. to Cabinet: The Use of Health Information Across the Continuum
From Clinician to Cabinet: The Use of Health Information Across the Continuum Better care. Improved quality and safety. More effective allocation of resources. Organizations in Canada that deliver mental
More informationData Quality Documentation, Hospital Morbidity Database
Data Quality Documentation, Hospital Morbidity Database Current-Year Information, 2011 2012 Standards and Data Submission Our Vision Better data. Better decisions. Healthier Canadians. Our Mandate To lead
More informationpaymentbasics The IPPS payment rates are intended to cover the costs that reasonably efficient providers would incur in furnishing highquality
Hospital ACUTE inpatient services system basics Revised: October 2015 This document does not reflect proposed legislation or regulatory actions. 425 I Street, NW Suite 701 Washington, DC 20001 ph: 202-220-3700
More informationGrey Bruce Health Services (GBHS) Executive Compensation Framework. February Final Copy
Grey Bruce Health Services (GBHS) Executive Compensation Framework February 2018 Final Copy Grey Bruce Health Service has established an Executive Compensation Framework, a new requirement of the provincial
More informationOntario Standardized Questionnaires for Reportable Enteric Pathogens. Companion Guide
Ontario Standardized Questionnaires for Reportable Enteric Pathogens Companion Guide January 30, 2015 Acknowledgements The Enteric, Zoonotic and Vector-Borne Diseases Unit at Public Health Ontario wishes
More informationFederal Economic Development Agency for Southern Ontario
Federal Economic Development Agency for Southern Ontario Departmental Performance Report The Honourable Navdeep Bains, P.C., M.P. Minister of Innovation, Science and Economic Development Her Majesty the
More informationMississauga Hospital 100 Queensway West Mississauga, ON L5B 1B8
Credit Valley Hospital 2200 Eglinton Avenue West Mississauga, ON L5M 2N1 Mississauga Hospital 100 Queensway West Mississauga, ON L5B 1B8 Queensway Health Centre 150 Sherway Drive Toronto, ON M9C 1A5 This
More informationPrimary Care Measures at the Sub-Region Level
Primary Care Measures at the Sub-Region Level Trillium Primary Health Care Research Day May 31, 2017 Paul Huras South East LHIN Overview The LHIN Mandate Primary Care Capacity Framework The South East
More informationOntario Mental Health Reporting System
Ontario Mental Health Reporting System Data Quality Documentation 2016 2017 All rights reserved. The contents of this publication may be reproduced unaltered, in whole or in part and by any means, solely
More informationAccreditation of Hospital Pharmacies Update
Accreditation of Hospital Pharmacies Update Ontario Hospital Pharmacy Management Seminar May 28, 2017 Judy Chong, RPh, BScPhm Manager, Hospital Practice Presenter Disclosure I have no current or past relationships
More informationNursing and Personal Care: Funding Increase Survey
Nursing and Personal Care: Funding Increase Survey Prepared for: Ministry of Health and Long-Term Care Long Term Care Facilities Branch 5 th Floor, Hepburn Block 80 Grosvenor Street Toronto, Ontario Prepared
More informationQuality Improvement Plan (QIP) Narrative for Health Care Organizations in Ontario
Quality Improvement Plan (QIP) Narrative for Health Care Organizations in Ontario 2/13/2018 Brockville General Hospital 1 Overview At Brockville General Hospital (BGH), we provide Acute Care (Emergency,
More informationGrey Bruce Health Services. Executive Compensation Framework. January 2018
Grey Bruce Health Services Executive Compensation Framework January 2018 2 Grey Bruce Health Service (GBHS) is in the process of establishing an Executive Compensation Framework, a new requirement of the
More informationAppendix H. Community Profile. Hamilton Niagara Haldimand Brant Local Health Integration Network
Appendix H Community Profile Hamilton Niagara Haldimand Brant Local Health Integration Network August 2006 ISBN 1-4249-2806-0 Table of Contents Executive Summary... 1 Characteristics of the Population
More informationHospital Mental Health Database, User Documentation
Hospital Mental Health Database, 2015 2016 User Documentation Production of this document is made possible by financial contributions from Health Canada and provincial and territorial governments. The
More informationRecommendations for Adoption: Diabetic Foot Ulcer. Recommendations to enable widespread adoption of this quality standard
Recommendations for Adoption: Diabetic Foot Ulcer Recommendations to enable widespread adoption of this quality standard About this Document This document summarizes recommendations at local practice and
More informationComparing the Value of Three Main Diagnostic-Based Risk-Adjustment Systems (DBRAS)
Comparing the Value of Three Main Diagnostic-Based Risk-Adjustment Systems (DBRAS) March 2005 Marc Berlinguet, MD, MPH Colin Preyra, PhD Stafford Dean, MA Funding Provided by: Fonds de Recherche en Santé
More informationCase Mix - Putting HIMs in the Mix. HealthAchieve November 3, 2014 Greg Zinck Manager, Case Mix Canadian Institute for Health Information
Case Mix - Putting HIMs in the Mix HealthAchieve November 3, 2014 Greg Zinck Manager, Case Mix Canadian Institute for Health Information 1 Objectives Case mix in general How do HIM professionals affect
More informationPresenter Disclosure. Presenter: [Jason Altenberg, Surkhab Peerzada] Relationships to commercial interests:
CFPC Conflict of Interest Presenter Disclosure Presenter: [Jason Altenberg, Surkhab Peerzada] Relationships to commercial interests: Grants/Research Support: None Speakers Bureau/Honoraria: None Consulting
More information