This profile provides an overview of the services provided at the Royal Inland Hospital in the areas of:

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Loraine Arnold
5 years ago
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Some of the data is reported by vs. Non-, which is based on self-identification at the time of registration. Small volumes (<5) have been suppressed.

In addition to Facility Profiles, Population Profiles by Local Health Area (LHA), Health Service (HSA), and Interior Health Authority can be found on the Interior Health website at: http://www.

1 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 within this document reflects services provided at the hospital, regardless of patient residence. This report is based on adults and children only. Newborns have been excluded. Some of the data is reported by vs. Non-, which is based on self-identification at the time of registration. Small volumes (<5) have been suppressed. The Interior Health Strategic Information Management Department produces a number of utilization and service reports. In addition to Facility Profiles, Population Profiles by Local Health Area (LHA), Health Service (HSA), and Interior Health Authority can be found on the Interior Health website at: es/pages/default.aspx More information is available upon request from Interior Health s Strategic Information Management Department. Inquiries and comments should be addressed to: Glenn Kissmann, Corporate Director, Strategic Information Management: glenn.kissmann@interiorhealth.ca (250) ext

2 Inpatients 2 Inpatient data provides information about acute care hospitals and the patients who are admitted to them. This page includes the number of beds in operation, occupancy rates, patient age and residence, as well as admissions through the Emergency Department and the average Resource Intensity Weight. Table 1: Number of Hospital Beds, - Medical / Surgical Beds Psychiatric Beds Rehabilitation Beds ICU / CCU Beds Obstetrical Beds Pediatric Beds Total Beds in Operation Table 1: Beds funded and in operation at fiscal year end (March 31). Source: MIS/GL; Excludes bassinets Figure 1: Percentage of Inpatient Cases by Patient Residence, Patient Local Health Area Kamloops Merritt 100 Mile House Cariboo-Chilcotin South Cariboo BC - Outside IH Salmon Arm North Thompson Lillooet Out-of-Province 1% Figure 1: Shows the percentage of hospitalizations at, based on where patients live. ; Only most common LHAs are shown 7 Figure 2: % of Inpatient Cases by Self-Identification and Age Group, 0-17 Years Years Years 65+ Years 4 47% 1 6% Non- 2 25% 2 18% Figure 2: Elderly patients (65+ years of age) account for the largest percentage of inpatient cases at Interior Health hospitals. Figure 3: Occupany Rates, % 113.7% 66.8% 69.0% Figure 3: Occupancy Rates are presented as an average, based on the number of beds staffed at March 31 each year. Source: MIS/GL; Excludes newborns and pediatrics in the nursery FIgure 5: Percentage of Inpatient Cases Admitted Through the ED, Figure 5: The majority of inpatients at Interior Health hospitals are admitted via the Emergency Department (ED). Source: DAD; Excludes newborns Figure 4: Number of Inpatient Cases by Self-Identification, - 11,367 1,281 11,495 1, ,913 1, Figure 4: Inpatient Case = A discharge from hospital Source: DAD; Excludes newborns Non- Figure 6: Average Resource Intensity Weight (RIW), - Figure 6: RIWs provide the estimated cost per hospitalization relative to the average inpatient in Canada (RIW = 1.0). A higher RIW means higher costs per inpatient case. Source: DAD CMG 2017, Excludes newborns

3 Inpatients 3 Grouping Methodologies categorize inpatients into similar groups for reporting purposes: Major Clinical Categories (MCCs) are large groups generally related to body systems; Case Mix Groups (CMGs) further categorize inpatients into groups based on similarities of diagnosis, intervention, length of stay and resource requirements such as costs. Figure 7: Most Common MCCs for Inpatient Cases, # of Cases 2K 1K 0K 1,674 Mental Diseases & Disorders 1,609 Circulatory System 1,472 Trauma/Injury/ Poisoning Figure 8: Most Common CMGs for Inpatient Cases, Unilateral Knee Replacement Chronic Obstructive Pulmonary Disease Vaginal Birth without Anaesthetic or Non-Major Intervention Viral/Unspecified Pneumonia Stress Reaction/Adjustment Disorder Substance Abuse with Other State 1,364 Pregnancy & Childbirth 1,196 Musculoskeletal System Figures 7 & 8: Show the most common types of inpatient cases at, i.e. the MCCs and CMGs which accounted for the most hospitalizations. Note: Some conditions are split into several CMGs due to differences in treatment and/or costs. Example: Vaginal Deliveries are split into four CMGs. Heart Failure without Coronary Angiogram Unilateral Hip Replacement Source: DAD; CMG2017; Excludes newborns Depressive Episode Caesarean Section with uterine scar, no induction # of Cases Figure 9: Most Common MCCs Accounting for Inpatient Days, # of Days 20K 10K 0K 19,311 Mental Diseases & Disorders 13,256 Circulatory System 12,042 Trauma/Injury/ Poisoning Rehabilitation Dementia Schizophrenia/Schizoaffective Disorder Chronic Obstructive Pulmonary Disease Fixation/Repair Hip/Femur Ischemic Event of Central Nervous System Heart Failure without Coronary Angiogram Depressive Episode Bypass/Extraction of Vein/Artery of Limb Viral/Unspecified Pneumonia 9,498 9,299 Other Reasons, e.g. Rehab, Convalescence Figure 10: Most Common CMGs Accounting for Inpatient Days, Respiratory System Figures 9 & 10: Show the conditions that accounted for the most inpatient days at Royal Inland Hospital. ALC days are included. The most common conditions do not necessarily account for the most inpatient days and vice versa. For example, at most IH hospitals, there are a large number of vaginal deliveries, but because those patients have very short hospital stays, they don't account for a significant proportion of the hospital days. Source: DAD; CMG 2017; Excludes newborns 0K 1K 2K 3K 4K # of Inpatient Days

4 Inpatients 4 Inpatient Days are calculated from admission date until discharge date, reported by: Acute/Rehab: Days where the patient receives acute care or rehabilitation services; Alternate Level of Care (ALC) : Days where acute services are no longer required, but the patient remains in hospital waiting for other resources Figure 11: Number of Inpatient Days by Self-Identification, - Number of Acute/ Rehab Days Number of Alternate Level (ALC) Days Total Inpatient Days Non- 7,143 8,448 9,199 1,461 1,397 1,744 17,392 18,639 17,834 8,604 9,845 10,943 68,715 74,478 77,492 86,107 93,117 95,326 Figure 11: Shows the three year trend in the number of Acute/Rehab, ALC, and Total Inpatient Days utilized at. Figure 12: ALC Days Rate by Self-Identification, % 20.0% % Non- Inpatient Surgical Cases % Figure 13: Average Length of Stay (ALOS) in Days, - ALOS - Acute/Rehab Days ALOS - Total Days (incl. ALC) Figure 12: ALC Rate = Percentage of inpatient days that were designated as Alternate Level of Care (ALC) Figure 13: ALOS = Average number of days per hospitalization reported by Acute/Rehab and Total Days Source: DAD; Excludes newborns Inpatient Surgical Case: A patient with a significant procedure during their hospitalization. The data shows the number and types of surgical patients, rather than the number of procedures performed or operating room utilization. Figure 14: Most Common Procedures for Inpatient Surgical Cases, Cesarean section delivery Implantation of internal device, knee joint Implantation of internal device, hip joint Fixation, femur Excision total, appendix Excision partial, prostate Excision total, gallbladder Implantation of internal device, heart N.. Repair, spinal vertebrae Excision total, uterus and surrounding s # of Surgical Cases Figure 14: Shows the most common types of inpatient surgical cases at. Each patient is counted only once and reported according to the most significant procedure during the hospitalization. Source: DAD; CIHI Intervention Partition List (IPL), Excludes newborns Figure 15: Surgical Cases as Percentage of Total Inpatients, Figure 16: Number of Inpatient Surgical Cases, - 4, ,504 4, % Figures 15 & 16: Show the percentage and number of inpatients who underwent significant procedures during their hospitalization. Source: DAD; CIHI Intervention Partition List; Excl NB

5 Surgical Day Care 5 Surgical Day Care (SDC) Case: A patient who undergoes a resource-intensive procedure, performed on an outpatient basis. The patient is not admitted to hospital and usually leaves on the same day as the procedure. Figure 17: Number of Surgical Day Care Cases, - *Cystoscopy/Endoscopy Other SDC Total SDC 7,750 7,575 8,014 11,125 11,432 11,530 18,875 19,007 19,544 Figure 17: Provides the number of SDC cases at, broken down by *Cystoscopies and Endoscopies vs. other SDC procedures. *Cystoscopy/Endoscopy = Principal procedure of cystoscopy. gatrointestinal endoscopy, or bronchoscopy as defined by the Ministry of Health. Figure 18: Most Common SDC Cases (Excluding *Cystoscopy/Endoscopy), Cataract Removal/Lens Insertion Spinal Vertebrae/Intervertebral Disc Intervention Carpal Tunnel Release Electroconvulsive Therapy (ECT) Other Minor Lower Urinary Tract Intervention Other Nervous System Intervention Hernia Repair, Open Approach Vitrectomy/Retinal Release Open Fixation/Fusion without Graft Dental/Periodontal Intervention Figure 18: Shows the most common SDC cases at, excluding Cystoscopies and Endoscopies. The cases are reported based on the Comprehensive Ambulatory Classification System (CACS) grouping methodology. Source: DAD; CACS 2017; Excludes newborns ,000 1,500 # of SDC Cases Figure 19: Percentage of SDC Cases by Patient Residence, Patient Local Health Area Kamloops Merritt Cariboo-Chilcotin 100 Mile House South Cariboo Salmon Arm North Thompson BC - Outside IH Lillooet 5% 1% 7 Figure 20: Percentage of SDC Cases by Self-Identification and Age Group, 0-17 Years Years Years 65+ Years 8% 25% 17% 41% 37% 26% 4 Figure 19: Shows who utilized SDC services at, based on where patients live. ; Only the most common LHAs are shown Non- Figure 20: Elderly patients (65+ years of age) accounted for the most SDC cases at many of the IH hospitals.

6 Emergency Department 6 Emergency Department (ED) data provides information on visits made to the Emergency Room. Most of the data is based on unscheduled ED visits. Figure 21: Number of Emergency Department Visits, Unscheduled vs. Scheduled, - Unscheduled ED Visits Scheduled ED Visits 68,545 70,285 71,913 Figure 22: Percentage of Unscheduled ED Visits by Self-Identification and Age Group, 0-17 Years Years Years 65+ Years 48% 37% 2 15% 21% % Figure 21: Shows the number and trend of ED visits at Royal Inland Hospital. Source: Unscheduled Visits - Admissions Universe; Scheduled Visits - MIS Non- Figure 22: Unlike Inpatient and SDC cases, elderly patients usually do not account for the most ED visits. Figure 23: Percentage of Unscheduled ED Visits Admitted to Hospital, by Self-Identification, % 12.8% % 11.9% Figure 24: Number of Unscheduled ED Visits Admitted to Hospital, by Self-Identification, - 7,570 8,355 7, ,082 Non- Non- Figure 23: Shows the percentage of unscheduled ED visits that resulted in admission to. Figure 24: Shows the number of unscheduled ED visits that results in admission to. Figure 25: Percentage of Unscheduled ED Visits by Triage Level, - L1: Resuscitation L2: Emergent L3: Urgent L4: Less Urgent L5: Non-Urgent Undifferentiated 50% % 46.0% 40% % 37.7% % of ED Visits 30% 20% 10% % 10.5% 5.6% 5.7% 5. 0% % /16 16/17 17/18 15/16 16/17 17/18 15/16 16/17 17/18 15/16 16/17 17/18 15/16 16/17 17/18 15/16 16/17 17/18 Figure 25: Provides the percentage of ED visits by Triage Level based on the Canadian Triage and Acuity Scale (CTAS).

Health Economics Program

Health Economics Program Issue Brief 2006-02 February 2006 Health Conditions Associated With Minnesotans Hospital Use Health care spending by Minnesota residents accounts for approximately 12% of the state