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Health Services Inventory – Rainy River District Final

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Health Services Inventory – Rainy River District Final Final Appendix 1d: Health Services Inventory – Rainy River District Final Contents Health Services Inventory – Rainy River District 1 PopulationEstimatesandProjections 1 AcuteCareHospitalsinRainyRiverDistrict 2 Access to Health Services in Rainy River District 3 Emergency Department Care 8 Long Term Care 10 Community Mental Health and Addictions 12 Emergency Department Use 14 Ambulatory Care Sensitive Conditions 18 HospitalAmbulatoryClinics 19 AlternateLevelofCareDays:Acute 20 Inpatient Days for External Causes 21 Forecasting Health Services in Rainy River District 22 HBAM:ClinicallyAdjustedForecasts 26 Final Rainy River District: Summary of Empirical Analysis Population Estimates and Projections Rainy River District accounts for 9 percent of the North West LHIN’s population and is expected to shrink by 3 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 11 percent over the next 10 years while the population of 65 to 79 year olds expected to increase by 34 percent. Rainy River District 10-year Age Group 2009 2019 Growth 00-19 5,681 5,031 -11% 20-44 6,226 6,043 -3% 45-64 6,351 5,743 -10% 65-79 2,392 3,195 34% 80+ 1,117 1,163 4% Total 21,767 21,175 -3% NW LHIN 239,579 238,464 0% Total Source: Ontario Ministry of Finance Population Estimates Rainy River has the North West LHIN’s lowest rate of population growth in the population 65 and older. Rainy River also has the LHIN’s fastest shrinking population in the 45-64 age group. Comparison of 10-Year Population Growth Forecasts by sub- LHIN Rainy Thunder Thunder North Age Kenora River Bay Bay West Group District District City District LHIN 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% Health Services Inventory: Rainy River District: Final 1 Final Comparison of 10-Year Population Growth Forecasts by sub- LHIN Rainy Thunder Thunder North Age Kenora River Bay Bay West Group District District City District LHIN Total 5% -3% -2% -4% 0% Source: Ontario Ministry of Finance Population Estimates Acute Care Hospitals in Rainy River District The table below summarizes the 2009/10 admissions and inpatient days at Rainy River district’s hospitals. The table includes acute care admissions for mental health diagnoses, but excludes admissions to designated mental health beds. Share of Share of Acute Facility Admissions Days District's LHIN's Beds Admissions Admissions Atikokan General 343 2,146 11 14% 1% Riverside - EMO 76 560 3 3% 0% Riverside-FORTFRANCES 1,888 7,862 27 78% 6% Riverside - RAINY RIVER 120 797 3 5% 0% Rainy River Total 2,427 11,365 44 100% 8% Source: DAD 2009/10; North West LHIN Health Services Inventory The table below shows the number of beds of each type at Rainy River district hospitals. Inpatient Mental Newborn Hospital Acute CCC ELDCAP Total Rehab Health Bassinets ATIKOKAN General 11 8 2 22 43 FORT FRANCES RIVERSIDE - FORT 27 6 6 39 FRANCES FORT FRANCES RIVERSIDE - EMO 3 12 15 FORT FRANCES RIVERSIDE - RAINY 3 21 24 RIVER Rainy River District 44 14 8 55 121 Source: North West LHIN Health Services Inventory Health Services Inventory: Rainy River District: Final 2 Final The table below shows that Rainy River residents received most of their acute care from local hospitals. 71 percent of the total inpatient days among Rainy River residents were provided by hospitals in Rainy River 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 Thunder Kenora Other Total Sub-LHIN of Patient River Bay Bay District LHIN Days District City 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 Rainy River 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 number of inpatient days 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 capital in 2009/10. For example, the number of inpatient days per capita in Rainy River district for Infectious and Parasitic Diseases was 1.77 times higher than expected. Thunder Kenora Thunder Rainy River District Bay District Bay City District Actual to Inpatient Actual to Actual to Actual to Chapter Expected Days Expected Expected Expected 01 Infectious/Parasitic Diseases 1.21 513 1.77 1.09 0.97 02 Neoplasms 1.24 1,376 1.20 1.42 1.07 03 Blood and Immune 2.12 134 1.15 1.94 1.91 Health Services Inventory: Rainy River District: Final 3 Final Thunder Kenora Thunder Rainy River District Bay District Bay City District Actual to Inpatient Actual to Actual to Actual to Chapter Expected Days Expected Expected Expected 04 Endocrine, Nutrition, Metabolic 2.41 556 1.08 3.09 2.54 05 Mental and Behavioural 2.32 803 1.37 3.13 1.22 06 Nervous System 1.38 308 1.12 1.18 1.08 07 Eye and Adnexa 2.01 12 1.31 1.24 2.87 08 Ear and Mastoid 2.81 68 2.64 3.11 2.45 09 Circulatory 1.43 2,158 1.00 2.43 1.50 10Respiratory 1.56 1,312 1.18 2.15 1.40 11 Digestive 1.52 1,170 1.01 1.85 1.83 12SkinandSubcutaneousTissue 2.84 145 1.11 1.45 2.13 13 Musculoskeletal and Connective 1.68 744 1.31 1.38 1.25 14 Genitourinary 1.52 361 0.66 1.56 1.52 15 Pregnancy and Childbirth 1.21 797 1.04 1.37 1.12 16 Perinatal Period 0.56 99 0.23 1.53 1.61 17 Congenital and Chromosomal 0.24 30 0.38 1.05 1.27 19 Injury and Poisoning 1.60 1,326 1.06 2.04 1.39 20 External Causes 3.39 3,023 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: Rainy River 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 Rainy River district’s population was 2.1 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 Genitourinary, Infectious and Parasitic Diseases, and Nervous System chapters. Resource use was lower than expected in the Circulatory and Respiratory chapters. The table below shows variance by clinical chapter for the hospitals in Rainy River district. Overall, Rainy River district hospitals provided 3.7 percent less service than expected given the characteristics of their patients.
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