Historical trends in public general hospitals

Area of Science:

• Health Services Research
• Hospital Administration
• Public Health Policy

Background:

• Canadian public general hospitals experienced significant shifts in utilization and structure between 1976 and 1986-87.
• Previous periods (1953-1973) were characterized by hospital system expansion, contrasting with the trends observed in this study.

Purpose of the Study:

• To examine and analyze hospital utilization trends in Canadian public general hospitals from 1976 to 1986-87.
• To compare these trends with previous periods and with hospital trends in the United States.
• To identify factors influencing these observed hospital utilization trends.

Main Methods:

• Analysis of provincial and national data on Canadian public general hospitals.
• Comparative analysis of hospital trends between 1976-1987, a prior period, and the United States.
• Examination of hospital bed numbers, bed rates per population, occupancy rates, average length of stay, separations, and patient-days.

Main Results:

• A decline in the total number of hospitals, with a decrease in small facilities (1-49 beds) and an increase in large facilities (300+ beds).
• A 7% net increase in hospital beds, but a 3% decrease in the bed rate per population due to population growth.
• Increased bed occupancy rates (77% to 83%), longer average length of stay, and a rise in patient-days per population, alongside a significant increase in long-stay units.

Conclusions:

• The observed trends represent a reversal from the expansionary period of 1953-1973, indicating a move towards consolidation and potentially increased efficiency.
• Factors such as improved efficiency, development of alternative care, technological advancements, demographic shifts, and provincial healthcare system variations likely contributed to these trends.
• While Canadian trends showed similarities to the US, differences in length of stay were noted, highlighting the impact of diverse healthcare system structures.