Historical trends in public general hospitals

This article examines utilization trends in Canadian public general hospitals from 1976 to 1986-87. These trends are then compared with a previous period, and with hospital trends in the United States. Findings for this report are based on both provincial and national data. There was an overall decline in the number of hospitals with a decrease in small (1-49 beds) and an increase in large (300+ beds) hospitals. The net result is a 7% increase in the number of beds, though due to the larger population there was a 3% decrease in the bed rate per population. The bed occupancy rate increased from 77% to 83% and the average length of stay also increased. The number of separations increased slightly but rates per population declined. Patient-days per population increased in most provinces and there was a significant increase in long-stay units. Despite general uniformity amongst the provinces there were some notable variations. The trends indicate a reversal of the situation in the 1953-1973 period which was marked by an expansion in the hospital system. Hospitals in the United States showed somewhat similar trends with the exception of length of stay. The trends may be ascribed to factors such as increased efficiency, the development of alternatives to inpatient care, technical improvements, demographic changes and the individuality of the provincial health care systems.