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Cost of hospital stay has climbed: CIHI report

The cost of a stay at Red Deer Regional Hospital Centre climbed 18.8 per cent in 2012-13.

The cost of a stay at Red Deer Regional Hospital Centre climbed 18.8 per cent in 2012-13.

Recently, the Canadian Institute for Health Information’s compared data from Canadian hospitals with its interactive web tool — Your Health System — and showed the cost of a standard hospital stay was $7,018 at the Red Deer hospital, up from $5,907 in 2011-12.

The average length of stay in Red Deer is 6.7 days.

Between 2012-13 and 2010-11, the cost of care in Red Deer jumped a whopping 39.2 per cent. A standard stay’s cost was $5,040 in 2010-11.

The CIHI says the cost of a standard stay provides a sense of how efficient acute care hospital services are provided, but does not tell how well those services were delivered.

Red Deer care cost 4.4 per cent less than the provincial average of $7,338 in 2012-13.

Provincially, costs have increased 9.6 per cent from 2011-12 when it cost $6,694. In 2010-11, it cost $6,493.

Compared to the national average of $5,567, care in Red Deer was 26 per cent higher in 2012-13.

National costs have risen slower between 2012-11 and 2012-13 at 2.9 per cent. The national cost in 2011-12 was $5,409, up from $5,338 in 2010-11.

Kerry Bales, chief zone officer with Alberta Health Services Central Zone, said demands from the increasing population and labour costs particular to Alberta’s economy are two big factors that drive hospital costs and sets it apart from the national average.

“The result is what you see in the CIHI report,” Bales said on Monday.

But there is always an opportunity to look at being more cost-effective, he said.

Patients requiring hip fracture surgery had longer waits in Red Deer in 2012-13 compared to provincial and national rates.

Bales said that’s also a direct reflection of the demand, along with the fact that Red Deer is the only regional health centre.

In Red Deer, 56.1 per cent of patients age 65 and older underwent hip fracture surgery within 48 hours of being admitted. The provincial rate was 81.8 per cent and nationally it was 82.5 per cent.

Between 2011-12 and 2012-13, Red Deer saw 25 per cent more patients waiting longer than 48 hours for surgery.

The CIHI says long wait times in older patients with a hip fracture are associated with a higher risk of complications following surgery, including death.

Bales said the project announced in January to develop two new obstetrical operating rooms at the Red Deer hospital will help.

“Once those new ORs come on line, it’s going to free up space in the main ORs to be able to actually put through other surgeries such as orthopedics and hip fractures.”

The project is in the design phase. Construction is expected to get underway in 2015 and the project completed some 18 months later.

Red Deer continues to perform more caesarian sections in low-risk births than the provincial or national average.

The Red Deer rate was 17.8 per cent, while the provincial rate was 13.3 and the national rate was 14.1 per cent.

According to CIHI, unnecessary C-section delivery increases maternal morbidity and mortality and is associated with higher costs. Lower rates may indicate more appropriate as well as more efficient care.

In 2011-12, the rate in Red Deer was slightly higher at 18.7 per cent.

Bales said the increasing rate of C-sections could be due to different reasons and it’s a trend others are seeing beyond Red Deer and Alberta.

Hospital deaths in Red Deer dropped slightly in 2012-13.

The CIHI has developed a standardized mortality rate. In Red Deer, hospital deaths were at 90, which meant for every 100 patients likely to die, 90 of them actually died. In 2011-12, the rate was 92.

The provincial rate for 2012-13 was 84 and the Canadian rate was 89.

“For Red Deer in particular, what we’ve seen is a fairly consistent reduction in that number over time. That’s really the piece we mostly look at. We’d like to continue to see it trend down,” Bales said.

Readmission of patients within 30 days of their initial discharge at the Red Deer hospital was 8.7 per cent, which was slightly lower than the provincial rate of 8.9 per cent and 8.8 per cent nationally.

In 2011-12, the rate was 9 per cent in Red Deer, and 8.7 per cent both provincially and nationally.

CIHI says that while not all readmissions can be prevented, the rate can often be reduced through better follow-up and coordination of care for patients after discharge.

In-hospital sepsis, which is a severe systemic infection, was lower in Red Deer with 2.8 per 1,000 patients discharged compared to 4.2 provincially and 4.4 nationally.

CIHI says appropriate preventive and therapeutic measures during a hospital stay can reduce the rate of infections and/or progression of infection to sepsis.

Bales credits Red Deer’s the low sepsis rate to the quality of work by hospital staff.

“It really is a large collaborative effort by many, many departments.”

To access the CIHI hospital review, go to yourhealthsystem.cihi.ca.

szielinski@www.reddeeradvocate.com