APPENDIX 3
Regional Capacity Assessment & Projections
Regional REGIONAL CAPACITY Priorities ASSESSMENT &
Local Future State PROJECTIONS: Health ReCAP Findings 2009
Provincial FINAL October 2009 Priorities Achieving Health
Results that matter
South East LHIN Local Health Integration Network Réseau local d’intégration des services de santé
ReCAP 2009 1
South East LHIN
Regional Capacity Assessment & Projections
Table of Contents TABLE OF CONTENTS...... 2 SUMMARY OF FINDINGS...... 3 Overview ...... 3 Demographics ...... 3 Population Projections...... 3 Aging Population...... 4 Data Issues ...... 4 Francophone ...... 4 Chronic Disease and Risk Factors...... 5 Unattached Patients ...... 5 Primary Health Care...... 5 Community Health Centres ...... 5 Emergency Department Utilization...... 5 Utilization of Hospital Inpatient Services ...... 6 Alternate Level of Care (ALC) ...... 6 Surgical and Medical, Day/Night, Rehabilitation, Complex Continuing Care...... 7 Adult Inpatient Mental Health...... 8 Addictions...... 8 Home Care ...... 8 Community Support Services...... 8 Conclusion...... 9 2. FACTS AND FIGURES ...... 10 Population ...... 10 Socio-economic Status...... 11 Aboriginal Population...... 11 Health Status ...... 12 Health Behaviours...... 12 Primary Health Care...... 12 Emergency Department (ED) Visits ...... 12 Acute Inpatient Separations ...... 13 Alternative Level of Care (ALC) Separations...... 14 Day/Night Procedures...... 15 Adult Inpatient Rehabilitation visits...... 16 Complex Continuing Care (CCC) ...... 17 Adult Inpatient Mental...... 18 Home Care ...... 18 Long-Term Care...... 19 Community Support Services...... 20 Community Health Centres ...... 21 Addictions Services...... 22 RECAP SECTOR PROFILES...... 24 RECAP SUB-LHIN PROFILES...... 24
ReCAP 2009 2
South East LHIN
Regional Capacity Assessment & Projections
south). Areas to the south also contain most of the urban Summary of Findings communities in the LHIN. Over 60% of the population is located in five of the 15 sub-LHIN planning areas. Overview Population Projections The purpose of the ReCAP report is to provide local data, where possible, that would support discussions related to the The South East LHIN population is projected to grow at 0.3% per development of the second Integrated Health Services Plan year over the next 3 years and 0.6% over the following 5 years. (IHSP2). The guiding principle behind this is that if Although the overall projected LHIN growth is generally reflected programs/services are to meet the needs of those they affect, then across sub-LHIN areas, there are a few areas where the growth greater emphasis has to be placed on the evidence behind local rates should be noted: planning and be supported by the collection and analysis of Increases for age groups: 45-64 years in Belleville (4% available data and projections at the local level. per year) and South Frontenac (5% per year); 65-74 in South Frontenac (10% per year) and Smiths Falls, Perth For the purpose of comparing information in sub-geographic & Lanark (5% per year); 85+ in Stone Mills, Loyalist regions, the South East LHIN has been divided into 15 sub-LHIN (14% per year), Prince Edward County (6% per year) and areas. They include: South East Leeds & Grenville (4% per year). Addington, North & Central Frontenac Decreases for age groups: 0-19 in Central Hastings and Belleville Nort h Hast ings North Hastings as well as 20-44 in Central Brockville Hastings, North Hastings, South Central Hastings Sm i t h s Fa l l s, Perth,Lanark East Leeds & Grenville and Gananoque, Leeds Addi ngt on - 416 7 North/Central Frontenac South East Leeds Grenville Smiths Falls, Perth, Lanark Kingston & the Islands 62
Ri d ea u La k es all less than 4% per year; North Hastings Brockville Prince Edward County Central Hastings 15 85+ in South Frontenac (>10%
Quinte West South Frontenac Gananoque 401 per year) and Addington, North & 37 - Leeds Rideau Lakes Stone Mills 41 - Loyalist Central Frontenac (7% per year). Kingston Smiths Falls, Perth & Lanark Belleville Tyendinaga & Islands - Napanee South East Leeds & Grenville Qui nt e West South Frontenac 49 A major factor influencing the population projection is in-and- Pr i n ce Ed w a r d Stone Mills, Loyalist 62 out immigration. Based on the results from the 2006 census, there Tyendinaga, Napanee is a higher percentage of in-migration within the 45-64 age groups for Central Hastings, North Hastings, Prince Edward County, Quinte West, Rideau Lakes, Smiths Falls, Perth & Lanark and Demographics South Frontenac. At the same time, there was also a notable Population demographics play an important role in health system population reduction in the 15-34 age group as a result of out- utilization trends and, by extension, health-care planning and policy migration in all areas except Belleville, Brockville and Kingston & development. In 2007, the population of the South East LHIN was Islands. 481,000 with 17% over 65 years of age. Overall, the South East LHIN has a higher percentage of elderly individuals than the rest of Another factor affecting population projections is the fertility the province (17.1% vs. 13.2% for persons 65+ in 2007). The distribution. Rural areas such as Addington, North & Central South East LHIN population is unevenly distributed with larger Frontenac, South Frontenac, Quinte West, Tyendinaga, Napanee, populations found along the highway 401 corridor (running east- Gananoque, Leeds and Rideau Lakes have higher fertility rates west) and a portion of the highway 416 corridor (running north- when compared to the more urban areas where most of the births
ReCAP 2009 3
South East LHIN
Regional Capacity Assessment & Projections occur within the ages of 20 to 29. In all areas, the teen birth rate is approximately 20% or lower, with the notable exception of The North American (NA) Indian made up the largest proportion of Belleville, where the teen birth rate is over 30%. individuals identifying as Aboriginal (56%) followed by those identifying as Métis 36%. the Métis population is on the rise, outpacing the growth of the other groups, as well as that of the Aging Population non-Aboriginal population, over the past decade. The 65+ population in the LHIN is expected to increase by approximately 21,000 from 2006 to 2011, representing a 4.3% Age Structure increase in this cohort. Data projections suggest that both the 65- The age distribution of on-reserve First Nations peoples 74 and 75+ age groups will increase in volume, but only the 65-74 (considered to be younger) differs substantially from the Ontario age group will increase in percentage growth. Although the per population as a whole. In 2007, 36% of the on-reserve registered capita health spending for persons aged 65+ averaged three to population was under the age of 20 in comparison to 24.3% of the five times more than for younger individuals, the aging of the off-reserve registered population and 25.1% of the Ontario population is too gradual a process to rank as a major cost driver population. Consequently, compared to the Ontario population, the in health care. Aboriginal population has a smaller proportion of older people. In 2007, 6.8% of the on-reserve registered population was aged 65 Elderly Living Alone or older, compared to 9.8% of the off-reserve registered Indian Residents who live on their own tend to be more dependent on population. Both percentages are substantially lower than the both formal as well as informal supportive care; the percentage for 13.2% of the Ontario population aged 65+ in calendar 2007. all sub-LHIN areas ranges between 17% and 31%. Belleville has the highest percentage of individuals 65+ living alone (31%) while Data Issues Stone Mills, Loyalist (17%) had the lowest. The Aboriginal identity population was counted the same way in 2006, 2001 and 1996, providing comparable data for three census Aboriginal Ancestry Populations years. However, some Indian reserves and settlements did not Data from Censuses of Population along with Indian and Northern participate in the census. Across the province in 2006, there were Affairs Canada are used to describe the population characteristics. 22 incompletely enumerated Indian reserves including Tyendinaga Note that the Census data does not include estimates from Mohawk Territory of the Mohawks of the Bay of Quinte. Further, Tyendinaga Mohawk Territory. there are no unique identifiers related to Aboriginals regarding health service utilization. This makes it difficult to understand the Population Volume and Growth utilization patterns of the Aboriginal peoples and, by extension, makes it difficult for planning. The South East LHIN is committed In the South East LHIN, there is only one main reserve, Tyendinaga to working with the Aboriginal communities in a respectful way to Mohawk Territory of the Mohawks of the Bay of Quinte. Another share demographic and health information for the purposes of reserve, the Mohawks of Akwesasne First Nation, though primarily planning health services. located within the Champlain LHIN, is still shared with the South East LHIN. This reserve has some lands along the St. Lawrence Francophone River and also extends into the province of Quebec and across the border into the United States. In the South East LHIN, approximately 2.5% of the total population (or 11,300 residents) are Francophone (i.e., claim There are an estimated 2,103 persons on reserve and 5,514 off French as their mother tongue) which is slightly below the 4.1% in reserve (7,617) who are registered First Nation residents. This the province as a whole. This volume and proportion has remained represents 4.5% of the total Ontario registered First Nations fairly stable for the LHIN over the last decade. Francophones are population. The South East LHIN has the 7th highest registered mainly clustered in the Kingston and Trenton areas and in rural First Nation population of all 14 LHINs, while the North West and communities along the eastern part of the LHIN. In some cases, North East LHINs have the highest.
ReCAP 2009 4
South East LHIN
Regional Capacity Assessment & Projections language barriers can compromise their ability to have their health Primary Health Care care needs met. In fiscal 2007/08, there were approximately 327,100 patients visiting general or family physicians with an average of 4.1 visits Chronic Disease and Risk Factors per patient. It is expected that the number of visits will increase to Chronic disease, such as cardiovascular disease (primarily heart 345,000 by 2012 – representing a 5% increase. Not surprisingly, disease and stroke), cancer or diabetes, is among the most older patients tend to have more frequent visits to these patients prevalent, costly and preventable of all health problems. Chronic than any other age group. Diseases of the circulatory system and disease has serious health impacts: it not only may cause musculoskeletal system were the top two reasons associated for premature death, but may have significant adverse effects on visits, followed by mental disorders. Mental disorders were top quality-of-life and may also result in adverse economic effects on reasons especially for females in the 20-44 and 45-64 age groups. families, communities and society in general. Compared to the Ontario population, the South East LHIN has a higher frequency of Community Health Centres chronic disease. Arthritis / rheumatism, diabetes, asthma, heart (Data Source: Individual CHC Management Database) disease, cancer and high blood pressure are all found in higher Community Health Centres (CHCs) are non-profit organizations frequency in the South East LHIN when compared to the province. that provide primary health and health promotion programs for In fact, the prevalence of chronic disease has been steadily individuals, families and communities. The South East LHIN has increasing over the recent years (2001 to 2005). As expected, four CHCs, located in Kingston, Merrickville, Portland and Tweed. older age groups have higher prevalence of chronic diseases with The majority of patient encounters in 2007 to CHCs in the LHIN the 65+ having the highest prevalence. Overall, these diseases were with nurses (43,000 or 39%) followed by physicians (36,000 account for slightly less than 90% of all deaths. Health Canada or 30%) and nurse practitioners (17,000 or 16%). Other types of predicts that deaths from chronic diseases will likely increase -- encounters were made by social workers, nutritionists, health most markedly, deaths from diabetes will increase by 44%. counselors, chiropodists and therapists.
Risk factors associated with any chronic disease include high Emergency Department Utilization cholesterol, obesity, physical inactivity and insufficient consumption of fruits and vegetables - together with alcohol and Emergency Departments (EDs) are a vital part of our primary and smoking, are found in higher rates in the South East LHIN when acute health care systems. EDs provide assessment, diagnosis and compared to the province. If these trends continue the burden of treatment of patients seeking immediate attention. In 2002, there illnesses related to chronic disease will only place additional was a total of 282,149 ED visits by LHIN residents. This volume pressure on the provision of health care in the LHIN. increased to 293,385 visits by 2006. Not surprisingly, the majority of visits were made by residents living in the areas of Unattached Patients Kingston & Islands, Smiths Falls, Perth, Lanark and Belleville. Age-specific rates for visits were higher among the young (0-19 In the South East LHIN, it is estimated the unattached patient rate years) as well as the older age groups (65+) for both sexes. is 7.9%. These patients tend to be male and a younger group. Males tend to visit the ED more often than their female Recent trends, however, suggest that more residents are able to counterparts, particularly for the older age groups. The overall access primary health care providers through new initiatives number of visits within the LHIN is expected to increase by 5,830 offered by the Ministry of Health and Long-Term Care (MOHLTC) visits or 2% over annually 2007-2012. There are a number of and the South East LHIN. This is evident by the fact that more hospitals that are expected to have fewer ED cases over this time physicians are billing under the new patient codes (14,920 new period, including Perth, Smiths Falls, and Quinte Health Care – patients in all) in 2008. This does not, however, address systemic Bancroft. issues in the acute care system as patients find themselves “unattached” as their family doctor often does not have hospital Of note: privileges. On average, Lennox & Addington County General
Hospital (LACGH), Perth & Smiths Falls District Hospital
ReCAP 2009 5
South East LHIN
Regional Capacity Assessment & Projections
PSF – Perth Site, PSF - Smiths Falls site, Quinte Health Occupancy Rates Care (QHC) – Bancroft site and QHC - Picton site register High occupancy rates within hospitals have been associated with less than 5 ED visits between midnight and 6:00 am. inefficient, prolonged care and, consequently, are more likely to be associated with increased infection rates, mortality rates and Over 15% of ED visits (mainly upper respiratory increased LOS. Occupancy rates in the LHIN differed significantly conditions) that could be managed elsewhere were by hospital size, teaching status, technological status and non- reported in PSFDH-Perth, LACGH and QHC-Trenton. rural location. Overall occupancy rates for medical beds were usually between 93%-95% except for PSFDH-Smiths Falls (69%). Utilization of Hospital Inpatient Services Rates for medical/surgical beds were typically within the 83%- 88% range though QHC-Trenton and Lennox & Addington General Identification and understanding of patterns of health care Hospital recorded rates above 93%. KGH and QHC-Belleville had utilization are essential for health-care planning. Past and current surgical beds with occupancy rates of 87% and 71% respectively. inpatient utilization, as well as population patterns, was considered in building the models used in predicting future use of Future Inpatient Needs hospitals and by extension, the number of beds required in the future. Patient stays in hospital are referred to as “inpatient Assuming that acute care utilization rates, market share for 2006 separations.” and 2007, and further that current occupancy levels stay in effect and accounting only for growth in the population; the expected Utilization Rates annual growth rates for the number of separations in the LHIN are: 2.3% for medicine, 1.4% for surgery, 4.5% for psychiatry and - In 2007, KGH (47%) and QHC-Belleville (24%) provided for almost 0.3% to -1.6% for pediatrics, newborns and obstetrics. Among the 3 out of every 4 acute inpatient separations in the LHIN. There program service groups, cardiology (2.7%) and pulmonary (3.2%) were, however, some striking variations in hospitalization rates are expected to grow faster than other services. among the sub-planning areas. For example, the Gananoque & Leeds, Addington, North & Central Frontenac, and Kingston areas Alternate Level of Care (ALC) have consistently had lower separation rates when compared to the rest of the planning areas. The rates for the younger age The rate of ALC days as a percentage of total hospital days has groups of both sexes are relatively stable across all sub-LHIN been described as an important indicator of health system areas. performance. Increasing numbers of ALC patients and/or long waits for appropriate levels of care are a symptom of significant Length of Stay issues related to patient flow, access to care, system integration, and availability of care and service options. Length of stay (LOS) is the number of days a patient remains in the hospital from admission to discharge. Although the LOS was ALC Trends relatively stable between 2002 and 2007, it varied markedly and persistently by hospital. This was more noticeable for newborn For the South East LHIN, 17.2% of total acute inpatient bed days and obstetrical services. For example, since 2002, Kingston were ALC days in 2007, which compared to the provincial average General Hospital has maintained an average LOS, in these related of 14%. The South East LHIN rate was actually the third highest services, which were approximately 2 days longer than the rest of rate among all 14 LHINs in the province. The LHIN has a long way the LHIN hospitals. This could be partly related to KGH’s role as a to go if it is to meet a target of 13% in 2009/10 as outlined in the provider of tertiary neonatal care. Ministry of Health and Long-Term Care (MOHLTC) - LHIN Accountability Agreement (MLAA). To attain this target, the LHIN Not surprisingly, patients aged 65 years and over had the longest requires an estimated reduction of 25% of the current 45,000 ALC LOS for both sexes. There is significant variation in LOS between days (estimated reduction of 11,315 days). hospitals especially among the older age groups. This is likely related to the complexity of care being provided at each location.
ReCAP 2009 6
South East LHIN
Regional Capacity Assessment & Projections
Other ALC Highlights for South East LHIN: Hospital Trends: In 2007, a total of 1,842 inpatient separations (or 5.1% The greatest number of ALC separations was at KGH. In of total separations) that were discharged from acute 2007, KGH had 35% (653 of 1,845) of all ALC institutions had an ALC component of their stay. separations. QHC–Belleville site had the second highest The average ALC LOS was 24.6 days compared to the separations with 573 in total. Collectively these two Ontario average of 18.6 days. hospitals accounted for two-thirds of the ALC patients. Over 50% of ALC patients are aged 75 and over. KGH accounted for 40% of the ALC days (18,283 of Females usually account for the majority of ALC 45,258 days). separations (53%-63% across the LHIN hospitals). KGH has an average ALC length of stay of 28 days. More than three-quarters of South East LHIN ALC Percentage of ALC days is highest at the smaller patients entered the system through an Emergency hospitals. Department. Almost half (47%) of current ALC separations in the South East LHIN were transferred to a continuing care facility, while 23% were provided home care and approximately 14% were deceased. Surgical and Medical, Day/Night, Rehabilitation, Complex Continuing Care Utilization rates for adult inpatient rehabilitation are usually below The information in the surgical and medical day/night section is 10 per 1,000 with the exception of Kingston & Islands and Stone obtained from the National Ambulatory Care Reporting System Mills/Loyalist where rates are 10 or more per 1,000 for both males (NACRS), developed by the Canadian Institute for Health and females. Most of the rehabilitation admissions in the South Information (CIHI) and the Ministry of Health and Long-Term Care East LHIN were seen at Providence Care (>360) followed by KGH of Ontario (MOHLTC). It is extremely important to recognize that (183 in 2006), QHC-Belleville (147) and BGH (51) (2007). the inconsistency in reporting by hospitals is a significant factor Rehabilitation bed days were also highest at Providence Care that is influencing the sub-LHIN rates. (>13,600) followed by QHC-Belleville with 5,800. Projections for adult inpatient rehabilitation services, which have been based In 2007, South East LHIN hospitals performed just under 54,000 only on changes in population growth, point to annual increases of Surgical/PARR (Post Anesthetic Recovery Room) procedures; one- 6.1%, 2.8% and 3.88% in admissions, bed days and beds quarter took place at Hotel Dieu Hospital (HDH), one-fifth took respectively. place at Brockville General Hospital (BGH) and QHC-Belleville, one- eighth were at KGH and 7% or less at each of the other hospitals. In 2007, circulatory diseases were the most frequently assessed diagnostic condition (23%-28% across South East LHIN hospitals) The 45-64 age group had the majority of Surgical/PARR for complex continuing care (CCC) patients, followed by mental procedures (29%-49%), followed by the 20-44 and the 65-74 age health (7%-17%) and musculoskeletal conditions (8%-18%). groups each accounting for about one-fifth of all procedures. Just Cancer, endocrine, nervous and respiratory conditions each over half of these procedures were provided to females. Five-year represented between 2%-8% of all assessed conditions for this projections for day/night procedures in the South East LHIN, based patient group, while all other conditions combined represented only on changes in population growth, indicate slow average 22%-29%. annual increases in the number of procedures/treatments for It is estimated that the number of CCC beds days will increase Surgical/PARR (1.6%), dialysis (1.7%) and radiation (3.1%). Both from 70,414 days (07/08) to 81,906 days by 2012 (based on a the number of oncology visits and cardiac catheterizations is 90% occupancy rate), thus representing a 16% increase over this projected to decline by about 1%. time period. A corresponding increase of 24 beds will be required
ReCAP 2009 7
South East LHIN
Regional Capacity Assessment & Projections to accommodate this increase in bed days; 226 beds (07/08) to (23%), tobacco (20%), prescription opiates (16%) and crack 250 beds (2012/13). (11%).
Adult Inpatient Mental Health Home Care In the past, some regional population studies have investigated (Data Source: Home Care Database) mental illness, but reliable local data on the prevalence of mental Generally, the number of applications and assessments for home illness is lacking. It has been estimated that nearly one-in-five care services in the South East LHIN has increased since 2005. Canadian adults will personally experience a mental illness during a By the end of the second quarter of 2008, the South East one-year period. Community Care Access Centre (CCAC) received 6,709 applications for home care services and conducted 6,686 Between 2006 and 2007, there was a 5% increase in the number assessments. The majority of applications to the South East of adult inpatient mental health admissions but matched by a drop CCAC are referred from hospital inpatient units (37%-42% since of 4% in the number of bed days (most of which was as a result of Q3 2007) followed by the community or other individuals (15%- the divestment of services at Providence Care into the 19%), GPs (12%-16%) and hospital outpatients (12%-13%). community). Among hospitals in the LHIN, Hotel Dieu and QHC- Belleville recorded increases in both admissions and bed days while The sub-LHIN distribution of applications and assessments by Providence Care and Royal Ottawa Health Care Group (ROHCG)- referral and eligibility categories largely mirror the distribution in Brockville showed declines. Designated long-term treatment the LHIN as a whole. Average length of stay for South East CCAC (39%) and forensic treatment (16%), provided mainly by admissions appears to be declining with time, particularly in the Providence Care accounted for more than half of all bed days in younger (0-19 years) and older (65+) age groups. By the end of Q3 2007 while acute care by all other institutions represented about 2007, the average length of stay was under 100 days with the 45% of all bed days. exception of males 0-19 (135 days on average). In 2007, most South East CCAC clients received either nursing services or case The majority of mental health bed days were to adults 20-64 years management visits followed by occupational therapy, (80% overall in fiscal 2007). Note, however, that there were more physiotherapy or personal support/home making services. Based on females 45-64 years compared to 20-44 years and conversely projections for the period 2007-2012 the annual growth in South fewer males 45-64 years than 20-44 years. East CCAC applications, assessments and admissions is likely to grow by 1.8%-1.9%. Addictions The impact of substance use and abuse on Canadian society in Community Support Services terms of health care, law enforcement, loss of productivity, and (Data Source: Management Information Systems (MIS) and safety of individuals and communities is increasingly significant. A Agency Management Databases) study on the costs of substance abuse in Canada found that the total annual cost in 2002 reached $39.8 billion. Community Support Services (CSS) includes: home support Over the last five-year period, the number of open admissions (new services – volunteer based; Alzheimer education; palliative care and ongoing cases) for substance abuse in the South East LHIN (life threatening or terminal illness); specialized services (acquired increased from over 7,600 in 2004 to 8,200 in 2006 before brain injury services, attendant outreach, assisted living services in dropping to 7,400 in 2008. supportive housing, services for seniors who are blind, hearing care and counselors for seniors. Annually, new admissions for substance abuse represented between 69%-79% of all open admissions during this period. There The CSS sector provides care for clients that are often aged 75+. are more men (70%) being treated. They tend to be between the Recent trends, however, suggest more care is being provided to age of 16 and 54. However, there are even younger patients (15 younger age groups. CSS agencies are providing care closer to or less) who are treated. The main substance for which treatment home. Meals on Wheels for example, are located within each sub- was required included alcohol (69%), cannabis (34%), cocaine LHIN area and service clients within each of those areas.
ReCAP 2009 8
South East LHIN
Regional Capacity Assessment & Projections
The population is aging in the South East LHIN, but this is a The number of referrals for attendant outreach services in the gradual process and will not be a major cost driver in health care LHIN is continuing to increase with time as the three agencies that especially in the short term. Chronic diseases such as diabetes, provide this type of care have developed waiting lists that seem to cancer, heart disease and the related risk factors are found in be growing on a monthly basis. Overall in the South East LHIN, the higher rates in the South East LHIN. number of individuals aged 65+ with disabilities is expected to increase from over 19,500 in 2007 to around 21,000 by 2012. Ninety percent of all deaths in the areas are associated with Most of the increase for this population is expected for individuals chronic disease. Many of these patients are being cared for in aged 65-74 (3.5%) followed by those aged 75-84 (1.4%) and hospitals and often end up as alternate level of care patients. The those aged 85+ (1.1%). LHIN has the third highest ALC rate and has much work to do if we are going to meet the target of 13% by 2009/10. Current Slightly less than 7,000 individuals in the South East LHIN levels of utilization in terms of admissions, emergency visits, and received Alzheimer education in 2007, representing a reduction of clients served in the community, procedures, occupancy rates, etc. about 900 individuals requesting these services in the previous provide a starting point in understanding the demands placed on three years. Most of the decline was attributed to fewer the health-care system today. Many individuals and families are individuals attending the Belleville/Hastings and Prince Edward relying on community services and this is reflected in the growing County sites. Individuals served at the other sites remained volumes and, in some cases, expanding wait lists. relatively constant during the period.
Despite a decline in the number of individuals requesting service, the number of hours of Alzheimer education has steadily increased, reaching just over 4,100 hours overall or an annual rate of increase of 10.1%. Much of this growth was as a result of increases at the Kingston and Leeds-Grenville sites, both providing 22% more hours of service annually since 2005. Contrary to the decrease in total individuals indicated above, some of the growth was also observed at the Belleville-Hastings site, which reported a 12% annual increase in the last four years.
Between 2004 and 2007, the number of clients who were provided with volunteer hospice visiting service remained generally constant for the majority of institutions in the LHIN. Although with wide fluctuations, most institutions provide 20 or fewer hours of volunteer hospice visiting services per client. At least two agencies, however, provide between 25-50 hours on average.
Conclusion A guiding principle of the South East LHIN is that local communities must be engaged in a continuous process of health system improvement and priority setting -- a process that must be supported by geographically relevant data and analysis. This report is aimed at providing the evidence to support this process.
ReCAP 2009 9
South East LHIN
Regional Capacity Assessment & Projections
Although the overall projected LHIN growth is generally reflected 2. Facts and Figures across sub-LHIN areas, there are a few areas where the growth rates should be notably different: This section represents a summary of the highlights of the Increases: 45-64 years in Belleville (4% per year) and Regional Capacity Assessment and Projection (ReCAP) project and South Frontenac (5% per year); 65-74 in South was designed to accompany the summary of main findings and the Frontenac (10% per year) and Smiths Falls/Perth/Lanark ReCAP sector and sub-LHIN profiles. Included in this section are (5% per year); 85+ in Stone Mills Loyalist (14% per key results of the analysis on demographic and socio-economic year), Prince Edward County (6% per year) and South status, health status, health behaviours as well as the utilization East Leeds Grenville (4% per year); of hospital and community health services across the LHIN. Please Decreases: 0-19 in Central Hastings and North Hastings note the following: as well as 20-44 in Central Hastings, North Hastings, Unless otherwise mentioned, all years represented in this South East Leeds Grenville and Smiths Falls/Perth/Lanark report are for fiscal periods. all less than 4% per year; 85+ in South Frontenac (11% All projections are for the five-year period 2008-2012 per year) and Addington North/Central Frontenac (7% per and are primarily based on the growth of the population year). across all sub-LHIN areas. The rural areas such as Addington, North & Central Frontenac, Population South Frontenac, Quinte West, Tyendinaga, Napanee, Gananoque, In calendar year 2007, the South East LHIN, with a population of Leeds and Rideau Lakes have higher fertility rates when compared 481,000, was growing at a rate of 0.3% per year and expecting to to the more urban areas where most of the births occur to women grow slightly faster (0.6%) in the following five years. Compared between the ages of 20 and 29. In nearly all areas, the teen birth to the other LHINs in the province, the South East LHIN had the rates are approximately 20% or lower with Belleville as the only fourth slowest growth rate until the year 2007, but will move up exception where the teen birth rate is over 30%. to the fifth slowest between 2007 and 2012. During that five- year period, the Central West, Mississauga, North Simcoe Points 6 to 12 are based on the results from the 2006 Census of Muskoka and the Central LHINs will have the fastest population Population (Note that these estimates do not include any data growth rates while the North West, North East, Erie St. Clair and from Tyendinaga Mohawk Territory) Toronto Central LHINs will have the slowest growth. There is a higher percentage of in-migration in the 45-64 age Most of the population growth in the South East LHIN will occur in groups for Central Hastings, North Hastings, Prince Edward the 65-74 (3.5% per year) and 45-64 (2.8% per year) age groups County, Quinte West, Rideau Lakes, Smiths Falls, Perth, Lanark while the 20-44 (-1.8% per year) and 0.19 (-0.7% per year) age and South Frontenac. At the same time, there are substantial groups are actually expected to have reduced population population reductions in the 15-34 age groups as a result of out- estimates. Individuals 85+ are projected to increase by 0.6% per migration in all areas except Belleville, Brockville and Kingston & year, a rate that will produce very few additional individuals in this Islands. ‘very old’ age cohort. The most densely populated areas of the LHIN are Belleville (198 When examined by sub-LHIN planning areas, about one-quarter of persons per km2), Kingston & Islands (190 persons per km2), the population resides in Kingston & Islands followed by Quinte Quinte West (74 persons per km2) and Brockville (46 persons per West (11%) and Belleville (10%). All other sub-LHIN areas account km2). All other areas have less than 30 persons per km2. As a for 5% or fewer persons, except Brockville (8%), Smiths whole, the population density in the LHIN is 26 persons per km2, Falls/Perth/Lanark (8%) and Prince Edward County (6%). the third lowest among the 14 LHINs.
ReCAP 2009 10
South East LHIN
Regional Capacity Assessment & Projections
Socio-economic Status Aboriginal Population Belleville has the highest percentage of individuals 65+ living Data from Statistics Canada (e.g., the Census) and Indian and alone (31%) while Stone Mills Loyalist (17%) has the lowest. The Northern Affairs Canada (INAC) are used to describe the percentage for all other sub-LHIN areas range between 21%-30%. population characteristics. It must be noted that Census data undercount Aboriginal peoples in Ontario. For example, the Kingston & Islands (39%) and neighbouring South Frontenac (41%) difference between the INAC Registry counts and Census counts sub-LHIN areas have the lowest percentages of the 20+ is greater for Ontario (36.7%) compared to the rest of Canada population without a high school diploma. In contrast, sub-LHIN (22.4%). The use of multiple data sources provides a more areas in the north-western part of the LHIN (North Hastings, complete profile of Aboriginal populations within Ontario LHINs. Central Hastings, Addington, and North and Central Frontenac) as This approach is employed to produce adjusted estimates of the well as Tyendinaga, Napanee have the highest percentages total Aboriginal population. (>55%). In the South East LHIN there is officially only one reserve, The highest percentage and volume of individuals without english Tyendinaga Mohawk Territory of the Mohawks of the Bay of as their mother tongue was noted in Quinte West (17% or 9,000), Quinte. However, there is another reserve, the Mohawks of Kingston & Islands (16% or 19,100), South East Leeds & Grenville Akwesasne First Nation, that is primarily located in the Champlain (12% or 4,000) and Belleville (9% or 4,300). All other sub-LHIN LHIN with some lands along the St. Lawrence River that are co- areas had between 5%-10% of the population without english as located with South East LHIN, as well as crossing into the their mother tongue with the exception of North Hastings (4%). province of Quebec and across the border into the United States.
Although fewer residents of the South East are francophone (i.e., In the South East LHIN, there are 2,103 on-reserve and 5,514 off- claim french as their mother tongue) compared to the province as a reserve registered First Nation persons for the 2007 calendar whole, 11,290 people within the LHIN still have french as their period. This represents 4.5% of the overall total of Ontario’s mother tongue, representing 2.5% of the total population. These registered First Nations population. The LHIN has the seventh estimates have remained fairly stable over the last decade. highest registered First Nation population with North West and Francophones are mainly clustered in the Kingston and Trenton North East LHIN having the highest. areas and in rural communities along the eastern part of the LHIN. In some cases, language barriers can compromise their ability to North American (NA) Indians made up the largest proportion of have their health care needs met. those identifying as Aboriginal (56%) followed by those identifying as Métis (36%). The Métis population in the South East LHIN is The population in the north-west corner of the LHIN (North 6% greater than that of the province and is the fastest growing Hastings, Central Hastings and Addington, North & Central Aboriginal population group in the South East LHIN. Frontenac) has the highest percentage of people not in the labour force (>41%) as well as the lowest average annual household In 2007, 36.1% of the on-reserve registered population in the LHIN incomes (<$47,000). Interestingly, Prince Edward County also was younger than 20 years in comparison to 24.3% of the off- recorded a high percentage not in the labour force (41%) but one reserve registered population in the LHIN and 25.1% of the Ontario of the higher average annual household incomes ($56,000). Stone population as a whole. Consequently, the on-reserve population Mills Loyalist and South Frontenac areas have among the lowest has a smaller proportion of elderly persons (65+) compared to the percentage of the population not in the labour force and the off-reserve and overall Ontario population (6.8% on-reserve versus highest average annual household incomes. 9.8% off-reserve and 13.2% for the province). Since the First Nations population numbers are derived from registry data, it is possible that the youngest age groups are under-estimated because of incomplete registration of young children and newborns. Conversely, it is also possible that the oldest age ranges are over-estimated in these data because of the lag time
ReCAP 2009 11
South East LHIN
Regional Capacity Assessment & Projections between the death of an individual and their removal from the Overall adult obesity in the LHIN ranges between 17%-25% but is registry. noted to be increasing and higher in Hastings/Prince Edward PHU. In the LHIN, the prevalence of eating fruit and vegetables According to the 2006 Census of Population, excluding the correlates positively with age and is increasing in the 45-64 age Tyendinaga Mohawk Territory, the highest percentage of the group. population who identified as Aboriginals came from North Hastings (10%) and Addington North and Central Frontenac (7%). Primary Health Care Notwithstanding, most of the Aboriginal population still reside in (Data Source: Primary Care Health Survey and OHIP Approved Kingston & Islands (2,500), Belleville (1,400), Quinte West (1,400) Claims) and North Hastings (1,200). Although the North American Indian Between 2006 and 2008, the overall percentage of unattached still remains the majority among the Aboriginal population, the patients in the LHIN was 7.9%, but higher for males (9.8% versus Métis population is noted to be the fastest growing aboriginal 6.0% for females) and higher for younger adults (12.2% for 16-34 population in the South East LHIN. year olds, 9.5% for 35-49 year olds, and 3.4% for 50+ years). In fiscal 2007, there were approximately 327,100 patients visiting Health Status general or family physicians and they averaged 4.1 visits annually. (Data Source: Canadian Community Health Surveys) It is expected the number of visits will increase to approximately In 2007, the prevalence of arthritis was 15.0%, 31.0% and 52.1% 345,000 by 2012 – representing a 5% increase since fiscal 2007. in 18-44, 45-64 and 65+ age groups respectively; much higher for The conditions for which clients required medical care from 65+ in Leeds, Lanark, Grenville pubic heath unit (PHU) regions family/general physicians were mainly diseases of the circulatory than in the province. system, musculoskeletal system and/or mental disorders (mental The male population in the LHIN generally has a higher asthma disorders was particularly high in adult females 20-64). prevalence compared to the province. In 2007, diabetes prevalence in the LHIN is 4.3%, 27.4% and Emergency Department (ED) Visits 49.1% (and increasing) in the 18-44, 45-64 and 65+ age groups (Data Source: National Ambulatory Care Reporting System) respectively. Rates in Hastings/Prince Edward for both sexes 45- Most ED visits are for individuals 20-44 (32.1%). In other age 64 are significantly higher than the province and males 65+ are groups Kingston General Hospital (KGH) and Quinte Health Care significantly higher compared to the province. (QHC)-Belleville see more patients from the 45-64 age group while Overall, the prevalence of heart disease in the LHIN is 21.0% but it other institutions see more in 0-19 age group. is much higher for males 65+ in Hastings/Prince Edward PHU. On average, Lennox & Addington County General Hospital (L&ACGH), Perth Smiths Falls District Hospital (PSFDH)-Perth, Health Behaviours PSFDH-Smiths Falls, QHC-Bancroft and QHC-Picton Hospitals (Data Source: Canadian Community Health Surveys) register fewer than five ED visits between midnight and 6 am. In 2007, the prevalence of daily/occasional smoking in the LHIN Over 15% of ED visits (mainly upper respiratory conditions) that was 33.2%, 27.1% and 12.0% in the 18-44, 45-64 and 65+ age could be elsewhere managed were reported in PSFDH-Perth, groups respectively (and rates were noted to be increasing in both L&ACGH and QHC-Trenton. the 18-44 and 65+ age groups). The rate was particularly higher Between 14%-16% of transferred ED visits were less urgent or for 18-44 females in Hastings/Prince Edward and non-urgent. ED utilization rates are generally higher in all age Leeds/Lanark/Grenville Public Heath Unit (PHU) regions and 18-44 groups in the LHIN compared to those in the province. In 2007, males in Hastings/Prince Edward PHU. Notably higher smoking these rates are especially higher in Prince Edward County, Smiths rates were also observed in Leeds/Lanark/Grenville females 65+. Falls, Perth, Lanark and Tyendinaga, Napanee. Heavy drinking rates in the LHIN appear to be falling for younger adults 18-44 but increasing for adults 45+. Accounting only for growth in the population, ED visits are Generally the level of physical inactivity is decreasing in the LHIN expected to increase in QHC-Belleville and KGH (each by 1.0% despite relatively higher rates for the 18-44 population in annually). Slightly reduced visits are anticipated in QHC-Bancroft Hastings/Prince Edward PHU.
ReCAP 2009 12
South East LHIN
Regional Capacity Assessment & Projections and PSFDH-Perth. As a whole, the growth in the LHIN is projected at 0.4% per year. Occupancy rates for medical beds were usually between 93%-95% except for PSFDH-Smiths Falls (69%). Rates for medical/surgical Acute Inpatient Separations beds were typically within the 83%-88% range though QHC- (Data Source: Discharge Abstract Database) Trenton and L&ACGH recorded rates above 93%. KGH and QHC- In 2007, KGH (47%) and QHC-Belleville (24%) provided care to Belleville had surgical beds with occupancy rates of 87% and 71% almost 3 out of every 4 acute inpatient separations in the LHIN. respectively.
Larger institutions (KGH and QHC-Belleville) tend to care for more In most hospitals, the length of stay for patients receiving medical of a younger patient population: individuals less than 45 years care increases steadily with age from about 1-3 days for represented over 40% of separations compared to 8%-39% in the individuals 0-19 years to roughly 7-9 days for persons aged 85+. smaller institutions. Overall, the age distribution did not change by For surgical patients, KGH consistently recorded longer lengths of more than 2% in any age group between 2002 and 2007. stay (as anticipated due to its tertiary centre role) ranging from 4 days for 0-19 year olds to over 10 days for persons 85+. In the In 2007, medical separations was the largest service group, other hospitals, the lengths of stay were more variable the older particularly in the smaller institutions (47%-89%) compared to the patient. For example, most hospital stays were 1-3 days for (36%-41%) KGH and QHC-Belleville. Acute care for newborns and patients 0-19 years and 2-4 days for patients 20-44 years. Older obstetric separations (19%-32%) was only provided at KGH, QHC- surgical patients, those aged 65+, tended to have relatively longer Belleville and Brockville General Hospital. Less than 15% of stays in BGH, L&ACGH and PSFDH-Smiths Falls (6-12 days) than separations at PSF-Smiths Falls, QHC-Bancroft and QHC-Trenton other hospitals (4-9 days). were surgical cases. Similar trends were noted in the acute inpatient bed days by service categories. Compared to the province, older patients receiving medical care in the South East LHIN tend to have slightly shorter lengths of stay. When examined by program service groups, cardiology (13.3%), On the other hand, it was more common for surgical patients to obstetrics (11.8%), neonatology (11.0%) and orthopedics (7.9%) stay longer in South East LHIN hospitals than for the province as a accounted for the majority of acute separations followed by whole. pulmonary (7.5%), gastro/hepatobiliary (7.4%), general surgery (6.8%), trauma (4.9%) and general medicine (4.9%). Apart from KGH, which provided acute care to patients from all sub-LHIN areas, most institutions’ patients were from same sub- Ambulatory Care Sensitive Conditions (ACSC) is a measure of LHIN area or an adjacent one to the hospital. More than 75% of appropriate medical care assuming that prior ambulatory care patients residing in Prince Edward County, Tyendinaga/Napanee or would prevent the onset of certain conditions. In 2007, the Smiths Falls/Perth/Lanark depended almost equally on the two percentage of separations considered to be ACSC cases was closest hospitals while the majority of residents in Kingston and higher in QHC-Trenton, QHC-Picton and LACGH (>6%) but much surrounding areas visited KGH for acute care. Approximately 3 out lower in KGH and PSF-Perth (<3%). of every 4 acute care patients received treatment from either KGH (47%) or QHC-Belleville (24%). The majority of patients (69%) receiving acute care in the LHIN were treated and discharged without the need for additional care Compared to the province, utilization rates for acute care services although this percentage is higher for KGH and BGH. Separations was lower in the South East LHIN for all age groups, particularly requiring further care included 15% for home care, 6% for for individuals aged 75-84 years. Within the LHIN, acute care continuing care (comprising of complex continuing care, utilization rates for medical care were notably higher in Prince rehabilitation and long term care) and 4% for acute care in another Edward County, South East Leeds & Grenville and Smiths Falls, institution. At the provincial level, 74% of separations were Perth and Lanark. discharged without the need for home care, 11% with home care and 7% with continuing care.
ReCAP 2009 13
South East LHIN
Regional Capacity Assessment & Projections
Assuming that acute care utilization rates and market share for PSFDH-Perth, both of which recorded a higher percentage of ALC 2006 and 2007 and current occupancy levels stay in effect and days for males in 2007. accounting only for growth in the population, the expected annual growth rates for the number of separations in the LHIN are: 2.3% Over 50% of ALC separations are for patients aged 75 and over. for medicine, 1.4% for surgery, 4.5% for psychiatry and -0.3% to - For the 85+ population, the percentage was particularly high in 1.6% for pediatrics, newborns and obstetrics. Among the program 2007 at QHC-Bancroft and QHC-Trenton. service groups, cardiology (2.7%) and pulmonary (3.2%) are expected to grow faster than other services. The percent ALC days in the LHIN across all age groups stabilized or declined between 2006 and 2007. Provincially, the percent of Alternative Level of Care (ALC) ALC has increased across all age groups since 2005. Separations (Data Source: Discharge Abstract Database) The highest percentage (47%) of ALC days was attributable to The South East LHIN percentage of ALC days (ALC days as a patients waiting for transfer to continuing care institutions percentage of all acute inpatient days) declined slightly between (including complex continuing, rehabilitation and long-term care) 2006 (18.6%) and 2007 (17.3%) but remains higher than the particularly from QHC-Trenton and Bancroft sites and LACGH; provincial average (14.0%). The provincial average increased from while 23% were waiting for home care and approximately 14% 12.1% in 2006. died while designated ALC. For patients waiting for admission to continuing care facilities, almost one-half of their total acute To meet the South East LHIN target of ALC days (13% or less of inpatient days were ALC. total acute inpatients days in fiscal 2009) requires an estimated reduction of 25% in the current 45,000 ALC days (an estimated The average ALC length of stay was 24.6 days compared to the reduction of 11,315 days required). provincial average of 18.6 days – which represented a difference of 6 days. More than three-quarters of South East LHIN ALC In 2007, there were 1,842 separations from area hospitals that patients came through the Emergency Department. included an ALC component to the patient’s stay. KGH (653) and QHC-Belleville (573) accounted for the greatest number of ALC The average ALC daily bed utilization was greatest in October separations over the year. For other institutions, QHC-Trenton 2006 with over 160 ALC patients across South East LHIN (191) and BGH (131) had the highest numbers of ALC separations. institutions. Just about half of these patients were ultimately discharged to continuing care. There were substantial increases in the reported numbers of ALC separations between 2002 and 2007 at all hospitals except BGH and QHC-Picton. Lennox & Addington County General Hospital (23.1% annually), PSFDH-Perth (18.1% annually) and PSFDH- Smiths Falls (13.7% annually) exhibited particularly large relative increases in the numbers of ALC patients.
There was a large increase in the number of ALC days at QHC- Trenton between 2002 and 2007 (from 1,160 to 5,694 ALC days). Moderate increases were also observed in QHC-Bancroft, both PSFDH sites and LACGH. KGH and BGH had comparably lower numbers of ALC days in 2007.
Females typically account for the greater number of ALC separations and ALC days. Notable exceptions QHC-Bancroft and
ReCAP 2009 14
South East LHIN
Regional Capacity Assessment & Projections
In KGH, the majority (69%) of the oncology visits are for Day/Night Procedures chemotherapy treatments while most in QHC-Belleville are for Data Source: National Ambulatory Reporting System) follow-up treatment.
Surgical/PARR (Post Anesthetic Recovery Dialysis Procedures Room) Procedures KGH -- with over 40,000 visits annually -- is the only reporting In 2007, South East LHIN hospitals performed just under 54,000 institution in the South East LHIN that offers dialysis services. Surgical/PARR procedures; one-quarter of which took place at Hotel Dieu Hospital (HDH), one-fifth each occurred at BGH and About 58% of dialysis procedures are for male patients. Just over QHC-Belleville, one-eighth at KGH and 7% or less at each of the 1 in 3 dialysis procedures are for individuals 45-64 years, 27% for other institutions. persons 65-74 years and 20% for persons 75-84 years. Hemodialysis was the dialysis service offered to more than 99% of About 51% of Surgical/PARR procedures at South East LHIN individuals requiring dialysis. hospitals were for females; slightly higher percentages were recorded in HDH, KGH and QHC-Trenton. Radiation Treatments Radiation treatment is only provided at KGH with over 20,000 The 45-64 age group had the majority of Surgical/PARR treatments per year. The gender of radiation treatment patients is procedures (29%-49%), followed by the 20-44 and the 65-74 age split equally between males and females. groups, each accounting for about one-fifth of all procedures. Individuals 0-19 and 85+ represented 5% and 4% of all of these Nearly 3 of every 4 radiation treatments are for individuals aged procedures respectively. 45-74 years. Persons aged 20-44 and those 75+ represented 6% and 20% of radiation treatments respectively. In most South East LHIN hospitals, gastro/hepatobiliary, ophthalmology and urology are the main type of surgical Cardiac Catheterizations procedures performed. KGH was responsible for more specialized In 2007, more than 2,100 cardiac catheterizations were type of surgeries while PSFDH-Smiths Falls and QHC-Trenton had performed at KGH, the only institution offering this procedure. The more urology and ophthalmology respectively. majority (>60%) of which are provided to male patients.
Oncology Visits Most (44%) of the cardiac catheterizations are for persons aged In the South East LHIN, KGH (58%) and QHC-Belleville (40%) 45-64 while 28% are provided to individuals aged 65-74 and 20% accounted for most of the oncology visits during the 2007 fiscal to individuals 75-84. period. BGH and PSFDH-Perth were the only other institutions reporting oncology visits. Day/Night Procedures The age-sex utilization rate for day/night procedures in the South Overall, about 54% of oncology visits are for female patients; East LHIN is almost identical to that of the province with the QHC-Bellville sees proportionally more females than KGH. exception of dialysis in 75-84 year olds (lower in LHIN) and Surgical/PARR in 75-84 year olds (higher in LHIN). More than two in every five oncology visits are for patients aged 45-64 years, followed by those aged 65-74 (26%-34%) and 85+ Five-year projections for day/night procedures in the South East (10%-15%). In KGH, 9% (or almost 900) of oncology visits are by LHIN, based only on changes in population growth, indicate slow individuals 19 years or younger. average annual increases in the number of procedures/treatments for surgical/PARR (1.6%), dialysis (1.7%) and radiation (3.1%). Both the number of oncology visits and cardiac catheterizations will likely decline by about 1%.
ReCAP 2009 15
South East LHIN
Regional Capacity Assessment & Projections
Adult Inpatient Rehabilitation visits was the admission class reported as short stay making up about Data Sources: Management Information System (MIS) [more 62% of all admissions in 2006. accurate but no details] and National Rehabilitation Reporting System (NRS) [includes demographic and service details of clients] With the exception of KGH, rehabilitation bed days were mainly utilized for patients recovering from stroke related conditions Compared to MIS, the NRS totals are very similar for both (28%-52%) followed by pulmonary associated conditions (15%- rehabilitation admissions and bed days in all South East LHIN 33%). In KGH most of the bed days were used up by patients with hospitals with the exception of Providence Care and QHC-Belleville either debility related (35%) or orthopedic conditions (34%). Some (under-reporting admissions and days in 2006 and 2007). Note bed days (12%) were also required for medically complex that no data was recorded for KGH in 2007 (these data were likely conditions. included with acute inpatient data). Noticeable changes were observed in how rehabilitation beds were By the end of 2007, most rehabilitation admissions in the South used between fiscal 2003 and 2007. In almost all hospitals, there East LHIN were seen in Providence Care (>360) followed by KGH was a reduction in the percentage of stroke-related conditions but (183 in 2006), QHC-Belleville (147) and BGH (51). Rehabilitation a corresponding increase in orthopedic conditions. There was also bed days were also highest at Providence Care (>13,600), trailed a tendency to accommodate a wider variety of conditions including by QHC-Belleville with 5,800. KGH, which usually has shorter more brain dysfunctions. In 2003, about 90% of bed days were rehabilitation length of stays, had only 1,505 bed days (in 2006) utilized for debility conditions but in addition to these and while BGH reported 1,369 by the end of 2007. orthopedic conditions, KGH also focused on limb amputations, cardiac, pulmonary and medically complex conditions. For the most part, both admissions and bed days reflect similar trends between 2003 and 2007. BGH, Providence Care and QHC- Nearly all hospitals in the South East LHIN achieved set goals and Belleville recorded only minor fluctuations during the period but returned rehabilitation patients back to the community (66%-80% KGH showed significant reductions, particularly in the number or of bed days). In other instances, the goals were met but patients admissions (337 in 2003 to 183 in 2006). were transferred to another facility. In KGH 56% of bed days were utilized to meet set goals but for 42% of bed days the goals Between 2003 and 2007, there was a notable shift in the were not achieved before patients were transferred to another percentage of adult females utilizing rehabilitation services (54% facility. of bed days) compared to adult males (48%). This pattern was also observed in all of the reporting institutions except BGH (which Generally for South East LHIN hospitals, patients stay between actually recorded a higher percentage of utilization for females— 30-40 days in rehabilitation beds regardless of age group. For 38% in 2003 to 51% in 2007). patients under 45 years of age at Providence Care the length of stay was approximately 50 days while at KGH it was roughly 8 Females utilize more rehabilitation services when they are older days on average. while males do the same at younger age groups. For example, in 2007, females aged 75+ accounted for 54% of overall Since 2004, adult inpatient rehabilitation occupancy rates at rehabilitation bed days compared to males in the same age group Providence Care and BGH have been fairly constant ranging which only represented 37% of bed days. Across hospitals, between 70% and 85%. Towards the end of the 2007 fiscal females aged 75-84 used rehabilitation services most frequently period, however, the highest occupancy rates were seen at QHC- while males aged 45-64 recorded the most rehabilitation bed days. Belleville (94%) and the lowest in KGH (41%). Individuals aged 85+ still accounted for 22% and 11% of bed days in females and males respectively. For individuals over the age of 65 years, utilization rates for inpatient rehabilitation is lower in South East LHIN than in the The class of admission for the vast majority of rehabilitation cases province: < 5 per 1,000 for 65-74 and <9 per 1,000 for 75+ in in the South East LHIN was initial rehabilitation care. Only in KGH South East LHIN compared to >7 per 1,000 for 65-74 and >17
ReCAP 2009 16
South East LHIN
Regional Capacity Assessment & Projections per 1,000 for 75+ in Ontario. Utilization rates in the South East For the majority of South East LHIN hospitals, the main source of LHIN are similar for both sexes whereas at the provincial level CCC patients is from acute care units (>87%). In BGH and rates are higher for females. Providence Care, only 34%-52% reported acute care as the source of transfer, but since 44%-59% were either other or unknown Across the South East LHIN, utilization rates are usually below 10 sources, a much larger percentage from acute care is anticipated per 1,000 with the exception of Kingston & Islands and Stone for these institutions. Mills/Loyalist where rates are 10 or more per 1,000 for both males and females. In 2007, circulatory diseases were the most frequently assessed diagnostic condition (23%-28% across South East LHIN Projections for adult inpatient rehabilitation services, which have institutions) for CCC patients, followed by mental health (7%- been based only on changes in population growth, point to annual 17%) and musculoskeletal conditions (8%-18%). Cancer, increases of 6.1%, 2.8% and 3.88% in admissions, bed days and endocrine, nervous and respiratory conditions each represented beds respectively. between 2%-8% of all assessed conditions for this patient group, while all other conditions combined represented 22%-29%. Complex Continuing Care (CCC) Data Sources: Management Information System (MIS) [more Overall in 2007, 1 in 3 complex care bed days was provided for accurate but no details] and Continuing Care Reporting System clinically complex care, 1 in 5 for medium-level rehabilitation care, (CCRS) [includes demographic and service details of clients] and 1 in 6 each for low-level rehabilitation care or special care. These distributions, however, varied extensively among the South Between 2003 and 2007, the number of admissions from CCRS East LHIN hospitals. For the same period, more than 1 in 4 bed was generally similar to that of MIS; the only notable exception days in Providence Care and QHC-Trenton and 2 in 5 bed days in being Providence Care with an average of about 40 more PSFDH-Perth were associated with the provision of medium-level admissions in MIS than CCRS. During the same period, there were rehabilitation care. Bed days for clinically complex care amounted substantial differences in the number of bed days between both to 25% or less in Providence Care, PSFDH-Smiths Falls or QHC- systems, particularly in Providence Care (with about 17,000 fewer Trenton. Almost one-quarter of bed days in QHC-Belleville were days in CCRS) and BGH (CCRS falling short by about 8,000 days). provided to special care patients. Between 2003 and 2007, In the other sites, the gap decreased with time and only QHC- clinically complex care had a reduction of more than 6,000 bed Belleville reported any differences of more than 1,000 days days while medium-level and low-level rehabilitation care each between both systems by the end of 2007. As a whole, the MIS dropped by more than 3,000 bed days. recorded 1,028 admissions and 75,941 bed days in 2007. After utilizing most of the reported bed days for complex Overall, females utilize complex care services more than males; continuing care, almost all South East LHIN hospitals end up although the percentage associated with bed days has declined transferring patients to other institutions (41%-52% of bed days) slightly over time (females were 63% in 2003 to 59% in 2007). or patients become deceased (11%-40% of bed days). The only Incidentally, this percentage has been falling only in the larger exception is Providence Care where the majority of bed days institutions (64% in 2003 to 56% in 2007 for BGH, Providence conclude with patients being discharged home (38% in 2007) or Care and QHC-Belleville combined versus 61% in 2003 to 69% in deceased (34%). Like all of the other previous indicators, there are 2007 for LACGH, PSFDH-Perth and QHC-Trenton combined). also high percentages (21% overall) of bed days with an unknown discharge status. In 2007, more than 1 in 3 bed days for complex continuing care (CCC) across the South East LHIN were for elderly patients aged Between 2003 and 2007, the average length of stay for complex 75+. A quarter of all bed days in BGH were provided to individuals continuing care patients has been falling in the majority of aged 65-74 and one fifth assigned to patients aged 45-64 in hospitals — BGH by 27 days, Providence Care by 27 days, LACGH Providence Care. by 12 days, PSFDH-Perth by 38 days. QHC-Belleville was the only institution in the South East LHIN reporting either constant or
ReCAP 2009 17
South East LHIN
Regional Capacity Assessment & Projections increasing lengths of stay during the period (0-2 days). By the end divestment of cases at Providence Care into the community). of 2007, average length of stay at QHC-Trenton was recorded at Among institutions in the LHIN, HDH and QHC-Belleville recorded 56.5 days while that at other institutions ranged from 30-46 days. increases in both admissions and bed days while Providence Care and ROHCG-Brockville showed declines. Designated long-term Occupancy rates for complex continuing beds generally remained treatment (39%) and forensic treatment (16%), provided mainly by constant since 2003 with Providence Care and QHC-Belleville Providence Care accounted for more than half of all bed days in recoding 82%-93% and BGH, PSFDH-Perth and QHC-Trenton with 2007 while acute care by all other institutions represented about over 95% of available bed days. LACGH had the lowest 45% of all bed days. occupancy rates of all LHIN institutions (38% in 2007). The majority of mental health bed days were to adults 20-64 years Compared to the province, the South East LHIN has similar (80% overall in fiscal 2007). Note, however, that there were more utilization rates for complex continuing care services: marginally females aged 45-64 years compared to those aged 20-44 years fewer than 5 per 1,000 for patients aged 65-74 and just over 10 and conversely fewer males aged 45-64 years than those aged 20- per 1,000 for patients aged 75+. 44 years.
In a few Sub-LHIN areas, utilization rates are much higher for Home Care patients aged 75+. Belleville, Central Hastings and Quinte (Data Source: Home Care Database) West/Brighton all have rates above 20 per 1,000. Since 2005, here have been increases in the number of applications and assessments for home care services in the South Projections for complex continuing care admissions and beds in the East LHIN. By the end of the second quarter of 2008, the South South East LHIN have been generated based only on the East Community Care Access Centre (CCAC) received 6,709 assumptions of changes in population growth and current applications for home care services and conducted 6,686 utilization patterns. Between 2007 and 2012 the number of assessments. The next three quarters indicated a substantial admissions, bed days and beds are projected to increase annually reduction in the number of applications which would likely be by 2.9%, 3.0% and 2.4% respectively. One-third of the 21 matched by a corresponding seasonal drop in assessments. additional complex continuing beds in the five-year period would be required in Providence Care. Bed days in PSFDH-Perth are In calendar year 2005, total admissions matched the number of expected to increase annually by almost 10%. applications, but since the first quarter of 2006, admissions fell short of applications, reaching a difference of over 1,600 by the Adult Inpatient Mental Health end of Q3 2007. Data Sources: Management Information System (MIS) [more accurate but no details] and Ontario Mental Health Reporting The majority of applications to the South East CCAC are referred System (OMHRS) [includes demographic and service details of from hospital inpatient units (37%-42% since Q3 2007) followed clients] by the community or other individuals (15%-19%), GPs (12%-16%) and hospital outpatients (12%-13%). Most applications to the For the 2006 and 2007 fiscal periods, the number of admissions South East CCAC are assessed as eligible to receive some form of and bed days reported by both the MIS and OMHRS were service, though mainly in-home service (60%-68% in calendar relatively the same at Hotel Dieu Hospital and QHC-Belleville 2007). About 1 in 10 applications were deemed not eligible for Hospitals but notably different at Royal Ottawa Health Care Group services (not meeting the criteria was the most common reason). (ROHCG)-Brockville and Providence Care (under-reporting of bed days in OMHRS). The sub-LHIN distributions of applications and assessments by referral and eligibility categories largely mirror the distribution in For the two-year period, there was a 5% increase in the number of the LHIN as a whole. adult inpatient mental health admissions but matched by a drop of 4% in the number of bed days (most of which was as a result of
ReCAP 2009 18
South East LHIN
Regional Capacity Assessment & Projections
The number of South East CCAC admissions differs substantially poisoning and circulatory diseases. For males, most clients were by sex and age group. Overall more females (55%) utilize the assessed with neoplasm, then mental (mainly aged 0-19), services offered by the South East CCAC and even more for clients circulatory, musculoskeletal and injury and poisoning diagnostic aged 85+ (67%). Only 28% of the clients aged 19 or younger categories. were female. The majority of South East CCAC clients are elderly (66% are aged 65+) while just over a quarter are other adults and South East CCAC admission rates in the LHIN for individuals aged 8% are youths. 75+ were slightly higher than those in the province. Stone Mills/Loyalist and South East Leeds/Grenville had particularly Service goals vary largely by the sex and age group of clients. higher admission rates than other areas in the LHIN. Younger clients utilize more school-based services (proportionally more males) but older clients depend more on residential care and Projections for South East CCAC activity were generated using in-home maintenance (proportionally more females). In-home changes in population growth and assume that service activity rehabilitation care is used more by adults aged 45-64 than any rates remain constant until 2012. For the period 2007-2012 the other age group. Most of these patterns appear to be increasing annual growth in SE CCAC applications, assessments and with time. admissions is likely to only grow marginally by 1.8%-1.9%.
The average length of stay for South East CCAC admissions Long-Term Care appears to be declining with time, particularly in the younger (aged (Data Source: Long-Term Care Home System Report, MOHLTC – 0-19) by more than half between Q1 2005 and Q3 2007 and older monthly reporting January 2007 - May 2009) (65+) age groups (by more than a third in the same period). By the The overall demand (long stay residents and waitlist) for LTC beds end of Q3 2007, the average length of stay was under 100 days in the South East LHIN was estimated at approximately 5,200 in with the exception of males 0-19 (135 days on average). May 2009, which represents about 14% of the total population aged 75+. Compared to other LHINs, the South East LHIN has South East CCAC clients who are younger tended to have the third highest percentage for LTC demand behind the two completed the service plan and were discharged from the South northern LHINs. East CCAC. Although some of the older clients also completed their service plan, many others were admitted to long-term care Between January-June 2007, the number of LTC residents (LTC), hospitalized or died. These distributions may have been increased by about 12 persons per month but has only fluctuated under-reported because of an increasing number of admission within 3,730 - 3,755 since. By the end of May 2009, LTC records in the youngest and oldest age groups that did not contain residents accounted for 75% of the total LTC demand. any discharge information. Similarly, the number of persons on the LTC waitlist had been In 2007, most South East CCAC clients received either nursing increasing at about 18 individuals per month to reach 1,865 by services or case management visits (>10,000 visits) followed by June 2007, but has remained basically flat since, ranging between occupational therapy, physiotherapy or personal support/home 1,860 and 1,880 persons. Generally the majority of persons on making services (>4,700 visits). the wait list are female (67%), indicated municipal (56%) or for- profit (36%) as their first choice, was assessed as Priority 3 (67%) Older clients (65+) generally received more case management, or Priority 2 (30%). For most of the reporting period, 25-37 nursing, personal support/homemaking or respite services while the persons were waiting in Priority 1B, 20-30 in Priority 1A1 and younger clients (<20 years) received occupational and speech <10 in Priority 1A. therapy and nursing shift support. Other clients mainly utilized nutrition, physiotherapy and social work services. The current LTC bed supply stands at 3,760 (past increases were only in July 2007 – 28 beds, and February 2007-10 beds). By The main diagnostic conditions assessed to South East CCAC May 2009, the South East LHIN bed supply by sector was: 2,008 female clients were musculoskeletal, then neoplasm, injury and For-profit homes (53%), 1,360 Municipal homes (36%), 410 Non-
ReCAP 2009 19
South East LHIN
Regional Capacity Assessment & Projections profit homes (11%). By type, the supply is 1,774 basic homes institution in the sub-LHIN. At least two agencies mainly serve two (48%), 997 semi-private homes (26%), 994 private homes (25%), or more sub-LHIN areas. 45 interim homes (1%) and 18 short-stay homes (0.5%). There are no convalescent care beds in the South East LHIN. Utilization The age group with the highest percentage of individuals (30% rates for LTC beds are all in excess of 97.5%. overall) requiring transportation are typically aged 75-84 years. One notable exception is Community & Primary Health Care Lanark For individuals who were placed into LTC homes, 40%-50% Leeds and Grenville (LLG) which had about one-third of individuals received their first choice, 20%-30% received their second choice, receiving transportation services falling in the 45-64 years of age and 20%-30% their third choice. The time to placement was cohort. For the most part, 1 in every 4 individuals using about 100 days, just over 100 days or about 150 days for first, transportation services is aged 85+. second and third choice respectively. By type, placement times have remained steady at about 100 days in for-profit homes but Unlike Meals on Wheels, transportation is more restricted to the slightly shorter in non-profit & charitable homes. At 119 days, residence of the individual. The only noteworthy institutions the South East LHIN has the third longest placement times among servicing more than one sub-LHIN are Addington, North and all LHINs in the province. Central Frontenac and Brockville. A few institutions likely had a large percentage of missing residence codes in their reported data The length of stay in a South East LHIN LTC home ranged between which could account for the low representation in some areas. 2.6 to 2.8 years between January 2007 and May 2009. As with Meals on Wheels, the rate (per 1,000 population) for Community Support Services clients receiving transportation increases with age. (Data Source: Management Information Systems (MIS) and Agency Management Databases) Diners Club / Meals to Wheels / Congregate Dining are available Community Support Services (CSS) include home support services from the majority of home support agencies. – volunteer based; Alzheimer education; palliative care (life threatening or terminal illness); specialized services (acquired brain Until 2007, utilization of other home support services has usually injury services, attendant outreach, assisted living services in remained constant with the exception of only a few cases. supportive housing, services for seniors who are blind, hearing care counselors for seniors. Specialized Community Support Services The number of referrals for attendant outreach services in the Home Support Services-Volunteer Based LHIN is continuing to increase with time: most of the referrals to About half of CSS institutions see more individuals aged 85+ Providence Care, increasing at a rate of 0.6 persons per month while others generally care the most for those aged 75-84. More since April 2006; more recently the waiting lists at the other recently, the Victorian Order of Nurses (VON) is providing specialized agencies (March of Dimes and Cheshire Homes) were additional care to younger age groups, especially persons 45-74 noted to be increasing by 0.8 to 1.1 persons per month within the years. About one-quarter of meals are provided to individuals less last 3 quarters of 2007. than 75 years of age. Meals on Wheels are distributed to individuals in all sub-LHIN areas Generally March of Dimes and Providence Care serve more clients and generally by the institution that is closest. Individuals in a aged 45-64 (>60%), while Cheshire Homes attend to just about few sub-LHIN areas (Central Hastings & Addington, North and the same number of clients age 45-64 as they do age 19-44 (35- Central Frontenac) receive proportionally more per capita of this 37%). Overall around 11% of clients receiving attendant outreach service than other areas. services are aged 65-74 and 6% are over the age of 75.
Compared to the sub-LHIN populations, Meals on Wheels are Clients who receive attendant outreach were reported to reside in supplied more to individuals aged 85+ and usually by one all sub-LHIN areas except Addington, North and Central Frontenac. Comparatively, more clients reside in Kingston & Islands and
ReCAP 2009 20
South East LHIN
Regional Capacity Assessment & Projections
Belleville areas. Services are usually provided by the institution Palliative Care within the county of the client. Between 2004 and 2007, the number of clients who were provided with volunteer hospice visiting service remained generally Overall in the South East LHIN, the number of individuals aged constant for the majority of institutions in the LHIN. 65+ with disabilities is expected to increase from over 19,500 in 2007 to around 21,000 by fiscal 2012. Most of the increase for Although with wide fluctuations, most institutions provide 20 or this population is expected for individuals aged 65-74 (3.5%) fewer hours of volunteer hospice visiting service per client. At followed by those aged 75-84 (1.4%) then those aged 85+ least two agencies, however, provide between 25-50 hours on (1.1%). average.
For the most part, this growth is also reflected within sub-LHIN The prevalence rates for selected diseases in the population aged areas, though more than normal increases are expected in South 65+ for cancer, chronic obstructive pulmonary disease, asthma Frontenac while only slightly more individuals are projected in and emphysema are all relatively flat and lower than 10%. The Addington North and Central Frontenac, Central Hastings & Prince rate for heart disease, which dropped since 2003, has leveled at Edward County. about 20 in every 100 persons.
Alzheimer Education Services Between 2001 and 2005, mortality rates have remained constant Fewer than 7,000 individuals in the South East LHIN received for most diseases except ischemic heart disease (declining by Alzheimer education in 2007, representing a reduction of about roughly 1 in every 100,000 persons). 900 individuals requesting these services in the previous three years. Most of the decline was attributed to fewer individuals Community Health Centres attending the Belleville/Hastings and Prince Edward County sites. (Data Source: Individual Community Health Centre [CHC] Individuals served at the other sites remained relatively constant Management Database) during the period. The majority of encounters in 2007 to LHIN CHCs were for nurses (43,000 or 39%) followed by physicians (36,000 or 30% and In spite of the decline in the number of individuals, the number of nurse practitioners (17,000 or 16%). Other types of encounters hours of Alzheimer education has been steadily increasing, were made to social workers, nutritionists, health counselors, reaching just over 4,100 hours overall or an annual rate of chiropodists and therapists. increase of 10.1%. Much of this growth was as a result of increases at the Kingston and Leeds-Grenville sites, both providing Among the LHIN CHCs, most of the encounters occurred in 22% more hours of service annually since 2005. Contrary to the Gateway CHC (32,000 or 30%) then Merrickville District decrease in total individuals indicated above, some of the growth Community Health Service Centre (30,000 or 27%), Kingston CHC was also observed at the Belleville-Hastings site, which reported a (25,000 or 22%) and Country Roads CHC (24,000 or 21%). 12% annual increase in the last four years. All CHCs, except Kingston CHC, had 38%-49% nurse encounters, Dementia cases (Alzheimer’s disease representing about 75% of 30%-33% physician encounters and 11%-15% nurse practitioner these cases) is projected to grow the fastest in the 85+ encounters. Kingston CHC had 19%, 24% and 23% of encounters population, particularly in the Frontenac, Leeds & Grenville and to nurses, physicians and nurse practitioners respectively. Hastings (>3.5% annually) counties which also have the most cases in the LHIN. Marginal growth is projected for Lanark and About 58% of all nurse encounters were from female clients Prince Edward counties (<3.2%). (Kingston CHC had 69% and other CHCs 57%). For physician encounters 59% were female (Kingston CHC had 66% and other CHCs (55%-60%). Nurse practitioner encounters were mainly from female clients (67%, although only 61% for KCHC and >70% from other CHCs.)
ReCAP 2009 21
South East LHIN
Regional Capacity Assessment & Projections
Addictions Services Approximately 51% of nurse encounters came from clients aged (Data Source: Drug and Alcohol Treatment Information System 20-64, while 40% were from clients aged 65+ and 9% under the [DATIS]) age of 20. Kingston CHC had a somewhat different profile from the other CHCs with proportionally more clients aged 20-64 (58% Substance Abuse vs. 53% or less respectively) and less aged 65+ (31% vs. >39% respectively). Over the last five-year period, the number of open admissions (carryover and new) for substance abuse in the South East LHIN For physicians, the overall percentage of encounters from clients increased from over 7,600 in 2004 to 8,200 in 2006 before 20-64 years of age was 58%, 65+ was 32% and <20 was 10%. dropping to 7,400 in 2008. Kingston CHC had a much higher percentage of encounters from clients aged 20-64 (68% vs. 63% or less) and proportionally fewer Annually new admissions for substance abuse represented clients aged 65+ (16% vs. 29 %). between 69%-79% of all open admissions during the period.
Overall about two-thirds of client encounters to nurse practitioners Most of the open admissions within a year were made up of either were from individuals between the ages of 20 and 64 while a an initial assessment/treatment (25%-29%), community treatment quarter were from youths under the age of 20 and 13% from (27%-28%) or case management (19%-23%). Less than a quarter those aged 65+. Kingston CHC had proportionally more of all open admissions required residential services including encounters from clients aged 20-64 (75%) and Merrickville District withdrawal management (16%-19%) or treatment (6%-7%). Community Health Service had proportionally more youths (39%). Although the majority of open admissions for substance abuse The average number of encounters per client was very similar were for individuals aged 35-54 years (43%-46%) considerable across all CHCs with the exception of those from males to nurse service was also needed for the younger population including those practitioners, which was higher than normal in Kingston CHC. aged 25-34 (23%-25%), 16-24 (19%-21%) and even youths younger than 15 years (3%-5%). There was an increase in the rate of encounters in the 75-84 age range for Central Hastings and Rideau Lakes sub-LHIN areas. Other important statistics for substance abuse admissions in 2008 were: Most of the services offered by CHCs are provided only to clients Males accounted for 70% of open admissions in areas within or adjacent to the sub-LHIN area of the CHC. Geographically - Frontenac (41%), Hastings (22%), Leeds/Grenville (14%), Lanark (7%) and Lennox & Addington The rates for encounters by sub-LHIN were higher in Rideau Lakes (7%) made up almost 85% of all admissions. & Central Hastings than in Smiths Falls, Perth, Lanark and The main drugs for which treatment was required Kingston & Islands, particularly in the population aged 65+. included alcohol (69%), cannabis (34%), cocaine (23%), tobacco (20%), prescription opiates (16%) and crack (11%). Projections for CHC services assume that increases are based Most admissions were made by individuals themselves mainly on changes in population growth and that utilization rates (49%) while others were usually referred by legal authorities remain constant until 2012. Encounters are projected to grow by (17%), addiction agencies (11%) or family members (9%). 1.2% for physicians, 1.0% for nurses and 0.2% for nurse practitioners. The number of clients is expected to growth at a Problem Gambling much slower pace: for physicians and nurses (0.8%) but marginally By the end of 2008, there were 310 open admissions for problem faster for nurse practitioners (0.4%). gambling in the South East LHIN, representing a drop of about 60 in the previous three years.
ReCAP 2009 22
South East LHIN
Regional Capacity Assessment & Projections
The percentage of new admissions for problem gambling has declined from over 75% in 2004 to less than 50% in 2008. A few other statistics on problem gambling in 2008 follow: Males represent 59% of open admissions During the course of the year, most of the open admissions would Frontenac, Hastings, Lanark, Leeds and Lennox & usually have received an initial assessment (34%-40%) or some Addington account for 54%, 19%, 15%, 8% and 5% form of community treatment (28%-42%). Slightly fewer respectively. admissions (20%-33%) would also have received case The main sources of income for problem gambling management services. admissions were normal employment (58%), family support (12%) and retirement income (7%). As with substance abuse, the majority of open admissions for More than half of the admissions were made by problem problem gambling were aged 35-54 years (43%-57%) but some gamblers themselves while 14% were referred by family are also younger (in 2008 19% 25-34 years of age, 12% 15-24 members, 6% from psychiatric/hospital services and 5% years, 2% were younger than 15 years). Only 7% of open through the legal system. admissions were aged 65+ in the same period.
ReCAP 2009 23
South East LHIN
Regional Capacity Assessment & Projections
ReCAP SECTOR Profiles
Emergency Department Profile Acute Inpatient Separations Profile Alternate Level of Care Profile Day/Night Procedure Profile Adult Inpatient Rehabilitation Profile Complex Continuing Care Profile Home Care Profile Community Support Services Profile Community Health Centre Profile Health Human Resource Profile Mental Health Profile (Coming, November 2009) Long-Term Care Profile (Coming, November 2009) Addictions Profile (Coming, November 2009)
ReCAP Sub-LHIN Profiles Addington, North & Central Frontenac Belleville Brockville Central Hastings Gananoque, Leeds Kingston & the Islands North Hastings Prince Edward County Quinte West Rideau Lakes Smiths Falls, Perth & Lanark South East Leeds & Grenville South Frontenac Stone Mills, Loyalist Tyendinaga, Napanee
ReCAP 2009 24
South East LHIN QHC-Ban QHC-Ban Version I - June 2009 PSF-P PSF-SF South East Local Health Integration Network
BGH Emergency Department Profile
KGH HDH QHC-Bel LACGH QHC-Tren Introduction: ED Visits by Institution & Age Group (2002/2007) QHC-Pic The Regional Capacity Assessment Project (ReCAP) provides a profile, including short-term projections, on the 60,000 Fig 1.1 utilization of health care services in the South East 85+ LHIN. Results of ReCAP are used to support the 75-84 recommendations in the Integrated Health Service Plan for the South East region. This short report on Emergency 50,000 65-74 Department (ED) visits is one in a series of summary 10 % 45-64 analyses from ReCAP that focuses on specific health care services. In the South East LHIN there are 9 institutions 9% 10 % 20-44 that provide comprehensive emergency care and one 40,000 5% 8% 0-19 institution that operates as an urgent care centre; 3 out of 7% 10 % 8% 9% the 10 institutions (KGH, QHC-Bel and HDH-UCC) are 4% 21% considered large EDs while the remaining 7 are small EDs. 6% 9% 30,000 24% 20% 24% Summary of Main Findings: 21% 7% 8% • Regardless of the year or type of institution, most visits to 23% 7% 9% 9% 10 % the ED are for individuals aged 20-44 years. For other age 9% 7% 7% 8% 8% 10 % 8% 9% 9% 23% groups, KGH and QHC-Bel have proportionally more visits 20,000 8% 36% 8% 8% 20% 8% 25% 9% from the 45-64 age group, while the other institutions see 40% 21% 21% 35% 9% 20% 24% 41% 33% 7% 25% 22% 10 % proportionally more of the 0-19 age group. Between 16- 25% 7% 10 % 32% 25% of ED visits originate from those persons aged 65+. 19 % 8% 25% 32% 31% 29% 27% 25% 9% 34% 10,000 34% 32% 30% 31% 26% 29% • Smaller institutions (LAGH, PSF-P, PSF-SF, QHC-Ban and 31% 28% 27% QHC-Pic) registered less than 5 ED visits on average 28% 25% 27% 22% 20% 22% 18 % 30% 32% 26% 27% 26% between midnight and 6:00am. All institutions registered 27% 26% 33% 26% 28% 21% 29% 27% 25% 9+ ED visits during morning, afternoon or evening 0 periods. 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 • Of those institutions providing comprehensive BGH HDH-UCC KGH LACGH PSF-P PSF-SF QHC-Ban QHC-Bel QHC-Pict QHC-Tren emergency care, a higher percentage of visits that could Fig 1.2 be managed elsewhere (>15%) were reported in QHC- Percentage of All ED Visits for South East LHIN & Ontario (2007) Tren, PSF-P and LAGH. The only institutions in the LHIN Indicator Category SE LHIN Ontario Major Ambulatory Cluster SE LHIN Ontario with less than 10% of this type of visit were BGH and KGH. Upper respiratory conditions (4-10%) accounted for <1 2.3% 2.2% Trauma, Coma & Toxic Effects 19.9% 21.0% the majority of these ED visits followed by otitis media 1-19 23.3% 21.9% Ear, Nose, Mouth & Throat 11.8% 9.9% and cystitis. HDH-UCC, operating as an urgent care centre, 20-44 31.1% 33.4% Skin & Subcutaneous Tissue 10.7% 9.5% recorded almost 20% of visits that could be managed Age Group 45-64 23.2% 23.3% Digestive System 9.7% 10.8% elsewhere - though some of these visits could be 7 65-74 8.6% 8.0% Medical Exam 7.6% 7.1% considered appropriate for this institution.
75-84 8.0% 7.7% Muskuloskeletal System 7.2% 6.6% • A large percentage of ED visits end up being treated and 85+ 3.5% 3.5% Respiratory System 6.3% 6.1% discharged (75-94%). In the larger institutions (KGH, QHC- Admitted 7.3% 9.5% Circulatory System 6.2% 6.8% Bel and BGH) 9-17% of ED visits resulted in an admission Disposition Discharged 86.3% 84.4% Kidney & Genitourinary Tract 5.5% 5.5% while 5-6% left or receive incomplete treatment. Visits that could be Nervous System 4.6% 5.0% 13.9% 13.4% • The number of transferred ED visits usually increased Managed Elsewhere 7 Mental Disease & Disorders 3.0% 3.8% between 2002 & 2007, particularly in KGH (reaching 4,000) Fig 1.3 Age-specific ED Utilization Rates and QHC-Bel (reaching 1,500). Despite most being urgent Legend: or more serious visits, KGH, QHC-Bel and BGH still had 14- (per 1,000) by Sex (2007) 16% of ED transfers that were less urgent or non urgent. 8 BGH-Brockville General Hospital Age Group SE LHIN Ontario • When compared to the province, ED utilization rates in HDH-UCC-Hotel Dieu Hospital-Urgent Care Centre <1 1,555.3 837.1 the South East LHIN are substantially higher in all age 1-19 676.3 383.3 groups, especially for infants under 1 year (>1,500 per KGH-Kingston General Hospital 20-44 659.9 413.1 1,000). At the SubLHIN level notably higher rates were observed in North Hastings, Prince Edward County, Smith LACGH-Lennox & Addington County General Hospital Female 45-64 502.1 368.8 Falls/Perth/Lanark and Tyendinaga/Napanee. 65-74 546.4 466.0 PSF-P-Perth & Smiths Falls Hospital-Perth 75-84 781.1 659.1 • The largest annual growth in unweighted ED visits PSF-SF-Perth & Smiths Falls Hospital-Smiths Falls 85+ 982.9 866.1 between 2007 and 2012 are expected in QHC-Bel and KGH (both at 1.0%) whereas 3 institutions (PSF-P, PSF-SF QHC-Ban-Quinte Health Care-Bancroft <1 1,699.8 964.7 and QHC-Ban) are likely to receive less visits. Overall, 1-19 667.8 407.3 unweighted ED visits in the LHIN is projected to grow QHC-Bel-Quinte Health Care-Belleville 20-44 545.6 358.6 marginally by 0.4%. Although similar trends are observed, Male 45-64 481.3 374.1 slightly more resource demands would be expected QHC-Pic-Quinte Health Care-Picton during the same period. The annual growth in the 65-74 596.9 509.9 QHC-Tren-Quinte Health Care-Trenton weighted visits indicate at least a 1.2% increase for KGH 75-84 936.6 729.1 and QHC-Bel and 1.0% for BGH. As a whole the S E LHIN is SE LHIN-South East Local Health Integration Network 85+ 1,164.2 1,000.7 projected to have a 0.8% growth in weighted visits. 9
Please send any questions or comments to: [email protected] Page 2 of 4 DRAFT South East Local Health Integration Network
Emergency Department Profile
Average Number ED Visits by Institution & Time of Day Percent of ED Visits that Could be Managed Elsewhere 7 (2007) (2007) 50 25% Fig 1.4 Fig 1.5 12:00 am-5:59 am 6:00 am-11:59 am 12:00 pm-5:59 pm 6:00 pm-11:59 pm Upp. Resp. Infections Otitis Media Cystitis Conjunctivitis 40 20%
30 15% 11%
37 10 % 10 % 45 10 % 34 9% 41 10% 20 36 7% 28 26
23 30 22 31 3% 27 6% 26 6% 19 26 19 4% 25 5% 21 3% 3% 3% 21 20 14 5% 2% 10 19 19 3% 17 19 18 16 4% 16 1% 1% 1% 13 13 2% 1% 3% 2% 3% 10 2% 9 2% 2% 2% 7 1% 7 2% 4 2% 1% 44 1% 1% 1% 1% 1% 2 3 0% 0 BGH KGH BGH KGH PSF-P PSF-P LACGH PSF-SF LACGH PSF-SF QHC-Bel QHC-Pic QHC-Bel QHC-Ban QHC-Pict HDH-UCC QHC-Ban HDH-UCC QHC-Tren QHC-Tren ED Visits by Institution & Major Ambulatory Cluster ED Visits by Institution & Disposition (2007) (2007) 50,000 50,000 Fig 1.6 Fig 1.7 Other Other Trauma/Coma 2% Admitted 45,000 Skin/Breast 45,000 Discharged 10 % Respiratory Incomplete/Client Left Nervous 4% 17% 40,000 40,000 7% Musculoskeletal 2% Mental 7% 21% 12 % 35,000 Med Exam 35,000 22% Kidney/Related E/N/T 20% 4% 30,000 Digestive 30,000 3% 1% 7% 7% 4% 7% Circulatory 4% 14 % 11% 4% 25,000 7% 19 % 25,000 7% 18 % 2% 6% 9% 4% 9% 2% 4% 7% 6% 5% 22% 5% 91% 20,000 13 % 11% 20,000 75% 2% 4% 8% 19 % 19 % 6% 7% 5% 6% 80% 8% 5% 7% 5% 19 % 15,000 13 % 11% 15,000 7% 6% 8% 8% 3% 88% 8% 7% 94% 8% 6% 12 % 7% 6% 5% 82% 7% 18 % 7% 9% 92% 5% 7% 9% 10,000 90% 10,000 11% 8% 6% 90% 8% 8% 6% 13 % 9% 11% 14 % 93% 10 % 16 % 12 % 5,000 15 % 16 % 10 % 5,000 16 % 10 % 8% 15 % 9% 10 % 9% 7% 8% 8% 6% 8% 6% 5% 3% 6% 5% 0 0 BGH KGH BGH KGH PSF-P PSF-P LACGH PSF-SF LACGH PSF-SF QHC-Bel QHC-Bel QHC-Ban QHC-Pict QHC-Ban QHC-Pict HDH-UCC HDH-UCC QHC-Tren QHC-Tren
48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 Phone: 613-967-0196 Fax: 613-967-1341 DRAFT Page 3 of 4 South East Local Health Integration Network
Emergency Department Profile
ED Visits treated at SE LHIN Institutions by Triage Level & Transfer Status 8 (2002/2007) Not Transferred, Treated at Presenting Institution Transferred from All Other Institutions Fig 1.8 Fig 1.9 I Resuscitation II Emergent III Urgent IV Less-urgent V Non-urgent I Resuscitation II Emergent III Urgent IV Less-urgent V Non-urgent 50,000 4,000 4% 14 %
40,000 8%
15% 3,000 46% 35% 20% 10 % 30,000 48% 41% 6% 6% 67% 2,000 56% 8%
61% 46% 20,000 25% 21% 33% 54% 71% 11% 63% 58% 14 % 50% 11% 42% 69% 60% 72% 39% 44% 46% 44% 33% 50% 47% 1,000 22% 10,000 42% 62% 48% 35% 24% 29% 15% 24% 49% 49% 32% 15% 27% 31% 24% 33% 28% 33% 25% 41% 61% 12 % 20% 22% 46% 12 % 11% 12 % 25% 58% 13 % 7% 11% 13 % 31% 24% 5% 26% 47% 5% 48% 18 % 45% 41% 56% 58% 60% 61% 0 0 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 BGH HDH-UCC KGH LACGH PSF-P PSF-SF QHC-Ban QHC-Bel QHC-Pic QHC-Tren BGH HDH-UCC KGH LACGH PSF-P PSF-SF QHC-Ban QHC-Bel QHC-Pic QHC-Tren
Fig 1.10 SE LHIN Distribution of ED Visits for SE SubLHIN areas by Emergency Department QHC-Belville SE LHIN Emergency Department (2007) QHC-Trenton
QHC-Picton North Hastings QHC-Bancroft Smiths Falls / Perth / Lanark Addington / PSF-Smiths Falls N&C Frontenac PSF-Perth
LACGH Rideau Lakes KGH SE Leeds / Central Grenville HDH-UCC Hastings South Frontenac BGH Brockville Stone Mills / Loyalist
Gananoque / Overall Distribution Tyendinaga Leeds of ED Visits for SE LHIN Belleville / Napanee Quinte West / 9% 14% Brighton Kingston & Islands 14% 10%
Prince Edward 7% County Distribution of ED Visits by 16% residents from outside 5% South East LHIN 8% 8% 10%
Please send any questions or comments to: [email protected] ED Visits for SE LHIN Residents ED Visits to SE LHIN Institution DRAFT by LHIN of Institution (2007) by LHIN of Residence (2007) Page 4 of 4
SE LHIN Institution SE LHIN Resident 20,343 Other LHIN Institution 19,757 Other LHIN Resident (7.1%) (6.9%) South East Local Health Integration Network (LHIN)
Emergency Department Profile 264,669 264,669 (92.9%) (93.1%) Fig 1.11 Age-specific ED Utilization Rates (per 1,000) by Sex and SubLHIN11 (2007) Fig 1.12
Fig 1.13 Reported and Projected ED Visits by SE LHIN Institution & Year 9-14 Unweighted Count 9 Weighted Count9
Institution Name Reported Projected Average Annual Reported Projected Average Annual Growth (%) Grow th (%) 2007 2012 2007-2012 2007 2012 2007-2012 Brockville General Hospital 24,726 25,141 0.3 1,230 1,277 0.8 Hotel Dieu Hospital-Urgent Care Centre 40,872 42,432 0.8 1,554 1,621 0.8 Kingston General Hospital 45,565 47,936 1.0 2,883 3,080 1.3 Lennox & Addington County General Hospital 21,665 22,069 0.4 875 905 0.7 Perth & Smiths Falls District Hospital-Perth 28,115 27,629 -0.3 1,031 1,022 -0.2 Perth & Smiths Falls District Hospital-Smiths Falls 22,959 22,451 -0.4 861 852 -0.2 Quinte Healthcare Corporation-Bancroft 13,638 12,620 -1.5 497 462 -1.5 Qunite Healthcare Corporation-Belleville 38,648 40,660 1.0 2,016 2,139 1.2 Quinte Healthcare Corporation-Picton 19,157 19,269 0.1 746 769 0.6 Quinte Healthcare Corporation-Trenton 29,081 29,914 0.6 1,207 1,269 1.0 South East Local Health Integ ration Network 284,426 290,119 0.4 12,899 13,397 0.8 General Notes and Limitations: Notes on Projections of Utilization of ED Visits : 1. Data Sources: National Ambulatory Care Reporting System (NACRS) and Population 9. Two types of projections are presented in this profile: unweighted (the actual estimates - Provincial Health Planning Database, MOHLTC. number of ED visits) and weighted (according to the Comprehensive Ambulatory 2. Population projections at the SubLHIN level were generated by the South East LHIN Classification System [CACS] 2006/07 Resource Intensity Weights [RIW]). based on cohort component methodology. Weighted visits adjust for diagnosis, age, gender, intervention, visit disposition, and anesthetic technique 3. ED visits in the SE LHIN exclude visits to the HDH-UCC Children Outpatient Centre. 10. Projections of the health care utilization are primarily based on changes in popu- 4. ED visits are reported for completed/discharged cases only. lation growth (including mortality, fertility and migration). 5. HDH-UCC registers patients between 8.00 am and 10.00 pm ; its closing time varies 11. Market share and utilization rates for 2007 are assumed to remain constant until between 11.00 pm and "open for 24 hours”. 2012. Note that all utilization rates for 2007 by region, sex and age group are 6. All estimates are reported for fiscal periods, e.g. 2007 is April 2007 - March 2008. based on 50 or more ED visits. 7. The computation of percentage of ED visits that could be managed elsewhere exclude 12. South East SubLHIN, sex and age group (0-19, 20-44, 45-64, 65-74, 75-84, 85+) individuals less than 1 year or greater than 74 years; CTAS levels 1, 2 or 3; or planned visits. are assumed to be independent strata. ED visits that could be managed elsewhere include visits for conjunctivitis, cystitis, otitis 13. Projections of health care utilization do not incorporate program realignments media and upper respiratory conditions (e.g. common cold, acute or chronic sinusitis and or enhancements, changes in service demand, technological or clinical develop- tonsillitis, acute pharyngitis, laryngitis or tracheitis, and other upper respiratory infections). ments, or changes in disease prevalence. 8. Transferred patients treated at SE LHIN EDs include visits originating from other 14. At the time of this publication preliminary data for fiscal 2008 pointed to greater emergency departments, chronic care, home care, long term care or mental health than expected growth in HDH-UCC. Future updates of this report will aim to institutions. incorporate other factors that influence the utilization of visits to this institution. DRAFT QHC-Ban Version I - July 2009 South East Local Health Integration Network
Hospitals Health Human Resources Profile
Distribution of Physicians by SubLHIN Area (2009) 4, 5 Fig 10.1 Introduction: The Regional Capacity Assessment Project (ReCAP) provides a profile, including short-term projections, on the utilization of health care services in the South East LHIN. Results of ReCAP are used to support the recommendations in the Integrated Health Service Plan for the South East region. This short report on Health Human Resources is one in a series of summary analyses from ReCAP. This report will begin by looking at physicians and nurses as a whole across the region and then provide sector specific information on hospitals, mental health and addictions, community support services and volunteers. Family Physicians Summary of Main Findings:
• Family Physicians are represented in each SubLHIN area.
• The majority of specialists are concentrated near one of Specialists the hospital sites (Belleville, Napanee, Kingston, Perth/ Smith Falls, Brockville)
• In 2007, 37% of the family medicine physicians were over the age of 55. Likewise, 34% of the specialists were over the age of 55. 1 SE LHIN Physicians by Age group (2003, 2005, 2007) • Of all the specialties Psychiatry, Gastroenterology and 550 Fig 10.2 ENT have the largest percentage of physicians over 60 500 12% years of age. 12% 13% 10% 450 9% 10% • Most of the family physicians within the SE LHIN are 400 22% enrolled in a primary care model. 20% 22% 20% 23% 27% 350 65+ • There are four Community Health Centres (CHC) , with
300 55-64 an additional one in development in Belleville. 15 FTE 31% physicians are employed by the 4 CHC’s along with 34% 30% 250 33% 32% 45-54 various allied health specialists including nurses, 32% 35-44 200 educators, social workers, etc. 18-34 150 • The SE LHIN region has 12 Family Health Teams (FHT) 30% 26% 25% 31% with 136 physicians and dietitians, social workers, 100 22% 27% nurses (all classes) and mental health workers. 50 11% 9% 8% 9% 5% 4% • The South East is ranked fourth among all LHIN’s and 0 above the Provincial average in family physician and 2003 2005 2007 2003 2005 2007 nurse rates per capita. Family Medicine (Including FM/EM) Specialists
Fig 10.3 Population Human Resource Rates (per 100,000) by LHIN 1, 2, 5 New Roles for Physicians in the South East: Number of Family Rate for Family Number of Rate for LHIN Physicians Physicians Nurses Nurses • The Physician Assistant (PA) role is currently being introduced to the Ontario 2007 (per 100,00) 2008 (per 100,000) Health Care System through various demonstration projects. While the PA Toronto Central 1,584 73.8 18,254 6.4 role is new in Ontario, PAs have been utilized in the United States and the North West 265 88.7 3,454 6.8 Canadian Forces for many years. The SE LHIN currently has one PA working Champlain 1,326 90.1 13,195 9.1 in the Emergency Department at Quinte Health Care Trenton. South East 476 101.1 6,241 7.7 North East 521 108.6 7,386 7.7 • Brockville is currently recruiting to fill a position within their Emergency North Simcoe 388 112.0 4,362 10.0 Department (ED). South West 762 122.8 11,544 8.1 Central 1,308 125.1 8,966 18.2 • A call for applications has recently gone out to all established Family Health Waterloo/Wellington 555 128.7 5,674 12.6 Teams (FHT) to employ Physician Assistants. Twenty (20) Family Health Hamilton /Niagara 1,050 131.1 13,797 10.0 Teams will be selected across Ontario. Mississauga 811 137.6 6,701 16.7 Central East 1,014 147.9 10,492 14.3 • International Medical Graduates who have been screened and selected by Central West 498 160.7 3,373 23.7 CEHPEA are also able to apply for PA positions across the province. Erie St. Clair 400 161.4 6,062 10.7 Ontario 10,958 111.0 120,265 10.6
Please send any questions or comments to: [email protected] Page 2 of 4 DRAFT South East Local Health Integration Network
Health Human Resources Profile
Fig 10.4 Distribution of Nurses by Age group, SE LHIN (2005 & 2007) 2 Fig 10.5 Selected Nurse Indicators, SE LHIN (2007) 2
5,000 Full Time 63.5% Hospital 62.3% Part Time 29.1% Community 19.8% 4,500 Registered Casual 7.3% LTC 9.4%
4,000 Nurses Other 8.5% 22% 25% 3,500 Female 94.4% Male 5.6%
65+ 3,000 55-64 Full Time 54.9% Hospital 48.8% 34% Part Time 36.9% Community 15.7% 2,500 32% 45-54 Registered Casual 8.2% LTC 31.4% 35-44 Practical 2,000 Other 4.0% 18-34 Nurses 1,500 18% 21% Female 91.8% Male 8.2% 26% 25% 1,000 36% 35% Full Time 87.7% Hospital 10.5% 500 29% 25% Part Time 10.5% Community 75.4% 17% 16% 16% 18% Nurse Casual 1.8% LTC 3.5% 0 Practitioners Other 10.6% 2005 2007 2005 2007
Registered Nurse Registered Practical Nurse Female 100%
Summary of Main Findings: New Roles for Nurses and Other Health Professionals :
• In 2007 the SE LHIN had a total of 1,661 Registered Practical Nurses (RPN), 4,375 • Nurse Performed Flexible Sigmidoscopy – A registered nurse Registered Nurses (RN) and 40 Nurse Practitioners (NP) working across all sectors. with extended education works along side a physician. This
• 27% of RN’s and 22% of RPN’s were over the age of 55 in 2007. new role supports the Ontario Colon Cancer Screening Initia- tive. • Approximately 2,681 Registered Nurses and 852 Registered Practical Nurses work in the seven hospitals within the SE LHIN. • Surgical First Assist – A registered nurse with additional certification works with the surgeon and the operating room • In 2008, Kingston General had the highest proportion of Registered Nurses, followed by team. Quinte Health Care. Providence Care has the highest proportion of Registered Practical Nurses among all SE LHIN hospitals. • Clinical Specialist Radiation Therapist – A new role open to radiation therapists with advanced training. The role was • There are roughly 52 Pharmacists, 44 Dietitians, 33 Speech and Language Pathologists created to improve access to Cancer Care services. and 124 Social Workers working at SE LHIN hospitals. • Anesthesia Assistant– A Respiratory Therapist or Registered • Only three of the seven hospitals are utilizing Personal Support Workers. Nurse who have completed an additional program work as part • Physiotherapy is the only therapy service offered at all seven hospitals. of the anesthesia team
Distribution of RNs & RPNs by Hospital & Distribution of PSWs by Hospital & Fig 10.6 Fig 10.7 Employment Status, SE LHIN (Q3 2008) 3 Employment Status, SE LHIN (Q3 2008) 3
1,400 240 Casual Casual Part Time 1,200 Part Time Full Time 200 Full Time Administration 1,000 Administration 160
800
120 600
80 400
200 40
0 0 LACGH BGH HDH KGH PC PSFDH QHC LACGH BGH HDH KGH PC PSFDH QHC LACGH BGH HDH KGH PC PSFDH QHC
Registered Nurse Registered Practical Nurse Personal Support Worker Legend: BGH - Brockville General Hospital PSF - Perth & Smiths Falls Hospital HDH - Hotel Dieu Hospital PC - Providence Care KGH - Kingston General Hospital QHC - Quinte Health Care LACGH - Lennox & Addington County General Hospital SE LHIN - South East Local Health Integration Network
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Phone: 613-967-0196 Fax: 613-967-1341 Health Human Resources Profile
Distribution of Therapists by Hospital & Employment Status, SE LHIN (Q3 2008) 3 Fig 10.8 50 Physiotherapy FT Physiotherapy PT Respiratory FT Respiratory PT Occupational FT Occupational PT Other FT Other PT 45
40
35
30
25
20
15
10
5
0 LACGH BGH HDH KGH PC PSFDH QHC
Distribution of Technologists & Technicians by Hospital & Employment Status, SE LHIN (Q3 2008) 3 Fig 10.9 250
Casual
23% Part Time 200 Full Time Administration
150
10%
100 71% 31%
50 28% 27% 25% 58% 22% 28% 25% 47% 31% 20% 67% 63% 70% 27% 53% 43% 23% 44% 55% 0 Technologist Technician Technologist Technician Technologist Technician Technologist Technician Technologist Technician Technologist Technician Technologist Technician LACGH BGH HDH KGH PC PSFDH QHC Fig 10.10 Other Health Human Resources by Hospital by Employment Status, SE LHIN (Q3 2008) 3 35 Casual
Part Time 30 Full Time
Administraton 25
20
15
10
5
0 PC PC PC PC BGH KGH BGH KGH BGH KGH BGH KGH QHC QHC HDH QHC HDH QHC HDH HDH PSFDH PSFDH PSFDH PSFDH LACGH LACGH LACGH LACGH Pharmacist Dietitian Speech & Language Pathologist Social Worker DRAFT Page 4 of 4
South East Local Health Integration Network
CSS Categories Home Support Alzheimer Education Community Health Centre Health Human Resources Profile Palliative Services Community Mental Health Specialized Services Addictions
4, 7 4, 7 Distribution of Volunteers in CSS, CHC & CMHA (2009) Number of FTE Positions in Community Support Services (2009) Fig 10.12 225 Fig 10.11 200
175 Community Mental Health Health Centres & Addictions 150 (112) (149) 125 Total of 4,790 Volunteers 100 204.0
75
107.3 50 92.6 Community Support 25 Services 41.9 (4,529) 17.5 0 Administration Coordinator Counselor Housing/Residential Other
Distribution of Addiction Human Resources (2009) 4, 7
Fig 10.13 Summary of Main Findings:
• Volunteers are a major resource component of the workforce among Community Health Service Providers
Team Administration • There are a total of 4,790 volunteers working within 33 Community Health Service Leader (13) (11) Providers.
• Not including volunteers, there are approximately 463 full time equivalent resources Total of 57 working in the community support service sector. Midnight Worker Addiction (2) HHR • There are a total of 45.5 full time equivalent resources working in the addiction sector. Of these, 81% are employed on a full time basis .
• 76% of employees who work in the Mental Health sector are employed on a full time Counselor basis. (31)
Distribution of Mental Health Human Resources by Employment Status, SE LHIN (2009) 4, 7 Fig 10.14 160 Full Time Part time Casual
140
120
100
80 85% 82% 36% 74% 60 59%
40 99% 13% 15% 41% 11% 20 88% 9% 6% 5% 82% 46% 13% 5% 18% 8% 4% 1% 0 Counselor Crisis Social Worker Administration Case Manager RN RPN Other Data Sources and Notes: 1. Ontario Physician Human Resource Data Centre 2007– data is renewed annually and is completed by Community Support Services, Mental Health, Addictions and Community derived from the College of Physicians and Surgeons of Ontario, records from the Health Centres providing information on HR breakdown, employment status and full Ontario Health Insurance Plan, information collected from physicians via a survey and time equivalent status by organization characteristics. An additional inventory of secondary sources including the Canadian Medical Directory, Ontario Medical physicians (family & specialist) were also conducted. Association and the Canadian College of Family Physicians. Data is represented on a 5. Population estimates at the LHIN level were accessed from the Provincial Health Plan- calendar year basis. ning Database., MOHLTC. 2. College of Nurses of Ontario – Membership Report 2008 – data is self reported by 6. SubLHIN assignments were mainly derived from the postal code of the physician’s members. office. 3. Management Information System, Ministry of Health and Long Term Care. 7. All HHR data obtained from surveys represent the entire organization, not just LHIN 4. SE LHIN Survey of Human Resources – 2009 – Health human resource surveys were funded aspects. 8. Human resources from Home and Long Term Care have not been included. DRAFT
QHC-Ban QHC-Ban Version I - June 2009 PSF-P PSF-SF South East Local Health Integration Network BGH
Acute Inpatient Separations Profile KGH QHC-Bel LACGH QHC-Tren QHC-Pic Acute Inpatient Separations by Institution & Age Group (2002/2007)1,2 Introduction:
20,000 10,000 The Regional Capacity Assessment Project (ReCAP) Fig 4.1 provides a profile, including short-term projections, on 7% 8% 6% the utilization of health care services in the South East 9,000 18,000 5% LHIN. Results of ReCAP are used to support the 85+ 14% 15% 14% recommendations in the Integrated Health Service Plan 16,000 15% 8,000 for the South East region. This short report on Acute 75-84 Inpatient (IP) separations is one in a series of summary analyses from ReCAP that focuses on specific health care 14,000 15% 7,000 14% 14% 65-74 15% services. In the South East LHIN there are 9 institutions 45-64 that provide acute inpatient care: 1 teaching hospital 12,000 6,000 (KGH), 1 large hospital (QHC-Bel), 1 medium hospital 20-44 17% 18% (BGH), 5 small hospitals (LACGH, PSF-P, PSF-SF, QHC-Pic, 10,000 24% 5,000 QHC-Tren) and 1 very small hospital (QHC-Ban). 22% 10% 0-19 11% Summary of Main Findings: 8,000 4,000 22% • In 2007, KGH accounted for the majority of acute care 20% 23% 23% separations (18,900) followed by QHC-Bel (9,600) and 6,000 23% 22% 3,000 18% BGH (4,300). All other institutions recorded less than 18% 10% 2,400 separations in the same year. 10% 4,000 2,000 21% 16% 20% 10% • Between 2002 and 2007 KGH and PSF-P were the only 22% 15% 12% 16% 14% 18% 26% 12% institutions that had an increase in the number of 20% 20% 2,000 24% 30% 29% 21% 24% 24% 25% 24% separations (annually 0.6% and 1.8% respectively). 19% 19% 1,000 18% 18% 28% 32% 28% 24% 24% 18% Notable decreases were observed in LAGH, PSF-SF, 20% 20% 21% 16% 21% 25% 22% 23% 24% 14% 19% 13% 12% 16% 23% 15% 18% 25% QHC-Ban and QHC-Tren (annually declining by >5%). 0 0 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 • Larger institutions (KGH and QHC-Bel) tended to care more for the younger patients: more than 40% of KGH BGH LAGH PSF-P PSF-SF QHC-Ban QHC-Bel QHC-Pict QHC-Tren separations were less than 45 years compared to 8%- Fig 4.2 Percentage of All Acute IP Separations for South East LHIN & Ontario (2007) 1,2 39% in the smaller institutions. Overall the age Indicator Category SE LHIN Ontario Most Responsible Diagnosis SE LHIN Ontario distribution did not change by more than 2% in any age group between 2002 & 2007. <1 10.8% 15.1% Trauma, Coma & Toxic Effects 15.8% 12.2% 1-19 14.3% 6.4% Pregnancy/Childbirth/Puerperium 10.8% 13.3% • In 2007, medical separations was the largest service group, especially in the smaller institutions (47%-89%) 20-44 17.6% 24.4% Factors - Health Status/Services 10.8% 15.1% compared to (36%-41%) KGH and QHC-Bel. Acute care Age Group 45-64 19.9% 20.2% Digestive System 9.5% 9.8% for Newborns and Obstetric patients (19%-32%) was 65-74 14.3% 12.7% Injury/Poisoning/External Causes 8.2% 7.3% only provided at KGH, QHC-Bel and BGH. Less than 15% 75-84 15.6% 14.3% Respiratory System 7.5% 6.6% of separations at PSF-SF, QHC-Ban and QHC-Tren were 85+ 7.6% 7.0% Muskuloskeletal System 7.1% 5.3% surgical cases. Similar trends were noted in the acute inpatient bed days by service categories. Discharged without home care 68.6% 73.7% Neoplasms 6.5% 6.7% Discharged with home care 14.8% 10.6% Kidney & Genitourinary Tract 4.9% 5.1% • Ambulatory Care Sensitive Conditions (ACSC) is a Disposition measure of appropriate medical care assuming that Transferred to continuing care 5.6% 7.0% Perinatal Conditions 4.7% 3.8% prior ambulatory care would prevent onset of certain Deceased/Stillbirth 5.0% 3.8% Endocrine/Nutritional/Metabolic 2.3% 2.3% conditions. In 2007, the percentage of separations Fig 4.3 considered to be ACSC cases was higher in QHC-Tren, Legend: Age-specific Acute IP Utilization Rates QHC-Pict and LAGH (>6%) but much lower in KGH and (per 1,000) by Sex (2007) 1,2, 3 PSF-P (<3%). BGH-Brockville General Hospital Age Group SE LHIN Ontario • The majority of patients receiving acute care at SE LHIN KGH-Kingston General Hospital <1 1,147.9 1,211.3 institutions was treated and discharged without need 1-19 22.4 24.1 for additional care (overall 69% but ranged from 37%- LACGH-Lennox & Addington County General Hospital 20-44 83.7 92.1 79% among all institutions). Separations with further care included 15% for home care, 6% for continuing Female 45-64 60.6 61.2 PSF-P-Perth & Smiths Falls Hospital-Perth care (complex continuing, rehab, long term) and 4% for 65-74 128.1 137.4 acute care in another institution. At the provincial level, PSF-SF-Perth & Smiths Falls Hospital-Smiths Falls 75-84 215.8 233.0 74% of separations were discharged without home care, 11% with home care and 7% to continuing care. QHC-Ban-Quinte Health Care-Bancroft 85+ 312.5 347.4 <1 1,138.0 1,241.5 • Occupancy rates for medical beds were usually QHC-Bel-Quinte Health Care-Belleville 1-19 18.6 22.7 between 93%-95% except for PSF-SF (69%). Rates for medical/surgical beds were typically within the 83%- QHC-Pic-Quinte Health Care-Picton 20-44 19.7 22.2 Male 45-64 67.3 69.4 88% range though QHC-Tren and LACGH recorded QHC-Tren-Quinte Health Care-Trenton rates above 93%. KGH and QHC-Bel had surgical beds 65-74 160.8 177.8 with occupancy rates of 87% and 71% respectively. 75-84 294.2 296.8 SE LHIN-South East Local Health Integration Network Continued—Page 2 85+ 390.7 427.8
Please send any questions or comments to: [email protected] Page 2 of 4 DRAFT South East Local Health Integration Network
Acute Inpatient Separations Profile
Acute Inpatient Separations by Institution & Service Type Acute Inpatient Bed Days by Institutions & Service Type Fig 4.4 (2002/2007) 1,2,5 Fig 4.5 (2002/2007) 1,2,5
130,000 45,000 20,000 10,000
Other Other 120,000 18,000 9,000 Surgery 40,000 Surgery
110,000 Psychiatry 29% Psychiatry 31% 16,000 34% 8,000 Obstetrics 100,000 35,000 Obstetrics 33% 36% 44% 47% Newborn Newborn 14,000 7,000 90,000 32% 30,000 Medicine Medicine 80,000 12,000 6,000 16% 16% 13% 25,000 70,000 10% 12% 10% 10,000 5,000 9% 8% 30% 60,000 12% 15% 20,000 10% 41% 16% 10% 11% 28% 39% 8,000 4,000 50,000 37% 32% 5% 8% 15,000 8% 6,000 3,000 40,000 7% 6% 17% 10% 9% 5% 16% 9% 30,000 10,000 14% 16% 5% 4,000 2,000 46% 41% 39% 41% 35% 15% 46% 19% 40% 21% 39% 13% 12% 36% 59% 47% 15% 10% 29% 13% 11% 20,000 55% 15% 15% 36% 40% 17% 11% 11% 50% 44% 5,000 2,000 1,000 47% 18% 15% 57% 77% 10,000 79% 81% 55% 73% 72% 47% 59% 75% 67% 75% 85% 73% 47% 75% 77% 56% 53% 49% 11% 10% 82% 85% 84% 85% 0 0 0 0 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007
KGH BGH LACGH PSF-P PSF-SF QHC-Ban QHC-Bel QHC-Pict QHC-Tren KGH BGH LACGH PSF-P PSF-SF QHC-Ban QHC-Bel QHC-Pict QHC-Tren
• In most institutions the length of stay for patients receiving medical care increases • Apart from KGH, which provided acute care to patients from all SubLHIN areas (Fig steadily with age from about 1-3 days for individuals 0-19 years to roughly 7-9 days 4.10), most institutions had patients from the actual or adjacent SubLHIN of the for persons aged 85+. For surgical patients, KGH consistently recorded longer patient residence. More than 75% of patients residing in Prince Edward County, lengths of stay, (as anticipated due to its tertiary centre role) ranging from 4 days for Tyendinaga/Napanee or Smiths Falls/Perth/Lanark depended almost equally on the 0-19 year olds to over 10 days for persons 85+. In the other institutions, the lengths 2 closest institutions while the majority of residents in Kingston and surrounding of stay were more variable the older the patient. For example most hospital stays areas visited KGH for acute care. Approximately 3 out of every 4 acute care patients were 1-3 days for patients 0-19 years and 2-4 days for patients 20-44 years. Older received treatment from either KGH (47%) of QHC-Bel (24%). surgical patients, those aged 65+, tended to have relatively longer stays in BGH, • Compared to the province, utilization rates for acute care services was lower in the LACGH, and PSF-SF (6-12 days) than other institutions (4-9 days). Compared SE LHIN for all age groups, particularly for individuals aged 75-84 years. Within the provincially, older patients in the SE LHIN receiving medical care tend to have LHIN, acute care utilization rates for medical care were notably higher in Prince slightly shorter lengths of stay. On the other hand, it was more common for surgical Edward County, SE Leeds & Grenville and Smiths Falls/Perth/Lanark . patients to stay longer in SE LHIN institutions than for the province as a whole. Continued—Page 3 Percent of Ambulatory Care Sensitive Acute Inpatient Separations by Bed Occupancy Rates (%) by Conditions by Institution (2007) 1,2,6 Institutions & Discharge Status (2007) 1,2 Institution & Service (2007) 1,4 10% 20,000 Fig 4.6 Fig 4.7 8.6 BGH KGH LACGH Fig 4.8 Other reason 25.5 PSF-P PSF-SF QHC-Ban 3% Transferred to similar acute inpatient facility Newborn 35.8 QHC-Bel QHC-Pic QHC-Tren 9% 18,000 4% Transferred to continuing care facility 57.0 20.8 Di scharged wi thout home care 8% 16,000 Discharged with home care 58.9 Obstetrics 43.1 Deceased/Stillbirth 7% 14,000 78.9 40.3
62.2 6% 12,000 ICU 74.7 81.9 87.5 82.2 69.3 79% 5% 10,000 93.9 4% 146 6% Medicine / 86.2 Surgery 4% 8,000 87.5 117.2 49 83.8 81.4
431 3% 70 6,000 71.3 63% 110 Surgery 296
2% 87.1 94 4,000
206 522 69.4 92.9 1% 2,000 72% 94.5 10% Medicine 20% 37% 66% 50% 41% 93.2 10% 5% 50% 16% 4% 0% 0 BGH KGH LACGH PSF-P PSF-SF QHC-Ban QHC-Bel QHC-Pic QHC-Tren BGH KGH LACGH PSF-P PSF-SF QHC-Ban QHC-Bel QHC-Pic QHC-Tren 0 20406080100120 % Occupancy DRAFT Page 3 of 4 48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 South East Local Health Integration Network
Phone: 613-967-0196 Fax: 613-967-1341 Acute Inpatient Separations Profile
Fig 4.9 Average Length of Stay (days) by Institution, Service & Age Group (2006 & 2007 combined) 1,2, 7 16 16 BGH KGH LACGH PSF-P PSF-SF Medicine-SELHIN Surgery-SELHIN QHC-Ban QHC-Bel QHC-Pict QHC-Tren Medicine-Ontario Surgery-Ontario 14 14
12 12
10 10
8 8 Days Days
6 6
4 4
2 2
0 0 0-19 20-44 45-64 65-74 75-84 85+ 0-19 20-44 45-64 65-74 75-84 85+ 0-19 20-44 45-64 65-74 75-84 85+ Medicine Surgery
• Assuming that acute care utilization rates and market share for 2006 and 2007 and • Compared provincially, older patients in the SE LHIN receiving medical care tend to current occupancy levels stay in effect, and that all other conditions remain have slightly shorter lengths of stay. On the other hand, it is more common for constant, the expected annual growth rates for the number of unweighted surgical patients to stay longer in SE LHIN institutions than in the province as a separations in the LHIN are: 2.3% for Medicine, 1.4% for Surgery, 4.5% for Psychiatry whole. and -0.3% to -1.6% for Pediatrics, Newborns and Obstretrics. For the most part, similar trends were observed for weighted number of separations.
SE LHIN Institutions Distribution of Acute Inpatient Separations for SE SubLHIN area 1,2 Fig 4.10 by SE LHIN Institutions (2007) QHC-Belville
QHC-Trenton
QHC-Picton
QHC-Bancroft
PSF-Smiths Falls
PSF-Perth
LACGH
KGH
BGH
Overall Distribution of Acute Inpatient Separations for SE LHIN
3% 3% 11%
24% Number of Separations to Match Size of Pie 9,000 Distribution for 4,500 1% 4% 47% Unknown SubLHIN 4% 3% 900 % Acute IP Separations to SE LHIN % Acute IP Separations for SE LHIN DRAFT Institutions by LHIN of Residence (2007) Residents by LHIN of Institution (2007) Page 4 of 4 SE LHIN Resident SE LHIN Institution 2,407 Other LHIN Resident 4,991 Other LHIN Institution (6.0%) (11.6%) South East Local Health Integration Network (LHIN)
Acute Inpatient Separations Profile 37,994 37,994 (94.0%) (88.4%) Age-Specific Acute Inpatient Separation Rates (per 1,000) by SubLHIN & Service (2006 & 2007 combined) 1,2,3,10
Fig 4.11
Reported and Projected Acute Inpatient Separations and Bed Days by SE LHIN Institution & Year 1,2, 3, 8-12 Fig 4.12 Medicine Surgery Pediatrics Newborn Obstetrics Psychiatry Other Avg. Avg. Avg. Avg. Avg. Avg. Avg. Institution Measure Annual Annual Annual Annual Annual Annual Annual Name 2007 2012 % 2007 2012 % 2007 2012 % 2007 2012 % 2007 2012 % 2007 2012 % 2007 2012 % Growth Growth Growth Growth Growth Growth Growth Seps 1,971 2,236 2.6 1,358 1,473 1.6 90 109 3.8 377 339 -2.1 428 355 -3.7 59 61 0.7 16 16 0.1 BGH Seps-PAC 2,341 2,834 3.9 2,162 2,348 1.7 54 67 4.3 84 77 -1.7 258 217 -3.4 168 169 0.1 46 37 -4.2 Bed days 10,977 12,869 3.2 8,234 8,842 1.4 168 207 4.2 820 755 -1.6 994 852 -3.0 571 539 -1.1 315 323 0.5 Seps 7,090 7,961 2.3 5,923 6,357 1.4 1,201 1,191 -0.2 2,251 2,224 -0.2 2,384 2,327 -0.5 108 202 13.3 <5 <5 KGH Seps-PAC 11,773 13,380 2.6 15,803 17,034 1.5 1,267 1,195 -1.2 1,481 1,471 -0.1 1,546 1,534 -0.1 205 381 13.2 3 <5 Bed days 48,053 53,733 2.3 51,858 55,814 1.5 4,469 4,410 -0.3 10,933 11,090 0.3 6,901 6,875 -0.1 990 1,896 13.9 8 14 12.4 Seps 878 969 2.0 201 213 1.1 35 44 4.9 15 16 0.9 LACGH Seps-PAC 1,069 1,216 2.6 287 307 1.3 91 130 7.3 38 48 4.6 Bed days 4,837 5,472 2.5 1,191 1,332 2.3 310 384 4.4 314 242 -5.1 Seps 908 898 -0.2 692 661 -0.9 52 45 -3.1 56 49 -2.6 PSF-P Seps-PAC 1,137 1,107 -0.5 1,303 1,249 -0.9 84 77 -1.8 163 125 -5.2 Bed days 6,020 5,769 -0.8 4,478 4,171 -1.4 442 383 -2.8 1,784 1,417 -4.5 Seps 829 1,011 4.0 247 268 1.7 258 216 -3.5 280 219 -4.8 32 47 8.1 36 36 0.0 PSF-SF Seps-PAC 1,120 1,231 1.9 370 399 1.5 44 36 -3.6 167 130 -4.8 85 113 5.9 116 106 -1.8 Bed days 6,184 6,753 1.8 1,623 1,641 0.2 505 433 -3.1 632 500 -4.6 347 463 5.9 1,225 1,047 -3.1 Seps 235 214 -1.9 28 31 2.1 6 6 -0.1 QHC-Ban Seps-PAC 426 386 -1.9 32 39 4.0 18 14 -3.9 Bed days 1,416 1,264 -2.2 222 252 2.5 19 25 5.9 Seps 3,054 3,397 2.2 2,788 3,001 1.5 628 588 -1.3 1,523 1,458 -0.9 1,536 1,377 -2.2 94 96 0.4 27 26 -0.4 QHC-Bel Seps-PAC 3,609 3,890 1.5 4,386 4,671 1.3 405 374 -1.6 427 391 -1.7 965 853 -2.4 213 220 0.7 43 33 -4.8 Bed days 16,331 16,986 0.8 11,719 12,510 1.3 1,505 1,357 -2.1 3,580 3,307 -1.6 3,648 3,185 -2.7 601 571 -1.0 229 179 -4.8 Seps 1,019 1,095 1.5 143 173 3.9 44 45 0.3 65 55 -3.4 66 65 -0.4 19 29 8.9 QHC-Pict Seps-PAC 1,100 1,246 2.5 224 229 0.4 7 7 0.6 29 26 -2.3 86 105 4.2 32 71 17.1 Bed days 5,101 5,516 1.6 994 1,060 1.3 68 74 1.8 104 95 -1.9 316 354 2.3 260 387 8.3 Seps 1,129 1,420 4.7 151 194 5.2 38 46 3.9 15 15 0.2 QHC-Tren Seps-PAC 1,586 1,856 3.2 280 305 1.7 204 171 -3.4 38 31 -4.2 Bed days 7,280 8,787 3.8 1,128 1,241 1.9 359 339 -1.1 210 189 -2.1 Seps 17,113 19,201 2.3 11,531 12,372 1.4 1,919 1,888 -0.3 4,453 4,282 -0.8 4,693 4,333 -1.6 490 612 4.5 188 192 0.4 SE LHIN Seps-PAC 24,161 27,144 2.4 24,847 26,580 1.4 1,727 1,636 -1.1 2,042 1,982 -0.6 2,965 2,760 -1.4 1,153 1,380 3.7 478 453 -1.1 Bed days 106,199 117,149 2.0 81,447 86,864 1.3 6,142 5,973 -0.6 15,906 15,660 -0.3 12,279 11,506 -1.3 3,955 4,955 4.6 4,345 3,798 -2.7 General Notes and Limitations: Notes on Projections of Acute Inpatient Separations : 1.1. All All estimates estimates are are reported reported for for fiscal fiscal periods, periods, e.g. e.g. 2007 2007 is Aprilis April 2007 2007 - March - March 2008. 2008. 8. Two types of projections are presented in this profile: unweighted (actual number 2.2. DataData Source: Source: ¨Hospital ¨Hospital Inpatient Inpatient Separati Separations,ons, Provincial Provincial Health Planning Health Database Planning - of Acute IP separations) and weighted (according to the PAC-10 weights). PAC fromDatabase Discharge - from Abstract Discharge Database. Abstract (Inclu Dadestabase. data for(Includes completed/discharged data for completed/ cases (Prospective Complexity Adjustment) represent the relative cost of care between only;discharged excludes cases adult only; mental excludes health adult cases). mental health cases). different patient types; adjusts for patient co-morbidities, age and length of stay. 3.3. Data Rates Source: are based Management on population Information estimates Syst andem, projections Ministry of from Health Ministry and Longof Finance Term 9. Projections of the health care utilization are primarily based on changes in Care.and the SE LHIN. population growth (including mortality, fertility and migration). 10. Market share , utilization rates and length of stay for 2006 and 2007 combined are 4.4. Categories Data Source: based Management on a modified Information HSRC grouping System, of Ministryacute care of services.Health and Long Term Care. assumed to remain constant until 2012. Occupancy rates for 2007 are also assumed to remain constant for the projection period. Note that medical and 5.5. ACSC Categories includes based Grand on mala modified status and Health other Services epileptic Restructuring convulsions, CommissionCOPD, Acute (HSRC) bron- chitis or Pneumonia when COPD is secondary, Asthma, Congestive heart failure, surgical utilization rates by region, sex and age group are based on 5 or more grouping of acute care services. Hypertention or Angina with selected procedures, Diabetes; Excludes patients 75+ Acute Inpatient separations. 6. ACSC includes Grand mal status and other epileptic convulsions, Chronic or with death as discharge status. 11. South East SubLHIN, sex and age group (0-19, 20-44, 45-64, 65-74, 75-84, 85+) are Obstructive Pulmonary Disease (COPD), Acute bronchitis or Pneumonia when assumed to be independent strata. 6. ExcludesCOPD is secondary,patients with Asthma, length Congestive of stay of heart1,000 failure, or more Hypertension days. or Angina with selected procedures, Diabetes; Excludes patients 75+ or with death as discharge 12. Projections of health care utilization do not incorporate program realignments or status. enhancements, changes in service demand, technological or clinical developments, or changes in disease prevalence. DRAFT
QHC-Ban QHC-Ban Version I - June 2009 PSF-P PSF-SF South East Local Health Integration Network BGH
Alternate Level of Care Profile KGH QHC-Bel LACGH QHC-Tren
QHC-Pic Historical ALC Days as Percentage of Total Acute Inpatient Days Introduction: The Regional Capacity Assessment Project (ReCAP) (Fiscal 2002 to 20081)2 (Fiscal 2009 to 20113) and Future Targets provides a profile, including short-term projections, Fig 5.1 20% on the utilization of health care services in the South East LHIN. Results of ReCAP are used to support the recommendations in the Integrated Health Service Plan for the South East region. This short report on Alternate Level of Care (ALC) for 15% acute separations is one in a series of summary LHIN-wide Target for analyses from ReCAP that focuses on specific Fiscal Year 2009/10 health care services. In the South East LHIN there 13% are 9 institutions that provide alternate level of care for acute patients: 1 teaching hospital (KGH), 1 10% large hospital (QHC-Bel), 1 medium hospital (BGH), 5 small hospitals (LACGH, PSF-P, PSF-SF, QHC-Pic, % ALC (Actual) QHC-Tren) and 1 very small hospital (QHC-Ban). 1 ALC days of stay in acute institutions as a percentage of total % ALC Target (2009) acute inpatient days (excluding newborns and stillborns) 5% % ALC Interim Targets 2 Overview of ALC: Interim estimate based on first 3 quarters of the fiscal year Provincial Target 3 Target for FY2009/10 (13%) as agreed to in Ministry LHIN Alternate Level of Care (ALC) patients remain in Current Trend Accountability Agreement; Targets for FY2010/11 and hospital beds because they cannot return home or 2011/12 are interim targets. access a long-term care bed. High numbers of ALC 0% patients occupying hospital beds can result in surgical cancellations and a high number of 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 admitted patients in the Emergency Department waiting for a bed in the hospital. Being discharged Partner organizations from across the LHIN are jointly involved in a number of projects to address home as soon as possible is very important with a appropriate patient placement and necessary care. Projects include reducing ER demand by greater risk of getting an infection while in hospital and the loss of muscle strength while waiting in a providing the necessary care in the community to maintain and support hospital bed. Some patients lose so much muscle Reduce ER independent living. Care in the community reduces the likelihood of needing to strength that they can no longer live on their own. Demand access the hospital. Other projects address patient movement within a hospital, between hospitals and other health care organizations aligning patient need with Summary of Main Findings:
Increase ER appropriate service. Some programs target specific disease groups while others • The South East LHIN percentage of ALC days (ALC Capacity / target specific paths in the patient journey to wellness. days as a percentage of all acute inpatient days) Performance Collectively the projects strive toward optimal use of the health care services declined slightly between 2006 (18.6%) and 2007 (17.3%) but remains higher than the provincial available across the LHIN with the goal to allow patients to move beyond the average (14.0%). The provincial average increased Improve Bed hospital system and back to the community. from 12.1% in 2006. Utilization • To meet the South East LHIN target of ALC days Estimated Reduction in ALC Patient Days to Reach Target for Fiscal 2009 accounting for 13% or less of total acute (Percent ALC and necessary reductions are based on data from FY2007/08) inpatients days in 2009 requires an estimated ALC Patients reduction of 25% of the current 45,000 ALC days Fig 5.2 (estimated reduction of 11,315 days required) 1,340 1,440 1,540 1,640 1,740 1,840 1,940 2,040 2,140 2,240 2,340 • In 2007, there were 1,842 separations from area 12 6.1% 6.6% 7.1% 7.5% 8.0% 8.4% 8.9% 9.4% 9.8% 10.3% 10.7% hospitals that included an ALC component to the 13 In6.7% 2007 institutions 7.2% across 7.7% the South 8.1% East LHIN 8.6% 9.1% 9.6% 10.1% 10.6% 11.1% 11.6% discharged 1,842 patients with an ALC patient’s stay. KGH (653) and QHC-Belleville (573) 14 component7.2% 7.7% of their stay. 8.2% The Average 8.8% ALC 9.3% LOS 9.8% 10.4%To 10.9% meet our 11.5% ALC target 12.0% of 13% 12.5% accounted for the greatest number of ALC 15 for7.7% these patients 8.3% was 8.8% 24.6 days 9.4% (for a total 10.0% of 10.5% 11.1%for 11.7% this year 12.3% we need 12.8% to reduce 13.4% separations over the year. Across the other 16 over8.2% 45,000 8.8% ALC Days). 9.4% 10.0% 10.6% 11.3% 11.9%the 12.5% number 13.1% of ALC days 13.7% across 14.3% hospitals, QHC-Trenton (191) and Brockville General Hospital (131) had the highest numbers of 17 That8.7% equates 9.4% to 124 10.0%acute 10.7% 11.3% 12.0% 12.6%hospitals 13.3% in 13.9% the South 14.6% East by 15.2% ALC Separations 18 beds9.2% filled 9.9%365 days 10.6%per 11.3% 12.0% 12.7% 13.3%an 14.0% estimated 14.7% 25%. 15.4% 16.1% year with ALC patients • There were substantial increases in the reported 19 9.7% 10.5% 11.2% 11.9% 12.6% 13.4% 14.1%This 14.8% can be 15.5% accomplished 16.3% by: 17.0% 20 10.2% 11.0% 11.8% 12.5% 13.3% 14.1% 14.8% 15.6% 16.4% 17.1% 17.9% numbers of ALC patients between 2002 and 2007 B A) Reducing the number of ALC at all hospitals except BGH and QHC-Picton. 21 10.8% 11.6% 12.4% 13.2% 14.0% 14.8% 15.6% 16.4% 17.2% 18.0% 18.8% C patients, LACGH, and the Perth and Smiths Falls hospital 22 11.3% 12.1% 12.9% 13.8% 14.6% 15.5% 16.3%B) 17.2% Reducing 18.0% the average 18.8% number 19.7% sites exhibited particularly large relative increases 23 11.8% 12.7% 13.5% 14.4% 15.3% 16.2% 17.1% 17.9%of ALC days 18.8% per ALC 19.7% patient, 20.6%or in the numbers of ALC patients.
Average ALC Length of Stay of Length ALC Average 24 12.3% 13.2% 14.1% 15.0% 16.0% 16.9% 17.8%C) 18.7% A combination 19.6% of the 20.5% above. 21.5% • There was a large increase in the number of ALC 25 12.8% 13.8% 14.7%A 15.7% 16.6% 17.6% 18.5% 19.5% 20.4% 21.4% 22.4% days at QHC-Trenton between 2002 and 2007 26 13.3% 14.3% 15.3% 16.3% 17.3% 18.3% 19.3% 20.3% 21.3% 22.3% 23.3% (from 1,160 to 5,694 ALC days). Similarly QHC- 27 13.8% 14.9% 15.9% 16.9% 18.0%Our 19.0% % ALC in 20.0% 21.1% 22.1% 23.1% 24.1% Bancroft, both PSF sites and LACGH have Fiscal 2007 demonstrated large increases. KGH and BGH had was 17.3% lower numbers of ALC days in 2007. Continued—Page 2
Please send any questions or comments to: [email protected] Page 2 of 4 DRAFT South East Local Health Integration Network
Alternate Level of Care Profile
Number of ALC Separations by Institution and Sex (2002/2007) Number of ALC Days by Institution and Sex (2002/2007) 700 250 25,000 6,000 Fig 5.3 M Fig 5.4 M
F F 560 200 20,000 4,800 38% 40% 45% 48%
46% 46% 420 39% 150 40% 15,000 3,600 42% 40% 49% 44%
280 100 47% 10,000 2,400 46% 26% 62% 48% 60% 55% 30% 52% 61% 54% 54% 43% 60% 49% 58% 140 60% 50 28% 5,000 41% 1,200 56% 51% 60% 59% 29% 53% 44% 49% 74% 50% 42% 70% 54% 47% 52% 43% 72% 65% 57% 59% 51% 71% 67% 56% 51% 40% 42% 41% 50% 58% 53% 57% 63% 35% 58% 78% 0 0 0 0 62% 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007 2002 2007
KGH QHC-Bel BGH LACGH PSF-P PSF-SF QHC-Ban QHC-Pict QHC-Tren KGH QHC-Bel BGH LACGH PSF-P PSF-SF QHC-Ban QHC-Pict QHC-Tren Distribution of ALC Separations by Institution (2002/2007) Distribution of ALC Days by Institution (2002/2007) 100% 100% 6% 6% 10% 9% Fig 5.5 7% 6% Fig 5.6 13% 14% 10% 10% 13% 5% 5% 2% 17% 16% 13% 3% QHC-Tren 18% QHC-Tren 80% 80% 16% 16% QHC-Pict QHC-Pict 32% 28% 31% 33% 5% 7% 35% 37% QHC-Bel 4% QHC-Bel 5% 60% 2% QHC-Ban 60% 7% 4% QHC-Ban 6% 3% PSF-SF PSF-SF 6% 8% 5% 4% 5% PSF-P 57% PSF-P 40% 40% 47% 59% 56% LACGH 41% LACGH 32% 40% 37% KGH KGH 24% 31% 33% 35% 20% BGH 20% BGH
13% 12% 14% 16% 15% 8% 8% 7% 7% 9% 10% 10% 0% 0% 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
• • Females typically account for the greatest numbers of ALC patients and ALC days. • The highest percentage of ALC days was attributable to patients going to ‘continuing care’ institutions. For patients waiting for admission to continuing • etsetaNotable exceptions QHC-Bancroft and PSF-Perth, both of which recorded a higher percentage of ALC days for males in 2007. care facilities almost one-half of their acute inpatient days were ALC. The category includes all transfers to non-acute facilities that provide continuing care including • The percentage of total inpatient days that are categorized as ALC increases with complex continuing care, general rehabilitation hospitals and long term care older patients. For the 85+ population, the percentage was particularly high in facilities. 2007 at QHC-Bancroft and QHC-Trenton. • The hospitals with the highest percentages of ALC days (QHC-Trenton and • The percent ALC days in the South East LHIN across all age groups stabilized or Bancroft sites and LACGH) have the greatest percentages of their ALC patients declined between 2006 and 2007. Provincially, the percent ALC has increased who were ultimately discharged to continuing care facilities. across all age groups since 2005. Continued—Page 3 Percent of ALC Days by Institution and Age Group (2002-2007)
Fig 5.7 Ontario Fig 5.8
SE LHIN Fig 5.9 DRAFT Page 3 of 4 48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 South East Local Health Integration Network
Phone: 613-967-0196 Fax: 613-967-1341 Alternate Level of Care Profile
Fig 5.10 Percent of ALC Days by Institution and Discharge Status (2003-2007)
Ontario Fig 5.11
SE LHIN
Fig 5.12
• The average length of stay for separations with an ALC component of their stay • Across the 15 sub-LHIN planning areas, ALC days are positively associated with the was highest for general surgery and dermatology (over 40 days). size of the population.
• The average ALC daily bed utilization was greatest in October 2006 with over 160 • ALC patients and corresponding ALC days are generally attributable to patients ALC patients across South East LHIN institutions. Approximately half of these from the local hospital catchment area. patients were ultimately discharged to ‘continuing care’.
SE LHIN Institutions Distribution of ALC Days for SE SubLHIN areas by SE LHIN Acute Inpatient Institutions (2007) QHC-Trenton
Fig 5.13 QHC-Picton
QHC-Belleville
QHC-Bancroft
PSF-Smiths Falls
PSF-Perth
LACGH
KGH
BGH
Overall Distribution of ALC Days for SE LHIN
11% 11% 3%
Number of ALC Days 16% to Match Size of Pie
12,000 Distribution for 40% 6,000 4% Unknown SubLHIN 5% 1,200 4% 6% DRAFT Page 4 of 4
South East Local Health Integration Network
Alternate Level of Care Profile
Average Length of Stay for ALC Separations by ALC Daily Bed Utilization by Discharge Status, Program Cluster Category, SE LHIN (2006 & 2007 combined) SE LHIN (2006-2007)
General Surgery 40.5 Fig 5.14 Fig 5.15 Dermatology 40.1 Psychiatry 37.1 Vascular Surgery 31.6 General Medicine 27.1 Rehabilitation 25.5 Urology 25.3 Cardiology 24.9
Endocrinology 23.8 Oncology 23.4 Neurology 23.0 Cardio/ Thoracic 22.5 Nephrology 22.5 Pulmonary 22.5 Rheumatology 21.6 Neurosurgery 20.6 Gastro/Hepatobiliary 20.6 Trauma 20.0 Haematology 19.8 Otolaryngology 19.0 Orthopaedics 16.0 Palliative 14.5 Plastic Surgery 9.5 Ophthalmology 7.5 Ungroupable 31.0
0 5 10 15 20 25 30 35 40 45
Reported and Projected ALC Separations & Bed Days (2007 & 2012) Fig 5.16 Separations Bed days Percentage of ALC Days Institution Name Average Annual Average Annual Growth (%) Growth (%) Curent Trends Target 2007 2012 2007-2012 2007 2012 2007-2012 2007 2012 2012 Brockville General Hospital 131 158 21.0 4,556 6,557 43.9 17.6 21.2 Kingston General Hospital 653 776 18.9 18,283 20,882 14.2 13.8 13.5 L & A County General Hospital 92 123 34.2 2,537 3,311 30.5 27.6 30.8 Perth & Smiths Falls Dist-Perth Site 69 69 -0.4 1,600 1,475 -7.8 11.2 11.2 Perth & Smiths Falls Dist-Smiths Falls 57 56 -1.5 2,366 2,108 -10.9 19.1 16.3 Quinte Health Care-Bancroft 31 28 -9.1 1,668 1,546 -7.3 50.1 50.0 Quinte Health Care-Belleville 573 626 9.3 7,350 8,083 10.0 17.6 17.5 Quinte Health Care-Picton 45 72 60.8 1,204 2,252 87.1 15.1 23.1 Quinte Health Care-Trenton 191 218 14.1 5,694 5,083 -10.7 38.8 32.5 South East LHIN 1,842 2,128 15.5 45,248 51,297 13.4 17.3 17.3 <10%
General Notes and Limitations:
1. All estimates are reported for fiscal periods, e.g. 2007 is April 2007 - March 6. Market share, utilization rates and length of stay for 2006 and 2007 2008. combined are assumed to remain constant until 2012. Occupancy rates for 1. All estimates are reported for fiscal periods, e.g. 2007 is April 2007 - March 2008. 2007 are also assumed to remain constant for the projection period. 2. Data Source: ¨Hospital Inpatient Separations, Provincial Health Planning 2. Data Source: ¨Hospital Inpatient Separations, Provincial Health Planning Database - Database - from Discharge Abstract Database. (Includes data for completed / 7. South East SubLHIN, sex and age group (0-19, 20-44, 45-64, 65-74, 75-84, from Discharge Abstract Database. (Includes data for completed/discharged cases only;discharged excludes cases adult only;mental excludes health cases). adult mental health cases). 85+) are assumed to be independent strata. 3.3. DataRates Source: are based Management on population Information estima Systtesem, and Ministry projections of Health from and LongMinistry Term of 8. Projections of health care utilization do not incorporate program realign- Care.Finance and the SE LHIN. ments or enhancements, changes in service demand, technological or 4. Categories based on a modified HSRC grouping of acute care services. clinical developments, or changes in disease prevalence. 4. Excludes patients with length of stay of 1,000 or more days. 5. ACSC includes Grand mal status and other epileptic convulsions, COPD, Acute bron- 5. chitisProjections or Pneumonia of the healthwhen COPDcare utilizationis secondary, are Asthma,primarily Congestive based on heart changes failure, in Hypertentionpopulation growthor Angina (including with selected mortality, procedures, fertility Diabetes;and migration). Excludes patients 75+ or with death as discharge status. 6. Excludes patients with length of stay of 1,000 or more days.
DRAFT
QHC-Ban QHC-Ban Version I - July 2009 PSF-P PSF-SF South East Local Health Integration Network BGH
Day / Night Procedure Profile HDH KGH
QHC-Bel LACGH QHC-Tren QHC-Pic Surgical / PARR Procedures by Institutions & Sex (2006/2007) 1,2,3 Introduction: 14,000 The Regional Capacity Assessment Project (ReCAP) Fig 6.1 provides a profile, including short-term projections, on 12,000 the utilization of health care services in the South East LHIN. Results of ReCAP are used to support the 10,000 46% 47% recommendations in the Integrated Health Service Plan for the South East region. This short report on Day/
47% 49% Night Procedures is one in a series of summary analyses 8,000 54% 54% from ReCAP that focuses on specific health care M services. In the South East LHIN there are 9 institutions F 6,000 that provide Day/Night procedures including Surgical/ Post Anaesthetic Recovery Room (PARR), Oncology, 47% 48% Dialysis, Radiation and Cardiac Catheterizations. 4,000 54% 53% 47% 53% 51% 46% Summary of Main Findings: 46% 46% 53% 2,000 59% 52% 53% 48% 50% • In 2007, SELHIN institutions performed just under 52% 48% 51% 47% 53% 54% 54,000 Surgical/PARR procedures; one quarter took 47% 52% 49% 52% 50% 41% 53% 48% 0 place at HDH, one fifth each occurred at BGH and 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 QHC-Bel, one eighth at KGH and 7% or less at each of the other institutions. BGH HDH KGH LACGH PSF-P PSF-SF QHC-Bel QHC-Pict QHC-Tren Surgical / PARR Procedures by Institutions & Age Group (2006/2007) 1,2,3 • Overall about 51% of Surgical/PARR visits to SELHIN 14,000 institutions were female; slightly higher percentages were recorded in HDH, KGH and QHC-Tren. Fig 6.2 12,000 15% 16% • The 45-64 age group had the majority of Surgical/ PARR procedures (29%-49%), followed by the 20-44 5% 6% and the 65-74 age groups each accounting for about 10,000 13% 14% 20% 20% 85+ one fifth of all procedures. Individuals 0-19 and 85+ 21% 21% 75-84 represented 5% and 4% of all of these procedures 8,000 19% 20% 65-74 respectively. 45-64 25% 25% • In most of the SE LHIN institutions Gastro/ 6,000 13% 20-44 35% 35% 12% Hepatobiliary, Ophthalmology and Urology are the 37% 0-19 14% 16% 38% main type of surgical procedures performed. KGH was responsible for more specialized type of surgeries 4,000 31% 31% 29% 29% 24% while PSF-SF and QHC-Tren had more Urology and 24% Ophthalmology respectively. 18% 21% 18% 16% 25% 23% 2,000 21% 22% 23% 35% 32% 21% 29% 30% • In the SE LHIN, KGH (58%) and QHC-Bel (40%) 14% 14% 47% 49% 35% 34% 9% 9% 38% 42% 40% 43% accounted for most of the Oncology visits during the 5% 4% 0 6% 6% 2007 fiscal period. BGH and PSF-P were the only other 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 institutions reporting Oncology visits. BGH HDH KGH LACGH PSF-P PSF-SF QHC-Bel QHC-Pict QHC-Tren • Overall about 54% of Oncology visits are for female Surgical/PARR Procedures by Institution & Complex Ambulatory Classification (2006/2007)1,2,3 patients; QHC-Bel sees proportionally more females 14,000 than KGH. Continued—Page 2 Fig 6.3 12,000 20% 20% Legend:
10,000 8% 6% 16% 16% BGH-Brockville General Hospital 21% 22% Other HDH-Hotel Dieu Hospital 10% 11% Urology-Other 8,000 7% 6% 27% 28% 12 % 12 % Urology-Cystoscopy KGH-Kingston General Hospital 15 % 15 % 7% 8% Orthopaedics LACGH-Lennox & Addington County General Hospital 6,000 6% 6% 5% 5% 4% 5% Ophthalmology 50% PSF-P-Perth & Smiths Falls Hospital-Perth 53% 18% 17% General Surgery 4,000 13% PSF-SF-Perth & Smiths Falls Hospital-Smiths Falls 14% Gastro/Hepatobiliary 14% 16% 12% 40% 41% 51% 46% QHC-Ban-Quinte Health Care-Bancroft 16% 29% 37% 44% 2,000 21% 43% 18 % 22% 23% 18 % 25% QHC-Bel-Quinte Health Care-Belleville 20% 20% 7% 6% 54% 59% 67% 79% 24% 48% 51% 17% 17% 23% 0 QHC-Pic-Quinte Health Care-Picton 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 QHC-Tren-Quinte Health Care-Trenton BGH HDH KGH LACGH PSF-P PSF-SF QHC-Bel QHC-Pict QHC-Tren
Please send any questions or comments to: [email protected] Page 2 of 4 DRAFT South East Local Health Integration Network
Day / Night Procedure Profile
Sex (2006/2007) Age (2006/2007) Complex Ambulatory Classification (2006/2007)
10,000 10,000 10,000 Fig 6.4 Fig 6.5 4% Fig 6.6 10% 9,000 9,000 9,000
3%
1,2,4 9% 8,000 8,000 8,000 24% 26% 50% 20% 7,000 7,000 7,000 6% 49% 25% 85+ Other 6,000 15% 6,000 6,000 75-84 Transfusion 40% M 5,000 5,000 65-74 5,000 Management F 34% 45-64 Follow-Up 4,000 4,000 47% 4,000 70% 47% 20-44 69% 74% Chemo 3,000 3,000 3,000 14 % 16% 0-19 50% 43% 51% 60% 2,000 22% 2,000 2,000 32% 42% 9% 7% 1,000 1,000 57% 57% 1,000 40% 21% 9% 9% 0 0 0 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007
Oncology VisitsOncology by Institution KGH PSF-P QHC-Bel KGH PSF-P QHC-Bel KGH PSF-P QHC-Bel
Sex (2006/2007) Age (2006/2007) Complex Ambulatory Classification Summary of Main Findings - Continued: (2006/2007) 50,000 50,000 50,000 Fig 6.7 Fig 6.8 Fig 6.9 • More than 2 in every 5 oncology visits are to patients 45,000 45,000 45,000 1,2,5 45-64 years, followed by 65-74 (26%-34%) and 85+ 5% 40,000 40,000 6% 40,000 (10%-15%). In KGH 9% (or almost 900) of oncology 20% visits are to individuals 19 years or younger. 35,000 35,000 21% 35,000 85+ 58% • In KGH most (69%) of the oncology visits are for 30,000 57% 30,000 75-84 30,000 Other M 27% 65-74 chemo treatments while the majority in QHC-Bel are 25,000 25,000 27% 25,000 Transfusion F for follow-up treatment. 45-64 99.7% 20,000 20,000 20,000 99.6% Hemodialysis 20-44 • KGH, with over 40,000 visits annually, is the only 15,000 15,000 0-19 15,000 reporting institution in the SELHIN that offers Dialysis 32% 35% 10,000 43% 42% 10,000 10,000 services. 5,000 5,000 5,000 • About 58% of Dialysis visits are for male patients. 14% 13% 0 0 0 • Just over 1 in 3 Dialysis visits are for individuals 45-64 Dialysis Visits by Institution 2006 2007 2006 2007 2006 2007 years, 27% for persons 65-74 years and 20% for KGH KGH KGH persons 75-84 years. Sex (2006/2007) Age (2006/2007) Treatments (2006/2007) • Hemodialysis was the dialysis service offered to more
22,000 22,000 22,000 than 99% of individuals requiring dialysis. Fig 6.10 Fig 6.11 Fig 6.12 1,2,6 19,800 19,800 19,800 17% 21% • Radiation treatment is only provided at KGH with over 17% 26% 17,600 17,600 17,600 20,000 treatments per year. 50% 4% 15,400 50% 15,400 85+ 15,400 Other • Radiation Treatments are provided equally to males 14% 4% 32% 75-84 Uterus 13,200 13,200 30% 13,200 12% and females. M 65-74 Prostate 11,000 11,000 11,000 • Nearly 3 in every 4 Radiation treatments are for F 45-64 30% Lymph Nodes 27% individuals 45-74 years. Persons aged 20-44 and 75+ 8,800 8,800 20-44 8,800 Lung 0-19 represented 6% and 20% of radiation treatments 6,600 6,600 6,600 42% 44% 30% Chest & Abdomen respectively. 50% 50% 29% 4,400 4,400 5% 4,400 6% Breast • In 2007 more than 2,100 Cardiac Caths were 14% 2,200 2,200 2,200 12% Brain performed at KGH, the only institution offering this 7% 6% 5% 5% 0 0 0 procedure. 2006 2007 2006 2007 2006 2007 • The majority (>60%) of Cardiac Caths are provided to Radiation Treatments by Institution KGH KGH KGH male patients. Sex (2006/2007) Age (2006/2007) Complex Ambulatory Classification • Most (44%) of the Cardiac Caths are also for persons (2006/2007) 45-64 while 28% are given to individuals 65-74 and 2,200 2,200 2,200 Fig 6.13 Fig 6.14 Fig 6.15 20% to individuals 75-84. 2,000 2,000 2,000 7% 1,2,7 10% 1,800 1,800 20% 1,800 • The age-sex utilization rate for Day/Night procedures 5% in the SELHIN is almost identical to that of the province 1,600 1,600 1,600 62% 85+ Other with the exception of Dialysis in 75-84 year olds (lower 1,400 1,400 1,400 28% 75-84 9% PTCA in SELHIN) and Surgical/PARR in 75-84 year olds 1,200 19% 8% M 1,200 65-74 1,200 (higher in SELHIN). 6% Circulatory System F 45-64 1,000 60% 1,000 1,000 • Five year projections for Day/Night procedures in the 26% 20-44 Cardiac Study 800 800 800 78% 0-19 SELHIN, based only on changes in population growth, 600 600 600 indicate slow average annual increases in the number 44% 77% 400 38% 400 45% 400 of procedures/treatments for Surgical/PARR (1.6%), 40% Dialysis (1.7%) and Radiation (3.1%). The number of 200 200 200 Oncology visits and Cardiac Caths would each likely 6% 4% 0 0 0
Cardiac Caths by Institution decline by about 1%. 2006 2007 2006 2007 2006 2007
KGH KGH KGH DRAFT Page 3 of 4 48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 South East Local Health Integration Network
Phone: 613-967-0196 Fax: 613-967-1341 Day / Night Procedure Profile
Distribution of Surgical / PARR Visits for SE SubLHIN areas SE LHIN Institutions
by SE LHIN Institutions (2007) 1,2,3 QHC-Bellville
QHC-Trenton
Fig 6.16 QHC-Picton
QHC-Bancroft
PSF-Smiths Falls
PSF-Perth
LACGH
HDH
KGH
BGH
Overall Distribution of Surgical / PARR Procedures for SE LHIN
7% 3% 20% Number of Surgical / PARR to Match Size of Pie 20% 12,000 6,000 25% 1,200 6% 4% 3% Distribution of Procedures by 12% residents from outside South East LHIN
1,2,4 1,2,5 Oncology Visits for SE SubLHIN areas by Institution (2007) Dialysis Visits for SE SubLHIN areas by Institution (2007)
Number of Oncology Visits Number of Dialysis Visits to Match Size of Pie to Match Size of Pie 5,000 20,000 2,500 10,000 500 2,000
Fig 6.17 Fig 6.18
Overall Distribution of Oncology Visits for SE LHIN 0.3 %
40 % Distribution of 59 % Distribution of Procedures by residents Procedures by residents from outside SE LHIN from outside SE LHIN 1 %
1,2,6 1,2,7 Radiation Treatments for SE SubLHIN areas by Institution (2007) Cardiac Catheterizations for SE SubLHIN areas by Institution (2007)
Number of Radiation Treatments Number of Cardiac Caths to Match Size of Pie to Match Size of Pie 6,000 500 3,000 250 600 50
Fig 6.19 Fig 6.20
Distribution of Distribution of Procedures by residents Procedures by residents from outside SE LHIN from outside SE LHIN Distribution of Day / Night Procedures for SE LHIN Residents Receiving Care Outside LHIN (2007) Care Received: DRAFT Inside SE LHIN Page 4 of 4 Surgical / PARR Oncology Dialysis Radiation Cardiac Caths Outside SE LHIN 2,066 1,632 Fig 6.21 6,274 (12%) (4%) 362 4,814 (11%) (16%) (21%) South East Local Health Integration Network
17,989 50,494 15,887 41,637 1,962 (79%) (89%) (88%) (96%) (84%) Day / Night Procedure Profile
Age-specific Utilization Rates for Day / Night Procedures by Age Group and SubLHIN (2006-2007) 1-7,9 Fig 6.22
South East LHIN Fig 6.23 Ontario Fig 6.24
Surgical/PARR (per 1,000) Oncology (per 1,000) Dialysis (per 1,000) Cardiac Caths (per 10,000) Radiation (per 1,000)
Reported and Projected Day / Night Procedures (2007 & 2012) 1-12 Fig 6.25 Surgical / PARR Oncology Dialysis Cardiac Catheterization Radiation Average Average Average Average Average Institution Name Annual Annual Annual Annual Annual 2007 2012 2007 2012 2007 2012 2007 2012 2007 2012 Growth (%) Growth (%) Growth (%) Growth (%) Growth (%) 2007-2012 2007-2012 2007-2012 2007-2012 2007-2012 Brockville General Hospital 10,711 11,622 1.6 57 33 -10.4 Hotel Dieu Hospital 13,168 14,539 2.0 Kingston General Hospital 6,737 6,950 0.6 9,900 10,499 1.2 43,536 47,335 1.7 2,101 1,997 -1.0 20,753 24,210 3.1 L & A County General Hospital 1,465 1,566 1.3 Perth & Smiths Falls Dist-Perth Site 2,365 2,522 1.3 207 243 3.3 Perth & Smiths Falls Dist-Smiths Falls 3,068 3,205 0.9 Quinte Health Care-Belleville 11,038 11,972 1.6 6,903 5,573 -4.2 Quinte Health Care-Picton 1,721 1,708 -0.2 Quinte Health Care-Trenton 3,676 4,310 3.2 South East LHIN 53,949 58,394 1.6 17,067 16,348 -0.9 43,536 47,335 1.7 2,101 1,997 -1.0 20,753 24,210 3.1 General Notes and Limitations: 1. All estimates are reported for fiscal periods, e.g. 2007 is April 2007 - March 2008. 7. Cardiac Catheterizations include: DI Cardiac Catheterization Lab, DI Cardiac 1.2. All Data estimates Source: are National reported Ambulatory for fiscal periods, Care Reporting e.g. 2007 is System April 2007 (NACRS) - March developed 2008. by Catheterization Interventional, DI Cardiac Catheterization Diagnostic Services. 2. Datathe CanadianSource: ¨Hospital Institute Inpatient for Health Separati Informaons,tion Provincial (CIHI) andHealth the Planning Ministry Database of Health - 8. Projections of the health care utilization are primarily based on changes in fromand Long-TermDischarge Abstract Care of Ontario.Database. (Includes data for completed/discharged cases population growth (including mortality, fertility and migration). 3. only;Surgical/Post excludes adultAnesthetic mental healthRecovery cases). Room (Surgical/PARR) visits include: IP 9. Market share and utilization rates for 2006 and 2007 combined are assumed to 3. DataOperating Source: Room, Management IP OR/PARR Information Combined, Syst ORem, GeneralMinistry Surgical,of Health OR and Cystology, Long Term OR remain constant until 2012. Care.Plastic Surgery, OR Neurosurgery, OR Ophthalmology, OR Orthopaedic, PARR, 10. Population estimates at the SubLHIN and LHIN levels were accessed from the PARR General, AC D/N Care-Pre/Post Op Care (OR/PARR Excl.), AC D/N Care-Surg 4. Categories based on a modified HSRC grouping of acute care services. Provincial Health Planning Database., MOHLTC. Population projections at the Proc (OR/PARR Incl.), AC D/N Care-Surg Operating Rooms, AC D/N SubLHIN level were generated by the South East LHIN based on cohort 5. ACSCCare–Endoscopy. includes Grand mal status and other epileptic convulsions, COPD, Acute bron- component methodology. 4. chitis Oncology or Pneumonia visits include: when AC COPD D/N Care is secondary,-Oncology, Asthma, AC D/N CongestiveCare-Oncology–Chemo, heart failure, Hypertention or Angina with selected procedures, Diabetes; Excludes patients 75+ 11. South East SubLHIN, sex and age group (0-19, 20-44, 45-64, 65-74, 75-84, 85+) AC D/N Care-Oncology-Other Supp. Therapy, Fund 3-AC D/N Care–Oncology. or with death as discharge status. are assumed to be independent strata. 5. Dialysis visits includes: AC D/N Care-Hemodialysis, AC D/N Care-Home Dialysis 6. Excludes patients with length of stay of 1,000 or more days. 12. Projections of health care utilization do not incorporate program realignments (Teaching) Comb, AC D/N Care-Home Hemo (Teaching), AC D/N Care-Self-Care or enhancements, changes in service demand, technological or clinical Hemodialysis. developments, or changes in disease prevalence. 6. Radiation includes: RAD Radiation Oncology, RAD Treatment. DRAFT QHC-Ban Version I - July 2009 South East Local Health Integration Network BGH
Adult Inpatient Rehabilitation Profile PC KGH QHC-Bel
Inpatient Rehab Admissions & Bed Days by Data Source (2003-2007)1-5 Introduction:
Fig 7.1 Admissions (NRS) Admissions (MIS TB) Days (NRS) Days (MIS TB) The Regional Capacity Assessment Project (ReCAP) provides 400 16,000 a profile, including short-term projections, on the utilization of health care services in the South East LHIN. Results of 350 14,000 ReCAP are used to support the recommendations in the Integrated Health Service Plan for the South East region. 300 12,000 This short report on Adult Inpatient Rehabi is one in a series of summary analyses from ReCAP that focuses on specific 250 10,000 health care services. In the SE LHIN, 4 institutions provide Adult Inpatient Rehab services: BGH, KGH, PC and QHC-Bel. 200 8,000 Days Summary of Main Findings:
Admissions 150 6,000 • This report utilizes data from 2 main sources: National 100 4,000 Rehabilitation Reporting System (NRS) and the Management Information System (MIS). NRS is applied 50 2,000 mainly for evaluating service utilization while MIS is used for general financial and statistical reporting. Although MIS 0 0 does not contain details required for a comprehensive review of the utilization of rehab services, the data source 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 is consistent with the daily census summary of patient BGH KGH PC QHC-Bel activity and therefore considered to be a more accurate summary of total admissions and bed days than the NRS. Inpatient Rehab Bed Days by Age Group - Females (2003/2007)1,2,4,5 Fig 7.2 17-44 45-64 65-74 75-84 85+ • Compared to MIS, the NRS totals are very similar for both 2,500 rehab admissions and bed days in all SE LHIN institutions with the exception of PC and QHC-Bel (under-reporting admissions and days in 2006 and 2007). Note that no data 2,000 was recorded for KGH in 2007 (These data are likely included with acute inpatient data).
• By the end of 2007 most of the rehab admissions in the SE 1,500 LHIN were seen in PC (>360) followed by KGH (183 in 2006), QHC-Bel (147) and BGH (51). Rehab bed days were also highest in PC (>13,600) but trailed by QHC-Bel with 1,000 5,800. KGH which usually has shorter rehab length of stays only had 1,505 bed days (in 2006) while BGH reported 1,369 by the end of 2007. 500 • For the most part, both admissions and bed days reflect similar trends between 2003 and 2007. BGH, PC and QHC- Bel just recorded minor fluctuations during the period but 0 KGH showed significant reductions, particularly in the 2003 2007 2003 2006 2003 2007 2003 2007 number or admissions (337 in 2003 to 183 in 2006). BGH KGH PC QHC-Bel • Between 2003 and 2007 there was a notable shift in the Inpatient Rehab Bed Days by Age Group - Males (2003/2007)1,2,4,5 percentage of adult females utilizing rehab services (54% Fig 7.3 of bed days) compared to adult males (48%). This pattern 17-44 45-64 65-74 75-84 85+ was also observed in all of the reporting institutions 2,500 except BGH (which actually recorded a higher percentage of utilization for females—38% in 2003 to 51% in 2007).
2,000 • Females utilize more rehab services when they are older while males do the same at younger age groups. For example in 2007 females 75+ accounted for 54% of overall 1,500 rehab bed days compared to males in the same age group which only represented 37% of bed days.
• Across institutions, females 75-84 utilized rehab services 1,000 most frequently while males 45-64 recorded the most rehab bed days. Note that individuals 85+ still accounted for 22% and 11% of bed days in females and males 500 respectively.
• In 2007, rehab admissions originated primarily from acute 0 care facilities either within the same institution (42%) or a 2003 2007 2003 2006 2003 2007 2003 2007 different institution (49%). There was however some variation in referral patterns depending on the institution BGH KGH PC QHC-Bel that provided the service. Admissions from within the same institution was the majority in BGH (82%), QHC-Bel Legend: (56%) and KGH (99%) while admissions from a different BGH-Brockville General Hospital PC-Providence Care institution was the most in PC (86%) but also high in QHC- Bel (36%). Private practice or other/unknown sources KGH-Kingston General Hospital QHC-Bel-Quinte Health Care - Belleville accounted for 5.2% and 3.6% of overall admissions respectively. Continued - Page 2
Please send any questions or comments to: [email protected] Page 2 of 4 DRAFT South East Local Health Integration Network
Adult Inpatient Rehabilitation Profile
Distribution of Inpatient Rehab Admissions by Distribution of Inpatient Rehab Admissions by Institution & Referral Source (2003/2007) 1,2,4 Institution & Admission Class (2003/2007) 1,2,4 100% 100% 5% 3% 4% 8% Fig 7.4 7% 5% Fig 7.5 14% 10% 16% 90% 90% 11% 19% 33% 80% 80% Other/Unknown 36% 70% 70% Other 36% 62% Private Practice 60% 60% Re-Admission
Inpatient Acute, Short Stay 50% 96% 98% 99% 50% 98% 98% Different Facility 93% 94% 96% 86% Initial Rehab 82% 84% 40% 78% Inpatient Acute, 40% Same Facility 67% 30% 30% 56% 50% 20% 20% 35%
10% 10%
0% 0% 2003 2007 2003 2006 2003 2007 2003 2007 2003 2007 2003 2006 2003 2007 2003 2007
BGH KGH PC QHC-Bel BGH KGH PC QHC-Bel Summary of Main Findings - Continued:
• The class of admission for the vast majority of rehab cases in the SE LHIN is for Initial Rehab • Generally for SE LHIN institutions patients stay between 30-40 days in Rehab beds regardless care. Only in KGH was the admission class reported as Short Stay for about 62% of all of age group. For patients under 45 years at PC the length of stay approximates 50 days admissions in 2006. while at KGH is roughly 8 days on average.
• With the exception of KGH, rehab bed days were mainly utilized for patients recovering from • Since 2004 Inpatient Rehab Occupancy rates in PC and BGH have been fairly constant stroke related conditions (28%-52%) followed by pulmonary associated conditions (15%- ranging between 70% and 85%. Towards the end of the 2006/2007 period however the 33%). In KGH most of the bed days were taken up by patients with either debility related highest occupancy rates for Inpatient Rehab were seen in QHC-Bel (94%) and the lowest in (35%) or orthopaedic conditions (34%). Some bed days (12%) were also required for medi- KGH (41%). cally complex conditions. • For individuals over 65 years, utilization rates for inpatient rehab is lower in SE LHIN than in • There were noticeable changes in how rehab beds were utilized between 2003 and 2007. In the province: < 5 per 1,000 for 65-74 and <9 per 1,000 for 75+ in SE LHIN compared to >7 almost all institutions there was a reduction in the percentage of stroke related conditions per 1,000 for 65-74 and >17 per 1,000 for 75+ in Ontario. Utilization rates in SE LHIN are but a corresponding increase in orthopaedic conditions. There was also a tendency to similar for both sexes whereas at the provincial level rates are higher for females. accommodate a wider variety of conditions including more brain dysfunctions. In 2003 • Across the SE LHIN region utilization rates are commonly below 10 per 1,000 with the about 90% of bed days were utilized for debility conditions but in addition to these and exception of Kingston & Islands and Stone Mills/Loyalist where rates are 10 or more per orthopaedic conditions, KGH also catered to limb amputations, cardiac, pulmonary and 1,000 for both males and females. medically complex conditions. • Projections for adult inpatient rehab services, which have been based only on changes in • Nearly all institutions in the SE LHIN achieved set goals and returned rehab patients back to population growth, point to annual increases of 6.1%, 2.8% and 3.88% in admissions, bed the community (66%-80% of bed days). In other instances the goals were met but patients days and beds respectively were transferred to another facility. In KGH 56% of bed days were utilized to meet set goals but for 42% of bed days the goals were not achieved before patients were transferred to • No cases reported for KGH in 2007 so data for 2006 was used as a proxy another facility. Distribution of Inpatient Rehab Bed Days by Distribution of Inpatient Rehab Bed Days by Institution & Rehabilitation Client Group (2003/2007) 1,2,4,5 Institution & Discharge Status (2003/2007) 1,2,4,5 100% 100% 4% 6% 3% Fig 7.6 3% Fig 7.7 6% 4% 3% 7% 9% 10% 12% 15% 11% 90% 90% 15% 13% 3% 17% 15% Other 9% 16% 29% 80% 3% 80% Medically Complex 42% 22% 3% 22% 3% 32% 33% 6% 20% 3% Other/Unknown 70% 9% 35% 4% Debility (except 70% Card/Pulm) 63% Pulmonary 5% 60% 8% 60% 5% Cardiac 8% 90% 4% 11% Goals Not 50% 50% 6% 10% Orthopaedic 12% Met/Trans to Conditions Other Unit/Facility 4% 4% Limb Amputation 40% 40% 82% 80% 12% 74% Goals 68% 15% Spinal Cord 4% 67% 65% 66% 67% Met/Transferred 30% Dysfunction 30% Neurological to Other 52% 50% 34% Conditions Unit/Facility 44% 20% Brain Dysfunction 20% Goals 32% 30% 28% Stroke Met/Discharge To 10% 10% Community 6% 3% 0% 0% 2003 2007 2003 2006 2003 2007 2003 2007 2003 2007 2003 2006 2003 2007 2003 2007
BGH KGH PC QHC-Bel BGH KGH PC QHC-Bel DRAFT Page 3 of 4 48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 South East Local Health Integration Network
Phone: 613-967-0196 Fax: 613-967-1341 Adult Inpatient Rehabilitation Profile
Average Length of Stay (days) for Inpatient Rehab Separations by Occupancy Rate for Inpatient Rehab Beds by Age Group & Institution (2006 & 2007 Combined) 1,2,4,5 Year & Institution (2003-2007) 1,3,4,5
Fig 7.8 Fig 7.9 50 100%
45 90%
40 80%
35 70%
30 BGH 60% KGH 25 50% PC
20 QHC-Bel 40%
15 30%
10 20%
5 10%
0 0% 17-44 45-64 65-74 75+ 2003 2004 2005 2006 2007
Distribution of Inpatient Rehabilitation Admissions for SE SubLHIN areas by SE LHIN Institutions (Average of 2006/2007)1,2
South East LHIN Rehabilitation Institution
QHC-Belleville PC Fig 7.10 KGH
BGH
Number of Rehab Admissions to Match Size of Pie 250 125
25
Overall Distribution of Rehab Admissions for SE LHIN Institutions
6% 21% 20%
Distribution of Rehab Admissions for Residents from outside SE LHIN
53% Distribution of Inpatient Rehab Admissions for SE LHIN DRAFT Residents Receiving Care Outside LHIN (2007) Page 4 of 4
(3%)
Outside LHIN South East Local Health Integration Network
SE LHIN (97%) Adult Inpatient Rehabilitation Profile
1,2,9 Fig 7.11 Age-Specific Rates for Inpatient Rehabilitation Admissions (per 1,000) by Sex and SubLHIN area (2006 & 2007 combined)
South East LHIN Fig 7.12 Ontario Fig 7.13
Reported and Projected Inpatient Rehab Admissions and Bed Days by SE LHIN Institution and Year (Average of 2006 & 2007) 1-11 Fig 7.14 Avg. Annual Statistic Reported Projected Institution Name % Growth 2006 2007 2008 2009 2010 2011 2012 2007-2012 Seps 48 51 51 52 54 55 56 1.9 Days 1,430 1,369 1,444 1,478 1,514 1,551 1,589 3.0 Brockville General Hospital Beds55 555663.7 Occ. 78.40% 75.70% 77.10% 77.10% 77.10% 77.10% 77.10% Seps 190 98 99 101 103 105 -9.4 Days 1,505 775 791 808 825 843 -9.2 Kingston General Hospital*10 Beds10 55556-8.2 Occ. 41.20% 41.20% 41.20% 41.20% 41.20% 41.20% Seps 380 363 383 391 399 408 417 2.8 Days 13,371 13,646 13,883 14,164 14,452 14,749 15,054 2.0 Providence Care Beds 46 46 47 48 49 50 51 2.1 Occ. 79.60% 81.30% 80.50% 80.50% 80.50% 80.50% 80.50% Seps 169 146 162 165 169 172 176 3.8 Days 5,788 5,829 5,980 6,109 6,243 6,381 6,528 2.3 Quinte Health Care-Belleville Beds 17 17 18 18 18 19 19 2.2 Occ. 93.30% 93.90% 93.60% 93.60% 93.60% 93.60% 93.60% Seps 787 560 694 707 723 738 754 6.1 South East LHIN Days 22,094 20,844 22,082 22,542 23,017 23,506 24,014 2.9 Beds 78 68 75 76 77 80 82 3.8 General Notes and Limitations: 1. All estimates are reported for fiscal periods, e.g. 2007 is April 2007 - March 2008. 7. Market share and utilization rates for 2006 and 2007 combined are assumed to 2. Data Source: National Rehabilitation Reporting System (NRS) developed by the remain constant until 2012. Canadian Institute for Health Information (CIHI) and the Ministry of Health and 8. South East SubLHIN, sex and age group (17-44, 45-64, 65-74, 75-84, 85+) are as- Long-Term Care of Ontario. NRS is an admission based system so incomplete or sumed to be independent strata. open cases are also included; total separations and corresponding lengths of stay 9. Population estimates at the SubLHIN and LHIN levels were accessed from the Provin- may not necessarily match separations and inpatient days obtained from MIS. cial Health Planning Database, MOHLTC. Population projections at the SubLHIN level 3. Data Source: Management Information System (MIS), Ministry of Health and Long were generated by the South East LHIN based on cohort component methodology. Term Care. 10. Since KGH did not report rehab beds in 2007, only data for 2006 (representing half of 4. For trending purposes St. Vincent de Paul, transferred from Providence Continuing rehab activities for the 2006/2007 period) were incorporated in the projections Care Centre to Brockville General Hospital in October 2006, is shown as BGH. 11. Projections of health care utilization do not incorporate program realignments or 5. In order to compute the number of bed days and length of stay, records without enhancements, changes in service demand, technological or clinical developments, discharge dates are assumed to be current patients. or changes in disease prevalence. 6. Projections of the health care utilization are primarily based on changes in population growth (including mortality, fertility and migration). DRAFT
QHC-Ban Version I - July 2009 PSF-P
BGH South East Local Health Integration Network
Complex Continuing Care Profile PC QHC-Bel LACGH QHC-Tren
QHC-Pict Complex Continuing Care Admissions & Bed Days by Data Source (2003-2007) 1-5 Introduction:
The Regional Capacity Assessment Project (ReCAP) provides a Fig 8.1 Admissions (CCRS) Admissions (MIS TB) Days (CCRS) Days (MIS TB) 400 35,000 profile, including short-term projections, on the utilization of health care services in the South East LHIN. Results of ReCAP are used to support the recommendations in the Integrated Health 350 30,000 Service Plan for the South East region. This short report on 300 Complex Continuing Care is one in a series of summary analyses 25,000 from ReCAP that focuses on specific health care services. There 250 are 6 institutions in the SELHIN, that provide complex continuing 20,000 care to patients: BGH, PC, LACGH, PSF-Perth, QHC-Bel, QHC-Pict
200 Days and QHC-Tren. 15,000 Summary of Main Findings: Admissions 150 • This report utilizes data from 2 main sources: Continuing Care 10,000 100 Reporting System (CCRS) and the Management Information System (MIS). CCRS is applied mainly for evaluating service 50 5,000 utilization while MIS is used for general financial and statistical reporting. Although MIS does not contain details required for a 0 0 comprehensive review of the utilization of Complex Continuing Care (CCC) services, the data source is consistent
2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 with the daily census summary of patient activity & therefore BGH PC LACGH PSF-Perth QHC-Bel QHC-Pict QHC-Tren considered to be a more accurate summary of total admissions and bed days than the CCRS. Complex Continuing Care Bed Days by Age Group - Females (2003/2007) 1,2,4,5 • Between 2003 & 2007 the number of admissions from the Fig 8.2 0-19 20-44 45-64 65-74 75-84 85+ CCRS was generally similar to that of the MIS -the only notable 6,000 exception being PC with an average of about 40 more admissions in MIS than CCRS. During the same period there were substantial differences in the number of bed days 5,000 between both systems, particularly in PC (with about 17,000 fewer days in CCRS) and BGH (CCRS falling short by about 8,000 4,000 days). In the other sites the gap decreased with time and only QHC-Bel reported any differences of more than 1,000 days between both systems by the end of 2007. As a whole the MIS 3,000 recorded 1,028 admissions and 75,941 bed days in 2007.
• Overall, females utilize complex care services more than males— although the percentage associated with bed days 2,000 has been declining with time (females were 63% in 2003 to 59% in 2007). Incidentally this percentage has been falling only 1,000 in the larger institutions (64% in 2003 to 56% in 2007 for BGH, PC and QHC-Bel combined versus 61% in 2003 to 69% in 2007 for LACGH, PSF-P and QHC-Tren combined). 0 • In 2007, more than 1 in 3 bed days for complex continuing care 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 (CCC) across the SE LHIN were for elderly patients 75+. It BGH PC LACGH PSF-P QHC-Bel QHC-Pict QHC-Tren should be pointed out however, that a quarter of all bed days Complex Continuing Care Bed Days by Age Group - Males (2003/2007) 1,2,4,5 in BGH were provided to individuals 65-74 and one fifth Fig 8.3 assigned to patients 45-64 in PC. 0-19 20-44 45-64 65-74 75-84 85+ • For the majority of SE LHIN institutions the main source of CCC 6,000 patients is from acute care units (>87%). In BGH & PC only 34%-52% reported acute care as the source of transfer but 5,000 since 44%-59% were either other or unknown sources, a much larger percentage from acute care is anticipated for these institutions. 4,000 • In 2007, circulatory diseases were the most frequently assessed diagnostic condition (23%-28% across SE LHIN institutions) for 3,000 CCC patients, followed by mental health (7%-17%) and musculoskeletal conditions (8%-18%). Cancer, Endocrine, Nervous & Respiratory conditions each represented between 2,000 2%-8% of all assessed conditions for this patient group, while all other conditions combined represented 22%-29%.
1,000 • Overall in 2007, 1 in 3 complex care bed days was provided for clinically complex care, 1 in 5 for medium-level rehab care, 1 in 6 each for low-level rehab care or special care. However these 0 distributions varied quite extensively among the SELHIN 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 institutions. For the same period more than 1 in 4 bed days in BGH PC LACGH PSF-P QHC-Bel QHC-Pict QHC-Tren PC and QHC-Tren and 2 in 5 bed days in PSF-P were associated with the provision of medium-level rehab care. Bed days for
Legend: clinically complex care amounted to 25% or less in PC, PSF-SF BGH - Brockville General Hospital QHC-Bel - Quinte Health Care-Belleville or QHC-Tren. Almost a quarter of bed days in QHC-Bel were PC - Providence Care QHC-Pict - Quinte Health Care-Picton provided to special care patients. Between 2003 & 2007 clinically complex care had a reduction of more than 6,000 bed LACGH - Lennox & Addington County General Hospital QHC-Tren - Quinte Health Care-Trenton days while medium-level and low-level rehab care each PSF-P - Perth & Smiths Falls Hospital-Perth dropped by more than 3,000 bed days. Continued - Page 2
Please send any questions or comments to: [email protected] Page 2 of 4 DRAFT South East Local Health Integration Network
Complex Continuing Care Profile
Distribution of Complex Continuing Care Admissions by Distribution of Complex Continuing Care Assessed Institution & Source of Transfer (2003/2007) 1,2,4 Conditions by Institution (2007) 1,2,4 100% 100% 3% 9% 8% 4% 4% Fig 8.4 Fig 8.5 9% 90% 4% 90% 24% 22% 27% 29% 28% 29% 80% 44% 80% Other 46% 48% 6% 8% 70% 59% Respiratory 70% 6% 4% 4% 3% 3% 4% Other/Unknown 2% 6% 4% 3% 60% Nervous 60% 13% 13% 10% 12% 4% Chronic/Rehab 8% 18% 50% Facility Musculoskeletal 5% 97% 97% 96% 94% 95% 96% 50% 90% 92% 7% 87% 13% Nursing/Home 14% 17% 40% Mental Health Care 12% 17% 4% 40% 12% 8% Acute Care 8% Endocrine 30% 7% 52% 10% 7% 49% 30% 46% 20% Circulatory 34% 27% 20% 24% 28% 23% Cancer 10% 27% 21% 10% 0% 8% 7% 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 3% 6% 5% 5% 0% BGH PC LACGH PSF-P QHC-Bel QHC-Pict QHC-Tren BGH PC LACGH PSF-P QHC-Bel QHC-Tren
Summary of Main Findings - Continued:
• After utilizing most of the reported bed days for complex continuing care, almost all SE • Compared to the province SE LHIN has very similar utilization rates for complex continuing LHIN institutions end up transferring patients to other institutions (41%-52% of bed days) care services: marginally fewer than 5 per 1,000 for patients 65-74 and just over 10 per or patients become deceased (11%-40% of bed days). The only exception is PC where the 1,000 for patients 75+. majority of bed days conclude with patients being discharged home (38% in 2007) or deceased (34%). Like all of the other previous indicators there are also high percentages • In a few SubLHIN areas however, utilization rates are much higher for patients aged 75+ (21% overall) of bed days with an unknown discharge status. in Belleville, Central Hastings and Quinte West/Brighton, all have rates above 20 per 1,000.
• Between 2003 and 2007 the average length of stay for complex continuing care patients • Projections for complex continuing care admissions and beds in the SELHIN have been have been falling in the majority of institutions in the SELHIN—BGH by 27 days, PC by 27 generated based only on the assumptions of changes in population growth and current days, LACGH by 12 days, PSF-P by 38 days. QHC-Bel was the only institution in the SELHIN utilization patterns. Between 2007 and 2012 the number of admissions, bed days and beds reporting either constant or increasing lengths of stay during the period (0-2 days). By the are projected to increase annually by 2.9%, 3.0% and 2.5% respectively. Of the 29 additional end of 2007, average length of stay at QHC-Tren was recorded at 56.5 days while that at CCC beds that would be required by the end of the 5 year period, 9 would be needed in other institutions ranged from 30-46 days. PC, 5 in PSF-P, 5 in QHC-Trenton and 4 or less in the remaining institutions.. Bed days in PSF-P are expected to increase annually by almost 10%. In the same time frame. • Occupancy rates for complex continuing beds generally remained constant since 2003 with PC recording 83%-92% and BGH, PSF-P, QHC-Bel and QHC-Tren with over 95% of available bed days. LACGH had the lowest occupancy rates of all SELHIN institutions (38% in 2007).
Distribution of Complex Continuing Care Days by Distribution of Complex Continuing Care Days by Institution & Resource Utilization Group (2003/2007) 1,2,4,5 Institution & Discharge Status (2003/2007) 1,2,4,5
100% 100% 4% 7% 5% 4% Fig 8.6 7% Fig 8.7 9% 10 % 8% 10 % 10 % 10 % 15 % 9% 15 % 18 % 90% 6% 90% 21% 3% 4% 23% 9% 16 % 25% 9% 6% 24% 31% 33% Reduced Physical 35% 34% 80% 43% Function 80% 42% 20% 47% 4% 9% Behavioural 10 % 56% Unknown 70% 33% Problems 70% 24% 10 % 36% 13 % 38% 39% Impaired Cognition 52% 38% 13 % 40% 6% 5% 63% 68% Discharged Home 60% 15 % 60% 13 % 52% 3% Clinically Complex 28% 10 % 16 % 69% 50% Care 50% Transferred to 14 % 7% 51% 13 % Special Care 47% Other Institution 24% 16 % 34% 43% 4% 12 % 40% 11% 40% 41% Deceased 15 % 13 % 9% 19 % Extensive Care 41% 23% 6% 42% 30% 30% 58% 6% Rehab - Low 48% 10 % 20% 38% 20% 40% 32% 12 % 39% 3% 38% 30% 8% 29% Rehab - Medium 34% 31% 17 % 29% 25% 26% 28% 6% 21% 22% 20% 22% 10% 10% 17 % 15 % Rehab - High-Ultra 15 % 12 % 11% 7% 7% 3% 0% 0% 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007
BGH PC LACGH PSF-P QHC-Bel QHC-Pict QHC-Tren BGH PC LACGH PSF-P QHC-Bel QHC-Pict QHC-Tren DRAFT Page 3 of 4 48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 South East Local Health Integration Network
Phone: 613-967-0196 Fax: 613-967-1341 Complex Continuing Care Profile
Average Length of Stay for Complex Continuing Care Occupancy Rate for Complex Continuing Care Admissions by Age Group & Institution (2003 - 2007) 1,2,4,5 Beds by Year & Institution (2003-2007) 1,2,3,4
Fig 8.8 Fig 8.9 80 100%
90% 70
80% 60 70% BGH 50 PC 60% LACGH 40 PSF-Perth 50% QHC-Bel 40% 30 QHC-Pict QHC-Tren 30% 20 20%
10 10%
0 0% 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007
Distribution of Complex Continuing Care Admissions for SE SubLHIN areas by SE LHIN Institutions (Average of 2006/2007) 1,2
SE LHIN Complex Continuing Care Institution QHC-Trenton
QHC-Belleville
LACGH
Fig 8.10 PC
PSF-P
BGH
Number of CCC Admissions to Match Size of Pie 300 150
30
Overall Distribution of CCC Admissions for SE LHIN Institutions
14% 20%
Distribution of CCC Admissions 24% for residents from outside SE LHIN 32% 7% 3% Distribution of Complex Continuing Care Admissions for SE LHIN DRAFT Residents Receiving Care Outside LHIN (2007) Page 4 of 4
(1%)
Outside LHIN South East Local Health Integration Network
SE LHIN (99%) Complex Continuing Care Profile
Fig 8.11 Age-Specific Rates for Complex Continuing Care Admissions (per 1,000) by SubLHIN Area (2006 & 2007 combined) 1,2,9
South East LHIN Fig 8.12 Ontario Fig 8.13
Fig 8.14 Reported and Projected Complex Continuing Care Admissions and Bed Days by SE LHIN Institution and Year (Average of 2006 & 2007) 1-11 Avg. Annual Statistic Reported Projected Institution %Growth 2006 2007 2008 2009 2010 2011 2012 2007-2012 Admissions 200 193 203 207 212 217 222 2.8 Days 14,155 14,079 14,566 14,916 15,275 15,648 16,035 2.6 Brockville General Hospital Beds 42 42 42 43 44 45 46 1.8 Occupancy 93.7% 95.9% 94.8% 94.8% 94.8% 94.8% 94.8% Admissions 347 323 344 351 357 364 371 2.8 Days 31,847 29,755 31,719 32,294 32,890 33,507 34,144 2.8 Providence Care Beds 96 98 100 102 103 105 107 1.8 Occupancy 91.0% 83.2% 87.1% 87.1% 87.1% 87.1% 87.1% Admissions 33 21 28 29 30 30 31 8.1 Days 1,135 1,105 1,173 1,227 1,282 1,337 1,394 4.8 Lennox & Addington County General Hospital Beds 8 8 8 9 9 10 10 4.6 Occupancy 38.9% 37.8% 38.4% 38.4% 38.4% 38.4% 38.4% Admissions 81 64 73 73 73 74 74 2.9 Days 5,941 2,803 4,424 4,435 4,449 4,465 4,485 9.9 Perth & Smiths Falls Hospital-Perth Beds178 121212121310.2 Occupancy 100.2% 96.0% 98.1% 98.1% 98.1% 98.1% 98.1% Admissions 218 238 233 238 242 246 251 1.1 Days 12,017 12,005 12,299 12,514 12,737 12,969 13,210 1.9 Quinte Health Care-Bellville Beds 33 33 35 35 36 37 37 2.5 Occupancy 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% Admissions 150 121 141 145 149 152 157 5.3 Days 10,846 10,667 11,207 11,503 11,806 12,119 12,441 3.1 Quinte Health Care-Trenton Beds 30 30 31 32 33 34 35 3.1 Occupancy 99.1% 97.5% 98.3% 98.3% 98.3% 98.3% 98.3% Admissions 1,029 960 1,022 1,043 1,063 1,083 1,106 2.9 South East LHIN Days 75,941 70,414 75,388 76,889 78,439 80,045 81,709 3.0 Beds 226 219 228 233 237 243 248 2.5 General Notes and Limitations: 1. All estimates are reported for fiscal periods, e.g. 2007 is April 2007 - March 2008. 7. Market share and utilization rates for 2006 and 2007 combined are assumed to remain 2. Data Source: Continuing Care Reporting System (CCRS) and its predecessor, Ontario constant until 2012. Chronic Care Patient System (OCCPS), both developed by the Canadian Institute for Health 8. South East SubLHIN, sex and age group (0-19, 20-44, 45-64, 65-74, 75-84, 85+) are assumed Information (CIHI) and the Ministry of Health and Long-Term Care of Ontario. CCRS is an to be independent strata. admission based system so incomplete or open cases are also included; total separations 9. Population estimates at the SubLHIN and LHIN levels were accessed from the Provincial and corresponding lengths of stay may not necessarily match separations and inpatient Health Planning Database, MOHLTC. Population projections at the SubLHIN level were days obtained from MIS. generated by the South East LHIN based on cohort component methodology. 3. Data Source: Management Information System (MIS), Ministry of Health and Long Term Care. 10. Projections of health care utilization do not incorporate program realignments or en- hancements, changes in service demand, technological or clinical developments, or 4. For trending purposes St. Vincent de Paul, transferred from Providence Continuing Care changes in disease prevalence.. Centre to Brockville General Hospital in October 2006, is shown as BGH. 5. In order to compute the number of bed days and length of stay, records without discharge dates are assumed to be current patients. 6. Projections of the health care utilization are primarily based on changes in population growth (including mortality, fertility and migration). DRAFT Page 1 of 8 Version I - June 2009
Smiths Falls South East Local Health Integration Network Brockville Home Care Profile Kingston
Belleville Number of Applications, Assessments & Admissions for Introduction: 1 , 2 SE LHIN Community Care Access Centre (Q1 2005 - Q2 2008) The Regional Capacity Assessment Project (ReCAP) 7,000 Fig 9.1 provides a profile, including short-term projections, on the utilization of health care services in the South East LHIN. Results of ReCAP are used to support the 6,500 recommendations in the Integrated Health Service Plan for the South East region. This short report on Home 6,000 Care services that are accessible through the South East Applications Community Care Access Centre (SE CCAC) is one in a series of summary analyses from ReCAP that focuses on 5,500 Assessments specific health care services.
Admissions Community Care Access Centre (CCAC): 5,000 Community Care Access Centre (CCAC) connects clients with care needed at home and in the community. Assistance is provided to help clients stay 4,500 in their own home longer by coordinating care in the community, including specialized support services.
4,000 CCAC also provide clients with information about Long- Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Term Care options if it becomes too difficult to live
2005 2006 2007 2008 independently at home. Summary of Main Findings: Number of Applications by Source Referral (Q1 2005 - Q2 2008) 1 , 2 8,000 • In spite of the inconsistent trends, there were general increases in the number of applications and Fig 9.2 assessments for home care services in the SE LHIN since 7,000 LTC 2005. By the end of Q2 2008 SE CCAC received 6,709 applications for home care services and conducted 11% 12% 6,000 11% 12% Hospital-Outpatient 6,686 assessments. Note that the next 3 quarters 11% 12% 11% 12% 12% indicated a substantial reduction in the number of 5,000 12% Hospital-Inpatient applications which would likely be matched by a 10% 11% 12% 36% 38% 41% 37% GP corresponding seasonal drop in assessments. 37% 37% 4,000 38% 13% 39% 37% • In calendar 2005 the number of admissions matched 42% 36% 36% Educational 35% Organization the number of applications but since Q1 2006 3,000 39% 11% 12% Community / Other admissions have fallen short of applications, reaching a 10% 11% 13% 12% 13% 11% 12% Individual difference of over 1,600 by the end of Q3 2007. 11% 12% 5% 2,000 11% 5% 12% CCAC 6% 19% 16% • The majority of applications to SE CCAC are referred 19% 19% 17% 18% 19% 19% 22% 18% 15% from hospital inpatient units (37%-42% since Q3 2007) 23% 20% 15% Client 1,000 16% followed by the community or other individuals (15%- 8% 9% 10% 12% 9% 10% 8% 8% 9% 9% 9% 9% 8% 8% 19%), GPs (12%-16%) & hospital outpatients (12%-13%). 6% 6% 5% 5% 5% 5% 5% 0 6% 5% 5% 5% 5% 4% 5% • Most applications to SE CCAC are assessed as eligible to Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 receive some form of service, though mainly in-home 2005 2006 2007 2008 service (60%-68% in calendar 2007). About 1 in 10 Number of Assessments by Service Eligibility (Q1 2005 - Q3 2007)1 , 2 applications were deemed not eligible for services (not 8,000 meeting the criteria was the most common reason).
Fig 9.3 • The SubLHIN distributions of applications and 7,000 assessments by referral and eligibility categories largely Not Eligible-Referred mirror the distribution in the LHIN as a whole. 4% 4% 11% 10% to Community 6,000 10% • Although there were not major changes over time, the 16% 4% 4% 16% Not Eligible-Criteria 18% 16% 16% number of SE CCAC admissions differs substantially by not met 5,000 15% 15% 16% sex and age group. Overall more females (55%) utilize 8% 8% 16% 15% 10% 11% Eligible-Other the services offered by the SE CCAC and even more for 15% 9% 9% 10% 4,000 clients 85+ (67%). Only 28% of the clients 19 or younger Eligible-Long Term were female. For the most part the majority of SE CCAC Care clients are elderly (66% are 65+) while just over a quarter 3,000 84% Eligible-Another CCAC are other adults and 8% are youths. 71% 83% 85% 71% 70% 68% • Service goals vary dependent largely on the sex and age 2,000 85% 60% 60% 60% Eligible-Client group of clients. Younger clients utilize more school- declined based services (proportionally more males) but older 1,000 Eligible-Admitted clients depend more on residential care and in-home In-home services maintenance (proportionally more females). In-home 0 rehab care is used more by adults 45-64 than any other Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 age group. Most of these patterns appear to be 2005 2006 2007 increasing with time. Continued - Page 3 Page 2 of 8 DRAFT South East Local Health Integration Network
Home Care Profile
Distribution of Applications for SE SubLHIN Areas by Source of Referral (2007) 1 ,2 Source of Referral Number of Applications Categories to match Size of Pie 5,000 Client 2,500 CCAC 500 Educational Organization
Hospital Inpatient Fig 9.4 Hospital Outpatient
General Physician
Long Term Care
Other Individual
Overall Distribution of Applications for SE LHIN
5.5% 17.8% 7.2% 3.6% 2.9%
13.2% Distribution of Applications for 38.6% residents from outside SE LHIN 11.2%
Distribution of Assessments for SE SubLHIN Areas by Service Eligibility (2007) 1 , 3 Service Eligibility Number of Assessments to match Size of Pie Categories 4,000 Eligible-Admitted 2,000 In-Home Services Eligible-Client Declined 400 Eligible-Another CCAC Fig 9.5 Eligible-Long Term Care
Eligible-Other
Not Eligible-Criteria Not Met Not Eligible-Referred to Community
Overall Distribution of Assessments for SE LHIN 1.1% 0.1% 10.5%
15.6%
59.9% Distribution of Assessments for residents from outside SE LHIN 10.4%
2.4% DRAFT Page 3 of 8 48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 South East Local Health Integration Network
Phone: 613-967-0196 Fax: 613-967-1341 Home Care Profile
1 , 2 Number of Community Care Access Centre (CCAC) Admissions by Sex & Age Group (Q1 2005 - Q3 2007) 1,200 Fig 9.6 Summary of Main Findings-continued:
• The average length of stay for SE 1,000 CCAC admissions appeared to be declining with time, particularly in 800 0-19 the younger (by more than half 20-44 between Q1 2005 and Q3 2007) and 600 45-64 older age groups (by more than a 65-74 third in the same period). By the end 400 of Q3 2007 the average length of 75-84 stay was under 100 days with the 85+ 200 exception of males 0-19 (135 days on average).
0 • SE CCAC clients who are younger Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 tended to have completed the 2005 2006 2007 2005 2006 2007 service plan and were discharged Female Male from the SE CCAC. Although some 1 , 2 Fig 9.7 Distribution of CCAC Admissions by Sex, Age Group & Initial Care Goal (2005 - 2007) of the older clients also completed their service plan, many others were Goals not yet determined In-Home- Acute In-Home- Maintenance In-Home- Rehab In-Home-End of Life In-Home-LTC Residential 100% admitted to LTC, hospitalized or 5% 5% 6% 6% 10% 9% 13% 15% 11% 11% 13% died. These distributions may have 90% 12% 11% 11% 12% 12% 14% 22% 21% 25% 25% 29% 30% 14% 31% been under-reported because of an 16% 37% 5% 35% 80% 10% 9% 11% 21% 40% 7% 8% 7% 20% 17% 41% 24% 46% 20% 16% increasing number of admission 70% 59% 61% 14% 20% 19% 62% 23% 26% records in the youngest and oldest 69% 16% 16% 13% 13% 6% 13% 13% 6% 60% 80% 81% 13% 17% 16% 18% age groups that did not contain any 17% 17% 18% 6% 15% 10% 5% 50% 12% 16% 17% 11% discharge information. 18% 15% 20% 13% 9% 11% 17% 17% 66% 70% 20% 40% 18% 75% 76% 74% 74% 21% 5% • 21% 54% 22% 18% In 2007, most SE CCAC clients 50% 44% 30% 22% 20% 54% 57% 6% 55% 37% 31% (>10,000) received either nursing 21% 46% 27% 16% 46% 39% 42% 20% 20% 36% 32% 33% services or case management visits 34% 27% 14% 5% 24% 22% 21% 24% 16% 15% followed by (>4,700 clients) either 10% 16% 18% 14% 16% 11% 11% 7% 7% 9% 10% 10% 6% 8% 9% 0% occupational therapy, physiotherapy or personal support/home making
2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 services. 0-19 20-44 45-64 65-74 75-84 85+ 0-19 20-44 45-64 65-74 75-84 85+
Female Male • Older clients (65+) generally received more case management, 1 , 2, 4 Average Length of Stay (Days) for CCAC Admissions by Sex & Age Group (Q1 2005 - Q3 2007) nursing, personal support/ 350 Fig 9.8 homemaking or respite services
300 while the younger clients (<20) received occupational and speech 250 therapy and nursing shift support. 0-19 Other clients mainly utilized 200 20-44 nutrition, physiotherapy and social 45-64 work services. 150 65-74 • The main diagnostic conditions 100 75-84 assessed to SE CCAC female clients 85+ were musculoskeletal, then 50 neoplasm, injury and poisoning, and circulatory diseases. For males most 0 clients were assessed with Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 neoplasm, then mental (mainly 0- 2005 2006 2007 2005 2006 2007 19), circulatory, musculoskeletal and Female Male injury & poisoning diagnostic categories. 1 , 2 Fig 9.9 Distribution of CCAC Admissions by Sex, Age Group & Discharge Status (2005 - 2007) Admitted to LTC Client Preference Completed Service Plan Died Hospitalized (>14 days) Transferred-Other CCAC Other Unknown • CCAC admission rates in the SE LHIN 100% for individuals 75+ were slightly 8% 6% 6% 8% 8% 7% 8% 8% 5% 7% 6% 13% 13% 10% 13% 9% 10% 14% 6% 90% 21% 6% 23% 20% higher than those in the province. 8% 26% 8% 12% 23% 33% 7% 31% 17% 17% 17% 17% 16% 14% 19% 16% 14% 7% 14% Stone Mills/Loyalist and SE Leeds/ 80% 15% 9% 13% 13% 5% 10% 12% 10% 47% 7% 7% 5% 5% 6% 8% 11% Grenville had particularly higher 70% 8% 8% 7% 9% 11% 8% 11% 7% 7% 12% 14% 18% 9% 13% 13% admission rates than other areas in 6% 22% 60% 8% 12% 18% the LHIN. 11% 50% 83% 81% 83% 81% 31% 80% 83% • 79% 44% 77% Projections for CCAC activity were 40% 71% 52% 40% 69% 68% 66% 65% 58% 55% 59% 69% 66% 59% 57% 59% 49% 43% 42% 31% 68% 42% 27% 28% generated using changes in 30% 61% 43% 6% 46% population growth and assume that 20% 5% service activity rates remain 10% 22% 16% 14% 15% 15% 16% constant until 2012. For the period 10% 12% 12% 7% 5% 9% 5% 5% 9% 8% 0% 2007-2012 the annual growth in CCAC applications, assessments and 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 admissions is likely to only grow 0-19 20-44 45-64 65-74 75-84 85+ 0-19 20-44 45-64 65-74 75-84 85+ marginally by 1.8%-1.9%. Female Male Page 4 of 8 DRAFT South East Local Health Integration Network
Home Care Profile
Community Care Access Centre Service Volume by Sex and Age Group (Q1 2005 –Q2 2008) 1 , 2
Female Male Fig 9.10 (Visits) Case Management
Female Male
Fig 9.11 (Hours) Homemaking Homemaking
Female Male Fig 9.12 (Visits) Nursing Services Services Nursing
Female Male
Fig 9.13 (Hours) Nursing Shift
Female Male Fig 9.14 (Visits) Nutrition/Dietetic
Female Male Fig 9.15 (Visits) Occupational Therapy Therapy Occupational DRAFT Page 5 of 8 48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 South East Local Health Integration Network
Phone: 613-967-0196 Fax: 613-967-1341 Home Care Profile
Community Care Access Centre Service Volume by Sex and Age Group (Q1 2005 –Q2 2008) 1 , 2
Female Male Fig 9.16 (Hours) Personal Services Services Personal
Female Male Fig 9.17 (Hours) Support/Homemaking
Female Male Fig 9.18 (Visits) Physiotherapy
Female Male Fig 9.19
(Hours) Respite
Female Male
Fig 9.20 (Visits) Social Work
Female Male
Fig 9.21 (Visits) Speech Therapy Therapy Speech Page 6 of 8 DRAFT South East Local Health Integration Network
Home Care Profile
8,000 1 , 2 Fig 9.22 19% Number of Clients Receiving CCAC Services by Service Type and Age group: 1000+ clients (2005-2007) 7,000 20% 11% 6,000 12% 13% 12% 12% 30% 23% 85+ 5,000 31% 10% 25% 24% 26% 25% 75-84 28% 26% 24% 26% 22% 4,000 19% 23% 65-74 17% 20% 20% 23% 17% 20% 3,000 20% 23% 24% 41% 24% 45-64 39% 39% 19% 18% 17% 19% 21% 21% 21% 10% 18% 13% 17% 2,000 34% 22% 17% 12% 20-44 22% 28% 34% 33% 31% 22% 23% 22% 11% 21% 28% 30% 29% 28% 24% 13% 13% 13% 12% 12% 27% 29% 30% 29% 14% 28% 17% 17% 17% 16% 14% 37% 38% 27% 28% 15% 16% 15% 14% 21% 22% 37% 0-19 1,000 21% 24% 18% 16% 25% 24% 16% 16% 17% 20% 45% 21% 20% 19% 11% 12% 11% 13% 14% 15% 19% 21% 23% 16% 10% 10% 42% 42% 20% 23% 23% 14% 14% 15% 26% 14% 16% 16% 0 10% 10% 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007
Case Management Nursing Services Occupational Personal Support / Physiotherapy Case Management Nursing Services Occupational Personal Support / Physiotherapy Therapy Homemaking Therapy Homemaking FemaleFemale Male
800 Number of Clients Receiving CCAC Services by Service Type and Age group: <1,000 clients (2005-2007) 1 , 2 Fig 9.23 700 6% 6% 6% 9% 8% 9% 600 5% 6% 6% 6% 5% 4% 85+ 500 11% 6% 11% 7% 7% 18% 75-84 10% 17% 19% 23% 14% 15% 5% 7% 400 20% 19% 21% 17% 23% 9% 65-74 17% 16% 15% 19% 23% 300 20% 19% 9% 7% 22% 14% 18% 20% 8% 17% 45-64 20% 8% 11% 17% 74% 74% 74% 28% 7% 20% 24% 19% 27% 24% 21% 21% 200 44% 47% 24% 20-44 29% 30% 52% 38% 31% 32% 54% 37% 26% 19% 50% 32% 30% 39% 33% 26% 44% 43% 48% 0-19 100 30% 49% 46% 45% 40% 9% 44% 10% 32% 21% 23% 6% 43% 24% 26% 11% 9% 38% 39% 21% 6% 51% 23% 16% 16% 15% 16% 34% 26% 7% 7% 8% 11% 16% 21% 13% 12% 31% 13% 14% 14% 14% 14% 9% 0 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007
Nutrition/Dietetic Personal Services Respite Social Work Speech Language Nutrition/Dietetic Personal Services Respite Social Work Speech Language Therapy Therapy
FemaleFemale MaleMale
2,000 Number of Client Assessments by Diagnosis Category & Age Group - Females (2005/2006) 1 , 2 Female Fig 9.24 1,800
1,600 20% 21% 7% 1,400 8% 22% 23% 1,200 32% 23% 85+ 21% 32% 32% 28% 33% 1,000 28% 75-84 26% 44% 44% 29% 26% 33% 800 65-74 13% 33% 21% 24% 39% 21% 35% 24% 600 37% 21% 11% 15% 45-64 15% 32% 19% 31% 9% 32% 24% 15% 33% 400 37% 25% 37% 8% 19% 20-44 20% 14% 13% 15% 16% 36% 23% 29% 17% 20% 32% 27% 18% 22% 26% 22% 18% 16% 27% 20% 11% 27% 200 34% 19% 9% 35% 22% 19% 22% 24% 28% 0-19 20% 11% 12% 33% 25% 32% 9% 8% 25% 24% 8% 21% 10% 20% 20% 10% 10% 8% 8% 14% 13% 20% 31% 22% 0 23% 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006
Neoplasms Endocrine/ Mental Disorders Nervous System Circulatory Respiratorry Digestive System Genitourinary Skin & Musculosketal Symptoms, Signs Injury & Other Nutrutional/ System System Subcutaneous System & Ill Defined Poisoning Metabolic/ Tissue Immunity
2,000 Number of Client Assessments by Diagnosis Category & Age Group - Males (2005/2006) 1 , 2 Male Fig 9.25 1,800
1,600
1,400
7% 8% 10% 1,200 12% 85+ 21% 24% 15% 1,000 16% 22% 75-84 5% 11% 10% 19% 6% 6% 9% 10% 800 9% 17% 15% 65-74 29% 7% 28% 21% 19% 27% 33% 24% 6% 35% 18% 18% 600 16% 15% 15% 33% 32% 19% 45-64 19% 28% 65% 29% 32% 32% 400 22% 32% 60% 19% 30% 33% 20-44 36% 24% 26% 31% 32% 29% 37% 17% 18% 61% 15% 22% 37% 200 35% 20% 18% 22% 15% 22% 26% 20% 30% 28% 30% 15% 23% 0-19 19% 19% 37% 32% 27% 24% 15% 17% 23% 18% 23% 21% 23% 27% 20% 9% 11% 24% 5% 27% 27% 12% 12% 11% 19% 18% 22% 0 9% 9% 7% 6% 24% 19% 2005 2006 2005 2006 2005 2006 2005 2006 2007 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006 2005 2006
Neoplasms Endocrine/ Mental Nervous System Circulatory Respiratorry Digestive System Genitourinary Skin & Musculosketal Symptoms, Signs Injury & Other Nutrutional/ Disorders System System Subcutaneous System & Ill Defined Poisoning Metabolic/ Tissue Immunity DRAFT Page 7 of 8 48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 South East Local Health Integration Network
Phone: 613-967-0196 Fax: 613-967-1341 Home Care Profile
Distribution of Admissions by Initial Service Goals (2007) 1 , 3 Distribution of Admissions by Discharge Status (2007) 1,3 Goal not yet determined Number of Admissions Admitted to LTC Number of Admissions In Home-Acute to Match Client Preference to Match In Home-Maintenance Size of Pie Completed Service Plan Size of Pie In Home-Rehab 3,000 Died 3,000 In Home-End of Life Hospitalized >14 days 1,500 In Home-LTC 1,500 Transferred to Other CCAC Residential Other 300 300 Unknown
Fig 9.26 Fig 9.27
Overall Distribution of Admissions Overall Distribution of for SE LHIN Admissions for SE LHIN 1.6% 2.8% 6.9% 20.0% 20.7% 1.9%
37.0% 2.8% 2.2% 1.9% Distribution for residents Distribution for residents 7.1% 50.8% from outside SE LHIIN from outside SE LHIIN 21.1% 8.2%
14.9%
1 , 2 1 , 2 Distribution of Case Management Visits (2007) Distribution of Nursing Visits (2007)
Number of Visits Number of Visits 0-19 to Match 0-19 to Match 20-44 Size of Pie 20-44 Size of Pie 45-64 6,000 45-64 6,000 65-74 65-74 3,000 3,000 75-84 75-84 85+ 600 85+ 600
Fig 9.28 Fig 9.29
Overall Distribution of Overall Distribution of Visits for SE LHIN Visits for SE LHIN 2.3%
9.5% 10.5% 19.0% 5.0% 11.0%
19.3% 23.7% 31.2% Distribution for residents 29.7% Distribution for residents from outside SE LHIIN from outside SE LHIIN 17.6% 21.3%
1 , 2 1 , 2 Distribution of Personal Support Visits (2007) Distribution of Physiotherapy Visits (2007)
Number of Visits Number of Visits 0-19 to Match 0-19 to Match 20-44 Size of Pie 20-44 Size of Pie 45-64 6,000 45-64 6,000 65-74 65-74 3,000 3,000 75-84 75-84 85+ 600 85+ 600
Fig 9.30 Fig 9.31
Overall Distribution of Overall Distribution of Visits for SE LHIN Visits for SE LHIN
2.6%
5.1% 6.6% 3.9% 12.7% 23.2% 16.9%
23.3% 30.0% Distribution for residents 16.2% Distribution for residents from outside SE LHIIN from outside SE LHIIN 36.0% 23.6% Page 8 of 8 DRAFT
Smiths Falls Brockville South East Local Health Integration Network (LHIN)
Kingston Belleville Home Care Profile
Fig 9.32 Age-Specific Rates for CCAC Admissions (per 1,000) by Sex and SubLHIN Area (2007) 1 ,3, 7
SE LHIN Ontario Fig 9.33 Fig 9.34
F
M
Annual Reported & Projected Applications , Assessments and Admissions Reported Projected 1-8 Average to South East Community Care Access Centre 2007 2008 2009 2010 2011 2012 % Growth Fig 9.35 Client 1,328 1,350 1,372 1,396 1,420 1,449 1.8 CCAC 2,263 2,306 2,349 2,393 2,438 2,489 1.9 Educactional Organization 892 889 887 885 884 877 -0.3 GP 3,261 3,321 3,384 3,448 3,514 3,591 1.9 2 Source of Referral Hospital-Inpatient 10,031 10,238 10,451 10,670 10,897 11,155 2.1 Hospital-Outpatient 2,992 3,041 3,092 3,145 3,199 3,262 1.7 LTC 746 761 776 791 806 823 2.0 Other 4,618 4,701 4,785 4,871 4,960 5,058 1.8 Total 29,948 30,471 31,011 31,566 32,143 32,796 1.8 Eligible-Admitted In-home services 16,128 16,405 16,693 16,991 17,300 17,648 1.8 Eligible-Aclient declined 528 538 548 558 568 581 1.9 Eligible-Another CCAC 2,538 2,588 2,639 2,691 2,746 2,809 2.0 3 Eligible-Long Term Care 4,245 4,339 4,433 4,528 4,626 4,730 2.2 Assessment Outcome Eligible-Other 23 23 23 24 24 24 1.1 Not Eligible-Criteria not met 2,329 2,371 2,414 2,458 2,505 2,555 1.9 Not Eligible-Referred to Community 249 253 258 263 268 274 1.9 Total 26,040 26,517 27,008 27,512 28,036 28,621 1.9 Goals not yet determined 437 449 460 473 485 496 2.6 In-Home- Acute 7,301 7,425 7,555 7,689 7,828 7,987 1.8 In-Home- Maintenance 3,042 3,102 3,163 3,227 3,292 3,366 2.0 3 In-Home- Rehab 4,379 4,440 4,504 4,570 4,640 4,716 1.5 Initial Care Goal In-Home-End of Life 403 412 421 431 440 453 2.4 In-Home-LTC 601 613 625 638 651 667 2.1 Residential 4,251 4,345 4,438 4,533 4,630 4,735 2.2 Total 20,414 20,785 21,167 21,559 21,967 22,420 1.9 General Notes and Limitations: 1. Data Source: Home Care Database System (HCD). HCD System is a client- 5. Market share and utilization rates for 2007 are assumed to remain constant centric system that collects information for the purpose of planning and until 2012. gaining clinical insight into clients who encounter service through Ontario’s 6. South East SubLHIN, sex and age group (0-9, 10-19, 20-44, 45-64, 65-74, 75-84, Community Care Access Centers . The system was implemented in Q1 2005. 85+) are assumed to be independent strata. CCAC application and service records were available up to Q2, 2008 while assessment and admission data were available up to Q3, 2007. 7. Population estimates at the SubLHIN and LHIN levels were accessed from the Provincial Health Planning Database, MOHLTC. Population projections at the 2. Estimates are reported for fiscal periods, e.g. 2007 is April 2007 - March 2008. SubLHIN level were generated by the South East LHIN based on cohort 3. Estimates are reported for calendar periods, e.g. 2007 is January 2007 - component methodology. December 2007 8. Projections of health care utilization do not incorporate program realignments 4. Length of Stay is computed for separated/discharged episodes only. or enhancements, changes in service demand, technological or clinical developments, or changes in disease prevalence.
DRAFT Page 1 of 8 Draft Version I - June 2009 South East Local Health Integration Network CSS Categories Home Support Alzheimer Education Palliative Services Community Support Services Profile Specialized Services
Introduction and General Overview
Introduction:
Community Support Services include: The Regional Capacity Assessment Project (ReCAP) provides a profile, including • Home Support Services – Volunteer Based short-term projections, on the utilization of health care services in the South • Alzheimer Education East LHIN (SE LHIN). Results of ReCAP are used to support the recommenda- • Palliative Care: Including life threatening or terminal illness tions in the Integrated Health Service Plan for the South East region. This short • Specialized Services: Including Acquired Brain Injury Services; Attendant report summarizes the key findings of Community Support Services. Outreach; Assisted Living Services in Supportive Housing (for people with
physical disabilities); services for seniors who are blind; hearing care General Overview: counselors for seniors
Community Support Services (CSS) are designed to support people with Utilization of Community Support Services in the South East LHIN:
“instrumental activities of daily living”. CSS services are based on a philosophy that values personalized service, and promotion of independence in people’s CSS services and units of measure have been designed to be responsive to com- own homes and other community settings. CSS respond to local needs in local munity health care needs as well as to meet the reporting and accountability communities in a culturally sensitive manner. The diversity of the services requirements of the LHIN and Ministry of Health and Long Term Care. A summary provided and the clients they serve and the ability to respond to the needs of of CSS services in the South East LHIN and the corresponding levels of utilization their community are the main focus and strength of CSS agencies. The goal of are shown in Fig 2.1. CSS is to enable individuals to remain as independent as possible in their homes /communities, by making support services available to them and their For Home Support Services, the main services provided to individual clients are caregivers. Overall the objectives are to promote independence; to enable Meals on Wheels, Transportation and Diners Club/Wheels to Meals/Congregate choice (in-home and other community settings); to provide education, support, Dining. Of these services, demand for Diners Club/Wheels to Meals/Congregate and relief to family and other caregivers; to promote health and wellness; and in Dining have been increasing the fastest (16% more individuals per year) followed some cases, to support and encourage the involvement of volunteers. Out- by Transportation (10% per year) and Meals on Wheels (3% per year). comes include: optimum health & social functioning; high quality independ- ence; shorten or avoided hospital stays and Emergency Room visits; delayed or Specialized Services, though given to a few individuals with disabilities, usually avoided admission to Long-Term Care. require more time per client (on average 580 hrs for Attendant Outreach, 330 hrs for disabled clients in Supportive Living and 275 hrs for ABI clients in Supportive Community Support Services are directly accessible to seniors, frail elderly and Housing Units in 2007). The number of individuals 65+ with disabilities in the persons with physical disabilities and chronic diseases. It is not a requirement for South East LHIN are expected to increase annually by 2.5%; the number of clients these services to be accessed through the CCAC. receiving Attendant Outreach have been decreasing at almost 1% per year.
In 2007, over 6,400 individuals received Alzheimer Education/Consulting Services
while 1,260 individuals utilized the Volunteer Hospice Visiting Services.
Utilization of Community Support Services for South East LHIN Agencies (2003 & 2007) 1 Average Units / Average Annual % Service Individuals Units Service Descriptiton Unit of Measure Individual Growth Categories 20072003 2007 2003 20072003 Indiv. Units Adult Day Service - ABI 1 full day equivalent of attendance 58 … 2,479 … 42.7 … … … Fig 2.1 Adult Day Service (Alzheimers/Other Aging Dementia) 1 full day equivalent of attendance 551 255 18,062 8,773 32.8 34.4 21.2 19.8 Adult Day Service-Integrated-Frail/Alzheimers/Other Dementia 1 full day equivalent of attendance 72 44 1,787 1,127 24.8 25.6 13.1 12.2 Caregiver Support - Support and Counselling 1 hour of counselling 17 28 94 32 5.5 1.1 -11.7 30.9 Caregiver Support - Training, Information and Education 1 hour of information or education 923 518 3,790 3,098 4.1 6.0 15.5 5.2 Caregiver Support - Respite Service (brokerage) 1 match arranged 15 15 26 20 1.7 1.3 0.0 6.8 Caregiver Support (Paid Staff) 1 hour of direct client service 123 118 12,909 11,369 105.0 96.3 1.0 3.2 Client Intervention and Assistance Service (Seniors) 1 hour of direct client service 1,196 293 3,994 2,038 3.3 7.0 42.1 18.3 Diners Club/Wheels to Meals/Congregate Dining 1 attendance 8,960 4,936 76,583 32,932 8.5 6.7 16.1 23.5 Home Support Emergency Response Systems 1 client served 151 312 449 2,469 3.0 7.9 -16.6 -34.7 Services Foot Care 1 session 4,610 1,906 14,117 9,991 3.1 5.2 24.7 9.0 Friendly Visiting 1 visit 1,544 … 47,592 … 30.8 … … … Home Help/Homemaking (brokerage) 1 match arranged 647 222 1,665 547 2.6 2.5 30.7 32.1 Home Help/Homemaking (Paid) 1 hour of direct client service 115 76 3,462 3,496 30.1 46.0 10.9 -0.2 Home Maintenance and Repair (Brokerage) 1 job arranged 625 461 2,561 781 4.1 1.7 7.9 34.6 Home Maintenance and Repair (First Nations Only) 1 hour of direct service 91 30 1,020 413 11.2 13.8 32.0 25.4 Meals on Wheels 1 meal delivered 2,732 2,443 137,474 112,143 50.3 45.9 2.8 5.2 Security Checks/Reassurance Service 1 completed contact 847 … 60,979 … 72.0 … … … Transportation 1 way trip (return trip counts as two) 3,851 2,671 70,836 62,495 18.4 23.4 9.6 3.2 Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach 1 hour of direct client service 198 205 115,246 123,109 582.1 600.5 -0.9 -1.6 Independence Training - ABI Outreach 1 hour of direct client service 515 262 7,506 5,363 14.6 20.5 18.4 8.8 Psychological Services - ABI 1 hour of direct client service 343 270 1,529 1,254 4.5 4.6 6.2 5.1 Supportive Living Service - ABI in SHU 1 day, 24 hours of service 21 17 5,764 6,000 274.5 352.9 5.4 -1.0 Specialized Supportive Living Service - ABI Outreach 1 hour of direct client service 28 7 3,715 3,101 132.7 443.0 41.4 4.6 Services Supportive Living Service - Physically Disabled Adults 1 day, 24 hours of service 47 43 15,810 15,439 336.4 359.0 2.2 0.6
Special Services For Persons with Acquired Hearing Loss 1 hour of direct client service 984 1,098 3,606 3,690 3.7 3.4 -2.7 -0.6 Special Services For the Blind and Visually Impaired 1 hour of direct client service 901 1,261 6,940 10,450 7.7 8.3 -8.1 -9.7 Alzheimer Psychogeriatric Consulting Services (Alzheimer Strategy) 1 hour of consulting service 6,409 5,689 3,268 2,892 0.5 0.5 3.0 3.1 Education Public Education Coordinator 1 hour of information or education 6,796 8,986 4,135 2,979 0.6 0.3 -6.7 8.5 Palliative Care Caregiver Support - Volunteer Hospice Visiting Service 1 hour of visiting 1,261 1,198 35,508 23,547 28.2 19.7 1.3 10.8 … Estimate not comparable / Computation not possible Please send any questions or comments to: [email protected] Page 2 of 8 DRAFT South East Local Health Integration Network
Community Support Services Profile
Home Support Services Clients receiving Meals on Wheels by CSS Agency & Age Group (2005-2007) 2 500
Community Support Services (CSS) includes volunteer- Fig 2.2 Unknown based Home Support Services. These are services 450 provided by local, not-for-profit agencies. Agencies 85+ coordinate the effort of many caring and committed 400 75-84 volunteers. Service delivery is by volunteers -- there 65-74 24% are approximately 9,000 volunteers in CSS agencies in 350 45-64 South Eastern Ontario giving 500,000+ hours/year, <45 which is equivalent to about 275 FTE positions. 300 49% 47% 41% 22% 21% 26% Home Support include a broad range of practical 42% 250 45% support services designed to help the elderly and 47% 35% 36% 20% adults with physical disabilities accomplish the tasks of 30% 200 41% everyday living -- “instrumental activities of daily 32% 34% 28% 34% 45% 28% 36% living”. As required by the Ontario Long-Term Care 34% 35% 150 35% 31% 34% 23% Act, eligibility for services is based upon assessed need; 37% 37% 34% 19 % A coordinator will discuss needs with new clients 35% 31% 25% 41% 100 23% 33% 9% 39% 29% 23% 27% 38% applying for Home Support. 14 % 11% 29% 30% 42% 15% 21% 25% 11% 13 % 42% 33% 8% 35% CSS Home Support providers: establish their own 7% 11% 37% 19 % 50 37% 27% 13 % 13 % 13 % 17% 24% 33% 20% 10 % 10 % 9% 62% 49% 47% 13 % 31% eligibility criteria; rely heavily on volunteers; have 14 % 20% 8% 29% 23% 21% 14 % 18 % 19 % 13 % 13 % 28% 47% 37% funding through client fees and other sources, such as 0 service clubs, municipalities, United Way and
fundraising ventures. It is estimated that for every 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 dollar funded by government, approximately $1.35 in CFCSC CPHC CCCH CCSH CHSLC GASAIL LASOS LOCS NFCS PECCCS VON service is provided (excludes cost of volunteer services). Client fees must be charged for prescribed Distribution of Clients receiving Meals on Wheels services. in SE SubLHIN areas by CSS Agency CSS services are often provided before the Community (2007) 2 Care Access Centre (CCAC) becomes involved with a client. CSS complements services provided through Fig 2.3 the CCAC. Summary of Findings: Meals on Wheels
• About half of CSS agencies see more individuals 85+ (>35% in CPHC, CCSH, CHSLC, GASAIL) while others generally care the most for those 75-84 (>33% in CFCSC, CCCH, LASOS, LOCS, PECCCS). More recently VON is providing additional care to younger age groups, especially persons 45-74 years. Overall about one quarter of meals are provided to individuals less than 75 years. Number of Clients • Meals on Wheels are distributed to individuals in all to match Size of Pie SubLHIN areas and generally by the agency that is 350 closest. Individuals in a few SubLHIN areas (Central 175 Hastings & Addington N/C Frontenac) receive 35 proportionally more per capita of this service than other areas. Note: certain areas are not adequately CFCSC LOCS represented because of missing data. CPHC NFCS Distribution for CCCH PECCCS CCSH CCNH • Compared to the SubLHIN populations, Meals on Unknown SubLHIN CHSLC MBQ Wheels are supplied more to individuals 85+ and GASAIL VON usually by one agency in the SubLHIN. CPHC and LASOS LASOS service 2 or more SubLHIN areas.
Rate (per 1,000 population) for Clients receiving Meals on Wheels by CSS Agency & SubLHIN of Residence (2007) 2, 3 Addington N/C Front. Belleville Brockville Fig 2.4 Central Hastings Gananoque Leeds Kingston and Islands Prince Edward County Quinte West Rideau Lakes SE Leeds Grenville Smith Falls, Perth, Lanark South Frontenac Stone Mills Loyalist Tyendinaga Napanee DRAFT Page 3 of 8 48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 South East Local Health Integration Network
Phone: 613-967-0196 Fax: 613-967-1341 Community Support Services Profile
2 Clients receiving Transportation by CSS Agency & Age Group (2005-2007) Transportation:
800
Fig 2.5 • The age group with the highest percentage of Unknown 700 individuals (30% overall) requiring transportation 85+ are typically 75-84 years. One notable exception 75-84 is CPHC which had about one third of individuals 600 45-64 years on transportation For the most part, 65-74 1 in every 4 individuals on transportation are 85+. 45-64 500 21% • Unlike Meals on Wheels, transportation is more 24% <45 30% 24% restricted to the residence of the individual - the 27% 400 30% 22% 29% only noteworthy agencies servicing more than
24% one SubLHIN are Addington N/C Frontenac and 22% 38% Brockville. Agencies like VON, CHSLC and CCSH 300 21% 22% 27% 18 % 26% 27% 35% had a large percentage of missing Sub-LHIN area 34% 21% 24% 11% 10 % 42% data, which would account for the low represen- 12 % 200 25% 34% 34% 12 % tation in some areas. 35% 35% 25% 30% 10 % 41% 15% 15% 19 % 24% 41% 31% 42% 36% • As with Meals on Wheels, the rate (per 1,000 100 17% 18 % 30% 24% 19 % 33% 31% 36% 36% 43% 41% 13 % 16 % 18 % 27% population) for clients receiving Transportation 53% 37% 25% 14 % 30% 20% 23% 13 % 47% 49% 44% 35% 23% 18 % 21% 34% 32% increases with age—though substantially more 19 % 26% 0 for CCCH, CHCSC and CPHC.
2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2005 2006 2007 2006 2007 2005 2006 2007 2005 2006 2007 CFCSC CPHC CCCCH CCCSH CHSLC GASAIL LASOS LOCS NFCS PECCCS VON Other Home Support Services:
Distribution of Clients receiving Transportation A summary of client counts for their other services in SE SubLHIN areas by CSS Agency is shown in Fig 2.7. 2 (2007) • Diners Club/Meals to Wheels / Congregate Dining is available from all agencies except Fig 2.6 CCNH.
• A wide variety of services are offered from CHSLC, CPHC, PECCCS and VON.
• Until 2007, utilization of services has usually remained constant with the exception of the following:
− Diners Club/Meals to Wheels / Congregate Dining, Foot care and Client Intervention and Assistance Services have been increasing in Number of Clients CHSLC since 2004. to match Size of Pie 350 − The number of individuals receiving Foot 175 Care have almost doubled since 2003. 35
CFCSC LOCS − In 2007, significantly more individuals are CPHC NFCS taking Diners Club / Meals to Wheels / Distribution for CCCH PECCCS Unknown SubLHIN CCSH CCNH Congregate Dining in LASOS and SAKR. CHSLC MBQ GASAIL VON − Caregiver Support-Training and Education LASOS from VON have dropped substantially from 2005 levels.
Rate (per 1,000 population) for Clients receiving Transportation by CSS Agency & SubLHIN of Residence (2007) 2 Addington N/C Front. Belleville Brockville Fig 2.7 Central Hastings Gananoque Leeds Kingston and Islands Prince Edward County Quinte West Rideau Lakes SE Leeds Grenville Smith Falls, Perth, Lanark South Frontenac Stone Mills Loyalist Tyendinaga Napanee Page 4 of 8 DRAFT South East Local Health Integration Network
Community Support Services Profile
Fig 2.8 Number of Clients receiving Other Home Support Services by Agency (2003-2007) 1 Caregiver Support - Support and Counseling Caregiver Support - Training, Information and Education Client Intervention and Assistance Service (Seniors) Diners Club/Wheels to Meals/Congregate Dining Foot Care Home Help/Homemaking (Brokerage) Home Maintenance and Repair (Brokerage)
CCCH CCNH CCSH CFCSC CHSLC CPHC GASAIL
LASOS LOCS MBQ NFCS PECCCS SAKR VON
Specialized Services
Attendant Outreach: Eligibility Criteria:
Funding in the South East is provided to three agencies to make attendant care To be eligible for attendant services, individuals must: services available through Supportive Housing and Attendant Care Outreach programs. Attendant care is defined as the provision of personal assistance with − be insured under the Health Insurance Act of Ontario; activities of daily living. Supportive Housing and Attendant Outreach services are − be at least 16 years of age or older; part of the broad spectrum of Community Support Services. − have a permanent physical disability and require physical assistance with activities of daily living such as bathing, dressing, transferring & Attendant Outreach Services: Service is provided in the client’s home between toileting; the hours of 6 a.m. and midnight on a pre-scheduled basis. Services may also be − have the ability to direct their own services - communicating with the provided at the workplace, college or university. attendants about what they want or need done and how; Assisted Living Services-Supportive Housing: Supportive Housing offers − be able to have any medical/professional needs met by the existing clients access to attendant services on a pre-scheduled and on a 24 hour basis community health network on a visitation basis. through a variety of housing options. Clients who use Attendant Services are persons with physical disabilities such as Adult Day Program: Service designed for adult members of the community, Cerebral Palsy, Arthritis, Stroke, Multiple Sclerosis, Muscular Dystrophy, Spinal especially seniors, with physical disabilities, memory or cognition deficits, sensory Cord Injury (SCI), etc. limitations & social or emotional problems that interfere with everyday activities.
Fig 2.9 Client Referral Activity for Attendant Outreach (Apr 06-Mar 09) 4 30 Cheshire-Received
25 Cheshire-Wait
March of Dimes-Received
20 March of Dimes-Wait
Providence Care-Wait 15
10
5
0 Jul-06 Jul-07 Jul-08 Oct-06 Jan-07 Oct-07 Jan-08 Oct-08 Jan-09 Jun-06 Sep-06 Dec-06 Feb-07 Jun-07 Sep-07 Dec-07 Feb-08 Jun-08 Sep-08 Dec-08 Feb-09 Apr-06 Apr-07 Apr-08 Nov-06 Mar-07 Nov-07 Mar-08 Nov-08 Mar-09 May-06 Aug-06 May-07 Aug-07 May-08 Aug-08 DRAFT Page 5 of 8 48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 South East Local Health Integration Network
Phone: 613-967-0196 Fax: 613-967-1341 Community Support Services Profile
Clients receiving Attendant Outreach by CSS Agency & Age Group (2005-2007)2 Specialized Services (continued) 100 Fig 2.11 Summary of Main Findings: Unknown 90 75+ • Most of the referrals for Attendant Outreach in 9% the LHIN are made to Providence Care, increasing 80 65-74 12% at a rate of 0.6 persons per month since April 45-64 70 13% 2006. By the end of fiscal 2007 there were 29 <45 individuals on the Providence Care wait list. For 60 Mach of Dimes, persons slowly started being added to the wait list between February and 15% 50 62% 64% October, 2007, increasing by just 2 persons. 18% 16% 33% 61% However the rate since November 2007 increased 40 to about 0.8 persons per month to reach 16 39% 30 37% 35% persons by the end of fiscal 2007. Only 2 additional persons received this service at March 20 61% of Dimes during the entire reporting period. 66% 45% Although the number of persons on the Cheshire 36% 10 37% 37% 24% 24% 23% Homes wait list is the smallest of the 3 agencies, 22% 24% 12% the rate has been faster than the other agencies 0 (1.1 persons since August 2008 to reach 9 persons 2005 2006 2007 2005 2006 2007 2005 2006 2007 by the end of fiscal 2007). Cheshire Homes also Cheshire Homes March of Dimes Providence Care provided an additional 10 persons with Attendant Outreach during the reporting period.
Distribution of Clients receiving Homemaking, Personal • Generally March of Dimes and Providence Care service more clients aged 45-64 (>60%) while Support, Attendant, Respite Services in SE SubLHIN areas Cheshire Homes attend to just about the same 2 by CSS Agency (2007) Fig 2.12 number of clients 45-64 as they do 19-44 (35- 37%). Overall around 11% of clients receiving Attendant Outreach are 65-74 & 6% 75+.
• Clients who receive Attendant Outreach reside in all SubLHIN areas except Addington N/C Frontenac. However comparatively more clients reside in Kingston and Islands and Belleville areas. Services are usually provided by the agency within the county of the client.
• Overall in the South East LHIN, the number of individuals aged 65+ with disabilities is expected to increase from over 19,500 in 2007 to around Number of Clients to match Size of Pie 21,000 by 2012. Most of the increase for this 50 population is expected for individuals 65-74 25 (3.5%) followed by those 75-84 (1.4%) then 85+ (1.1%). 5 • For the most part, this growth is also reflected CH within SubLHIN areas, though more than normal MOD PCHC increases are expected in South Frontenac South Distribution for Unknown SubLHIN Frontenac while only slightly more individuals are projected in Addington N/C Frontenac, Central Hastings & Prince Edward County.
Projected Number of Individuals with Disabilities by SubLHIN and Age Group (2007 & 2012) 5 Fig 2.13 2007 2012 Average Annual % Growth SubLHIN 65-74 75-84 85+ 65-74 75-84 85+ 65-74 75-84 85+ Addington / N&C Frontenac 308 136 61 337 142 43 3.8 1.6 -14.3 Belleville 995 774 344 1,181 817 361 6.8 2.0 3.0 Brockville 875 628 224 1,032 647 272 7.0 1.2 6.8 Central Hastings 567 285 109 616 298 116 3.3 1.8 1.0 Gananoque / Leeds 340 212 77 407 210 83 7.5 -0.7 -0.5 Kingston & Islands 2,182 1,647 701 2,706 1,766 692 8.8 2.3 -1.5 North Hastings 348 202 59 394 191 53 4.8 -2.5 -0.3 Prince Edward County 785 442 118 841 499 156 2.8 4.5 13.1 Quinte West / Brighton 1,269 707 183 1,450 803 213 5.3 5.2 6.1 Rideau Lakes 335 164 56 373 194 47 4.3 6.6 -6.4 SE Leeds / Grenville 422 235 64 500 245 79 7.0 1.2 8.4 Smiths Falls / Perth / Lanark 787 539 212 997 540 190 9.8 0.7 -4.0 South Frontenac 300 139 52 490 180 29 20.5 10.4 -23.4 Stone Mills / Loyalist 478 216 58 549 271 112 5.7 9.4 27.7 Tyendinaga / Napanee 488 311 112 563 310 123 6.0 6.0 6.0 South East LHIN 10,477 6,636 2,428 12,437 7,112 2,570 3.5 1.4 1.1 Page 6 of 8 DRAFT South East Local Health Integration Network
Community Support Services Profile
Fig 2.14 Alzheimer Education Number of Individuals receiving Alzheimer Education by 1 CSS Agency & Year (2003-2007) The five Alzheimer agencies in South East region, 3000 which form the Alzheimer Societies in South East Ontario, provide professional and volunteer ASBH support, education and counseling services for 2500 individuals with Alzheimer Disease.
Alzheimer services include: 2000 ASK ∗ Support Groups: (Family/Caregiver Support and "Circle of Friends" Early Stage Support) ∗ One-to-One Support 1500 ASLC ∗ Online Support ∗ Public Education 1000 ∗ Caregiver ∗ Safely Home ASLG 500
Summary of Findings:
• Overall just under 7,000 individuals in the South 0 ASPEC East LHIN received Alzheimer Education in 2007; 2003 2004 2005 2006 2007 this represented a reduction of about 900 individuals requesting these services in the Fig 2.15 previous 3 years. Most of the decline was Number of Hours of Alzheimer Education provided by attributed to fewer individuals attending the CSS Agency & Year (2003-2007) 1 Belleville/Hastings and Prince Edward County sites. Individuals served at the other sites 1400 remained relatively constant during the period. ASBH
• In spite of the decline in the number of 1200 individuals, the number of hours of Alzheimer Education has been steadily increasing, reaching just over 4,100 hours overall or an annual rate of 1000 ASK increase of 10.1%. Much of this growth was as a result of increases at the Kingston and Leeds- Grenville sites, both providing 22% more hours of 800 service annually since 2005. Contrary to the decrease in total individuals indicated above, 600 ASLC some of the growth was also observed at the Belleville-Hastings site, which reported a 12% annual increase in the last 4 years. 400 • Dementia cases (representing about 75% of ASLG Alzheimer cases) is projected to grow the fastest in the 85+ population, particularly in the 200 Frontenac, Leeds & Grenville and Hastings (>3.5% annually) counties which also have the most 0 cases in the LHIN. Marginal growth is projected ASPEC for Lanark and Prince Edward counties (<3.2%). 2003 2004 2005 2006 2007
Estimated & Projected Number of Dementia Cases by County & Age Group (2005-2012) 3, 6 Fig 2.16 1,400
1,200
1,000
800 85+
75-84 600 65-74
400
200
0 2005 2006 2007 2008 2009 2010 2011 2012 2005 2006 2007 2008 2009 2010 2011 2012 2005 2006 2007 2008 2009 2010 2011 2012 2005 2006 2007 2008 2009 2010 2011 2012 2005 2006 2007 2008 2009 2010 2011 2012 Frontenac Hastings Lanark Leeds & Grenville Prince Edward DRAFT Page 7 of 8 48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 South East Local Health Integration Network
Phone: 613-967-0196 Fax: 613-967-1341 Community Support Services Profile
Fig 2.17 Number of Clients receiving Volunteer Hospice Visiting Service Palliative Care by CSS Agency (2003-2007) 1 450 Hospice provides invaluable palliative care to ter- BGH minally ill clients and their caregivers, providing 400 support and companionship in the final stages of CFCSC clients’ lives. Services are offered in the client’s home, area long term care homes and hospitals. 350 CHSL Hospice is a volunteer driven service, where care is given by trained, experienced and compassionate HK 300 members of the community who donate their time HLA and effort to this cause. 250 Hospice services include volunteer support, which HNH 200 can vary depending on the needs of the client. HPE Volunteers can do many things for clients in their home: making a favourite meal, reading or playing 150 LOCS games. They do a lot of listening, become friends and ensure that the client is not alone. Having a 100 PC volunteer in the home allows the family/caregiver HHH the opportunity to enjoy much needed respite 50 time. Hospices have volunteers who have HQ completed specialized training; provide pediatric 0 palliative care as well as grief support.
2003 2004 2005 2006 2007 Summary of Findings:
Fig 2.18 Average Number of Hours provided for Volunteer Hospice Visiting • Between 2004 and 2007 the number of clients Service by CSS Agency (2003-2007) 1 who were provided with Volunteer Hospice Visit- ing Service remained generally constant for the 60 majority of agencies except for PC (no data for BGH 2007 but experienced a 50% reduction in clients in 2 years) and HQ which has been servicing 14% CFCSC more clients on an annual basis. 50 CHSL • Although with wide fluctuations, most agencies provide 20 or fewer hours of Volunteer Hospice 40 HLA Visiting Service per client. Notable exceptions are HPE and CHSL both of which consistently provide HNH between 25-50 hours on average.
30 • The prevalence rates for selected diseases in the HPE population 65+ are shown in Fig 2.19. Rates for Cancer, COPD, Asthma and Emphysema are all LOCS 20 relatively flat and lower than 10%. The rate for heart disease, which dropped since 2003, has PC leveled at about 20 in every 100 persons.
10 HHH • Between 2001 and 2005 mortality rates have remained constant for most diseases except HQ ischaemic heart disease (declining by roughly 1 in every 100,000 persons). 0 2003 2004 2005 2006 2007
Fig 2.19 Prevalence Rate (%) for Population 65+ with Selected Fig 2.20 Mortality Rate (per 100,000) for Population 65+ 7 Chronic Diseases SE LHIN (2001-2007) 6 for Selected Diseases SE LHIN (2001-2005) 60 120 Ischaemic Heart
Cerebrovascular 50 100 Other Circulatory Asthma Lung Cancer
Cancer 40 80 Colon Cancer
Lymphoma COPD 30 60 Breast Cancer Diabetes Prostate Cancer
20 Emphyzema 40 Other Neoplasms
Lower Respiratory Heart Disease Influenza & Pneumonia 10 20 Diabetes
Dementia/Alzheimers 0 0 2001 2003 2005 2007 2001 2002 2003 2004 2005 DRAFT Page 8 of 8
South East Local Health Integration Network
Community Support Services Profile
Projecting the Short-term Demand for Community Support Services
Methodology and Results An important component of ReCAP for the South East LHIN is the projecting of the While there are many factors that influence the service demand, client demographics future demand for health care services so that effective planning can be including age, sex and residence have been noted to be key determinants. In the conducted. In this report some results have already been provided of the absence of other data, the South East LHIN has adopted a similar approach to what was increased need for certain Community Support Services. Based on referral data employed for hospitals to project the future short term demand for Home Support provided by 3 agencies, there is an indication of at least 1.4 persons per month services. This basically involved the application of base utilization rates (fiscal 2006 and that are being placed on a wait list to receive Attendant Outreach. Although the 2007 combined) by age, sex and residence to population projections. However in increase in number of individuals requesting Alzheimer Education falls short of the future publications of this report, additional factors would be incorporated into the expected growth, there is strong evidence that much more hours of education are analysis, including the impact of current initiatives (like Easier+; Home At Last; Home provided otherwise. Also, given the relatively stable or declining prevalence and First; ER/CCAC Notification System; SMILE) on the utilization of CSS services. mortality rates for certain diseases, any increase in the demand for Volunteer Summary of Projections Home Support Services Hospice Visiting would likely increase with the growth of the population. • Projections of the annual growth in the number of clients ranged between 0 and 3% for When additional Home Support Services are required Community Support Sector the majority of CSS agencies and services. try to meet the need beyond what funding is available by holding various fund- • Growth was more variable across agencies than across services. raising events along with other initiatives. In order words the Community Support Sector tries to satisfy the identified needs in the community. As a consequence • CFCSC (2-.0-4.6%) and PECCS (1.6-3.7%) projected the highest growth among all agencies. estimates that are supplied during and at the end of any reporting period are • Fewer clients are projected for CHSLC (Home Help and Home Maintenance) and NFCS indicative of the true demand that exist for these services. (Meals on Wheels). Projected Percentage Annual Growth (2007-2012) for CSS Organizations by Home Support Service 3. 9-12 Fig 2.21 Home Support Service CFCSC CPHC CCCH CCSH CHSLC GASAIL LASOS LOCS NFCS PECCCS PC Adult Day Service 2.0 2.0 2.7 0.1 1.7 Caregiver Support 2.5 1.5 1.2 1.5 0.5 -0.1 2.1 Client Intervention 2.8 2.2 1.4 2.0 0.3 1.6 3.3 Congregate Dining 2.6 2.3 1.5 1.9 0.2 1.6 1.0 1.1 1.5 1.9 Foot Care 2.5 2.2 0.8 1.3 3.3 1.2 3.2 Friendly Visiting / Reassurance Service 4.6 2.3 1.5 1.9 -0.6 0.6 3.1 0.7 2.7 3.1 Home Help 2.4 2.4 1.5 1.6 0.2 1.8 0.4 3.7 Home Maintenance 2.1 1.6 1.6 -0.2 1.7 3.4 Meals on Wheels 3.4 2.4 1.5 1.6 0.0 0.9 0.6 0.8 -0.4 3.2 Social Recreational Service 1.5 2.3 1.6 Transportation 3.2 2.1 1.4 1.4 0.6 2.2 2.8 0.6 0.3 3.3 General Notes and Limitations: 1. Data Source: Management information Systems, MOHLTC 8. Mortality Rates for Selected Diseases computed using data from the Ontario Registrar General, provided through the Provincial Health Planning Database, 2. Data Source: Individual Community Support Services Data Collection Systems MOHLTC 3. Rates computed using LHIN and county level population estimates and projections from Ontario Ministry of Finance 9. Projections of the health care utilization are primarily based on changes in population growth (including mortality, fertility and migration) 4. Data Source: Referral data provided from Individual Databases of Specialized Community Support Services. 10. Market share and utilization rates for 2006 and 2007 are assumed to remain constant until 2012 5. Estimates for the population with disabilities computed using population 11. South East SubLHIN, sex and age group (0-19, 20-44, 45-64, 65-74, 75-84, 85+) estimates and projections as well as prevalence data from the 2006 are assumed to be independent strata Participation and Activity Limitation Survey, Statistics Canada 12. Projections of health care utilization do not incorporate program 6. Estimates of the Number of Dementia Cases computed using prevalence data realignments or enhancements, changes in service demand, technological or from Dementia Projections for the Counties, Regional Municipalities, and clinical developments, or changes in disease prevalence Districts of Ontario, Hopkins and Hopkins, Dec-05 7. Prevalence Rate for Chronic Diseases estimated using Canadian Community Health Survey, Cycles 1.1-4.1, Statistics Canada
Legend: ASBH Alzheimer Society of Belleville-Hastings HHH Heart of Hastings Hospice ASK Alzheimer Society of Kingston HK Hospice Kingston ASLC Alzheimer Society of Lanark County HLA Hospice Lennox & Addington ASLG Alzheimer Society of Leeds-Grenville HNH Hospice North Hastings ASPEC Alzheimer Society of Prince Edward County HPE Hospice Prince Edward BGH Bro ckv ille Gen era l Hosp ital HQ The Regional Hospice of Quinte Inc. CCCH Community Care for Central Hastings LASOS Lennox and Addington Seniors Outreach Services CCNH Community Care for North Hastings LOCS La nd O'La kes Com m un ity S ervices Corp ora tion CCSH Community Care for South Hastings Inc. MBQ Mohawks of the Bay of Quinte CFCSC Central Frontenac Community Services Corporation MOD March of Dimes (Rehabilitation Foundation for the Disabled) CH Cheshire Homes (Hastings-Prince Edward) Inc. NFCS Northern Frontenac Comm unity Services Corporation CHS The Canadian Hearing Society PCBIS Pro vid ence Care - Reg ion al Com m un ity Brain In ju ry S erv ices CHSLC Community Home Support - Lanark County PCHC Providence Care - Hildegard Centre CNIBHPE C.N.I.B. Hastings & Prince Edward Counties PECCCS The Prince Edward County Community Care For Seniors Assoc. CNIBK Canadian National Institute for the Blind - Kingston District PTI Pathways to Independence CPHC Com m un ity P rim ary & Health Ca re - Lan ark, Leed s & Gren ville SAKKR Seniors Association Kingston Region GASAIL Ganano qu e and A rea Serv ices to A ssist Independent Living Inc. VON VON Canada - Ontario Branch DRAFT QHC-Ban Version I - June 2009 MDCHSC South East Local Health Integration Network CRCHC
GCHC Community Health Centre Profile
KCHC
Physician Encounters by Sex, Age Group & Institution Introduction: 1 (2003/2007) The Regional Capacity Assessment Project (ReCAP) provides a 10,000 profile, including short-term projections, on the utilization of Fig 3.1 85+ health care services in the South East LHIN. Results of ReCAP are used to support the recommendations in the Integrated Health 8,000 75-84 Service Plan for the South East region. This short report on Community Health Centres (CHC) is one in a series of summary 65-74 analyses from ReCAP that focuses on specific health care services. In the South East LHIN there are 4 Community Health Centres. 6,000 45-64
20-44 Community Health Centre Services: 14% 8% 11% Community Health Centres are non-profit organizations that 17% 13% 4,000 18% 14% 10-19 15% provide primary health and health promotion programs for 15% 16% 23% 11% individuals, families and communities. Services within each CHC 17% 18% 14% 0-9 27% 45% 20% 15% 21% 13% are based on the needs within the community served. Each CHC 42% 27% 20% 24% is unique in the types of services offered. 2,000 36% 40% 30% 29% 45% 44% 28% 33% 34% Primary Care - CHC’s offer primary care services by way of 22% 21% 19% 19% 16% 20% 38% 13% 11% 13% 31% 15% scheduled appointments, extended hours service, walk-in 59% 12% 0 8% appointments and access to lab work. Primary Care resources are 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 on call 24/7 and also perform home visits.
CRCHC GCHC KCHC MDCHSC CRCHC GCHC KCHC MDCHSC Mental Health & Addictions Services - Mental health counseling & support services including access to visiting Female Male psychiatrist, methadone management, needle exchange, Nurse Practitioner Encounters by Sex, Age Group & Institution (2003/2007) 1 addiction counseling and Hepatitis C treatment are available. 10,000 Illness Prevention - Is a major component of CHC services and Fig 3.2 85+ includes such programs as: regional stroke strategy, smoking cessation, annual flu clinics, diabetic education, peer support 8,000 75-84 programs, oral health, cervical screening clinics, colorectal screening, asthma action plans and teen health clinic and youth 65-74 services designed to promote healthy active living. 6,000 45-64 Inter-professional Services - Inter-professional services offered at the SELHIN CHCs: nutritional support, counseling intervention 20-44 support focused on food security, financial crisis, housing and 4,000 10-19 employment, pregnant teen support, pre/post natal care and breastfeeding support, respiratory therapy and physiotherapy 0-9 are a few examples. 25% 21% 2,000 30% Health Promotion – CHC’s health promotion programs are 42% 31% 51% 37% targeted toward youth, teens, parents, families, seniors and 32% vulnerable populations. Primary Health Care providers offer 14% 24% 19% 33% 35% 61% 30% 39% 22% 11% 39% 66% 47% primary and secondary prevention and refer clients to self-help 13% 17% 29% 30% 57% 0 20% groups, nutritional counseling programs, literacy cafes, CDPM 2003 2007 2007 2003 2007 2003 2007 2003 2007 2007 2003 2007 2003 2007 self-management programs and many others that are offered CRCHC GCHC KCHC MDCHSC CRCHC GCHC KCHC MDCHSC locally.
Female Male Community Capacity Building - CHC’s aim to build capacity by 1 providing food security programs, community dinners, back-to- Nurse Encounters by Sex, Age Group & Institution (2003/2007) school backpack program, community gardens, immigration 10,000 services, dental coalition, community kitchen program, affordable Fig 3.3 85+ recreation, geriatric programs, literacy & computer programs to name a few examples. 8,000 75-84 14% Service Integration – CHC’s work in partnerships with agencies 65-74 who support access to services and build on service/care offered 17% 15% at the local level. Some of the agencies include, but are not 6,000 14% 45-64 limited to local schools, food banks, community support 17% 20-44 agencies, professional health care providers, municipalities, 18% 25% 10% libraries, recreational centers, service clubs, OPP, universities, 18% 15% 4,000 19% 39% 20% 19% 10-19 mental health services and early year’s centers. CHC’s also 21% 24% 22% provided preceptorship opportunities for nurse practitioners, 15% 15% 0-9 23% 31% 14% 21% 40% 25% 13% 36% registered nurses, registered practical nurses and dietitians. 29% 20% 2,000 36% 27% 25% 40% 26% 27% 18% 30% 34% Summary of Main Findings: 18% 25% 21% 22% 16% 26% 30% 14% 17% 36% 16% 9% 20% 11% • The majority of encounters in 2007 to SELHIN CHCs were with 9% 15% 31% 13% 0 nurses (43,000 or 39%) followed by physicians (36,000 or 30% and nurse practitioners (17,000 or 16%). Other types of 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 encounters were made to social workers, nutritionists, health CRCHC GCHC KCHC MDCHSC CRCHC GCHC KCHC MDCHSC counselors, chiropodists and therapists.
Female Male • Among SELHIN CHCs, most of the encounters occurred in GCHC (32,000 or 30%) then MDCHSC (30,000 or 27%), KCHC
CRCHC-Country Roads Community Health Centre (25,000 or 22%) and CRCHC (24,000 or 21%). Legend: GCHC-Gateway Community Health Centre • All CHCs except KCHC had 38%-49% nurse encounters, 30%- 33% physician encounters and 11%-15% nurse practitioner KCHC-Kingston Community Health Centre encounters. KCHC had 19%, 24% and 23% of encounters to MDCHSC-Merrickville District Community Health Services Centre nurses, physicians and nurse practitioners respectively. Continued - Page 2
Please send any questions or comments to: [email protected] Page 2 of 4 DRAFT South East Local Health Integration Network
Community Health Centre Profile
Other Resource Specialties Encounters by Age Group & Institution (2007)1 1,200 6,600 Fig 3.4 85+ 4% 75-84 4% 1,000 5,500 65-74 26% 10 % 17 % 45-64
800 20-44 4,400 28% 10-19
0-9 600 51% 3,300
61% 68% 400 17 % 2,200 21% 13 % 52% 40% 10 % 16 % 15 % 21% 14 % 21% 41% 25% 20% 47% 24% 37% 200 44% 38% 1,100 20% 38% 32% 30% 31% 45% 51% 40% 16 % 23% 46% 4% 23% 9% 78% 35% 13 % 13 % 25% 33% 32% 11% 13 % 11% 14 % 11% 9% 33% 9% 12 % 13 % 37% 12 % 0 0 CRCHC MDCHSC GCHC KCHC CRCHC GCHC KCHC MDCHSC KCHC MDCHSC CRCHC MDCHSC CRCHC GCHC KCHC MDCHSC CRCHC GCHC KCHC MDCHSC
Chiropodist Counselor Dietitian / Nutritionist Occ. Ther. Physio Res. Ther. Social Worker Other Number of Clients Visiting CHC by Resource Specialty & Age Group (2007)1 4,500 Fig 3.5 85+ 4,000 75-84 3,500 14 % 65-74 3,000 45-64 2,500 35% 17 % 11% 12 % 12 % 20-44 2,000 14 % 13 % 10-19 14 % 15 % 37% 1,500 41% 39% 38% 50% 27% 24% 25% 0-9 35% 30% 33% 23% 1,000 27% 22% 29% 31% 21% 22% 39% 23% 24% 45% 20% 19 % 36% 32% 500 25% 35% 22% 26% 17 % 13 % 15 % 21% 0 CRCHC GCHC KCHC MDCHSC CRCHC GCHC KCHC MDCHSC CRCHC GCHC KCHC MDCHSC CRCHC GCHC KCHC MDCHSC
Physician Nurse Practioner Nurse Other Specialities
Average Encounters by Resource Specialty, Sex & Age Group (2007)1 12 Fig 3.6 CRCHC GCHC KCHC MDCHSC 10
8
6
4
2
0 0-9 0-9 0-9 0-9 0-9 0-9 85+ 85+ 85+ 85+ 85+ 85+ 10-19 20-44 45-64 65-74 75-84 10-19 20-44 45-64 65-74 75-84 10-19 20-44 45-64 65-74 75-84 10-19 20-44 45-64 65-74 75-84 10-19 20-44 45-64 65-74 75-84 10-19 20-44 45-64 65-74 75-84 Female Male Female Male Female Male
Physician Nurse Practitioner Nurse DRAFT Page 3 of 4 48 Dundas Street West, Unit 2 Belleville, Ontario K8P 1A3 South East Local Health Integration Network
Phone: 613-967-0196 Fax: 613-967-1341 Community Health Centre Profile
Distribution of Encounters by Resource Specialty & Mode of Contact (2007) Distribution of Encounters by Resource Specialty & Disease Diagnosis (2007) 100% 100% Fig 3.7 Fig 3.8 13% 16% 18% 17% 23% 21% 23% 26% 26% 25% 26% 30% 32% 30% 27% 35% Other Causes 80% 38% 80% 41% 40% 40% 44% 5% Walk-in 47% 3% Skin & 30% 3% subcutaneous 13% Urgent / 3% 23% 4% Same Day 5% 4% Mental disorders 4% 60% Scheduled 60% 13% 4% 5% 3% 9% 3% 6% 5% 8% Circulatory On-call 3% 9% 3% 3% 56% 6% 3% 54% 87% 8% 4% 4% 50% 44% 8% 93% 56% 7% 4% 4% Endocrine, 76% N/A (phone) 7% 6% 72% 10% 16% Nutritional & 40% 40% 3% 9% 3% Metabolic 48% 49% Crisis / 11% 70% Musculosketal Emergency 50% 46% 13% 11% 54% Infectious 47% diseases 5% 42% 42% 20% 6% 20% 38% 36% 32% 29% Factors related to 26% contact with 22% 22% 22% 16% 17% 18% health system 12% 10%
0% 0% KCHC KCHC KCHC KCHC KCHC KCHC GCHC GCHC GCHC GCHC GCHC GCHC CRCHC CRCHC CRCHC CRCHC CRCHC CRCHC MDCHSC MDCHSC MDCHSC MDCHSC MDCHSC MDCHSC Physician Nurse Practitioner Nurse Physician Nurse Practitioner Nurse
1 1 Distribution of Physician Encounters for SE SubLHIN areas by CHC (2007) Distribution of Nurse Encounters for SE SubLHIN areas by CHC (2007)
Fig 3.9 Fig 3.10
9,000 9,000 4,500 4,500
900 900 Distribution for Distribution for Unknown SubLHIN CRCHC Unknown SubLHIN CRCHC GCHC GCHC KCHC KCHC MDCHSC MDCHSC
Distribution of Nurse Practitioner Encounters for SE SubLHIN areas by CHC (2007)
Fig 3.11 Summary of Main Findings - continued:
• Overall about 58% of all nurse encounters were from female clients (KCHC had 69% and other CHCs 57%). For physician encounters 59% were female (KCHC had 66% and other CHCs (55%-60%). Nurse practitioner encounters were mainly from female clients (67%, although only 61% for KCHC and >70% from other CHCs.).
• Approximately 51% of nurse encounters came from clients 20-64, while 40% were from clients 65+ and 9% under 20. Again KCHC had a somewhat different profile from the other CHCs with proportionally more clients 20-64 (58% vs 53% or less respectively) and less 65+ (31% vs >39% respectively).
• For physicians the overall percentage of encounters from clients 20-64 was 58%, 65+ was 32% and <20 was 10%. KCHC had a much higher percentage of encounters from 20-64 year clients (68% vs 63% or less) and proportionally fewer clients 65+ (16% vs 29%+).
• Overall about two thirds of client encounters to nurse practitioners were from individuals 9,000 20-64 while a quarter were from youths <20 and 13% from the elderly 65+. KCHC had 4,500 proportionally more encounters from clients 20-64 (75%) and MDCHSC had 900 proportionally more youths (39%). Distribution for Unknown SubLHIN CRCHC • The average number of encounters per client was very similar across all CHCs with the GCHC KCHC exception of those from males to nurse practitioners which was higher than normal in MDCHSC KCHC.. Continued - Page 4 DRAFT Page 4 of 4
South East Local Health Integration Network
Community Health Centre Profile
Rate for Encounters to Physicians (per 1,000 population) for Selected SubLHINs (2006 & 2007 combined) 1 ,4 Fig 3.12
Rate for Encounters to Nurse Practitioners (per 1,000 population) for Selected SubLHINs (2006 & 2007 combined) Fig 3.13
Rate for Encounters to Nurses (per 1,000 population) for Selected SubLHINs (2006 & 2007 combined) Fig 3.14
Fig 3.15 Reported and Projected Clients & Encounters by Resource Specialty and SE LHIN Community Health Centre (2006-2012) Clients Encounters FTE Count Reported & Projected Clients per FTE Reported & Projected Encounters per FTE
Resource Speciality CHC Average Average Average Annual Average Average Annual Average 2006 & 2007 2006 & 2008 2007 2006 & 2007 2012 % Growth 2006 & 2007 2012 % Growth CRCHC 1,980 7,295 3.0 660 715 1.5 2,432 2,676 1.8 GCHC 2,216 8,153 3.0 739 757 0.4 2,718 2,876 1.0 Physician KCHC 1,531 5,504 3.2 478 503 0.9 1,720 1,828 1.1 MDCHSC 2,351 7,782 3.0 784 812 0.7 2,594 2,746 1.0 SE LHIN 8,078 28,734 12.2 2,661 2,787 0.8 9,463 10,126 1.2 CRCHC 1,342 3,356 2.0 671 716 1.2 1,678 1,772 1.0 GCHC 1,559 3,940 2.0 779 763 -0.4 1,970 1,905 -0.6 Nurse Practitioner KCHC 1,481 5,104 2.0 741 771 0.7 2,552 2,670 0.8 MDCHSC 1,268 3,696 1.8 704 717 0.3 2,053 1,998 -0.5 SE LHIN 5,650 16,096 7.8 2,895 2,967 0.4 8,253 8,345 0.2 CRCHC 2,111 9,713 4.4 480 527 1.7 2,208 2,442 1.9 GCHC 3,597 13,392 4.5 799 814 0.3 2,976 3,131 0.9 Nurse KCHC 1,602 5,434 7.0 229 239 0.8 776 815 0.9 MDCHSC 1,268 3,696 3.6 352 358 0.3 1,027 999 -0.5 SE LHIN 8,577 32,235 19.5 1,860 1,939 0.8 6,986 7,387 1.0 Summary of Main Findings - continued: General Notes and Limitations:
• There is an increase in the rate of encounters in the 75-84 age range for Central Hastings 1. All estimates are reported for fiscal periods, e.g. 2007 is April 2007-March 2008. and Rideau Lakes SubLHIN regions 2. Data Source: ¨Community Health Centres: CHC MIS (Purkinje) • The majority of encounters to SE LHIN CHCs were scheduled: 50%-76% for physician, 44%- 3. Market share and utilization rates for 2006 and 2007 combined are assumed to remain 72% for nurses and 48%-56% for nurse practitioners. constant until 2012. • Most of the services offered by CHCs are provided to clients in areas within or adjacent to 4. South East SubLHIN, sex and age group (0-9, 10-19, 20-44, 45-64, 65-74, 75-84, 85+) are the SubLHIN of the CHC. assumed to be independent strata. • The rates for encounters by SubLHIN were higher in Rideau Lakes & Central Hastings than 5. Population estimates at the SubLHIN and LHIN levels were accessed from the Provincial in Smiths Falls/Perth/Lanark and Kingston & Islands, particularly in the elderly population Health Planning Database., MOHLTC. Population projections at the SubLHIN level were 65+. generated by the South East LHIN based on cohort component methodology. • .Projections for CHC services assume that increases are based on changes in population 6. Projections of health care utilization do not incorporate program realignments or en- growth and that utilization rates remain constant until 2012. Encounters are projected to hancements, changes in service demand, technological or clinical developments, or grow by 1.2% for physicians, 1.0% for nurses and 0.2% for nurse practitioners. The number changes in disease prevalence. of clients are expected to grow at a much slower pace: for physicians and nurses (0.8%) but marginally faster for nurse practitioners (0.4%). South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Addington, North and Central Frontenac
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 Addington EastAddington East 75-79 b YearN/C Front. LHIN OntarioN/C Front. LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 9,145 482,078 12,705,344 e 50-54 2006 2009 9,155 486,101 13,050,754 Quick Facts: 45-49 2011 9,260 492,452 13,349,125 2 G 40-44 2016 Size: 3,390 km r 2016 9,430 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 2,092 80,630 1,649,293 22.9% 16.7% 13.0% Total: 9,080 20-24 2009 2,144 86,097 1,770,571 23.4% 17.7% 13.6% Aged 65+: 2,090 15-19 2011 2,162 90,168 1,864,941 23.3% 18.3% 14.0% 10-14 2016 2,422 105,224 2,214,279 25.7% 20.6% 15.6% % 65+: 23.0% 5-9 Aged 75+ 0-4 Density: 2.7 persons/km2 2006 818 37,269 781,257 8.9% 7.7% 6.1% 600 400 200 0 200 400 600 2009 800 38,990 837,672 8.7% 8.0% 6.4% Population 2011 772 40,324 871,594 8.3% 8.2% 6.5% 2016 799 44,307 959,871 8.5% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 244 9,648 192,104 2.7% 2.0% 1.5% 2009 213 10,718 228,156 2.3% 2.2% 1.7% 2011 174 11,302 249,961 1.9% 2.3% 1.9% 2016 190 12,494 294,008 2.0% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System Lung & related Colon & related Neoplasms Census Characteristics Chronic lower respiratory Respiratory System disease (incl. COPD) South Addington East Diabetes N/C Front. LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 30.8% 20.0% 18.7% Dementia/Alzheimers Nervous System = Other causes of death within the Completed post-secondary education (age 25+) 42.1% 53.4% 56.8% International Classification of Diseases Unemployment rate (age 15+) 6.3% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 47.6% 62.4% 67.1% External Causes Proportion of population living in low income 13.6% 11.9% 14.7% English Mother tongue 93.1% 91.5% 69.8% Other diseases French Mother tongue 1.1% 2.7% 4.4% Immigrants 7.4% 9.3% 28.3% 0 102030405060Recent Immigrants (5 years) 0.1% 0.8% 4.8% Number of Deaths Visible minorities 2.1% 3.3% 22.8% Aboriginal Identity 7.2% 2.8% 2.0%
Health Status Kingston, Frontenac and Lennox & Addington Public Health1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 57.1 (51.5 - 62.6) 46.4 (35.9 - 57) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 41.3 (36.2 - 46.3) 59.1 (48.6 - 69.6) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 46.0 (40.9 - 51.1) 81.4 (73.7 - 89.1) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 83.6 (79.7 - 87.5) 93.1 (88.4 - 97.9) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * Daily Smokers 22.8 (17.8 - 27.8) - - 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) * Exposed To Second Hand Smoke In Home 10.4 (5.1 - 15.7) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 21.0 (16.2 - 25.8) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 52.5 (46.2 - 58.9) 51.6 (41.5 - 61.7) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 45.3 (39.8 - 50.9) 49.6 (39.5 - 59.7) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 42.3 (37.2 - 47.4) 51.6 (39.4 - 63.9) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) Has A Lot Of Stress (Age 18+) 23.4 (19 - 27.9) - - 23.9 (21.2 - 26.7) 8.7 * (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 22.2 (17.5 - 26.9) 54.4 (42.9 - 65.9) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 6.2 * (4 - 8.4) 22.2 * (14 - 30.5) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) Asthma 11.1 * (7.3 - 15) 11.0 * (4.3 - 17.6) 10.0 (7.8 - 12.3) 9.2 * (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 20.0 (15.9 - 24.2) 53.4 (43.2 - 63.5) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for Kingston, Frontenac and Lennox & Addington Public Health are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): Addington, North and Central Frontenac
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
6,000 6,000 Females 1,600 Outside SE LHIN 5,000 5,000 QHC-Trenton 1,400
QHC-Picton 85+ QHC-Belleville 1,200 4,000 4,000 75-84 I Resuscitation QHC-Bancroft 65-74 II Emergent 1,000 PSF - Smiths Falls 45-64 3,000 III Urgent 3,000 PSF - Perth 800 20-44 IV Less-urgent LACGH 0-19 V Non-urgent 2,000 2,000 KGH 600 HDH BHG 400 1,000 1,000 200
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 1,600 all Services (hours) (meals) (1-way trips) Actual Projected #% Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% 1,400 Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 1,200 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 1,000 65-74 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 800 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 600 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 400 pending verification with local data management personnel Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach 200 Area of Service Provision 2006 2012 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 4,587 86.6% 708 13.4% 5,295 100.% 5,287 700 15.3% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 784 76.0% 248 24.0% 1,032 100.% 791 7 0.8% Acute Days of Stay 4,926 72.5% 1,867 27.5% 6,793 100.% 4,958 32 0.6% Individuals Served (2007) ALC1 Separations 39 86.7% 6 13.3% 45 100.% 33 ( 6) (16.5%) Females Head Office Location of Provider ALC Days of Stay 1,170 93.3% 84 6.7% 1,254 100.% 845 ( 325) (27.8%) 600 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 917 78.5% 251 21.5% 1,168 100.% 1,247 330 36.0% Oncology Visits 317 88.1% 43 11.9% 360 100.% 329 12 3.8% 500 Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 1,101 99.1% 10 0.9% 1,111 100.% 1,030 ( 71) (6.5%) 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 54 83.1% 11 16.9% 65 100.% 51 ( 3) (6.1%) 400 South East LHIN 28,430 Radiation Treatments 481 83.4% 96 16.6% 577 100.% 575 94 19.5% 65-74 All Outpatient Events 2,870 69.7% 1,247 30.3% 4,117 100.% 3,231 361 12.6% 45-64 Clients with Open Admission to program... Rehabilitation 300 20-44 Cases 1076.9% 323.1% 13 100.% 8 ( 2) (18.6%) Problem Gambling Substance Abuse 0-19 County 2004 2008 2004 2008 Days 259 63.8% 147 36.2% 406 100.% 203 ( 56) (21.5%) Complex Continuing Care 200 Frontenac 39 86 1,462 2,023 Cases 1083.3% 216.7% 12 100.% 12 2 18.2% Hastings 21 15 811 1,043 Days 233 89.6% 27 10.4% 260 100.% 307 74 31.8% Lanark 7 26 290 600 Adult Mental Health 100 Leeds-Gren. 35 50 429 806 Cases 20 100.0% - - 20 100.% 16 ( 4) (19.8%) Lenn. & Add. 12 15 489 841 Days 354 100.0% - - 354 100.% 318 ( 36) (10.3%) Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 1,200 1,200 600
Outside LHIN 1,000 1,000 QHC-Trenton 500 85+ QHC-Picton 75-84 800 800 QHC-Belleville 400 Other 65-74 QHC-Bancroft Obstetrics 45-64 PSF- Smiths Falls 600 Newborn 600 300 20-44 PSF- Perth Surgery 0-19 LACGH Medicine 400 400 KGH 200 HDH BGH 200 200 100
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital Inpatient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Belleville
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 East East 75-79 b YearBelleville LHIN Ontario Belleville LHIN Ontario 70-74 c 65-69 2016 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 49,115 482,078 12,705,344 e 50-54 2006 2009 51,123 486,101 13,050,754 Quick Facts: 45-49 2011 53,200 492,452 13,349,125 2 G 40-44 Size: 250 km r 2016 57,151 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 8,765 80,630 1,649,293 17.8% 16.7% 13.0% Total: 48,820 20-24 2009 9,154 86,097 1,770,571 17.9% 17.7% 13.6% Aged 65+: 8,770 15-19 2011 9,512 90,168 1,864,941 17.9% 18.3% 14.0% 10-14 2016 11,204 105,224 2,214,279 19.6% 20.6% 15.6% % 65+: 18.0% 5-9 Aged 75+ 0-4 Density: 197.8 persons/km2 2006 4,607 37,269 781,257 9.4% 7.7% 6.1% 2,500 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2,500 2009 4,729 38,990 837,672 9.3% 8.0% 6.4% Population 2011 4,845 40,324 871,594 9.1% 8.2% 6.5% 2016 5,012 44,307 959,871 8.8% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 1,336 9,648 192,104 2.7% 2.0% 1.5% 2009 1,424 10,718 228,156 2.8% 2.2% 1.7% 2011 1,451 11,302 249,961 2.7% 2.3% 1.9% 2016 1,577 12,494 294,008 2.8% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System
Lung & related Colon & related Breast Prostate Neoplasms Chronic lower Lymph, Blood & related Census Characteristics respiratory disease Respiratory System South East Diabetes Influenza and pneumonia Belleville LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 21.6% 20.0% 18.7% Dementia/Alzheimers Completed post-secondary education (age 25+) 51.2% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 6.5% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 63.5% 62.4% 67.1% External Causes Proportion of population living in low income 15.1% 11.9% 14.7% English Mother tongue 91.2% 91.5% 69.8% Other diseases French Mother tongue 1.7% 2.7% 4.4% Immigrants 9.9% 9.3% 28.3% 0 100 200 300 400 500 600 700 800 900 1000 Recent Immigrants (5 years) 1.1% 0.8% 4.8% Visible minorities 5.3% 3.3% 22.8% Number of Deaths Aboriginal Identity 2.9% 2.8% 2.0%
Health Status Hastings and Prince Edward Counties Health Unit1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 53.5 (46.9 - 60) 38.5 (29.7 - 47.3) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 43.0 (37.6 - 48.5) 61.6 (50.7 - 72.5) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 48.9 (41.9 - 55.9) 61.8 (52.4 - 71.2) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 79.1 (73.9 - 84.2) 90.9 (85 - 96.7) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * * Daily Smokers 21.1 (15.6 - 26.6) 12.4 (6.9 - 17.9) 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) Exposed To Second Hand Smoke In Home 12.4 * (7.1 - 17.7) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 21.3 (14.5 - 28.2) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 56.5 (49.7 - 63.4) 53.2 (42.4 - 64) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 42.7 (36.9 - 48.5) 60.9 (51.4 - 70.3) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 43.2 (36 - 50.4) 50.5 (39.8 - 61.1) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) * Has A Lot Of Stress (Age 18+) 22.1 (18.1 - 26.2) - - 23.9 (21.2 - 26.7) 8.7 (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 28.2 (23.4 - 32.9) 51.7 (42 - 61.3) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 8.0 * (4.8 - 11.1) 15.3 * (8.6 - 22) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) * * * Asthma 6.1 (3.7 - 8.5) 6.9 (3 - 10.9) 10.0 (7.8 - 12.3) 9.2 (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 19.4 (14.7 - 24.1) 47.9 (35.4 - 60.3) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for the Hastings and Prince Edward Counties Health Unit are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): Belleville
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
35,000 35,000 Females 1,600 Outside SE LHIN 30,000 30,000 QHC-Trenton 1,400
QHC-Picton 85+ 25,000 25,000 1,200 QHC-Belleville 75-84 I Resuscitation QHC-Bancroft 65-74 20,000 II Emergent 20,000 1,000 PSF - Smiths Falls 45-64 III Urgent PSF - Perth 800 20-44 15,000 IV Less-urgent 15,000 LACGH 0-19 V Non-urgent KGH 600 10,000 10,000 HDH BHG 400 5,000 5,000 200
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 1,600 all Services (hours) (meals) (1-way trips) Actual Projected #% Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% 1,400 Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 1,200 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 1,000 65-74 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 800 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 600 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 400 pending verification with local data management personnel Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach 200 Area of Service Provision 2006 2012 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 28,105 96.2% 1,097 3.8% 29,202 100.% 31,983 3,878 13.8% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 5,206 93.4% 368 6.6% 5,574 100.% 5,794 588 11.3% Acute Days of Stay 25,670 92.0% 2,226 8.0% 27,896 100.% 26,561 891 3.5% Individuals Served (2007) ALC1 Separations 379 97.7% 9 2.3% 388 100.% 394 15 4.0% Females Head Office Location of Provider ALC Days of Stay 5,811 96.1% 234 3.9% 6,045 100.% 5,916 105 1.8% 600 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 6,427 94.2% 397 5.8% 6,824 100.% 7,710 1,283 20.0% Oncology Visits 3,273 98.0% 68 2.0% 3,341 100.% 2,932 ( 341) (10.4%) 500 Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 5,727 99.9% 3 0.1% 5,730 100.% 6,759 1,032 18.0% 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 230 91.3% 22 8.7% 252 100.% 241 11 4.8% 400 South East LHIN 28,430 Radiation Treatments 2,708 96.8% 89 3.2% 2,797 100.% 2,908 200 7.4% 65-74 All Outpatient Events 18,365 70.4% 7,710 29.6% 26,075 100.% 20,550 2,185 11.9% 45-64 Clients with Open Admission to program... Rehabilitation 300 20-44 Cases 5786.4% 913.6% 66 100.% 80 23 40.3% Problem Gambling Substance Abuse 0-19 County 2004 2008 2004 2008 Days 2,239 97.0% 70 3.0% 2,309 100.% 3,072 833 37.2% Complex Continuing Care 200 Frontenac 39 86 1,462 2,023 Cases 163 99.4% 1 0.6% 164 100.% 168 5 3.3% Hastings 21 15 811 1,043 Days 7,377 99.8% 18 0.2% 7,395 100.% 8,103 726 9.8% Lanark 7 26 290 600 Adult Mental Health 100 Leeds-Gren. 35 50 429 806 Cases 234 94.0% 15 6.0% 249 100.% 247 13 5.7% Lenn. & Add. 12 15 489 841 Days 2,510 91.4% 237 8.6% 2,747 100.% 4,554 2,044 81.4% Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 6,000 6,000 600
Outside LHIN 5,000 5,000 QHC-Trenton 500 85+ QHC-Picton 75-84 4,000 4,000 QHC-Belleville 400 Other 65-74 QHC-Bancroft Obstetrics 45-64 PSF- Smiths Falls 3,000 Newborn 3,000 300 20-44 PSF- Perth Surgery 0-19 LACGH Medicine 2,000 2,000 KGH 200 HDH BGH 1,000 1,000 100
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Brockville
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 East East 75-79 b YearBrockville LHIN Ontario Brockville LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 38,829 482,078 12,705,344 e 50-54 2006 2009 39,204 486,101 13,050,754 Quick Facts: 45-49 2011 39,826 492,452 13,349,125 2 G 40-44 2016 Size: 830 km r 2016 41,195 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 7,107 80,630 1,649,293 18.3% 16.7% 13.0% Total: 38,050 20-24 2009 7,534 86,097 1,770,571 19.2% 17.7% 13.6% Aged 65+: 7,110 15-19 2011 7,863 90,168 1,864,941 19.7% 18.3% 14.0% 10-14 2016 9,459 105,224 2,214,279 23.0% 20.6% 15.6% % 65+: 18.7% 5-9 Aged 75+ 0-4 Density: 45.9 persons/km2 2006 3,509 37,269 781,257 9.0% 7.7% 6.1% 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2009 3,651 38,990 837,672 9.3% 8.0% 6.4% Population 2011 3,767 40,324 871,594 9.5% 8.2% 6.5% 2016 4,019 44,307 959,871 9.8% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 905 9,648 192,104 2.3% 2.0% 1.5% 2009 1,006 10,718 228,156 2.6% 2.2% 1.7% 2011 1,096 11,302 249,961 2.8% 2.3% 1.9% 2016 1,186 12,494 294,008 2.9% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System
Lung & related Colon & related Breast Prostate Neoplasms Chronic lower Lymph, Blood & related Census Characteristics respiratory disease Respiratory System South East Diabetes Influenza and pneumonia Brockville LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 21.2% 20.0% 18.7% Dementia/Alzheimers Completed post-secondary education (age 25+) 52.0% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 6.5% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 62.3% 62.4% 67.1% External Causes Proportion of population living in low income 11.0% 11.9% 14.7% English Mother tongue 91.9% 91.5% 69.8% Other diseases French Mother tongue 2.8% 2.7% 4.4% Immigrants 8.2% 9.3% 28.3% 0 100 200 300 400 500 600 700 800 Recent Immigrants (5 years) 0.5% 0.8% 4.8% Visible minorities 2.2% 3.3% 22.8% Number of Deaths Aboriginal Identity 1.4% 2.8% 2.0%
Health Status Leeds, Grenville & Lanark District Health Unit 1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 54.8 (49.2 - 60.3) 38.2 (26.6 - 49.7) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 47.2 (41.7 - 52.7) 67.2 (57.6 - 76.8) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 44.6 (38.8 - 50.3) 70.9 (58.9 - 82.9) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 79.1 (74.8 - 83.3) 89.5 (82.3 - 96.7) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * Daily Smokers 21.6 (17.2 - 26) - - 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) Exposed To Second Hand Smoke In Home 12.4 * (7.5 - 17.3) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 23.0 (17 - 28.9) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 52.1 (46.6 - 57.6) 61.7 (49.8 - 73.6) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 41.9 (36.4 - 47.5) 45.1 (35.3 - 54.9) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 38.5 (33.3 - 43.7) 44.2 (33.8 - 54.6) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) * * Has A Lot Of Stress (Age 18+) 24.8 (19.7 - 29.9) 16.1 (6.6 - 25.6) 23.9 (21.2 - 26.7) 8.7 (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 25.2 (20.8 - 29.7) 48.7 (37.1 - 60.3) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 7.1 (4.8 - 9.3) 20.9 * (11.5 - 30.3) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) * * Asthma 11.9 (7.7 - 16) - - 10.0 (7.8 - 12.3) 9.2 (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 18.2 (14.6 - 21.7) 45.0 (35 - 55.1) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for the Leeds, Grenville and Lanark District Health Unit are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): Brockville
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
25,000 25,000 Females 1,600 Outside SE LHIN QHC-Trenton 1,400 20,000 20,000 QHC-Picton 85+ 1,200 QHC-Belleville 75-84 I Resuscitation 15,000 15,000 QHC-Bancroft 65-74 II Emergent 1,000 PSF - Smiths Falls 45-64 III Urgent PSF - Perth 800 20-44 IV Less-urgent 10,000 10,000 LACGH 0-19 V Non-urgent KGH 600 HDH 5,000 5,000 BHG 400
200
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 1,600 all Services (hours) (meals) (1-way trips) Actual Projected #% Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% 1,400 Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 1,200 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 1,000 65-74 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 800 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 600 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 400 pending verification with local data management personnel Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach 200 Area of Service Provision 2006 2012 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 19,649 95.5% 934 4.5% 20,583 100.% 20,988 1,339 6.8% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 3,491 87.1% 519 12.9% 4,010 100.% 3,849 358 10.2% Acute Days of Stay 19,451 86.9% 2,936 13.1% 22,387 100.% 21,702 2,251 11.6% Individuals Served (2007) ALC1 Separations 101 96.2% 4 3.8% 105 100.% 133 32 31.3% Females Head Office Location of Provider ALC Days of Stay 3,005 98.4% 49 1.6% 3,054 100.% 5,158 2,153 71.6% 700 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 6,162 93.1% 456 6.9% 6,618 100.% 7,223 1,061 17.2% 600 Oncology Visits 618 78.7% 167 21.3% 785 100.% 883 265 42.8% Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 460 59.2% 317 40.8% 777 100.% 818 358 77.9% 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 169 79.7% 43 20.3% 212 100.% 198 29 17.3% 500 South East LHIN 28,430 Radiation Treatments 1,048 71.1% 427 28.9% 1,475 100.% 1,944 896 85.5% 65-74 All Outpatient Events 8,457 53.9% 7,223 46.1% 15,680 100.% 11,066 2,609 30.8% 400 45-64 Clients with Open Admission to program... Rehabilitation 20-44 Cases 40 74.1% 14 25.9% 54 100.% 50 10 24.7% Problem Gambling Substance Abuse 300 0-19 County 2004 2008 2004 2008 Days 1,132 84.3% 211 15.7% 1,343 100.% 1,463 331 29.2% Complex Continuing Care Frontenac 39 86 1,462 2,023 Cases 111 99.1% 1 0.9% 112 100.% 137 26 23.5% 200 Hastings 21 15 811 1,043 Days 3,770 99.9% 4 0.1% 3,774 100.% 5,241 1,471 39.0% Lanark 7 26 290 600 Adult Mental Health Leeds-Gren. 35 50 429 806 Cases 192 95.0% 10 5.0% 202 100.% 198 6 3.1% 100 Lenn. & Add. 12 15 489 841 Days 2,848 94.6% 163 5.4% 3,011 100.% 3,201 353 12.4% Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 5,000 5,000 700
4,500 4,500 Outside LHIN 600 4,000 QHC-Trenton 4,000 85+ QHC-Picton 500 75-84 3,500 3,500 QHC-Belleville Other 65-74 3,000 3,000 QHC-Bancroft Obstetrics 400 45-64 PSF- Smiths Falls 2,500 Newborn 2,500 20-44 PSF- Perth Surgery 300 0-19 2,000 2,000 LACGH Medicine KGH 1,500 1,500 HDH 200 1,000 1,000 BGH 100 500 500
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Central Hastings
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 Central EastCentral East 75-79 b YearHastings LHIN OntarioHastings LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 23,127 482,078 12,705,344 e 50-54 2006 2009 22,571 486,101 13,050,754 Quick Facts: 45-49 2011 21,987 492,452 13,349,125 2 G 40-44 2016 Size: 2,640 km r 2016 22,127 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 3,964 80,630 1,649,293 17.1% 16.7% 13.0% Total: 21,570 20-24 2009 4,103 86,097 1,770,571 18.2% 17.7% 13.6% Aged 65+: 3,960 15-19 2011 4,153 90,168 1,864,941 18.9% 18.3% 14.0% 10-14 2016 5,144 105,224 2,214,279 23.2% 20.6% 15.6% % 65+: 18.4% 5-9 Aged 75+ 0-4 Density: 8.2 persons/km2 2006 1,660 37,269 781,257 7.2% 7.7% 6.1% 1,500 1,000 500 0 500 1,000 1,500 2009 1,678 38,990 837,672 7.4% 8.0% 6.4% Population 2011 1,706 40,324 871,594 7.8% 8.2% 6.5% 2016 1,839 44,307 959,871 8.3% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 455 9,648 192,104 2.0% 2.0% 1.5% 2009 460 10,718 228,156 2.0% 2.2% 1.7% 2011 469 11,302 249,961 2.1% 2.3% 1.9% 2016 509 12,494 294,008 2.3% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System
Lung & related Colon & related Breast Prostate Neoplasms Chronic lower Lymph, Blood & related Census Characteristics respiratory disease Respiratory System South Influenza and pneumonia Central East Diabetes Hastings LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 28.5% 20.0% 18.7% Dementia/Alzheimers Completed post-secondary education (age 25+) 44.5% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 6.3% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 58.5% 62.4% 67.1% External Causes Proportion of population living in low income 12.7% 11.9% 14.7% English Mother tongue 95.2% 91.5% 69.8% Other diseases French Mother tongue 1.2% 2.7% 4.4% Immigrants 6.3% 9.3% 28.3% 0 20 40 60 80 100 120 140 160 Recent Immigrants (5 years) 0.1% 0.8% 4.8% Visible minorities 0.8% 3.3% 22.8% Number of Deaths Aboriginal Identity 3.1% 2.8% 2.0%
Health Status Hastings and Prince Edward Counties Health Unit1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 53.5 (46.9 - 60) 38.5 (29.7 - 47.3) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 43.0 (37.6 - 48.5) 61.6 (50.7 - 72.5) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 48.9 (41.9 - 55.9) 61.8 (52.4 - 71.2) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 79.1 (73.9 - 84.2) 90.9 (85 - 96.7) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * * Daily Smokers 21.1 (15.6 - 26.6) 12.4 (6.9 - 17.9) 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) Exposed To Second Hand Smoke In Home 12.4 * (7.1 - 17.7) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 21.3 (14.5 - 28.2) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 56.5 (49.7 - 63.4) 53.2 (42.4 - 64) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 42.7 (36.9 - 48.5) 60.9 (51.4 - 70.3) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 43.2 (36 - 50.4) 50.5 (39.8 - 61.1) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) * Has A Lot Of Stress (Age 18+) 22.1 (18.1 - 26.2) - - 23.9 (21.2 - 26.7) 8.7 (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 28.2 (23.4 - 32.9) 51.7 (42 - 61.3) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 8.0 * (4.8 - 11.1) 15.3 * (8.6 - 22) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) * * * Asthma 6.1 (3.7 - 8.5) 6.9 (3 - 10.9) 10.0 (7.8 - 12.3) 9.2 (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 19.4 (14.7 - 24.1) 47.9 (35.4 - 60.3) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for the Hastings and Prince Edward Counties Health Unit are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): Central Hastings
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
14,000 14,000 Females 1,600 Outside SE LHIN 12,000 12,000 QHC-Trenton 1,400
QHC-Picton 85+ 10,000 10,000 1,200 QHC-Belleville 75-84 I Resuscitation QHC-Bancroft 65-74 8,000 II Emergent 8,000 1,000 PSF - Smiths Falls 45-64 III Urgent PSF - Perth 800 20-44 6,000 IV Less-urgent 6,000 LACGH 0-19 V Non-urgent KGH 600 4,000 4,000 HDH BHG 400 2,000 2,000 200
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 1,600 all Services (hours) (meals) (1-way trips) Actual Projected #% Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% 1,400 Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 1,200 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 1,000 65-74 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 800 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 600 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 400 pending verification with local data management personnel Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach 200 Area of Service Provision 2006 2012 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 7,745 62.2% 4,713 37.8% 12,458 100.% 11,908 4,163 53.7% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 1,860 78.0% 525 22.0% 2,385 100.% 1,779 ( 81) (4.3%) Acute Days of Stay 9,111 73.8% 3,230 26.2% 12,341 100.% 8,398 ( 713) (7.8%) Individuals Served (2007) ALC1 Separations 112 84.8% 20 15.2% 132 100.% 113 1 1.1% Females Head Office Location of Provider ALC Days of Stay 1,194 56.5% 921 43.5% 2,115 100.% 1,756 562 47.0% 600 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 2,593 81.9% 574 18.1% 3,167 100.% 3,145 552 21.3% Oncology Visits 1,539 94.9% 83 5.1% 1,622 100.% 1,307 ( 232) (15.1%) 500 Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 650 73.7% 232 26.3% 882 100.% 1,186 536 82.5% 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 111 74.0% 39 26.0% 150 100.% 136 25 22.3% 400 South East LHIN 28,430 Radiation Treatments 901 87.6% 128 12.4% 1,029 100.% 1,082 181 20.1% 65-74 All Outpatient Events 5,794 64.8% 3,145 35.2% 8,939 100.% 6,856 1,062 18.3% 45-64 Clients with Open Admission to program... Rehabilitation 300 20-44 Cases 1773.9% 626.1% 23 100.% 23 6 33.6% Problem Gambling Substance Abuse 0-19 County 2004 2008 2004 2008 Days 505 76.2% 158 23.8% 663 100.% 738 233 46.1% Complex Continuing Care 200 Frontenac 39 86 1,462 2,023 Cases 45 95.7% 2 4.3% 47 100.% 53 8 17.3% Hastings 21 15 811 1,043 Days 1,943 97.8% 44 2.2% 1,987 100.% 2,380 437 22.5% Lanark 7 26 290 600 Adult Mental Health 100 Leeds-Gren. 35 50 429 806 Cases 74 92.5% 6 7.5% 80 100.% 60 ( 14) (19.2%) Lenn. & Add. 12 15 489 841 Days 764 90.1% 84 9.9% 848 100.% 856 92 12.0% Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 3,000 3,000 600
Outside LHIN 2,500 2,500 QHC-Trenton 500 85+ QHC-Picton 75-84 2,000 2,000 QHC-Belleville 400 Other 65-74 QHC-Bancroft Obstetrics 45-64 PSF- Smiths Falls 1,500 Newborn 1,500 300 20-44 PSF- Perth Surgery 0-19 LACGH Medicine 1,000 1,000 KGH 200 HDH BGH 500 500 100
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Gananoque Leeds
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 Gananoque EastGananoque East 75-79 b YearLeeds LHIN OntarioLeeds LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 14,917 482,078 12,705,344 e 50-54 2006 2009 15,104 486,101 13,050,754 Quick Facts: 45-49 2011 15,384 492,452 13,349,125 2 G 40-44 2016 Size: 610 km r 2016 15,864 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 2,623 80,630 1,649,293 17.6% 16.7% 13.0% Total: 14,720 20-24 2009 2,741 86,097 1,770,571 18.1% 17.7% 13.6% Aged 65+: 2,620 15-19 2011 2,840 90,168 1,864,941 18.5% 18.3% 14.0% 10-14 2016 3,403 105,224 2,214,279 21.4% 20.6% 15.6% % 65+: 17.8% 5-9 Aged 75+ 0-4 Density: 24.0 persons/km2 2006 1,203 37,269 781,257 8.1% 7.7% 6.1% 800 600 400 200 0 200 400 600 800 2009 1,207 38,990 837,672 8.0% 8.0% 6.4% Population 2011 1,207 40,324 871,594 7.8% 8.2% 6.5% 2016 1,262 44,307 959,871 8.0% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 301 9,648 192,104 2.0% 2.0% 1.5% 2009 328 10,718 228,156 2.2% 2.2% 1.7% 2011 335 11,302 249,961 2.2% 2.3% 1.9% 2016 360 12,494 294,008 2.3% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System
Lung & related Colon & related Breast Prostate Neoplasms Chronic lower Lymph, Blood & related Census Characteristics respiratory disease Respiratory System South Influenza and pneumonia Gananoque East Diabetes Leeds LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 19.5% 20.0% 18.7% Dementia/Alzheimers Completed post-secondary education (age 25+) 51.3% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 6.0% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 65.4% 62.4% 67.1% External Causes Proportion of population living in low income 8.8% 11.9% 14.7% English Mother tongue 94.4% 91.5% 69.8% Other diseases French Mother tongue 1.6% 2.7% 4.4% Immigrants 7.2% 9.3% 28.3% 0 10203040506070Recent Immigrants (5 years) 0.5% 0.8% 4.8% Visible minorities 1.6% 3.3% 22.8% Number of Deaths Aboriginal Identity 1.6% 2.8% 2.0%
Health Status Leeds, Grenville & Lanark District Health Unit 1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 54.8 (49.2 - 60.3) 38.2 (26.6 - 49.7) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 47.2 (41.7 - 52.7) 67.2 (57.6 - 76.8) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 44.6 (38.8 - 50.3) 70.9 (58.9 - 82.9) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 79.1 (74.8 - 83.3) 89.5 (82.3 - 96.7) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * Daily Smokers 21.6 (17.2 - 26) - - 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) Exposed To Second Hand Smoke In Home 12.4 * (7.5 - 17.3) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 23.0 (17 - 28.9) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 52.1 (46.6 - 57.6) 61.7 (49.8 - 73.6) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 41.9 (36.4 - 47.5) 45.1 (35.3 - 54.9) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 38.5 (33.3 - 43.7) 44.2 (33.8 - 54.6) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) * * Has A Lot Of Stress (Age 18+) 24.8 (19.7 - 29.9) 16.1 (6.6 - 25.6) 23.9 (21.2 - 26.7) 8.7 (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 25.2 (20.8 - 29.7) 48.7 (37.1 - 60.3) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 7.1 (4.8 - 9.3) 20.9 * (11.5 - 30.3) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) * * Asthma 11.9 (7.7 - 16) - - 10.0 (7.8 - 12.3) 9.2 (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 18.2 (14.6 - 21.7) 45.0 (35 - 55.1) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for the Leeds, Grenville and Lanark District Health Unit are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): Gananoque Leeds
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
6,000 6,000 Females 1,600 Outside SE LHIN 5,000 5,000 QHC-Trenton 1,400
QHC-Picton 85+ QHC-Belleville 1,200 4,000 4,000 75-84 I Resuscitation QHC-Bancroft 65-74 II Emergent 1,000 PSF - Smiths Falls 45-64 3,000 III Urgent 3,000 PSF - Perth 800 20-44 IV Less-urgent LACGH 0-19 V Non-urgent 2,000 2,000 KGH 600 HDH BHG 400 1,000 1,000 200
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 1,600 all Services (hours) (meals) (1-way trips) Actual Projected #% Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% 1,400 Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 1,200 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 1,000 65-74 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 800 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 600 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 400 pending verification with local data management personnel Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach 200 Area of Service Provision 2006 2012 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 5,140 96.3% 200 3.7% 5,340 100.% 5,455 315 6.1% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 1,050 94.1% 66 5.9% 1,116 100.% 1,099 49 4.6% Acute Days of Stay 6,300 92.6% 504 7.4% 6,804 100.% 7,169 869 13.8% Individuals Served (2007) ALC1 Separations 29 93.5% 2 6.5% 31 100.% 46 17 58.5% Females Head Office Location of Provider ALC Days of Stay 970 97.8% 22 2.2% 992 100.% 1,275 305 31.4% 600 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 1,859 96.2% 74 3.8% 1,933 100.% 2,049 190 10.2% Oncology Visits 369 99.2% 3 0.8% 372 100.% 450 81 22.0% 500 Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 1,454 100.0% - - 1,454 100.% 1,316 ( 138) (9.5%) 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 72 86.7% 11 13.3% 83 100.% 83 11 15.9% 400 South East LHIN 28,430 Radiation Treatments 557 99.8% 1 0.2% 558 100.% 724 167 29.9% 65-74 All Outpatient Events 4,311 67.8% 2,049 32.2% 6,360 100.% 4,623 312 7.2% 45-64 Clients with Open Admission to program... Rehabilitation 300 20-44 Cases 1789.5% 210.5% 19 100.% 28 11 63.3% Problem Gambling Substance Abuse 0-19 County 2004 2008 2004 2008 Days 423 93.8% 28 6.2% 451 100.% 908 485 114.8% Complex Continuing Care 200 Frontenac 39 86 1,462 2,023 Cases 27 100.0% - - 27 100.% 30 3 10.5% Hastings 21 15 811 1,043 Days 660 100.0% - - 660 100.% 1,070 410 62.2% Lanark 7 26 290 600 Adult Mental Health 100 Leeds-Gren. 35 50 429 806 Cases 38 90.5% 4 9.5% 42 100.% 34 ( 4) (11.4%) Lenn. & Add. 12 15 489 841 Days 685 98.1% 13 1.9% 698 100.% 517 ( 168) (24.6%) Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 1,400 1,400 600
Outside LHIN 1,200 1,200 QHC-Trenton 500 85+ QHC-Picton 1,000 1,000 75-84 QHC-Belleville 400 Other 65-74 QHC-Bancroft 800 Obstetrics 800 45-64 PSF- Smiths Falls Newborn 300 20-44 PSF- Perth 600 Surgery 600 0-19 LACGH Medicine KGH 200 400 400 HDH BGH 200 200 100
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Kingston & Islands
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 Kingston EastKingston East 75-79 b Yearand Islands LHIN Ontarioand Islands LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 122,082 482,078 12,705,344 e 50-54 2006 2009 123,051 486,101 13,050,754 Quick Facts: 45-49 2011 125,341 492,452 13,349,125 2 G 40-44 2016 Size: 630 km r 2016 129,467 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 18,728 80,630 1,649,293 15.3% 16.7% 13.0% Total: 119,070 20-24 2009 19,899 86,097 1,770,571 16.2% 17.7% 13.6% Aged 65+: 18,730 15-19 2011 20,865 90,168 1,864,941 16.6% 18.3% 14.0% 10-14 2016 24,641 105,224 2,214,279 19.0% 20.6% 15.6% % 65+: 15.7% 5-9 Aged 75+ 0-4 Density: 190.4 persons/km2 2006 9,558 37,269 781,257 7.8% 7.7% 6.1% 6,000 4,000 2,000 0 2,000 4,000 6,000 2009 9,918 38,990 837,672 8.1% 8.0% 6.4% Population 2011 10,070 40,324 871,594 8.0% 8.2% 6.5% 2016 10,773 44,307 959,871 8.3% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 2,674 9,648 192,104 2.2% 2.0% 1.5% 2009 2,837 10,718 228,156 2.3% 2.2% 1.7% 2011 2,782 11,302 249,961 2.2% 2.3% 1.9% 2016 3,129 12,494 294,008 2.4% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System
Lung & related Colon & related Breast Prostate Neoplasms Chronic lower Lymph, Blood & related Census Characteristics respiratory disease Respiratory System South Influenza and pneumonia Kingston East Diabetes and Islands LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 14.9% 20.0% 18.7% Dementia/Alzheimers Completed post-secondary education (age 25+) 61.5% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 7.0% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 64.1% 62.4% 67.1% External Causes Proportion of population living in low income 15.2% 11.9% 14.7% English Mother tongue 86.2% 91.5% 69.8% Other diseases French Mother tongue 3.5% 2.7% 4.4% Immigrants 14.1% 9.3% 28.3% 0 200 400 600 800 1000 1200 1400 1600 1800 2000 Recent Immigrants (5 years) 1.8% 0.8% 4.8% Visible minorities 7.1% 3.3% 22.8% Number of Deaths Aboriginal Identity 2.1% 2.8% 2.0%
Health Status Kingston, Frontenac and Lennox & Addington Public Health1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 57.1 (51.5 - 62.6) 46.4 (35.9 - 57) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 41.3 (36.2 - 46.3) 59.1 (48.6 - 69.6) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 46.0 (40.9 - 51.1) 81.4 (73.7 - 89.1) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 83.6 (79.7 - 87.5) 93.1 (88.4 - 97.9) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * Daily Smokers 22.8 (17.8 - 27.8) - - 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) * Exposed To Second Hand Smoke In Home 10.4 (5.1 - 15.7) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 21.0 (16.2 - 25.8) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 52.5 (46.2 - 58.9) 51.6 (41.5 - 61.7) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 45.3 (39.8 - 50.9) 49.6 (39.5 - 59.7) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 42.3 (37.2 - 47.4) 51.6 (39.4 - 63.9) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) Has A Lot Of Stress (Age 18+) 23.4 (19 - 27.9) - - 23.9 (21.2 - 26.7) 8.7 * (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 22.2 (17.5 - 26.9) 54.4 (42.9 - 65.9) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 6.2 * (4 - 8.4) 22.2 * (14 - 30.5) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) Asthma 11.1 * (7.3 - 15) 11.0 * (4.3 - 17.6) 10.0 (7.8 - 12.3) 9.2 * (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 20.0 (15.9 - 24.2) 53.4 (43.2 - 63.5) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for Kingston, Frontenac and Lennox & Addington Public Health are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): Kingston & Islands
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
80,000 80,000 Females 1,600 Outside SE LHIN 70,000 70,000 QHC-Trenton 1,400
60,000 60,000 QHC-Picton 85+ 1,200 QHC-Belleville 75-84 50,000 I Resuscitation 50,000 QHC-Bancroft 65-74 II Emergent 1,000 PSF - Smiths Falls 45-64 40,000 III Urgent 40,000 PSF - Perth 800 20-44 IV Less-urgent LACGH 30,000 0-19 30,000 V Non-urgent KGH 600 20,000 20,000 HDH BHG 400 10,000 10,000 200
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 1,600 all Services (hours) (meals) (1-way trips) Actual Projected #% Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% 1,400 Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 1,200 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 1,000 65-74 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 800 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 600 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 400 pending verification with local data management personnel Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach 200 Area of Service Provision 2006 2012 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 70,360 98.0% 1,433 2.0% 71,793 100.% 72,607 2,247 3.2% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 9,148 96.3% 349 3.7% 9,497 100.% 9,639 491 5.4% Acute Days of Stay 56,793 96.4% 2,107 3.6% 58,900 100.% 62,351 5,558 9.8% Individuals Served (2007) ALC1 Separations 422 99.1% 4 0.9% 426 100.% 404 ( 18) (4.3%) Females Head Office Location of Provider ALC Days of Stay 12,864 99.7% 39 0.3% 12,903 100.% 10,831 (2,033) (15.8%) 600 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 11,677 97.3% 326 2.7% 12,003 100.% 12,817 1,140 9.8% Oncology Visits 3,638 99.3% 25 0.7% 3,663 100.% 3,678 40 1.1% 500 Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 15,810 99.7% 46 0.3% 15,856 100.% 16,939 1,129 7.1% 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 444 96.5% 16 3.5% 460 100.% 466 22 4.9% 400 South East LHIN 28,430 Radiation Treatments 5,715 99.2% 47 0.8% 5,762 100.% 6,144 429 7.5% 65-74 All Outpatient Events 37,284 74.4% 12,817 25.6% 50,101 100.% 40,045 2,761 7.4% 45-64 Clients with Open Admission to program... Rehabilitation 300 20-44 Cases 183 95.8% 8 4.2% 191 100.% 257 74 40.3% Problem Gambling Substance Abuse 0-19 County 2004 2008 2004 2008 Days 5,167 99.6% 20 0.4% 5,187 100.% 6,640 1,473 28.5% Complex Continuing Care 200 Frontenac 39 86 1,462 2,023 Cases 198 98.0% 4 2.0% 202 100.% 228 30 15.2% Hastings 21 15 811 1,043 Days 6,904 97.0% 211 3.0% 7,115 100.% 9,622 2,718 39.4% Lanark 7 26 290 600 Adult Mental Health 100 Leeds-Gren. 35 50 429 806 Cases 741 94.5% 43 5.5% 784 100.% 776 35 4.8% Lenn. & Add. 12 15 489 841 Days 13,932 92.1% 1,191 7.9% 15,123 100.% 22,898 8,966 64.4% Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 12,000 12,000 600
Outside LHIN 10,000 10,000 QHC-Trenton 500 85+ QHC-Picton 75-84 8,000 8,000 QHC-Belleville 400 Other 65-74 QHC-Bancroft Obstetrics 45-64 PSF- Smiths Falls 6,000 Newborn 6,000 300 20-44 PSF- Perth Surgery 0-19 LACGH Medicine 4,000 4,000 KGH 200 HDH BGH 2,000 2,000 100
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: North Hastings
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 North EastNorth East 75-79 b YearHastings LHIN OntarioHastings LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 12,403 482,078 12,705,344 e 50-54 2006 2009 11,980 486,101 13,050,754 Quick Facts: 45-49 2011 11,550 492,452 13,349,125 2 G 40-44 2016 Size: 2,210 km r 2016 11,493 510,626 14,149,965
o 35-39 2011 Aged 65+ Population (2006) u 30-34 p 25-29 2006 2,509 80,630 1,649,293 20.2% 16.7% 13.0% Total: 11,490 20-24 2009 2,581 86,097 1,770,571 21.5% 17.7% 13.6% Aged 65+: 2,510 15-19 2011 2,592 90,168 1,864,941 22.4% 18.3% 14.0% 10-14 2016 3,104 105,224 2,214,279 27.0% 20.6% 15.6% % 65+: 21.8% 5-9 Aged 75+ 0-4 Density: 5.2 persons/km2 2006 1,059 37,269 781,257 8.5% 7.7% 6.1% 800 600 400 200 0 200 400 600 800 2009 1,057 38,990 837,672 8.8% 8.0% 6.4% Population 2011 1,019 40,324 871,594 8.8% 8.2% 6.5% 2016 1,071 44,307 959,871 9.3% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 233 9,648 192,104 1.9% 2.0% 1.5% 2009 231 10,718 228,156 1.9% 2.2% 1.7% 2011 221 11,302 249,961 1.9% 2.3% 1.9% 2016 241 12,494 294,008 2.1% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System
Lung & related Colon & related Breast Prostate Neoplasms Chronic lower Lymph, Blood & related Census Characteristics respiratory disease Respiratory System South North East Diabetes Influenza and pneumonia Hastings LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 29.2% 20.0% 18.7% Dementia/Alzheimers Completed post-secondary education (age 25+) 44.2% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 6.6% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 51.6% 62.4% 67.1% External Causes Proportion of population living in low income 11.3% 11.9% 14.7% English Mother tongue 95.4% 91.5% 69.8% Other diseases French Mother tongue 1.0% 2.7% 4.4% Immigrants 6.6% 9.3% 28.3% 0 20 40 60 80 100 120 140 Recent Immigrants (5 years) 0.0% 0.8% 4.8% Visible minorities 0.5% 3.3% 22.8% Number of Deaths Aboriginal Identity 10.3% 2.8% 2.0%
Health Status Hastings and Prince Edward Counties Health Unit1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 53.5 (46.9 - 60) 38.5 (29.7 - 47.3) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 43.0 (37.6 - 48.5) 61.6 (50.7 - 72.5) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 48.9 (41.9 - 55.9) 61.8 (52.4 - 71.2) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 79.1 (73.9 - 84.2) 90.9 (85 - 96.7) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * * Daily Smokers 21.1 (15.6 - 26.6) 12.4 (6.9 - 17.9) 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) Exposed To Second Hand Smoke In Home 12.4 * (7.1 - 17.7) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 21.3 (14.5 - 28.2) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 56.5 (49.7 - 63.4) 53.2 (42.4 - 64) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 42.7 (36.9 - 48.5) 60.9 (51.4 - 70.3) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 43.2 (36 - 50.4) 50.5 (39.8 - 61.1) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) * Has A Lot Of Stress (Age 18+) 22.1 (18.1 - 26.2) - - 23.9 (21.2 - 26.7) 8.7 (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 28.2 (23.4 - 32.9) 51.7 (42 - 61.3) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 8.0 * (4.8 - 11.1) 15.3 * (8.6 - 22) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) * * * Asthma 6.1 (3.7 - 8.5) 6.9 (3 - 10.9) 10.0 (7.8 - 12.3) 9.2 (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 19.4 (14.7 - 24.1) 47.9 (35.4 - 60.3) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for the Hastings and Prince Edward Counties Health Unit are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): North Hastings
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
14,000 14,000 Females 2,000 Outside SE LHIN 12,000 12,000 1,800 QHC-Trenton
QHC-Picton 1,600 85+ 10,000 10,000 QHC-Belleville 1,400 75-84 I Resuscitation QHC-Bancroft 8,000 65-74 8,000 II Emergent 1,200 PSF - Smiths Falls 45-64 III Urgent PSF - Perth 1,000 20-44 6,000 IV Less-urgent 6,000 LACGH 0-19 V Non-urgent KGH 800 4,000 4,000 HDH 600 BHG 2,000 2,000 400 200 0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 2,000 all Services (hours) (meals) (1-way trips) Actual Projected #% 1,800 Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 1,600 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% 1,400 Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 65-74 1,200 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 1,000 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% 800 Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 600 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 pending verification with local data management personnel 400 Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach Area of Service Provision 2006 2012 200 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 9,356 91.4% 884 8.6% 10,240 100.% 9,669 313 3.3% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 690 60.2% 457 39.8% 1,147 100.% 638 ( 52) (7.5%) Acute Days of Stay 3,683 58.5% 2,614 41.5% 6,297 100.% 3,466 ( 217) (5.9%) Individuals Served (2007) ALC1 Separations 43 76.8% 13 23.2% 56 100.% 49 6 14.8% Females Head Office Location of Provider ALC Days of Stay 1,418 91.7% 129 8.3% 1,547 100.% 1,691 273 19.3% 700 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 409 31.4% 894 68.6% 1,303 100.% 1,269 860 210.2% 600 Oncology Visits 211 46.8% 240 53.2% 451 100.% 441 230 108.8% Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 830 85.3% 143 14.7% 973 100.% 930 100 12.1% 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 29 31.9% 62 68.1% 91 100.% 80 51 174.6% 500 South East LHIN 28,430 Radiation Treatments 264 47.9% 287 52.1% 551 100.% 573 309 116.9% 65-74 All Outpatient Events 1,743 57.9% 1,269 42.1% 3,012 100.% 3,292 1,549 88.9% 400 45-64 Clients with Open Admission to program... Rehabilitation 20-44 Cases 10 34.5% 19 65.5% 29 100.% 12 2 17.4% Problem Gambling Substance Abuse 300 0-19 County 2004 2008 2004 2008 Days 331 54.2% 280 45.8% 611 100.% 508 177 53.6% Complex Continuing Care Frontenac 39 86 1,462 2,023 Cases 8 80.0% 2 20.0% 10 100.% 10 2 27.2% 200 Hastings 21 15 811 1,043 Days 339 90.4% 36 9.6% 375 100.% 390 51 15.0% Lanark 7 26 290 600 Adult Mental Health Leeds-Gren. 35 50 429 806 Cases 4588.2% 611.8% 51 100.% 31 ( 14) (31.8%) 100 Lenn. & Add. 12 15 489 841 Days 473 76.4% 146 23.6% 619 100.% 418 ( 55) (11.7%) Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 1,400 1,400 700
Outside LHIN 1,200 1,200 600 QHC-Trenton 85+ QHC-Picton 1,000 1,000 500 75-84 QHC-Belleville Other 65-74 QHC-Bancroft 800 Obstetrics 800 400 45-64 PSF- Smiths Falls Newborn 20-44 PSF- Perth 600 Surgery 600 300 0-19 LACGH Medicine KGH 400 400 HDH 200 BGH 200 200 100
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Prince Edward County
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ Prince SouthPrince South 80-84 Edward EastEdward East 75-79 b YearCounty LHIN OntarioCounty LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 26,362 482,078 12,705,344 e 50-54 2006 2009 26,240 486,101 13,050,754 Quick Facts: 45-49 2011 26,316 492,452 13,349,125 2 G 40-44 Size: 1,050 km r 2016 2016 26,960 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 5,561 80,630 1,649,293 21.1% 16.7% 13.0% Total: 25,500 20-24 2009 5,863 86,097 1,770,571 22.3% 17.7% 13.6% Aged 65+: 5,560 15-19 2011 6,064 90,168 1,864,941 23.0% 18.3% 14.0% 10-14 2016 7,298 105,224 2,214,279 27.1% 20.6% 15.6% % 65+: 21.8% 5-9 Aged 75+ 0-4 Density: 24.3 persons/km2 2006 2,335 37,269 781,257 8.9% 7.7% 6.1% 1,500 1,000 500 0 500 1,000 1,500 2009 2,524 38,990 837,672 9.6% 8.0% 6.4% Population 2011 2,702 40,324 871,594 10.3% 8.2% 6.5% 2016 2,895 44,307 959,871 10.7% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 516 9,648 192,104 2.0% 2.0% 1.5% 2009 556 10,718 228,156 2.1% 2.2% 1.7% 2011 628 11,302 249,961 2.4% 2.3% 1.9% 2016 714 12,494 294,008 2.6% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System
Lung & related Colon & related Breast Prostate Neoplasms Chronic lower Lymph, Blood & related Census Characteristics respiratory disease Respiratory System Prince South Influenza and pneumonia Edward East Diabetes County LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 19.6% 20.0% 18.7% Dementia/Alzheimers Completed post-secondary education (age 25+) 54.1% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 6.0% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 59.0% 62.4% 67.1% External Causes Proportion of population living in low income 9.2% 11.9% 14.7% English Mother tongue 93.9% 91.5% 69.8% Other diseases French Mother tongue 1.7% 2.7% 4.4% Immigrants 9.5% 9.3% 28.3% 0 50 100 150 200 250 300 350 Recent Immigrants (5 years) 0.3% 0.8% 4.8% Visible minorities 1.3% 3.3% 22.8% Number of Deaths Aboriginal Identity 2.4% 2.8% 2.0%
Health Status Hastings and Prince Edward Counties Health Unit1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 53.5 (46.9 - 60) 38.5 (29.7 - 47.3) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 43.0 (37.6 - 48.5) 61.6 (50.7 - 72.5) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 48.9 (41.9 - 55.9) 61.8 (52.4 - 71.2) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 79.1 (73.9 - 84.2) 90.9 (85 - 96.7) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * * Daily Smokers 21.1 (15.6 - 26.6) 12.4 (6.9 - 17.9) 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) Exposed To Second Hand Smoke In Home 12.4 * (7.1 - 17.7) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 21.3 (14.5 - 28.2) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 56.5 (49.7 - 63.4) 53.2 (42.4 - 64) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 42.7 (36.9 - 48.5) 60.9 (51.4 - 70.3) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 43.2 (36 - 50.4) 50.5 (39.8 - 61.1) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) * Has A Lot Of Stress (Age 18+) 22.1 (18.1 - 26.2) - - 23.9 (21.2 - 26.7) 8.7 (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 28.2 (23.4 - 32.9) 51.7 (42 - 61.3) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 8.0 * (4.8 - 11.1) 15.3 * (8.6 - 22) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) * * * Asthma 6.1 (3.7 - 8.5) 6.9 (3 - 10.9) 10.0 (7.8 - 12.3) 9.2 (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 19.4 (14.7 - 24.1) 47.9 (35.4 - 60.3) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for the Hastings and Prince Edward Counties Health Unit are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): Prince Edward County
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
30,000 30,000 Females 2,200 Outside SE LHIN 2,000 25,000 25,000 QHC-Trenton 1,800 QHC-Picton 85+ QHC-Belleville 20,000 20,000 1,600 75-84 I Resuscitation QHC-Bancroft 1,400 65-74 II Emergent PSF - Smiths Falls 45-64 15,000 III Urgent 15,000 1,200 PSF - Perth 20-44 IV Less-urgent 1,000 LACGH 0-19 V Non-urgent 10,000 10,000 KGH 800 HDH 600 BHG 5,000 5,000 400
200 0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 2,200 all Services (hours) (meals) (1-way trips) Actual Projected #% 2,000 Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% 1,800 Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 1,600 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 1,400 65-74 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 1,200 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 1,000 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 800 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 *Community Health Centre (CHC) Actual and Projected 600 South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 pending verification with local data management personnel Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach 400 Area of Service Provision 2006 2012 200 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 19,936 97.9% 423 2.1% 20,359 100.% 20,744 808 4.1% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 2,689 93.6% 183 6.4% 2,872 100.% 2,783 94 3.5% Acute Days of Stay 13,579 93.6% 923 6.4% 14,502 100.% 14,412 833 6.1% Individuals Served (2007) ALC1 Separations 92 97.9% 2 2.1% 94 100.% 156 64 69.0% Females Head Office Location of Provider ALC Days of Stay 1,889 99.3% 14 0.7% 1,903 100.% 3,622 1,733 91.7% 900 Belleville 4,629 Outpatient Events/Clinic Visits 2 800 Brockville 5,392 Surgical/PARR 3,031 93.0% 228 7.0% 3,259 100.% 3,591 560 18.5% Kingston & Islands 7,560 Oncology Visits 1,412 94.1% 89 5.9% 1,501 100.% 1,204 ( 208) (14.7%) 700 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 3,241 100.0% 1 0.0% 3,242 100.% 3,535 294 9.1% 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 140 95.9% 6 4.1% 146 100.% 134 ( 6) (4.4%) 600 South East LHIN 28,430 Radiation Treatments 1,091 91.6% 100 8.4% 1,191 100.% 1,155 64 5.8% 65-74 All Outpatient Events 8,915 71.3% 3,591 28.7% 12,506 100.% 9,618 703 7.9% 45-64 Clients with Open Admission to program... 500 Rehabilitation 20-44 Cases 2275.9% 724.1% 29 100.% 25 3 12.7% Problem Gambling Substance Abuse 400 0-19 County 2004 2008 2004 2008 Days 943 94.9% 51 5.1% 994 100.% 913 ( 30) (3.1%) Complex Continuing Care 300 Frontenac 39 86 1,462 2,023 Cases 18 100.0% - - 18 100.% 22 4 20.6% Hastings 21 15 811 1,043 Days 639 100.0% - - 639 100.% 1,028 389 60.9% 200 Lanark 7 26 290 600 Adult Mental Health Leeds-Gren. 35 50 429 806 Cases 63 84.0% 12 16.0% 75 100.% 64 1 2.2% 100 Lenn. & Add. 12 15 489 841 Days 825 88.7% 105 11.3% 930 100.% 1,097 272 33.0% Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 3,500 3,500 900
Outside LHIN 800 3,000 3,000 QHC-Trenton 85+ QHC-Picton 700 2,500 2,500 75-84 QHC-Belleville 600 Other 65-74 QHC-Bancroft 2,000 Obstetrics 2,000 45-64 PSF- Smiths Falls 500 Newborn 20-44 PSF- Perth 1,500 Surgery 1,500 400 0-19 LACGH Medicine KGH 300 1,000 1,000 HDH 200 BGH 500 500 100
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Quinte West
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 Quinte EastQuinte East 75-79 b YearWest LHIN OntarioWest LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 54,439 482,078 12,705,344 e 50-54 2006 2009 55,255 486,101 13,050,754 Quick Facts: 45-49 2011 56,130 492,452 13,349,125 2 G 40-44 2016 Size: 720 km r 2016 58,662 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 8,826 80,630 1,649,293 16.2% 16.7% 13.0% Total: 52,950 20-24 2009 9,508 86,097 1,770,571 17.2% 17.7% 13.6% Aged 65+: 8,830 15-19 2011 9,954 90,168 1,864,941 17.7% 18.3% 14.0% 10-14 2016 12,096 105,224 2,214,279 20.6% 20.6% 15.6% % 65+: 16.7% 5-9 Aged 75+ 0-4 Density: 73.9 persons/km2 2006 3,624 37,269 781,257 6.7% 7.7% 6.1% 3,000 2,000 1,000 0 1,000 2,000 3,000 2009 3,921 38,990 837,672 7.1% 8.0% 6.4% Population 2011 4,126 40,324 871,594 7.4% 8.2% 6.5% 2016 4,773 44,307 959,871 8.1% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 735 9,648 192,104 1.4% 2.0% 1.5% 2009 808 10,718 228,156 1.5% 2.2% 1.7% 2011 859 11,302 249,961 1.5% 2.3% 1.9% 2016 975 12,494 294,008 1.7% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System
Lung & related Colon & related Breast Prostate Neoplasms Chronic lower Lymph, Blood & related Census Characteristics respiratory disease Respiratory System South Quinte East Diabetes Influenza and pneumonia West LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 21.9% 20.0% 18.7% Dementia/Alzheimers Completed post-secondary education (age 25+) 49.1% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 5.7% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 62.3% 62.4% 67.1% External Causes Proportion of population living in low income 11.1% 11.9% 14.7% English Mother tongue 91.5% 91.5% 69.8% Other diseases French Mother tongue 4.3% 2.7% 4.4% Immigrants 8.2% 9.3% 28.3% 0 50 100 150 200 250 300 350 400 450 500 Recent Immigrants (5 years) 0.4% 0.8% 4.8% Visible minorities 2.0% 3.3% 22.8% Number of Deaths Aboriginal Identity 2.6% 2.8% 2.0%
Health Status Hastings and Prince Edward Counties Health Unit1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 53.5 (46.9 - 60) 38.5 (29.7 - 47.3) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 43.0 (37.6 - 48.5) 61.6 (50.7 - 72.5) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 48.9 (41.9 - 55.9) 61.8 (52.4 - 71.2) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 79.1 (73.9 - 84.2) 90.9 (85 - 96.7) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * * Daily Smokers 21.1 (15.6 - 26.6) 12.4 (6.9 - 17.9) 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) Exposed To Second Hand Smoke In Home 12.4 * (7.1 - 17.7) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 21.3 (14.5 - 28.2) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 56.5 (49.7 - 63.4) 53.2 (42.4 - 64) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 42.7 (36.9 - 48.5) 60.9 (51.4 - 70.3) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 43.2 (36 - 50.4) 50.5 (39.8 - 61.1) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) * Has A Lot Of Stress (Age 18+) 22.1 (18.1 - 26.2) - - 23.9 (21.2 - 26.7) 8.7 (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 28.2 (23.4 - 32.9) 51.7 (42 - 61.3) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 8.0 * (4.8 - 11.1) 15.3 * (8.6 - 22) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) * * * Asthma 6.1 (3.7 - 8.5) 6.9 (3 - 10.9) 10.0 (7.8 - 12.3) 9.2 (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 19.4 (14.7 - 24.1) 47.9 (35.4 - 60.3) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for the Hastings and Prince Edward Counties Health Unit are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): Quinte West
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
35,000 35,000 Females 1,600 Outside SE LHIN 30,000 30,000 QHC-Trenton 1,400
QHC-Picton 85+ 25,000 25,000 1,200 QHC-Belleville 75-84 I Resuscitation QHC-Bancroft 65-74 20,000 II Emergent 20,000 1,000 PSF - Smiths Falls 45-64 III Urgent PSF - Perth 800 20-44 15,000 IV Less-urgent 15,000 LACGH 0-19 V Non-urgent KGH 600 10,000 10,000 HDH BHG 400 5,000 5,000 200
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 1,600 all Services (hours) (meals) (1-way trips) Actual Projected #% Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% 1,400 Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 1,200 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 1,000 65-74 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 800 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 600 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 400 pending verification with local data management personnel Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach 200 Area of Service Provision 2006 2012 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 27,680 92.5% 2,256 7.5% 29,936 100.% 30,494 2,814 10.2% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 3,606 88.8% 456 11.2% 4,062 100.% 3,978 372 10.3% Acute Days of Stay 18,269 86.8% 2,783 13.2% 21,052 100.% 20,403 2,134 11.7% Individuals Served (2007) ALC1 Separations 222 95.3% 11 4.7% 233 100.% 280 58 25.9% Females Head Office Location of Provider ALC Days of Stay 5,524 97.6% 136 2.4% 5,660 100.% 5,780 256 4.6% 600 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 4,462 80.1% 1,111 19.9% 5,573 100.% 6,016 1,554 34.8% Oncology Visits 1,909 89.8% 216 10.2% 2,125 100.% 1,978 69 3.6% 500 Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 3,320 93.2% 242 6.8% 3,562 100.% 4,336 1,016 30.6% 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 227 90.4% 24 9.6% 251 100.% 240 13 5.9% 400 South East LHIN 28,430 Radiation Treatments 1,660 84.9% 296 15.1% 1,956 100.% 2,194 534 32.2% 65-74 All Outpatient Events 11,578 65.8% 6,016 34.2% 17,594 100.% 14,764 3,186 27.5% 45-64 Clients with Open Admission to program... Rehabilitation 300 20-44 Cases 30 68.2% 14 31.8% 44 100.% 42 12 39.3% Problem Gambling Substance Abuse 0-19 County 2004 2008 2004 2008 Days 1,123 72.7% 422 27.3% 1,545 100.% 1,568 445 39.6% Complex Continuing Care 200 Frontenac 39 86 1,462 2,023 Cases 127 100.0% - - 127 100.% 154 27 21.3% Hastings 21 15 811 1,043 Days 6,382 100.0% - - 6,382 100.% 9,628 3,246 50.9% Lanark 7 26 290 600 Adult Mental Health 100 Leeds-Gren. 35 50 429 806 Cases 174 92.6% 14 7.4% 188 100.% 159 ( 15) (8.6%) Lenn. & Add. 12 15 489 841 Days 1,931 93.4% 137 6.6% 2,068 100.% 2,022 91 4.7% Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 5,000 5,000 600
4,500 4,500 Outside LHIN 500 4,000 QHC-Trenton 4,000 85+ QHC-Picton 3,500 3,500 75-84 QHC-Belleville 400 Other 65-74 3,000 3,000 QHC-Bancroft Obstetrics 45-64 PSF- Smiths Falls 2,500 Newborn 2,500 300 20-44 PSF- Perth Surgery 0-19 2,000 2,000 LACGH Medicine KGH 200 1,500 1,500 HDH 1,000 1,000 BGH 100 500 500
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Rideau Lakes
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 Rideau EastRideau East 75-79 b YearLak es LHIN OntarioLakes LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 11,054 482,078 12,705,344 e 50-54 2006 2009 11,335 486,101 13,050,754 Quick Facts: 45-49 2011 11,639 492,452 13,349,125 2 G 2016 40-44 Size: 710 km r 2016 12,153 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 2,266 80,630 1,649,293 20.5% 16.7% 13.0% Total: 11,000 20-24 2009 2,417 86,097 1,770,571 21.3% 17.7% 13.6% Aged 65+: 2,270 15-19 2011 2,489 90,168 1,864,941 21.4% 18.3% 14.0% 10-14 2016 3,034 105,224 2,214,279 25.0% 20.6% 15.6% % 65+: 20.6% 5-9 Aged 75+ 0-4 Density: 15.4 persons/km2 2006 901 37,269 781,257 8.2% 7.7% 6.1% 700 600 500 400 300 200 100 0 100 200 300 400 500 600 700 2009 960 38,990 837,672 8.5% 8.0% 6.4% Population 2011 996 40,324 871,594 8.6% 8.2% 6.5% 2016 1,091 44,307 959,871 9.0% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 225 9,648 192,104 2.0% 2.0% 1.5% 2009 209 10,718 228,156 1.8% 2.2% 1.7% 2011 188 11,302 249,961 1.6% 2.3% 1.9% 2016 222 12,494 294,008 1.8% 2.4% 2.1% Ischaemic Heart Disease Circulatory System
Lung & related Breast Neoplasms Census Characteristics South Respiratory System < 5 Rideau East Lakes LHIN Ontario Blood Forming/Endocrine < 5 No certificate, degree or diploma (age 25+) 19.8% 20.0% 18.7% Completed post-secondary education (age 25+) 54.1% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 5.2% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 60.8% 62.4% 67.1% External Causes Proportion of population living in low income 7.2% 11.9% 14.7% English Mother tongue 94.8% 91.5% 69.8% Other diseases French Mother tongue 2.6% 2.7% 4.4% Immigrants 6.6% 9.3% 28.3% 0 5 10 15 20 25 30 Recent Immigrants (5 years) 0.4% 0.8% 4.8% Visible minorities 1.0% 3.3% 22.8% Number of Deaths Aboriginal Identity 2.9% 2.8% 2.0%
Health Status Leeds, Grenville & Lanark District Health Unit 1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 54.8 (49.2 - 60.3) 38.2 (26.6 - 49.7) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 47.2 (41.7 - 52.7) 67.2 (57.6 - 76.8) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 44.6 (38.8 - 50.3) 70.9 (58.9 - 82.9) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 79.1 (74.8 - 83.3) 89.5 (82.3 - 96.7) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * Daily Smokers 21.6 (17.2 - 26) - - 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) Exposed To Second Hand Smoke In Home 12.4 * (7.5 - 17.3) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 23.0 (17 - 28.9) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 52.1 (46.6 - 57.6) 61.7 (49.8 - 73.6) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 41.9 (36.4 - 47.5) 45.1 (35.3 - 54.9) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 38.5 (33.3 - 43.7) 44.2 (33.8 - 54.6) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) * * Has A Lot Of Stress (Age 18+) 24.8 (19.7 - 29.9) 16.1 (6.6 - 25.6) 23.9 (21.2 - 26.7) 8.7 (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 25.2 (20.8 - 29.7) 48.7 (37.1 - 60.3) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 7.1 (4.8 - 9.3) 20.9 * (11.5 - 30.3) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) * * Asthma 11.9 (7.7 - 16) - - 10.0 (7.8 - 12.3) 9.2 (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 18.2 (14.6 - 21.7) 45.0 (35 - 55.1) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for the Leeds, Grenville and Lanark District Health Unit are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): Rideau Lakes
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
8,000 8,000 Females 2,000 Outside SE LHIN 7,000 7,000 1,800 QHC-Trenton
6,000 6,000 QHC-Picton 1,600 85+ QHC-Belleville 1,400 75-84 5,000 I Resuscitation 5,000 QHC-Bancroft 65-74 II Emergent 1,200 PSF - Smiths Falls 45-64 4,000 III Urgent 4,000 PSF - Perth 1,000 20-44 IV Less-urgent LACGH 3,000 3,000 0-19 V Non-urgent KGH 800
2,000 2,000 HDH 600 BHG 400 1,000 1,000 200 0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 2,000 all Services (hours) (meals) (1-way trips) Actual Projected #% 1,800 Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 1,600 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% 1,400 Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 65-74 1,200 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 1,000 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% 800 Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 600 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 pending verification with local data management personnel 400 Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach Area of Service Provision 2006 2012 200 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 6,796 96.3% 260 3.7% 7,056 100.% 7,423 627 9.2% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 770 85.8% 127 14.2% 897 100.% 828 58 7.5% Acute Days of Stay 4,855 84.4% 899 15.6% 5,754 100.% 5,257 402 8.3% Individuals Served (2007) ALC1 Separations 24 92.3% 2 7.7% 26 100.% 27 3 10.5% Females Head Office Location of Provider ALC Days of Stay 804 98.9% 9 1.1% 813 100.% 843 39 4.9% 700 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 1,287 89.1% 158 10.9% 1,445 100.% 1,541 254 19.8% 600 Oncology Visits 244 82.4% 52 17.6% 296 100.% 361 117 47.8% Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 542 95.8% 24 4.2% 566 100.% 555 13 2.4% 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 39 78.0% 11 22.0% 50 100.% 45 6 14.4% 500 South East LHIN 28,430 Radiation Treatments 508 73.3% 185 26.7% 693 100.% 628 120 23.6% 65-74 All Outpatient Events 2,620 63.0% 1,541 37.0% 4,161 100.% 3,130 510 19.4% 400 45-64 Clients with Open Admission to program... Rehabilitation 20-44 Cases 5 55.6% 4 44.4% 9 100.% 7 2 42.9% Problem Gambling Substance Abuse 300 0-19 County 2004 2008 2004 2008 Days 124 74.3% 43 25.7% 167 100.% 186 62 50.3% Complex Continuing Care Frontenac 39 86 1,462 2,023 Cases 1789.5% 210.5% 19 100.% 23 6 32.8% 200 Hastings 21 15 811 1,043 Days 682 85.0% 120 15.0% 802 100.% 947 265 38.8% Lanark 7 26 290 600 Adult Mental Health Leeds-Gren. 35 50 429 806 Cases 31 93.9% 2 6.1% 33 100.% 32 1 1.8% 100 Lenn. & Add. 12 15 489 841 Days 429 96.2% 17 3.8% 446 100.% 373 ( 56) (12.9%) Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 1,200 1,200 700
Outside LHIN 600 1,000 1,000 QHC-Trenton 85+ QHC-Picton 500 75-84 800 800 QHC-Belleville Other 65-74 QHC-Bancroft Obstetrics 400 45-64 PSF- Smiths Falls 600 Newborn 600 20-44 PSF- Perth Surgery 300 0-19 LACGH Medicine 400 400 KGH HDH 200 BGH 200 200 100
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: South East Leeds Grenville
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 SE Leeds EastSE Leeds East 75-79 b YearGrenville LHIN OntarioGrenville LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2016 2006 19,340 482,078 12,705,344 e 50-54 2006 2009 18,869 486,101 13,050,754 Quick Facts: 45-49 2011 18,529 492,452 13,349,125 2 G 40-44 Size: 630 km r 2016 18,268 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 2,986 80,630 1,649,293 15.4% 16.7% 13.0% Total: 18,380 20-24 2009 3,192 86,097 1,770,571 16.9% 17.7% 13.6% Aged 65+: 2,990 15-19 2011 3,354 90,168 1,864,941 18.1% 18.3% 14.0% 10-14 2016 3,962 105,224 2,214,279 21.7% 20.6% 15.6% % 65+: 16.2% 5-9 Aged 75+ 0-4 Density: 29.1 persons/km2 2006 1,230 37,269 781,257 6.4% 7.7% 6.1% 1,000 800 600 400 200 0 200 400 600 800 1,000 2009 1,287 38,990 837,672 6.8% 8.0% 6.4% Population 2011 1,330 40,324 871,594 7.2% 8.2% 6.5% 2016 1,417 44,307 959,871 7.8% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 264 9,648 192,104 1.4% 2.0% 1.5% 2009 292 10,718 228,156 1.5% 2.2% 1.7% 2011 323 11,302 249,961 1.7% 2.3% 1.9% 2016 328 12,494 294,008 1.8% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System Lung & Colon & related related Prostate Neoplasms Chronic lower Census Characteristics respiratory disease Respiratory System South SE Leeds East Diabetes Grenville LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 21.3% 20.0% 18.7% Dementia/Alzheimers Completed post-secondary education (age 25+) 51.9% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 5.2% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 60.9% 62.4% 67.1% External Causes Proportion of population living in low income 9.1% 11.9% 14.7% English Mother tongue 92.2% 91.5% 69.8% Other diseases French Mother tongue 3.7% 2.7% 4.4% Immigrants 8.2% 9.3% 28.3% 0 102030405060708090 Recent Immigrants (5 years) 0.4% 0.8% 4.8% Visible minorities 1.9% 3.3% 22.8% Number of Deaths Aboriginal Identity 1.9% 2.8% 2.0%
Health Status Leeds, Grenville & Lanark District Health Unit 1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 54.8 (49.2 - 60.3) 38.2 (26.6 - 49.7) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 47.2 (41.7 - 52.7) 67.2 (57.6 - 76.8) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 44.6 (38.8 - 50.3) 70.9 (58.9 - 82.9) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 79.1 (74.8 - 83.3) 89.5 (82.3 - 96.7) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * Daily Smokers 21.6 (17.2 - 26) - - 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) Exposed To Second Hand Smoke In Home 12.4 * (7.5 - 17.3) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 23.0 (17 - 28.9) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 52.1 (46.6 - 57.6) 61.7 (49.8 - 73.6) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 41.9 (36.4 - 47.5) 45.1 (35.3 - 54.9) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 38.5 (33.3 - 43.7) 44.2 (33.8 - 54.6) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) * * Has A Lot Of Stress (Age 18+) 24.8 (19.7 - 29.9) 16.1 (6.6 - 25.6) 23.9 (21.2 - 26.7) 8.7 (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 25.2 (20.8 - 29.7) 48.7 (37.1 - 60.3) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 7.1 (4.8 - 9.3) 20.9 * (11.5 - 30.3) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) * * Asthma 11.9 (7.7 - 16) - - 10.0 (7.8 - 12.3) 9.2 (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 18.2 (14.6 - 21.7) 45.0 (35 - 55.1) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for the Leeds, Grenville and Lanark District Health Unit are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): South East Leeds Grenville
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
9,000 9,000 Females 1,600 8,000 8,000 Outside SE LHIN QHC-Trenton 1,400 7,000 7,000 QHC-Picton 85+ QHC-Belleville 1,200 6,000 6,000 75-84 I Resuscitation QHC-Bancroft 65-74 5,000 II Emergent 5,000 1,000 PSF - Smiths Falls 45-64 III Urgent PSF - Perth 4,000 800 20-44 4,000 IV Less-urgent LACGH 0-19 V Non-urgent 3,000 3,000 KGH 600 HDH 2,000 2,000 BHG 400
1,000 1,000 200
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 1,600 all Services (hours) (meals) (1-way trips) Actual Projected #% Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% 1,400 Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 1,200 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 1,000 65-74 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 800 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 600 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 400 pending verification with local data management personnel Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach 200 Area of Service Provision 2006 2012 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 5,612 65.8% 2,923 34.2% 8,535 100.% 7,854 2,242 40.0% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 1,258 74.3% 435 25.7% 1,693 100.% 1,314 56 4.4% Acute Days of Stay 7,215 77.7% 2,073 22.3% 9,288 100.% 7,459 244 3.4% Individuals Served (2007) ALC1 Separations 39 90.7% 4 9.3% 43 100.% 48 9 22.8% Females Head Office Location of Provider ALC Days of Stay 1,431 90.5% 151 9.5% 1,582 100.% 1,806 375 26.2% 800 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 2,422 84.7% 438 15.3% 2,860 100.% 3,026 604 24.9% 700 Oncology Visits 134 27.5% 354 72.5% 488 100.% 513 379 282.7% Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 235 39.7% 357 60.3% 592 100.% 669 434 184.6% 600 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 62 76.5% 19 23.5% 81 100.% 85 23 36.3% Radiation Treatments 150 16.4% 763 83.6% 913 100.% 997 847 564.5% South East LHIN 28,430 500 65-74 All Outpatient Events 3,003 49.8% 3,026 50.2% 6,029 100.% 5,289 2,286 76.1% 45-64 Clients with Open Admission to program... Rehabilitation 400 20-44 Cases 13 48.1% 14 51.9% 27 100.% 24 11 85.1% Problem Gambling Substance Abuse 0-19 County 2004 2008 2004 2008 Days 338 55.9% 267 44.1% 605 100.% 647 309 91.3% Complex Continuing Care 300 Frontenac 39 86 1,462 2,023 Cases 51 92.7% 4 7.3% 55 100.% 50 ( 1) (2.9%) Hastings 21 15 811 1,043 Days 1,173 80.6% 283 19.4% 1,456 100.% 1,121 ( 52) (4.4%) 200 Lanark 7 26 290 600 Adult Mental Health Leeds-Gren. 35 50 429 806 Cases 75 88.2% 10 11.8% 85 100.% 69 ( 6) (7.6%) 100 Lenn. & Add. 12 15 489 841 Days 1,023 81.8% 227 18.2% 1,250 100.% 1,232 209 20.4% Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 2,500 2,500 800
Outside LHIN 700 2,000 QHC-Trenton 2,000 85+ QHC-Picton 600 75-84 QHC-Belleville Other 500 65-74 1,500 1,500 QHC-Bancroft Obstetrics 45-64 PSF- Smiths Falls Newborn 400 20-44 PSF- Perth Surgery 0-19 1,000 1,000 LACGH Medicine 300 KGH
HDH 200 500 500 BGH 100
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Smiths Falls, Perth, Lanark
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ Smiths SouthSmiths South 80-84 Falls, Perth, EastFalls, Perth, East 75-79 b YearLanark LHIN OntarioLanark LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 35,932 482,078 12,705,344 e 50-54 2006 2009 35,340 486,101 13,050,754 Quick Facts: 45-49 2011 34,919 492,452 13,349,125 2 G 40-44 2016 Size: 1,400 km r 2016 35,577 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 6,344 80,630 1,649,293 17.7% 16.7% 13.0% Total: 33,900 20-24 2009 6,688 86,097 1,770,571 18.9% 17.7% 13.6% Aged 65+: 6,340 15-19 2011 6,948 90,168 1,864,941 19.9% 18.3% 14.0% 10-14 2016 8,573 105,224 2,214,279 24.1% 20.6% 15.6% % 65+: 18.7% 5-9 Aged 75+ 0-4 Density: 24.2 persons/km2 2006 3,108 37,269 781,257 8.6% 7.7% 6.1% 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2009 3,062 38,990 837,672 8.7% 8.0% 6.4% Population 2011 3,008 40,324 871,594 8.6% 8.2% 6.5% 2016 3,227 44,307 959,871 9.1% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 858 9,648 192,104 2.4% 2.0% 1.5% 2009 826 10,718 228,156 2.3% 2.2% 1.7% 2011 779 11,302 249,961 2.2% 2.3% 1.9% 2016 815 12,494 294,008 2.3% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System
Lung & related Colon & related Breast Prostate Neoplasms Chronic lower Lymph, Blood & related Census Characteristics respiratory disease Respiratory System Smiths South Falls, Perth, East Diabetes Influenza and pneumonia Lanark LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 19.4% 20.0% 18.7% Dementia/Alzheimers Completed post-secondary education (age 25+) 53.4% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 6.3% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 61.4% 62.4% 67.1% External Causes Proportion of population living in low income 10.5% 11.9% 14.7% English Mother tongue 94.1% 91.5% 69.8% Other diseases French Mother tongue 3.2% 2.7% 4.4% Immigrants 6.3% 9.3% 28.3% 0 100 200 300 400 500 600 700 Recent Immigrants (5 years) 0.4% 0.8% 4.8% Visible minorities 0.9% 3.3% 22.8% Number of Deaths Aboriginal Identity 2.8% 2.8% 2.0%
Health Status Leeds, Grenville & Lanark District Health Unit 1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 54.8 (49.2 - 60.3) 38.2 (26.6 - 49.7) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 47.2 (41.7 - 52.7) 67.2 (57.6 - 76.8) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 44.6 (38.8 - 50.3) 70.9 (58.9 - 82.9) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 79.1 (74.8 - 83.3) 89.5 (82.3 - 96.7) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * Daily Smokers 21.6 (17.2 - 26) - - 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) Exposed To Second Hand Smoke In Home 12.4 * (7.5 - 17.3) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 23.0 (17 - 28.9) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 52.1 (46.6 - 57.6) 61.7 (49.8 - 73.6) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 41.9 (36.4 - 47.5) 45.1 (35.3 - 54.9) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 38.5 (33.3 - 43.7) 44.2 (33.8 - 54.6) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) * * Has A Lot Of Stress (Age 18+) 24.8 (19.7 - 29.9) 16.1 (6.6 - 25.6) 23.9 (21.2 - 26.7) 8.7 (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 25.2 (20.8 - 29.7) 48.7 (37.1 - 60.3) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 7.1 (4.8 - 9.3) 20.9 * (11.5 - 30.3) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) * * Asthma 11.9 (7.7 - 16) - - 10.0 (7.8 - 12.3) 9.2 (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 18.2 (14.6 - 21.7) 45.0 (35 - 55.1) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for the Leeds, Grenville and Lanark District Health Unit are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): Smiths Falls, Perth, Lanark
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
40,000 40,000 Females 2,200 35,000 Outside SE LHIN 35,000 2,000 QHC-Trenton 1,800 30,000 30,000 QHC-Picton 85+ QHC-Belleville 1,600 75-84 25,000 I Resuscitation 25,000 QHC-Bancroft 1,400 65-74 II Emergent PSF - Smiths Falls 45-64 20,000 III Urgent 20,000 1,200 PSF - Perth 20-44 IV Less-urgent LACGH 1,000 15,000 0-19 15,000 V Non-urgent KGH 800 10,000 HDH 10,000 600 BHG 5,000 5,000 400 200 0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 2,200 all Services (hours) (meals) (1-way trips) Actual Projected #% 2,000 Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% 1,800 Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 1,600 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 1,400 65-74 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 1,200 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 1,000 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 800 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 *Community Health Centre (CHC) Actual and Projected 600 South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 pending verification with local data management personnel Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach 400 Area of Service Provision 2006 2012 200 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 34,170 90.7% 3,513 9.3% 37,683 100.% 36,157 1,987 5.8% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 2,585 74.0% 909 26.0% 3,494 100.% 2,623 38 1.5% Acute Days of Stay 18,592 77.7% 5,329 22.3% 23,921 100.% 17,956 ( 636) (3.4%) Individuals Served (2007) ALC1 Separations 97 86.6% 15 13.4% 112 100.% 105 8 8.2% Females Head Office Location of Provider ALC Days of Stay 2,975 94.4% 177 5.6% 3,152 100.% 2,912 ( 63) (2.1%) 600 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 3,516 78.2% 979 21.8% 4,495 100.% 4,824 1,308 37.2% Oncology Visits 396 37.2% 669 62.8% 1,065 100.% 1,094 698 176.3% 500 Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 2,582 98.0% 54 2.0% 2,636 100.% 2,828 246 9.5% 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 67 47.9% 73 52.1% 140 100.% 154 87 130.4% 400 South East LHIN 28,430 Radiation Treatments 337 12.9% 2,267 87.1% 2,604 100.% 2,791 2,454 728.1% 65-74 All Outpatient Events 6,898 58.8% 4,824 41.2% 11,722 100.% 11,691 4,793 69.5% 45-64 Clients with Open Admission to program... Rehabilitation 300 20-44 Cases 5 16.7% 25 83.3% 30 100.% 5 0 3.1% Problem Gambling Substance Abuse 0-19 County 2004 2008 2004 2008 Days 229 41.5% 323 58.5% 552 100.% 160 ( 69) (29.9%) Complex Continuing Care 200 Frontenac 39 86 1,462 2,023 Cases 48 90.6% 5 9.4% 53 100.% 51 3 6.0% Hastings 21 15 811 1,043 Days 1,588 98.6% 22 1.4% 1,610 100.% 2,521 933 58.8% Lanark 7 26 290 600 Adult Mental Health 100 Leeds-Gren. 35 50 429 806 Cases 68 77.3% 20 22.7% 88 100.% 68 0 0.3% Lenn. & Add. 12 15 489 841 Days 932 68.0% 439 32.0% 1,371 100.% 1,348 416 44.6% Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 4,500 4,500 600
4,000 4,000 Outside LHIN QHC-Trenton 500 3,500 85+ 3,500 QHC-Picton 75-84 3,000 3,000 QHC-Belleville 400 Other 65-74 QHC-Bancroft Obstetrics 45-64 2,500 2,500 PSF- Smiths Falls Newborn 300 20-44 PSF- Perth 2,000 Surgery 2,000 0-19 LACGH Medicine 1,500 1,500 KGH 200 HDH 1,000 1,000 BGH 100 500 500
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: South Frontenac
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 South EastSouth East 75-79 b YearFrontenac LHIN OntarioFrontenac LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 17,882 482,078 12,705,344 e 50-54 2006 2009 19,043 486,101 13,050,754 Quick Facts: 45-49 2011 20,286 492,452 13,349,125 2 G 40-44 Size: 940 km r 2016 2016 22,157 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 2,028 80,630 1,649,293 11.3% 16.7% 13.0% Total: 18,230 20-24 2009 2,407 86,097 1,770,571 12.6% 17.7% 13.6% Aged 65+: 2,030 15-19 2011 2,736 90,168 1,864,941 13.5% 18.3% 14.0% 10-14 2016 3,838 105,224 2,214,279 17.3% 20.6% 15.6% % 65+: 11.1% 5-9 Aged 75+ 0-4 Density: 19.4 persons/km2 2006 784 37,269 781,257 4.4% 7.7% 6.1% 1,200 700 200 300 800 2009 821 38,990 837,672 4.3% 8.0% 6.4% Population 2011 836 40,324 871,594 4.1% 8.2% 6.5% 2016 1,041 44,307 959,871 4.7% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 197 9,648 192,104 1.1% 2.0% 1.5% 2009 168 10,718 228,156 0.9% 2.2% 1.7% 2011 116 11,302 249,961 0.6% 2.3% 1.9% 2016 132 12,494 294,008 0.6% 2.4% 2.1% Ischaemic Heart Disease Circulatory System
Lung & related Colon & related Prostate Neoplasms Census Characteristics Respiratory System South South East Frontenac LHIN Ontario Blood Forming/Endocrine < 5 No certificate, degree or diploma (age 25+) 15.8% 20.0% 18.7% Completed post-secondary education (age 25+) 58.7% 53.4% 56.8% Nervous System < 5 = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 5.3% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 68.4% 62.4% 67.1% External Causes Proportion of population living in low income 5.3% 11.9% 14.7% English Mother tongue 94.9% 91.5% 69.8% Other diseases French Mother tongue 1.7% 2.7% 4.4% Immigrants 6.0% 9.3% 28.3% 0 5 10 15 20 25 30 35 Recent Immigrants (5 years) 0.3% 0.8% 4.8% Visible minorities 1.3% 3.3% 22.8% Number of Deaths Aboriginal Identity 3.0% 2.8% 2.0%
Health Status Kingston, Frontenac and Lennox & Addington Public Health1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 57.1 (51.5 - 62.6) 46.4 (35.9 - 57) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 41.3 (36.2 - 46.3) 59.1 (48.6 - 69.6) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 46.0 (40.9 - 51.1) 81.4 (73.7 - 89.1) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 83.6 (79.7 - 87.5) 93.1 (88.4 - 97.9) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * Daily Smokers 22.8 (17.8 - 27.8) - - 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) * Exposed To Second Hand Smoke In Home 10.4 (5.1 - 15.7) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 21.0 (16.2 - 25.8) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 52.5 (46.2 - 58.9) 51.6 (41.5 - 61.7) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 45.3 (39.8 - 50.9) 49.6 (39.5 - 59.7) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 42.3 (37.2 - 47.4) 51.6 (39.4 - 63.9) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) Has A Lot Of Stress (Age 18+) 23.4 (19 - 27.9) - - 23.9 (21.2 - 26.7) 8.7 * (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 22.2 (17.5 - 26.9) 54.4 (42.9 - 65.9) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 6.2 * (4 - 8.4) 22.2 * (14 - 30.5) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) Asthma 11.1 * (7.3 - 15) 11.0 * (4.3 - 17.6) 10.0 (7.8 - 12.3) 9.2 * (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 20.0 (15.9 - 24.2) 53.4 (43.2 - 63.5) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for Kingston, Frontenac and Lennox & Addington Public Health are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): South Frontenac
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
8,000 8,000 Females 1,600 Outside SE LHIN 7,000 7,000 QHC-Trenton 1,400
6,000 6,000 QHC-Picton 85+ 1,200 QHC-Belleville 75-84 5,000 I Resuscitation 5,000 QHC-Bancroft 65-74 II Emergent 1,000 PSF - Smiths Falls 45-64 4,000 III Urgent 4,000 PSF - Perth 800 20-44 IV Less-urgent LACGH 3,000 0-19 3,000 V Non-urgent KGH 600 2,000 2,000 HDH BHG 400 1,000 1,000 200
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 1,600 all Services (hours) (meals) (1-way trips) Actual Projected #% Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% 1,400 Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 1,200 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 1,000 65-74 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 800 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 600 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 400 pending verification with local data management personnel Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach 200 Area of Service Provision 2006 2012 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 6,962 97.8% 155 2.2% 7,117 100.% 8,062 1,100 15.8% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 1,131 95.8% 50 4.2% 1,181 100.% 1,269 138 12.2% Acute Days of Stay 5,781 94.5% 335 5.5% 6,116 100.% 7,691 1,910 33.0% Individuals Served (2007) ALC1 Separations 33 97.1% 1 2.9% 34 100.% 36 3 9.7% Females Head Office Location of Provider ALC Days of Stay 739 98.8% 9 1.2% 748 100.% 960 221 29.9% 600 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 1,407 98.0% 29 2.0% 1,436 100.% 1,737 330 23.5% Oncology Visits 500 99.0% 5 1.0% 505 100.% 538 38 7.7% 500 Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 950 100.0% - - 950 100.% 1,080 130 13.7% 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 6689.2% 810.8% 74 100.% 80 14 21.7% 400 South East LHIN 28,430 Radiation Treatments 699 99.1% 6 0.9% 705 100.% 753 54 7.8% 65-74 All Outpatient Events 3,622 67.6% 1,737 32.4% 5,359 100.% 4,189 567 15.7% 45-64 Clients with Open Admission to program... Rehabilitation 300 20-44 Cases 2288.0% 312.0% 25 100.% 28 6 25.9% Problem Gambling Substance Abuse 0-19 County 2004 2008 2004 2008 Days 809 96.9% 26 3.1% 835 100.% 827 18 2.2% Complex Continuing Care 200 Frontenac 39 86 1,462 2,023 Cases 1487.5% 212.5% 16 100.% 18 4 29.1% Hastings 21 15 811 1,043 Days 680 89.0% 84 11.0% 764 100.% 616 ( 64) (9.5%) Lanark 7 26 290 600 Adult Mental Health 100 Leeds-Gren. 35 50 429 806 Cases 4189.1% 510.9% 46 100.% 41 ( 0) (0.3%) Lenn. & Add. 12 15 489 841 Days 747 82.5% 159 17.5% 906 100.% 1,055 308 41.2% Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 1,400 1,400 600
Outside LHIN 1,200 1,200 QHC-Trenton 500 85+ QHC-Picton 1,000 1,000 75-84 QHC-Belleville 400 Other 65-74 QHC-Bancroft 800 Obstetrics 800 45-64 PSF- Smiths Falls Newborn 300 20-44 PSF- Perth 600 Surgery 600 0-19 LACGH Medicine KGH 200 400 400 HDH BGH 200 200 100
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Stone Mills, Loyalist
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 Stone Mills EastStone Mills East 75-79 b YearLoyalist LHIN OntarioLoyalist LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 23,430 482,078 12,705,344 e 50-54 2006 2009 23,626 486,101 13,050,754 Quick Facts: 45-49 2011 23,803 492,452 13,349,125 2 G 40-44 Size: 1,030 km r 2016 2016 24,681 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 p 25-29 2011 2006 3,066 80,630 1,649,293 13.1% 16.7% 13.0% Total: 22,630 20-24 2009 3,450 86,097 1,770,571 14.6% 17.7% 13.6% Aged 65+: 3,070 15-19 2011 3,734 90,168 1,864,941 15.7% 18.3% 14.0% 10-14 2016 4,795 105,224 2,214,279 19.4% 20.6% 15.6% % 65+: 13.5% 5-9 Aged 75+ 0-4 Density: 22.0 persons/km2 2006 1,133 37,269 781,257 4.8% 7.7% 6.1% 1,200 700 200 300 800 2009 1,348 38,990 837,672 5.7% 8.0% 6.4% Population 2011 1,556 40,324 871,594 6.5% 8.2% 6.5% 2016 1,783 44,307 959,871 7.2% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 246 9,648 192,104 1.0% 2.0% 1.5% 2009 338 10,718 228,156 1.4% 2.2% 1.7% 2011 440 11,302 249,961 1.8% 2.3% 1.9% 2016 540 12,494 294,008 2.2% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System
Lung & related Colon & related Neoplasms Chronic lower Breast Census Characteristics respiratory disease Lymph, Blood & related Respiratory System South Stone Mills East Diabetes Loyalist LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 16.9% 20.0% 18.7% Dementia/Alzheimers Completed post-secondary education (age 25+) 53.7% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 4.5% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 65.8% 62.4% 67.1% External Causes Proportion of population living in low income 8.1% 11.9% 14.7% English Mother tongue 95.2% 91.5% 69.8% Other diseases French Mother tongue 1.9% 2.7% 4.4% Immigrants 7.0% 9.3% 28.3% 0 20 40 60 80 100 120 140 Recent Immigrants (5 years) 0.4% 0.8% 4.8% Visible minorities 0.9% 3.3% 22.8% Number of Deaths Aboriginal Identity 2.9% 2.8% 2.0%
Health Status Kingston, Frontenac and Lennox & Addington Public Health1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 57.1 (51.5 - 62.6) 46.4 (35.9 - 57) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 41.3 (36.2 - 46.3) 59.1 (48.6 - 69.6) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 46.0 (40.9 - 51.1) 81.4 (73.7 - 89.1) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 83.6 (79.7 - 87.5) 93.1 (88.4 - 97.9) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * Daily Smokers 22.8 (17.8 - 27.8) - - 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) * Exposed To Second Hand Smoke In Home 10.4 (5.1 - 15.7) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 21.0 (16.2 - 25.8) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 52.5 (46.2 - 58.9) 51.6 (41.5 - 61.7) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 45.3 (39.8 - 50.9) 49.6 (39.5 - 59.7) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 42.3 (37.2 - 47.4) 51.6 (39.4 - 63.9) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) Has A Lot Of Stress (Age 18+) 23.4 (19 - 27.9) - - 23.9 (21.2 - 26.7) 8.7 * (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 22.2 (17.5 - 26.9) 54.4 (42.9 - 65.9) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 6.2 * (4 - 8.4) 22.2 * (14 - 30.5) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) Asthma 11.1 * (7.3 - 15) 11.0 * (4.3 - 17.6) 10.0 (7.8 - 12.3) 9.2 * (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 20.0 (15.9 - 24.2) 53.4 (43.2 - 63.5) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for Kingston, Frontenac and Lennox & Addington Public Health are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): Stone Mills, Loyalist
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
12,000 12,000 Females 2,000 Outside SE LHIN 1,800 10,000 10,000 QHC-Trenton
QHC-Picton 1,600 85+ QHC-Belleville 8,000 8,000 75-84 I Resuscitation 1,400 QHC-Bancroft 65-74 II Emergent 1,200 PSF - Smiths Falls 45-64 6,000 III Urgent 6,000 PSF - Perth 1,000 20-44 IV Less-urgent LACGH 0-19 V Non-urgent 800 4,000 4,000 KGH HDH 600 BHG 2,000 2,000 400
200 0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 2,000 all Services (hours) (meals) (1-way trips) Actual Projected #% 1,800 Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 1,600 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% 1,400 Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 65-74 1,200 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 1,000 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% 800 Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 600 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 pending verification with local data management personnel 400 Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach Area of Service Provision 2006 2012 200 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 10,651 97.9% 230 2.1% 10,881 100.% 11,346 695 6.5% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 1,608 95.3% 79 4.7% 1,687 100.% 1,891 283 17.6% Acute Days of Stay 9,362 94.0% 599 6.0% 9,961 100.% 12,489 3,127 33.4% Individuals Served (2007) ALC1 Separations 67 94.4% 4 5.6% 71 100.% 107 40 60.4% Females Head Office Location of Provider ALC Days of Stay 2,111 99.3% 15 0.7% 2,126 100.% 2,948 837 39.6% 900 Belleville 4,629 Outpatient Events/Clinic Visits 2 800 Brockville 5,392 Surgical/PARR 2,028 96.9% 65 3.1% 2,093 100.% 2,350 322 15.9% Kingston & Islands 7,560 Oncology Visits 650 96.0% 27 4.0% 677 100.% 756 106 16.3% 700 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 1,640 94.9% 89 5.1% 1,729 100.% 2,375 735 44.8% 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 99 99.0% 1 1.0% 100 100.% 110 11 11.6% 600 South East LHIN 28,430 Radiation Treatments 985 95.3% 49 4.7% 1,034 100.% 1,220 235 23.8% 65-74 All Outpatient Events 5,402 69.7% 2,350 30.3% 7,752 100.% 6,811 1,409 26.1% 45-64 Clients with Open Admission to program... 500 Rehabilitation 20-44 Cases 31 91.2% 3 8.8% 34 100.% 46 15 49.6% Problem Gambling Substance Abuse 400 0-19 County 2004 2008 2004 2008 Days 1,078 95.1% 55 4.9% 1,133 100.% 1,198 120 11.1% Complex Continuing Care 300 Frontenac 39 86 1,462 2,023 Cases 20 100.0% - - 20 100.% 36 16 78.0% Hastings 21 15 811 1,043 Days 766 100.0% - - 766 100.% 1,920 1,154 150.7% 200 Lanark 7 26 290 600 Adult Mental Health Leeds-Gren. 35 50 429 806 Cases 60 93.8% 4 6.3% 64 100.% 84 24 40.4% 100 Lenn. & Add. 12 15 489 841 Days 873 87.8% 121 12.2% 994 100.% 2,236 1,363 156.2% Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 2,000 2,000 900
1,800 1,800 Outside LHIN 800 1,600 QHC-Trenton 1,600 85+ QHC-Picton 700 1,400 1,400 75-84 QHC-Belleville 600 Other 65-74 1,200 1,200 QHC-Bancroft Obstetrics 45-64 PSF- Smiths Falls 500 1,000 Newborn 1,000 20-44 PSF- Perth Surgery 400 0-19 800 800 LACGH Medicine KGH 300 600 600 HDH 200 400 400 BGH
200 200 100
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization South East Local Health Integration Network (LHIN) Sub-LHIN Planning Area Profile: Tyendinaga, Napanee
Age Distribution, 2006, 2011 and 2016 (projected) Demography
85+ South South 80-84 Tyendinaga EastTyendinaga East 75-79 b YearNapanee LHIN OntarioNapanee LHIN Ontario 70-74 c 65-69 Population Counts Percentage of Total Population A 60-64 Total Population g 55-59 Females Males 2006 24,021 482,078 12,705,344 e 50-54 2006 2009 24,208 486,101 13,050,754 Quick Facts: 45-49 2011 24,283 492,452 13,349,125 2 G 40-44 2016 Size: 770 km r 2016 25,442 510,626 14,149,965 35-39 o Aged 65+ Population (2006) u 30-34 2011 p 25-29 2006 3,765 80,630 1,649,293 15.7% 16.7% 13.0% Total: 21,290 20-24 2009 3,913 86,097 1,770,571 16.2% 17.7% 13.6% Aged 65+: 3,770 15-19 2011 4,018 90,168 1,864,941 16.5% 18.3% 14.0% 10-14 2016 4,904 105,224 2,214,279 19.3% 20.6% 15.6% % 65+: 17.7% 5-9 Aged 75+ 0-4 Density: 27.5 persons/km2 2006 1,740 37,269 781,257 7.2% 7.7% 6.1% 1,200 700 200 300 800 2009 1,770 38,990 837,672 7.3% 8.0% 6.4% Population 2011 1,789 40,324 871,594 7.4% 8.2% 6.5% 2016 1,864 44,307 959,871 7.3% 8.7% 6.8% Leading Causes of Death in the Sub-LHIN Planning area, 2001-2004 Aged 85+ 2006 459 9,648 192,104 1.9% 2.0% 1.5% 2009 479 10,718 228,156 2.0% 2.2% 1.7% 2011 500 11,302 249,961 2.1% 2.3% 1.9% 2016 529 12,494 294,008 2.1% 2.4% 2.1% Ischaemic Heart Disease Cerebrovascular diseases Circulatory System
Lung & related Colon & related Breast Prostate Neoplasms Chronic lower Lymph, Blood & related Census Characteristics respiratory disease Respiratory System South Tyendinaga East Diabetes Influenza and pneumonia Napanee LHIN Ontario Blood Forming/Endocrine No certificate, degree or diploma (age 25+) 24.9% 20.0% 18.7% Dementia/Alzheimers Completed post-sec ondary education (age 25+) 44.6% 53.4% 56.8% Nervous System = Other causes of death within the International Classification of Diseases Unemployment rate (age 15+) 5.6% 6.2% 6.4% (10th revision) Chapter Labour force participation rate (age 15+) 64.2% 62.4% 67.1% External Causes Proportion of population living in low income 11.0% 11.9% 14.7% English Mother tongue 95.0% 91.5% 69.8% Other diseases French Mother tongue 1.6% 2.7% 4.4% Immigrants 5.2% 9.3% 28.3% 0 50 100 150 200 250 300 350 Recent Immigrants (5 years) 0.2% 0.8% 4.8% Visible minorities 1.2% 3.3% 22.8% Number of Deaths Aboriginal Identity 4.3% 2.8% 2.0%
Health Status Kingston, Frontenac and Lennox & Addington Public Health1 South East LHIN Ontario Total Population Aged 65 and Older Total Population Aged 65 and Older Total Population Aged 65 and Older Overall Health Status Self-rated Health: Very Good or Excellent 57.1 (51.5 - 62.6) 46.4 (35.9 - 57) 54.2 (50.4 - 58) 40.5 (34.5 - 46.5) 59.9 (58.9 - 60.9) 37.9 (35.9 - 40) Activity Limitation 41.3 (36.2 - 46.3) 59.1 (48.6 - 69.6) 43.6 (40.3 - 46.9) 62.7 (56.2 - 69.1) 33.5 (32.6 - 34.4) 59.1 (57 - 61.3) Use of Preventive Care Received Flu Shot In Past Year 46.0 (40.9 - 51.1) 81.4 (73.7 - 89.1) 46.9 (43.1 - 50.7) 70.3 (64.1 - 76.6) 35.9 (35 - 36.8) 70.1 (68.2 - 72) Contact With Medical Doctor In Past Year 83.6 (79.7 - 87.5) 93.1 (88.4 - 97.9) 80.8 (78.2 - 83.4) 91.6 (88.3 - 94.9) 81.4 (80.6 - 82.2) 90.5 (89.4 - 91.7) Health Practices * Daily Smokers 22.8 (17.8 - 27.8) - - 22.3 (19.3 - 25.4) 11.4 (7.6 - 15.2) 16.3 (15.6 - 17) 7.7 (6.7 - 8.8) * Exposed To Second Hand Smoke In Home 10.4 (5.1 - 15.7) - - 11.7 (8.6 - 14.7) - - 6.1 (5.6 - 6.6) 4.6 (3.5 - 5.6) Heavy Alcohol Consumption 21.0 (16.2 - 25.8) - - 22.1 (18.6 - 25.6) 7.5 * (3.6 - 11.5) 21.7 (20.8 - 22.6) 7.1 (5.7 - 8.5) Obese Or Overweight 52.5 (46.2 - 58.9) 51.6 (41.5 - 61.7) 53.8 (49.8 - 57.8) 54.7 (48.3 - 61) 49.6 (48.6 - 50.6) 53.4 (51.3 - 55.6) Physically Inactive 45.3 (39.8 - 50.9) 49.6 (39.5 - 59.7) 44.5 (41 - 48.1) 53.3 (47 - 59.7) 49.0 (48 - 50.1) 54.2 (52.2 - 56.3) Consumes Fruiits / Vegetables 5+ Times A Day 42.3 (37.2 - 47.4) 51.6 (39.4 - 63.9) 42.8 (39.3 - 46.3) 49.0 (42.3 - 55.6) 39.7 (38.7 - 40.8) 41.6 (39.4 - 43.7) Has A Lot Of Stress (Age 18+) 23.4 (19 - 27.9) - - 23.9 (21.2 - 26.7) 8.7 * (4.9 - 12.5) 22.5 (21.7 - 23.3) 10.9 (9.6 - 12.2) Chronic Conditions Arthritis / Rheumatism 22.2 (17.5 - 26.9) 54.4 (42.9 - 65.9) 25.6 (22.7 - 28.6) 51.9 (45.6 - 58.2) 16.4 (15.8 - 17) 47.1 (45.1 - 49.1) Diabetes 6.2 * (4 - 8.4) 22.2 * (14 - 30.5) 7.0 (5.5 - 8.6) 19.6 (14.6 - 24.5) 6.1 (5.6 - 6.5) 16.9 (15.2 - 18.6) Asthma 11.1 * (7.3 - 15) 11.0 * (4.3 - 17.6) 10.0 (7.8 - 12.3) 9.2 * (5.7 - 12.7) 8.2 (7.7 - 8.8) 7.3 (6.3 - 8.3) High Blood Pressure 20.0 (15.9 - 24.2) 53.4 (43.2 - 63.5) 19.8 (17.3 - 22.3) 49.0 (42 - 56) 16.4 (15.8 - 17.1) 47.2 (45.1 - 49.3)
Source: Canadian Community Health Survey (CCHS), 2007 Numbers in brackets represent the 95% confidence intervals (CI) around the estimates . 1CCHS estimates are not available for sub-LHIN planning areas. Estimates for Kingston, Frontenac and Lennox & Addington Public Health are used for this profile. - - Because of high sampling variability this estimate is not available * Value is significantly different than the provincial estimate Estimates are for the population aged 12 or older, unless otherwise indicated.
Sub-LHIN Planning Area Profile (cont’d): Tyendinaga, Napanee
Emergency Department Utilization
ED Visits by Area Residents by CTAS Level ED Visits by Institution Rate (/1,000) of ED Visits by Age Group
25,000 25,000 Females 2,000 Outside SE LHIN 1,800 QHC-Trenton 20,000 20,000 QHC-Picton 1,600 85+ QHC-Belleville 75-84 I Resuscitation 1,400 15,000 15,000 QHC-Bancroft 65-74 II Emergent 1,200 PSF - Smiths Falls 45-64 III Urgent PSF - Perth 1,000 20-44 IV Less-urgent 10,000 10,000 LACGH 0-19 V Non-urgent KGH 800 HDH 600 5,000 5,000 BHG 400
200 0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Community Support Services (selected) Community Care Access Centre (CCAC) Males Caregiver Support Meals on Wheels Transportation 2007/08 20012/13 Change 07-12 2,000 all Services (hours) (meals) (1-way trips) Actual Projected #% 1,800 Head Office Location of Provider 2006 2012 2006 2012 2006 2012 Admissions 8,251 11,396 3,145 38.1% Addington N/C Frontenac 1,160 2,015 5,110 2,968 3,130 2,858 Services 1,600 85+ Belleville 7,077 12,827 18,800 20,990 5,858 5,715 In-Home Acute 44,307 43,457 ( 850) (1.9%) 75-84 Brockville 2,590 2,970 14,000 23,111 4,500 8,015 In-Home Maintenace 216,305 228,140 11,835 5.5% 1,400 Central Hastings 588 - 4,100 4,867 2,800 3,289 In-Home Rehab 31,389 29,826 (1,563) (5.0%) 65-74 1,200 Kingston 5,109 - 125,063 900 900 In-Home End-of-Life 14,559 14,177 ( 382) (2.6%) 45-64 North Hastings 2,600 4,695 4,500 7,573 6,500 9,419 In-Home LTC 64,034 67,614 3,580 5.6% 1,000 20-44 Prince Edward County 3,822 7,503 15,000 27,597 1,525 2,346 Residential 1,406 1,394 ( 12) (0.8%) 0-19 Quinte West 26,109 58,984 49,675 128,120 9,380 19,223 Total 372,000 384,608 12,608 3.4% 800 Smiths Falls, Perth, Lanark 10,744 8,150 50,860 68,389 30,559 46,063 Tyendinaga Napanee 2,780 1,101 9,500 10,148 13,000 16,205 600 *Community Health Centre (CHC) Actual and Projected South East LHIN 62,579 95,927 171,545 285,078 78,152 110,430 pending verification with local data management personnel 400 Homemaking/Personal Supp/Attendant/Respite-Phys Dis Outreach Area of Service Provision 2006 2012 200 Hospital-based Services Hastings/Prince Edward 34,000 17,616 0 Frontenac/Leeds Grenville/Lanark 81,972 76,044 2007/08 Actual 20012/13 Projected 2002 2003 2004 2005 2006 2007 South East LHIN 115,972 93,660 To SE LHIN Hospitals Outside SE LHIN Total Change 07-12 #% of Total #% of Total #% of Total ##% Community Mental Health ER Visits 17,380 96.9% 557 3.1% 17,937 100.% 18,348 968 5.6% and Addictions IP Events (Acute Institutions) Rate (/1,000) of Inpatient Events by Age Group No. of Separations 2,118 90.6% 220 9.4% 2,338 100.% 2,188 70 3.3% Acute Days of Stay 11,929 89.0% 1,472 11.0% 13,401 100.% 12,307 378 3.2% Individuals Served (2007) ALC1 Separations 95 95.0% 5 5.0% 100 100.% 126 31 32.6% Females Head Office Location of Provider ALC Days of Stay 2,013 90.3% 217 9.7% 2,230 100.% 3,150 1,137 56.5% 700 Outpatient Events/Clinic Visits Belleville 4,629 2 Brockville 5,392 Surgical/PARR 2,297 88.7% 294 11.3% 2,591 100.% 2,594 297 12.9% 600 Oncology Visits 677 96.4% 25 3.6% 702 100.% 687 10 1.5% Kingston & Islands 7,560 85+ Smiths Falls, Perth, Lanark 9,091 Dialysis Visits 2,825 96.1% 114 3.9% 2,939 100.% 2,998 173 6.1% 75-84 Tyendinagua Napanee 1,758 Cardiac Caths 153 90.5% 16 9.5% 169 100.% 153 ( 0) (0.1%) 500 South East LHIN 28,430 Radiation Treatments 885 92.4% 73 7.6% 958 100.% 1,184 299 33.8% 65-74 All Outpatient Events 6,837 72.5% 2,594 27.5% 9,431 100.% 7,617 780 11.4% 400 45-64 Clients with Open Admission to program... Rehabilitation 20-44 Cases 1676.2% 523.8% 21 100.% 22 6 35.8% Problem Gambling Substance Abuse 300 0-19 County 2004 2008 2004 2008 Days 447 80.8% 106 19.2% 553 100.% 658 211 47.2% Complex Continuing Care Frontenac 39 86 1,462 2,023 Cases 28 100.0% - - 28 100.% 29 1 3.6% 200 Hastings 21 15 811 1,043 Days 1,421 100.0% - - 1,421 100.% 1,022 ( 399) (28.1%) Lanark 7 26 290 600 Adult Mental Health Leeds-Gren. 35 50 429 806 Cases 95 96.9% 3 3.1% 98 100.% 88 ( 7) (7.2%) 100 Lenn. & Add. 12 15 489 841 Days 2,020 93.4% 142 6.6% 2,162 100.% 3,063 1,043 51.6% Prince Ed. <5 <5 105 151 0 Inpatient Visits by Area Residents by Service Type Inpatient Visits by Institution 2002 2003 2004 2005 2006 2007 Males 2,500 2,500 700
Outside LHIN 600 2,000 QHC-Trenton 2,000 85+ QHC-Picton 500 75-84 QHC-Belleville Other 65-74 1,500 1,500 QHC-Bancroft Obstetrics 400 45-64 PSF- Smiths Falls Newborn 20-44 PSF- Perth Surgery 300 0-19 1,000 1,000 LACGH Medicine KGH HDH 200 500 500 BGH 100
0 0 0 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007
Hospital In-Patient Utilization