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Appendix 1C: Health Services Inventory

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Appendix 1C: Health Services Inventory Final Appendix 1c: Health Services Inventory - Kenora District Final Contents Health Services Inventory - Kenora District 1 PopulationEstimatesandProjections 1 AcuteCareHospitalsinKenoraDistrict 2 Access to Health Services in Kenora District 3 Emergency Department Care 8 Long Term Care 10 Community Mental Health and Addictions 12 Emergency Department Use 14 Ambulatory Care Sensitive Conditions 19 HospitalAmbulatoryClinics 20 AlternateLevelofCareDays:Acute 21 Inpatient Days for External Causes 22 Forecasting Health Services in Kenora District 22 HBAM:ClinicallyAdjustedForecasts 26 Final Kenora District: Summary of Empirical Analysis Population Estimates and Projections Kenora District accounts for 28 percent of the North West LHIN’s population and is expected to grow by 5 percent over the next 10 years. Expected growth rates vary by age group. For example, the population aged 0 to 19 is expected to decrease by 7 percent over the next 10 years while the population of 65 to 79 year olds expected to increase by 46 percent. Kenora District 10-year Age Group 2009 2019 Growth 00-19 20,273 18,931 -7% 20-44 21,245 22,170 4% 45-64 17,575 18,288 4% 65-79 5,603 8,203 46% 80+ 1,755 2,088 19% Kenora District Total 66,451 69,681 5% NW LHIN Total 239,579 238,464 0% Source: Ontario Ministry of Finance Population Estimates Kenora is the only NW LHIN district with positive population growth expected over the next 10 years. Comparison of 10-Year Population Growth Forecasts by sub-LHIN Rainy Kenora Thunder Thunder North West Age Group River District Bay City Bay District LHIN District 00-19 -7% -11% -16% -17% -13% 20-44 4% -3% -7% -7% -3% 45-64 4% -10% -7% -8% -4% 65-79 46% 34% 42% 43% 42% 80+ 19% 4% 14% 14% 14% Total 5% -3% -2% -4% 0% Source: Ontario Ministry of Finance Population Estimates Health Services Inventory: Kenora District: Final 1 Final Acute Care Hospitals in Kenora District The table below summarizes the 2009/10 admissions and inpatient days at Kenora district’s hospitals. The table includes acute care admissions for mental health diagnoses, but excludes admissions to designated mental health beds. Kenora hospitals accounted for 23 percent of the LHIN’s total admissions. Within the district, Lake of the Woods District Hospital was the largest acute care provider and accounted for 38 percent of the district’s total admissions. Share of Share of Acute Hospital Admissions Days District's LHIN's Beds Admissions Admissions Dryden Regional Health Centre 1,332 10,513 31 20% 5% Kenora Lake-Of-The-Woods District 2,538 15,571 55 38% 9% Red Lake Marg Cochenour Memorial 948 3,366 14 14% 3% Sioux Lookout Meno-Ya-Win 1,942 9,422 39 29% 7% Kenora Total 6,760 38,872 139 100% 23% Source: North West LHIN Health Services Inventory; DAD 2009/10 The table below shows the number of hospital beds of each type at Kenora district hospitals. Lake of the Woods hospital is the only hospital outside of Thunder Bay City with designated mental health beds. All hospitals in the district had newborn bassinets. Mental Newborn Hospital Acute CCC ELDCAP Total Health Bassinets DRYDEN Regional 31 10 4 45 KENORALakeOfTheWoods 55 10 19 8 92 RED LAKE Marg Cochenour Memorial 14 4 2 40 SIOUX LOOKOUT Meno-Ya-Win H. C. 39 8 4 51 William A. “Bill” George Extended Care 20 Facility Kenora District 139 32 19 18 20 248 Source: North West LHIN Health Services Inventory Health Services Inventory: Kenora District: Final 2 Final The table below shows that Kenora residents received most of their acute care from local hospitals. 76 percent of the total inpatient days among Kenora residents were provided by hospitals in Kenora district, while 22 percent of days were provided at Thunder Bay Regional Health Sciences Centre. Market share of acute inpatient days by sub-LHIN 2009/10 Rainy Thunder Kenora Thunder Other Total Sub-LHIN of Patient River Bay District Bay City LHIN Days District District Kenora District 76% 0% 22% 0% 2% 45,312 Rainy River District 4% 71% 22% 0% 3% 14,255 Thunder Bay City 0% 0% 93% 0% 7% 94,928 Thunder Bay District 1% 0% 42% 50% 6% 23,732 Total Days 35,407 10,531 111,248 12,057 8,984 178,227 Source: DAD 2009/10 Access to Health Services in Kenora District Acute Inpatient and Day Surgery The table below shows the ratio of actual to expected inpatient days by diagnosis chapter for each of the NW LHIN’s sub-LHINs. The expected controls for differences in the age and sex profiles of each sub-LHIN’s population and is based on the provincial average rate of inpatient days per capita in each chapter in 2009/10. For example, the number of inpatient days per capita in Kenora district for Endocrine, Nutritional, and Metabolic disorders was 2.41 times higher than expected. Rainy Thunder Thunder Kenora District River Bay Bay City District District Inpatient Actual to Actual to Actual to Actual to Chapter Days Expected Expected Expected Expected 01 Infectious/Parasitic Diseases 827 1.21 1.77 1.09 0.97 02 Neoplasms 3,347 1.24 1.20 1.42 1.07 03 Blood and Immune 594 2.12 1.15 1.94 1.91 04 Endocrine, Nutrition, Metabolic 2,811 2.41 1.08 3.09 2.54 05 Mental and Behavioural 2,932 2.32 1.37 3.13 1.22 Health Services Inventory: Kenora District: Final 3 Final Rainy Thunder Thunder Kenora District River Bay Bay City District District Inpatient Actual to Actual to Actual to Actual to Chapter Days Expected Expected Expected Expected 06 Nervous System 955 1.38 1.12 1.18 1.08 07 Eye and Adnexa 50 2.01 1.31 1.24 2.87 08 Ear and Mastoid 162 2.81 2.64 3.11 2.45 09 Circulatory 6,533 1.43 1.00 2.43 1.50 10 Respiratory 3,919 1.56 1.18 2.15 1.40 11 Digestive 4,242 1.52 1.01 1.85 1.83 12SkinandSubcutaneousTissue 871 2.84 1.11 1.45 2.13 13 Musculoskeletal and Connective 2,183 1.68 1.31 1.38 1.25 14 Genitourinary 1,832 1.52 0.66 1.56 1.52 15 Pregnancy and Childbirth 3,502 1.21 1.04 1.37 1.12 16 Perinatal Period 1,030 0.56 0.23 1.53 1.61 17 Congenital and Chromosomal 76 0.24 0.38 1.05 1.27 19 Injury and Poisoning 4,432 1.60 1.06 2.04 1.39 20 External Causes 8,243 3.39 2.70 6.03 0.94 Source: DAD 2009/10 Access to acute inpatient and day surgery in the North West LHIN was measured using the HBAM framework. HBAM accounts for population size, socio-demographic characteristics (including rural geography and socioeconomic status) and health characteristics. In the table below, positive variances indicate higher use of acute inpatient and day surgery resources than expected and negative variances indicate lower use than expected. Under HBAM, expected service use is the provincial average service use conditional on the patient’s age, SES, rural geography, and disease group. Importantly, expected service use is conditional on admission. Variance therefore shows the difference between actual and expected services for patients admitted to hospital. Regions with high rates of hospital use, including the North West LHIN, do not automatically have high variances. Health Services Inventory: Kenora District: Final 4 Final Rainy Thunder Thunder North Kenora Chapter River Bay Bay LHIN District District District City Total 01 Infectious/Parasitic Diseases 3.1% -8.1% 9.3% -4.0% -1.8% 02 Neoplasms 2.2% -0.3% -1.3% 1.8% 1.3% 03 Blood and Immune -14.0% 19.7% -17.0% -9.1% -9.6% 04 Endocrine, Nutrition, Metabolic -1.0% -12.5% -9.5% 8.2% 2.7% 05 Mental and Behavioural 12.4% -38.1% 13.2% 15.5% 5.7% 06 Nervous System 3.7% 8.2% -5.6% -5.1% -1.3% 07 Eye and Adnexa 9.6% -0.1% -14.3% 4.1% 4.0% 08 Ear and Mastoid -6.8% -2.9% -2.3% -7.3% -6.1% 09 Circulatory -5.1% -0.9% 3.9% 5.9% 2.8% 10 Respiratory -2.7% 5.7% -15.3% -1.3% -3.0% 11 Digestive -0.8% -11.3% 16.9% 1.1% 1.4% 12 Skin and Subcutaneous Tissue -6.3% -5.5% -23.9% 2.3% -3.9% 13 Musculoskeletal and Connective -1.0% 2.7% -5.0% 3.0% 1.1% 14 Genitourinary 2.4% 5.0% -6.0% 3.3% 2.3% 15 Pregnancy and Childbirth -0.3% 0.1% 0.4% -1.0% -0.5% 16 Perinatal Period 0.0% 0.0% 0.0% 0.0% 0.0% 17 Congenital and Chromosomal -0.5% 17.7% 12.5% 0.6% 2.5% 19 Injury and Poisoning -0.7% -7.9% 1.0% -0.5% -1.1% 20 External Causes 0.8% -0.7% -0.8% -1.3% -0.4% Total Variance -1.2% -2.1% -0.7% 1.8% 0.4% Source: HBAM 2009/10 Overall, acute service use among Kenora district’s population was 1.2 percent less than expected. Variance from the population perspective assesses the actual use of services by the district or LHIN’s population regardless of where (in Ontario) they received care. Resource use was higher than expected in the nervous system and infectious / parasitic disease chapters.
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