Sioux Lookout LHH Profile

Transcription

8
Local Health Hub Profile – Sioux Lookout
Northern Integrated District Network
Spring 2013
North West LHIN  RLISS du Nord-Ouest
Local Health Hub Profile – Sioux Lookout 2
Table of Contents
INTRODUCTION........................................................................................................................................... 4
DEMOGRAPHICS AND POPULATION CHARACTERISTICS ................................................................... 5
DEMOGRAPHICS........................................................................................................................................................5
LHIN FUNDED HEALTH SERVICES ........................................................................................................... 9
ACUTE CARE.............................................................................................................................................................9
LONG-TERM CARE (LTC) .........................................................................................................................................9
COMPLEX CONTINUING CARE (CCC) ......................................................................................................................9
INPATIENT REHABILITATION ....................................................................................................................................10
INPATIENT MENTAL HEALTH ...................................................................................................................................12
COMMUNITY BASED CARE......................................................................................................................................15
Primary Care ....................................................................................................................................................15
Home Care .......................................................................................................................................................15
ANALYSIS OF ACUTE CARE HOSPITAL DISCHARGES ....................................................................... 17
MARKET SHARE OF ACUTE CARE DISCHARGES ....................................................................................................17
HOSPITALIZATIONS RELATED TO DIABETES ...........................................................................................................20
DIABETES AND AMPUTATIONS ................................................................................................................................22
DEMENTIA PATIENT POPULATION ..........................................................................................................................24
HOSPITAL USE AT THE END OF LIFE (IN-HOSPITAL PALLIATIVE CARE) ................................................................24
DISCHARGES FROM THE LOCAL HEALTH HUB’S ACUTE CARE HOSPITAL - SIOUX LOOKOUT ..............................26
MENO YA W IN HEALTH CENTRE ............................................................................................................................26
ALTERNATE LEVEL OF CARE (ALC) LENGTH OF STAY (LOS) ..............................................................................27
RE-ADMISSIONS FOR SELECT CONDITIONS ...........................................................................................................28
ANALYSIS OF AMBULATORY CARE VISITS.......................................................................................... 29
EMERGENCY (ED) VISITS .......................................................................................................................................29
EMERGENCY VISITS RELATED TO DIABETES .........................................................................................................32
NON-URGENT EMERGENCY VISITS ........................................................................................................................33
ED W AIT TIMES ......................................................................................................................................................33
Sioux Lookout Local Health Hub Profile
Introduction
This profile is one of a series of 14, corresponding to each of the 14 Local Health Hubs (LHHs) in the
North West LHIN. The Sioux Lookout LHH is the only LHH in the Northern Integrated District Network
(IDN), which in turn is one of the five IDNs in the North West LHIN’s new integrated health system model.
The map below illustrates the location of the Local Health Hub communities and the Integrated District
Networks.
Figure 1: Map of the North West LHIN
Demographics and Population Characteristics
Demographics
The following table lists the communities (census subdivisions (CSDs)) that are aligned to the Sioux
Lookout Local Health Hub, as well as their respective population counts from the 2006 and 2011
1
censuses and the percentage population change over that time period .
Table 1: Sioux Lookout Local Health Hub Communities, 2006 and 2011 Census
CSD/Community
Type of CSD
2006 Census
2011 Census
% Change
Bearskin Lake
Indian Reserve
459
456*
Cat Lake 63C
Indian Reserve
492
489
-0.6
Deer Lake
Indian Reserve
681
763
12
Fort Hope 64
Indian Reserve
1144
1394*
Fort Severn 89
Kasabonika Lake
Indian Reserve
Indian Reserve
429*
681
334
965*
Kee-Way-Win
Indian Reserve
318
340
Kingfisher Lake 1
Indian Reserve
415
473*
Kitchenuhmaykoosib Aaki 84
(Big Trout Lake)
Lac Seul 28
Indian Reserve
916
904
-1.3
Indian Reserve
821
872
6.2
Lansdowne House
Setttlement
0
0
MacDowell Lake
Settlement
0
0
Muskrat Dam Lake
Indian Reserve
252
260
Neskantaga
Indian Reserve
265
311*
North Spirit Lake
Indian Reserve
259
263
1.5
Osnaburgh 63B
Indian Reserve
347
425
22.5
Pickle Lake
Township
479
425
-11.3
Pikangikum 14
Indian Reserve
2100
2,411*
Poplar Hill
Indian Reserve
457
510*
Sachigo Lake 1
Indian Reserve
450
445*
Sandy Lake 88
Indian Reserve
1843
1861
1
Sioux Lookout
Municipality
5183
5037
-2.8
Slate Falls
Setttlement
164
186
13.4
Summer Beaver
Setttlement
362
33*
6.9
3.2
1
Communities aligned to the Sioux Lookout Local Health Hub as at February 28, 2013. Osnaburgh 63A and
Ojibway Nation of Saugeen (Savant Lake) in the Thunder Bay District Census Subdivision will be aligned with
Sioux Lookout LHH/Northern IDN moving forward.
CSD/Community
Type of CSD
2006 Census
2011 Census
Wapekeka 2
Indian Reserve
350
368
Wawakapewin (Long Dog
Lake)
Weagamow Lake 87
Webequie
Wunnumin 1
Indian Reserve
21
43*
Indian Reserve
Indian Reserve
Indian Reserve
700
614
487
736*
724*
533*
Sioux Lookout LHH Total
12,527
Adjusted
429
Sioux Lookout LHH
20,689
Total data used for communities with missing Census information.
*Adjusted
- Indian Registry
Data Sources: 1. Statistics Canada. 2011 Census and 2006 Census.
% Change
5.1
20,260
9034
21,561
4.2%
2. Registered Populations at http://pse5-esd5.ainc-inac.gc.ca/fnp/Main/Index.aspx?lang=eng
The following table presents some of the demographic characteristics of the Sioux Lookout LHH (and
Northern IDN), with comparisons to the other IDNs and the overall North West LHIN population.
Table 2: Population Characteristics, 2011 Census
Indicator
City of
TBay IDN
Thunder
Bay
District
IDN
Rainy
River
IDN
Kenora
IDN
Sioux Lookout
LHH/ Northern
IDN
North
West
LHIN
Total
Population
121,600
24,460
20,370
43,130
21,560
231,120
% Age 65+
17.2%
14.3%
17.3%
15.5%
6.6%
16.0%
% Age 75+
8.5%
5.5%
8.6%
6.9%
2.6%
7.3%
%
Aboriginal
3
Identity
8.3%
19.9%
21.7%
21.8%
77.8%
19.2%
% Francophone
2.7%
10.5%
1.5%
2.9%
0.9%
3.4%
2
Data Source: Statistics Canada. 2011 Census and 2006 Census.
1
Six census subdivisions assigned to Thunder Bay District IDN in this profile will be removed from Thunder
Bay District IDN moving forward. Two csds will move to Northern IDN and four csds will move to City of
Thunder Bay IDN.
2
Adjusted for incompletely enumerated Indian Reserve Census Subdivisions.
3
Based on 2006 Census; questions on Aboriginal identity not included in 2011 Census.
Key Findings:
 The population of the Sioux Lookout LHH is younger than in the broader North West LHIN;
 The proportion of the residents who self-identify as aboriginal is much higher than in and of the
other IDNs and the broader North West LHIN.
The following table shows the latest health behaviour indicators from the Canadian Community Health
Survey (CCHS) for the Northwestern Health Unit (NWHU), Thunder Bay District Health Unit (TBDHU),
North West LHIN and Ontario. Note that residents living on Indian Reserve census subdivisions are not
2
included in the CCHS.
Table 3: Self-Reported Health Behaviours/Practices, Canadian Community Health Survey
2009/2010, age 12+
Thunder Bay Northwestern
North
Indicator
District Health Health Unit
West
Unit (TBDHU)
(NWHU)
LHIN
Overweight or obese, age 18+ (%)
60.2
65.5
61.7
Pain or discomfort that prevents activities (%)
18.8
19.6
19.0
Current smoker; daily or occasional (%)
24.6
22.4
23.9
Heavy drinking (%)
20.4
22.2
20.9
Leisure-time physical activity; moderately active or active (%)
57.3
59.7
58.0
Regular medical doctor (%)
84.4
81.3
83.5
Contact with a medical doctor in the past 12 months (%)
80.2
77.4
79.3
Source: Statistics Canada. 2011. Health Profile. Statistics Canada Catalogue no. 82-228-XWE. Ottawa. Released
2011. http://www12.statcan.gc.ca/health-sante/82-228/index.cfm?Lang=E
ON
52.0
13.5
18.9
15.9
50.5
91.1
82.2
June 28
Key Finding:

The rates of heavy drinking and being overweight in the NWHU area are slightly higher than in
the TBDHU area, and higher than provincial rates.
The following table gives an indication of the burden of chronic disease in the North West LHIN, based on
self-reported chronic conditions.
Table 4: Self-Reported Prevalence of Chronic Conditions, Canadian Community Health Survey,
2009/10
Indicator
Thunder Bay
Northwestern North
ON
District Health
Health Unit
West
Unit (TBDHU)
(NWHU)
LHIN
Canadian Community Health Survey, 2009/10: % report being diagnosed by health professional
1
20.5%
26.6%
Arthritis -age 15+
57.8%
-age 65+
49.2%
Diabetes -age 12+
6.7%
7.3%
-age 65+
19.2%
25.9%
21.6%
High blood pressure -age 12+
19.2%
57.9%
-age 65+
53.6%
Chronic obstructive pulmonary disease
(COPD) -age 35+
7.3%
3.5%
14.2%
-age 65+
4.6%
Mood disorders - age 12+
8.8%
7.1%
- age 65+
9.8%
9.0%
1. Bolded estimates are significantly different from the provincial estimate.
22.4%
51.6%
6.9%
21.1%
19.9%
56.7%
6.2%
11.5%
17.3%
46.7%
6.8%
19.6%
17.4%
49.7%
4.2%
7.2%
8.3%
9.5%
6.8%
6.0%
Source: Statistics Canada. Table 105-0502 - Health indicator profile, two year period estimates, by age group and
sex, Canada, provinces, territories, health regions (2011 boundaries) and peer groups, occasional CANSIM
(database). (Accessed January 30, 2013).
2
There are two public health units in the North West LHIN area – Northwestern Health Unit (NWHU) and Thunder
Bay District Health Unit (TBDHU). The Northwestern Health Unit area corresponds to the Northern, Kenora and
Rainy River IDN areas of the North West LHIN. The Thunder Bay District Health Unit area corresponds to the City of
Thunder Bay and the Thunder Bay District IDN areas of the North West LHIN.
Key Finding:
 Rates of arthritis are higher in the North West LHIN, particularly in the Northwestern Health Unit
area.
Diabetes
The table below shows the estimated number of adults (age 18 years and over) in North West LHIN with
3
diabetes and the percentage that have had the recommended testing for diabetics.
Table 5: Diabetes Prevalence, age 18+ and Testing Status based on Ontario's Baseline Diabetes
Dataset Initiative (BDDI), as of March 31, 2011
% of Patients with Diabetes
Area – Patient Residence
All 3 tests AIC within
All patients
1
past 6
with Diabetes done
months
LDL-C
within past
year
2
Retinal eye exam
within past 2 yrs
Kenora District (Kenora
and Northern IDNs)
6,146
31
48
55
64
Rainy River IDN
1,770
34
54
56
74
Thunder Bay District IDN
2,592
16
53
26
70
City of Thunder Bay IDN
10,817
40
60
66
69
North West LHIN Total
21,325
34
55
57
68
Ontario Total
989,212
40
57
69
68
Source: HAB. Chronic conditions, prevalence, mortality, hospitalizations (2012-07-25) data product. July
2012.
Individuals are identified as having diabetes if they have had at least one hospitalization or two physician service
claims over a two-year period with a diabetes related diagnostic code. Women with gestational diabetes are not
included. Prevalence numbers are refined based on feedback from physicians who review patient lists and provide
validation on diabetes status.
1. Testing rates for HbA1c and LDL-C only include tests conducted in community labs and captured in the
Claims History Database (CHDB). Lab tests for A1C or LDL-C conducted in hospitals are not individually
submitted and therefore cannot be analysed for diabetes patients. Analysis of Eye Exams is also based on
CHDB. Only retinal eye exams where a fee-for-service claim was submitted are included. Exams that were
paid out-of-pocket by the patient are not included. Some providers (i.e., ophthalmologists in alternate
payment plans) may not submit claims. The percent of patients receiving exams may be underestimated in
areas where there are a larger proportion of non-FFS providers conducting retinal eye exams
Key Findings:


The North West LHIN has a higher prevalence of diabetes at 11.3% of the adult population (age
18 and over) vs. 9.3% provincially;
As of March 31, 2012, the number has increased to 22,345, 11.8% of the adult population
compared to 9.7% provincially.
3
The Baseline Diabetes Database Initiative (BDDI) was created by the Ministry using a validated algorithm to identify
Ontario residents, age 18+, with diabetes based on administrative data sources.
LHIN Funded Health Services
Acute Care
The Sioux Lookout Local Health Hub has one acute care hospital – Sioux Lookout Meno Ya Win Health
Centre.
In addition to acute care beds, there are a number of other inpatient bed types located in the acute care
facilities in the Northern IDN.
Table 6: Bed Types in Acute Care Hospitals
Hospital
Acute
Sioux Lookout Meno Ya Win
Health Centre
Inpatient
Rehab
CCC
36
5
Mental
Health
Newborn
Bassinets
4
William A. “Bill” George Extended
Care Facility
Northern IDN
ELDCAP
20
36
5
4
20
Source: Web Enabled Reporting System (WERS); extracted Jan. 2012.
Long-Term Care (LTC)
There are no Long-Term Care (LTC) homes in the Sioux Lookout LHH area, but there are 20 Elderly
Capital Assistance Program (ELDCAP) beds at William A. “Bill” George Extended Care Facility in Sioux
Lookout.
Complex Continuing Care (CCC)
The type of patient occupying CCC beds varies from hospital to hospital within the LHIN and across the
province and is reflected in the CCC bed rate per population 75+. The table below shows the 2010 bed
rate in each Integrated District Network area within the North West LHIN.
Table 7: CCC Bed Rate per Population Age 75+, 2010
IDN Area
City of Thunder Bay City IDN
Kenora IDN
Northern IDN
Rainy River IDN
North West LHIN
Ontario
Beds per 1,000
Population 75+
31
17
9
9
16
16.1
6.6
Data Source: Preyra Solutions Group. Complex Continuing Care in
the North West LHIN. June 2012.
Key Findings:
 In 2010, the CCC bed rate in the North West LHIN was more than twice the provincial average of
7 beds per 1,000 seniors age 75+;
 The Northern and Kenora IDNs have the lowest CCC bed rate of all IDNs within the North West
LHIN;

The average frailty of acute discharges to CCC in North West is lower than the provincial
4
average .
Inpatient Rehabilitation
St. Joseph’s Care Group (SJCG) located in the city of Thunder Bay has 50 Inpatient Rehabilitation beds
which service all residents of the North West LHIN.
The following tables show where patients admitted to SJCG for general rehab episodes and specialty
rehab episodes live within the North West LHIN.
Table 8a: Number of General Rehab Episodes for Inpatient Rehabilitation by Rehabilitation Client
Group (RCG) and Patient Residence, Fiscal y\Years 2009/10 to 2011/12 Combined
Rehab Client Group
CoTB
IDN
AMPUTATION OF
LIMB
ARTHRITIS
PAIN SYNDROMES
ORTHOPAEDIC
CONDITIONS
OTHER
All RCGs
Northern
IDN
Kenora
IDN
Rainy
River IDN
North
West
LHIN
Total
SJCG
32
69
10
<5
32
5
7
8
0
<5
17
<5
59
153
20
61
154
22
806
16
12
<5
6
0
16
<5
885
20
910
21
933
55
21
40
1137
1168
Data Source: Inpatient Rehabilitation Main Table, intelliHEALTH ONTARIO; extracted Jan. 2013.
Key Findings:


Northern IDN residents accounted for less than 5% (4.7%) of general rehab episodes at SJCG;
Of all rehab episodes for Northern IDN residents, more than half were for arthritis (58.2%).
Table 8b: Number of Specialty Rehab Episodes for Inpatient Rehabilitation by Rehabilitation Client
Group (RCG) and Patient Residence, Fiscal Years 2009/10 to 2011/12 Combined
Rehab Client
Group
STROKE
BRAIN
DYSFUNCTION
NEUROLOGICAL
CONDITIONS
SPINAL CORD
4
CoTB
IDN
Northern
IDN
Kenora
IDN
Rainy
River
IDN
North
West LHIN
Total
SJCG
251
21
42
15
379
385
42
9
<5
5
69
73
28
8
<5
<5
0
0
<5
<5
36
15
36
15
Preyra Solutions Group. Complex Continuing Care in the North West LHIN. June 2012.
Rehab Client
Group
CoTB
IDN
Northern
IDN
Kenora
IDN
Rainy
River
IDN
North
West LHIN
Total
SJCG
DYSFUNCTION
OTHER
All RCGs
<5
<5
<5
0
6
6
333
34
47
22
505
515
Data Source: Inpatient Rehabilitation Main Table, intelliHEALTH ONTARIO; extracted Jan. 2013.
Key Findings:
 Residents of the Northern IDN accounted for 6.6% of specialty rehab episodes;
 Of all rehab episodes for IDN residents, the majority were for stroke (61.8%).
The table below shows the breakdown of discharges and average length of stay for St. Joseph’s Care
Group discharges by Rehab Client Group (RCG) for fiscal year 2010/11.
Table 9: Rehab Discharges from St. Joseph’s Care Group, fiscal year 2010/11
Rehab Client Group
(01.1) STROKE - LEFT BODY
INVOLVEMENT (RIGHT BRAIN)
(08.11) ORTHOPAEDIC CONDITIONS
- STATUS POST UNILATERAL HIP
FRACTURE
(01.4) STROKE - NO PARESIS
(03.1) NEUROLOGICAL CONDITIONS
- MULTIPLE SCLEROSIS
(02.22) BRAIN DYSFUNCTION TRAUMATIC - CLOSED INJURY
(02.1) BRAIN DYSFUNCTION - NONTRAUMATIC
(02.2) BRAIN DYSFUNCTION –
TRAUMATIC
- STATUS POST UNILATERAL KNEE
REPLACEMENT
- STATUS POST UNILATERAL HIP
REPLACEMENT
- STATUS POST REVISION OF
UNILATERAL HIP REPLACEMENT
(CIHI CATEGORY)
(08.3) ORTHOPAEDIC CONDITIONS STATUS POST PELVIC FRACTURE
(04.130) NON-TRAUMATIC SPINAL
CORD DYSFUNCTION – OTHER
- STATUS POST REVISION OF
UNILATERAL KNEE REPLACEMENT
(CIHI CATEGORY)
Total
NW
Provincial North West
Weighted
Average Average
'Excess'
Cases
LOS
LOS
Days
#
Discharges
Total
Days
48
2,371
80
49
37
614
57
2,016
63
35
25
597
31
1,367
42
44
27
542
6
680
16
113
41
436
5
563
21
113
41
357
8
679
26
85
41
350
6
649
25
108
66
252
115
1,359
55
12
10
184
77
1,235
48
16
14
152
23
604
15
26
20
149
8
320
9
40
22
143
<5
233
8
58
27
127
10
245
5
25
13
115
565
16,963
589
30
25
2838
Rehab Client Group
#
Discharges
Total
Days
NW
Provincial North West
Weighted
Average Average
'Excess'
Cases
LOS
LOS
Days
Source: Preyra Solutions Group. Inpatient Rehabilitation in the North West LHIN. June 2012.
Key Findings:


St. Joseph’s Care Group rehab patients have longer lengths of stay than the provincial average,
controlling for case mix (complexity of case) using RCGs;
SJCG focuses on post-acute IP rehabilitation for hip and knee replacement patients and stroke
patients.
Inpatient Mental Health
There are no designated Inpatient Mental Health beds in the Sioux Lookout LHH area or the Northern
IDN. The following table contains the location of the Inpatient Mental Health beds in the North West
LHIN.
Table 10: Designated (Adult) Mental Health Beds in North West LHIN
IDN Area
Lake Of The Woods District Hospital
Kenora
Acute Psych.
Thunder Bay Regional Health Sciences Centre
City of Thunder Bay
Acute Psych.
30
City of Thunder Bay
Forensic
20
St Joseph's Care Group (SJCG)
City of Thunder Bay
M.H. Rehab
71
Type
Mental
Health
Beds
19
Provider Name
5
140
Source: PwC. Draft North West LHIN Blueprint Project Report. Dec. 2011.
The graphs in Figure 2 (a and b) show the distribution of patient residence for patients admitted to Lake of
the Woods District Hospital and Thunder Bay Regional Health Sciences Centre (Acute Psychiatric beds).
Figure 2a: Utilization of Designated (Adult) Mental Health Acute Psychiatric Beds in North West
LHIN by Patient Residence
5
The number of beds at SJCG is being reduced to 38. These mental health rehabilitation beds and related
outpatient and outreach programs will serve people with serious mental illness, concurrent disorders, acquired brain
injury, dual disorders and/or geriatric psychiatric illness.
Number of Patients
Patients Admitted to LOTW District Hospital Acute Mental
Health by IDN: 2009/10 - 2011/12
180
160
140
120
100
80
60
40
20
0
Kenora
Source: IP Adult MH Assessment,
Treatment, Diagnosis, intelliHealth
Ontario; extracted March 22, 2013
Rainy River
2009/2010
Northern
Other
2010/2011
City of Thunder
Bay
District of
Thunder Bay
2011/2012
Figure 2b: Utilization of Designated (Adult) Mental Health Acute Psychiatric Beds in North West
LHIN by Patient Residence
Patients Admitted to TBRHSC Acute Mental Health by IDN:
2009/10 - 2011/12
Number of Patients
1200
1000
800
600
400
200
0
City of Thunder
District of
Bay
Thunder Bay
2009/2010
Northern
2010/2011
Kenora
Rainy River
Other
2011/2012
Key Finding:

Most patients admitted to inpatient mental health acute psychiatric beds at Lake of the Woods
District Hospital in Kenora and Thunder Bay Regional Health Sciences Centre are from the same
IDN as where the hospital is located.
The following graphs show the distribution of admissions to inpatient adult mental health beds, by primary
reason for admission, over the three most recent years for which there is complete information.
Figure 3a: Reasons for Admission to Designated (Adult) Mental Health Acute Psychiatric Beds at
Lake of the Woods District Hospital
Number of Unique Patients
Patients Admitted to LOTW Hospital Acute Mental Health by
Primary Diagnosis: 2009/10 - 2011/12
80
70
60
50
40
30
20
10
0
2009/2010
2010/2011
2011/2012
Figure 3b: Reasons for Admission to Designated (Adult) Mental Health Acute Psychiatric Beds at
Number of Unique Patients
Patients Admitted to TBRHSC Acute Mental Health by Primary
Diagnosis: 2009/10 - 2011/12
500
450
400
350
300
250
200
150
100
50
0
2009/2010
2010/2011
2011/2012
Key Findings:


Mood disorders accounted for the highest number of admissions at TBRHSC while schizophrenia
and other psychotic disorders accounted for the most admissions at LOTW;
Substance-related disorders accounted for the second most number of admissions at TBRHSC
while adjustment disorders accounted for the second most admissions at LOTW.
Community Based Care
Primary Care
The table below shows the distribution of active physicians (as of December 2011) in the North West
LHIN area.
Table 11: 2011 Active Physicians in North West LHIN by Integrated District Network
Integrated District Network
(IDN)
Number of Family Medicine
Physicians
Number of
Specialists
Kenora IDN
56
13
Rainy River IDN
22
2
25
0
140
165
Northern IDN
37
3
280
183
Data Source: Ontario Physician Human Resources Data Centre Active Physician Registry, December 31,
2011.
Key Findings:


Within the Northern IDN, as of Dec. 31, 2011, there were 37 active physicians;
There are no Community Health Centres or Family Health Teams in the Northern IDN.
Home Care
The following graph shows the number of distinct clients receiving Home Care services by fiscal year for
each of the Integrated District Networks in the North West LHIN.
Figure 4: Number of Home Care Clients by Integrated District Network
Number of Home Care (CCAC) Clients
25.0
# of distinct clients
6,000
20.0
5,000
4,000
15.0
3,000
10.0
2,000
5.0
1,000
0
% Population Age 65+
7,000
0.0
TBayDt IDN
2008/09
CoTB IDN Rainy River IDN Kenora IDN Northern IDN
Integrated District Network Area
2009/10
2010/11
%Age 65+
Data Source: Home Care Main Table, intelliHEALTH ONTARIO;extracted fall 2012.
Key Findings:


The Northern IDN has seen an increase in the number of CCAC clients from 313 in 2008/09 to
338 in 2009/10 to 369 in 2010/11;
Northern IDN residents account for 3.0%, 3.3% and 3.6% of North West CCAC’s clients in the
three fiscal years respectively.
The following table shows the distribution of CCAC clients living in the Sioux Lookout LHH by service
goals in fiscal year 2010/11.
Table 12: CCAC Clients from Marathon LHH by Service Goal, fiscal year 2010/11
% Clients with
Service Time
# Distinct
Service Goal
(Hours)
Clients
Service Goal
( >= 1 goal)
Acute (in-home)
1,557.00
112
30.4%
End of Life (In-home)
12
3.3%
1,116.25
Long-Term Care Placement
62
16.8%
179.00
Long-Term Supportive (in-home)
34
9.2%
3,179.75
Maintenance (in-home)
57
15.4%
2,665.50
Rehabilitation (in-home)
175
47.4%
1,819.00
Other
7
1.9%
15.00
Total
459
10,534.50
Data Source: Home Care Main Table, intellIHEALTH ONTARIO; extracted Jan. 9, 2013.
Each client may have more than one service goal, accounting for the total number of distinct clients for
each service goal being higher than the actual number of unique individuals receiving service (459
compared to 369).
Service Activity by Service Goal
For patients with an End-of-Life service goal, two-thirds (65.2%) of service time was for “combined
personal support and homemaking service” followed by 28.8% for nursing visits.
For clients with an acute (in-home) goal, the majority of service time (82.5%) was for nursing visits; 12.2%
of service time was for case management.
For clients with a service goal of long-term support (in-home), over two-thirds of service time (69.3%) was
for combined personal support and homemaking services, followed by a quarter (25.1%) of the service
time for nursing visits.
For clients with a maintenance (in-home) service goal, just under one-half (48.6%) of service time was for
combined personal support and homemaking services, followed by 37.9% of service time for nursing
visits.
All service time for clients with a goal of long-term care placement was for case management.
For CCAC clients with a rehabilitation (in-home) service goal, approximately one-quarter (28.5%) of
service time was for nursing visits. In terms of therapy services, 23.1% of service time was for speech
language therapy, 18.9% for physiotherapy and 10.0% for occupational therapy. Case management
accounted for 10.3% and combined personal support and homemaking services accounted for 9.2% of
service time.
Over all service goals, combined personal support and homemaking services accounted for 41.8% of all
service time, while nursing visits accounted for 37.3%.
Analysis of Acute Care Hospital Discharges
Market Share of Acute Care Discharges
The following figure shows where residents of the Sioux Lookout LHH went for acute care in fiscal years
2009/10 – 2011/12.
Figure 5: Distribution of Inpatient Acute Care Discharges for Sioux Lookout LHH residents
Acute Care Discharges for Sioux Lookout LHH Residents by Fiscal
Year and Location of Hospital
# of Discharges
4000
3500
150
81
3000
619
638
67
563
977
2500
967
Other Prov
Other North West
LHIN Hospitals
Other LHINs
919
2000
Kenora IDN
1500
Manitoba
1000
1804
2195
1843
500
0
2009-2010
2010-2011
Discharge Fiscal Year
2011-2012
CoTB LHH (TBRHSC)
Sioux Lookout LHH
Data Source: DAD, CIHI
Portal; extracted Jan. 14,
2013.
Key Findings:

Discharges from Sioux Lookout Meno Ya Win Health Centre accounted for just over half (52.9%
over the three years) of acute care discharges to Sioux Lookout LHH residents.

Thunder Bay Regional Health Sciences Centre (TBRHSC) accounted for another quarter of
discharges to Sioux Lookout LHH residents (25.9% over the three fiscal years);

Hospitals in Manitoba accounted for 16.5% of acute care discharges to Sioux Lookout LHH
residents over the three fiscal years.
In terms of discharges from the hospital located in the Sioux Lookout Local Health Hub—Sioux Lookout
Meno Ya Win Health Centre—the following graph shows the distribution of discharges by patient
residence and fiscal year.
Figure 6: Distribution of Inpatient Acute Care Discharges from Sioux Lookout Meno Ya Win Health
Centre by Patient Residence and Fiscal Year
Sioux Lookout Meno Ya Win Health Centre Discharges by
Patient Residence and Fiscal Year
2500
55
Out of Province/
Other LHIN
116
2000
38
# of discharges
114
37
107
Rainy River/ Kenora
IDNs
1500
1000
2,176
1,770
Thunder Bay
District/ City of
Thunder Bay IDNs
1,805
500
Sioux Lookout LHH
0
2009/10
2010/11
2011/12
Discharge Fiscal Year
Data Source: Inpatient
Discharge Main Table,
intellIHEALTH ONTARIO;
extracted Jan. 4, 2013.
Key Findings:



The majority of the discharges were from Sioux Lookout LHH residents, ranging from 91.1%
in 2009/10 to 92.0%% in 2011/12.
Other North West LHIN residents accounted for approximately 7% of discharges, followed by
residents of other provinces and other LHIN areas in Ontario;
There was a 20% increase in the number of discharges between 2010/11 and 2011/12, from
1968 to 2366.
The following table illustrates the extent of acute care service received by Sioux Lookout LHH residents
from Thunder Bay Regional Health Sciences Centre (TBRHSC).
Table 13: % Acute Care Discharges for Sioux Lookout LHH residents from TBRHSC by Most
Responsible Diagnosis Chapter, fiscal years 2009/10 – 2011/12 combined
ICD10 Chapter
Diseases of the nervous system (G00-G99)
Injury, poisoning and certain other consequences of
external causes (S00-T98)
Certain conditions originating in the perinatal period (P00P96)
Diseases of musculoskeletal system and connective tissue
(M00-M99)
Total # Acute Care
Discharges for
LHH Residents
(all hospitals)
155
% Discharges
from TBRHSC
48.4%
1082
47.2%
588
40.8%
367
40.6%
Total # Acute Care
Discharges for
LHH Residents
(all hospitals)
408
% Discharges
from TBRHSC
34.3%
Neoplasms (C00-D48)
286
31.5%
Diseases of the circulatory system (I00-I99)
618
29.9%
Mental and behavioural disorders (F00-F99)
383
29.0%
Symptoms, signs and abnormal clinical and laboratory
findings (R00-R99)
Certain infectious and parasitic diseases (A00-B99)
596
28.7%
246
28.5%
Endocrine, nutritional and metabolic diseases (E00-E90)
367
28.1%
Diseases of the skin and subcutaneous tissue (L00-L99)
173
27.2%
39
25.6%
ICD10 Chapter
Diseases of the genitourinary system (N00-N99)
Diseases of the ear and mastoid process (H60-H95)
Diseases of the eye and adnexa (H00-H59)
31
22.6%
886
21.6%
84
20.2%
1677
19.4%
Diseases of the digestive system (K00-K93)
751
17.2%
Congenital malformations, deformations and chromosomal
abnormalities (Q00-Q99)
Factors influencing health status and contact with health
services (Z00-Z99)
All Discharges
102
13.7%
2197
12.7%
11,036
25.9%
Diseases of the respiratory system (J00-J99)
Diseases of the blood and blood-forming organs and
certain disorders involving the immune mechanism (D50D89)
Pregnancy, childbirth and puerperium (O00-O99)
Data Source: DAD, CIHI Portal; extracted March 27, 2013.
Key Findings:


Over the last three complete fiscal years, 26% of all discharges for Sioux Lookout LHH residents
(including those out-of-province and out of North West LHIN) were from TBRHSC;
TBRHSC accounts for over 10% of discharges from all most responsible diagnosis chapters.
Hospitalizations Related to Diabetes
The number of discharges and total length of stay for North West LHIN patients with a most responsible
diagnosis of diabetes have consistently been double that of the province, based on crude rates as
illustrated in the following table.
Table 14a: Discharges and Total Length of Stay for Diabetes (Most Responsible Diagnosis) in
Ontario Hospitals, Fiscal Years 2008/09 – 2010/11
North West LHIN
2008
2009
2010
Ontario
#
Discharges
Discharge
Rate
Length of
Stay (Days)
IP_Days
Rate
Discharge
Rate
IP_Days
Rate
513
508
497
214.0
212.4
208.2
5,179
5,342
4,944
2,160.5
2,233.7
2,070.6
97.8
96.3
93.1
1,002.9
988.4
923.9
Source: HAB. Chronic conditions, prevalence, mortality, hospitalizations (2012-07-25) data product. July 2012.
Key Finding:

The hospitalization rate for diabetes in the North West LHIN is more than double that of the
province.
The table below shows the distribution of discharges and length of stay for fiscal year 2010/11 by IDN
area.
Table 14b: Discharges and Total Length of Stay for Diabetes (Most Responsible Diagnosis), Fiscal
Year 2010/11 by Patient Residence
Area - Patient Residence
Inpatient Discharges Inpatient Length of Stay
(Days)
Kenora District (Kenora and Northern IDNs)
140
1,757
Rainy River IDN
60
590
69
745
228
1,852
497
4,944
Source: HAB, MOHLTC. Chronic conditions, prevalence, mortality, hospitalizations (2012-07-25) data product.
July 2012.
Key Findings:



6
45 of these discharges were from Sioux Lookout Meno Ya Win Health Centre;
The majority of discharges were from Thunder Bay Regional Health Sciences Centre (270 or
6
54.3%);
Of the 497 discharges from Ontario hospitals in 2010/11, with a most responsible diagnosis of
diabetes, 58 of those involved amputations, accounting for 1,203 days length of stay.
Inpatient Discharge Main Table, intellIHEALTH ONTARIO; extracted July 20, 2012.
The following graph shows the distribution of discharges with most responsible diagnosis by hospital
location (including all of Canada) by the last three fiscal years 2009/10 to 2011/12.
Figure 7: Distribution of Inpatient Acute Care Discharges with Most Responsible Diagnosis of
Diabetes by Hospital Location and Fiscal Year
300
Inpatient Discharges with Most Responsible Diagnosis of
Diabetes by
Hospital Location and Fiscal Year
# of Discharges
250
2009-2010
200
2010-2011
150
2011-2012
100
50
0
Kenora
IDN
Rainy Northern CoTB IDN
River IDN
IDN
TBayDt
IDN
Other
LHINs
Other
Prov.
Hospital Location
Data Source: DAD, CIHI Portal: extracted Jan 29, 2013
Key Findings:




If the 88 diabetes discharges (most responsible diagnosis) from hospitals across Canada for
North West LHIN residents is included, the number of diabetes discharges for North West LHIN
residents increases 17.7 %, from 497 in 2010/11 to 585;
During fiscal year 2011/12 there were 496 discharges from Ontario facilities and 548 overall;
The majority of out-of-province discharges occur in Manitoba. Out-of-province discharges
accounted for 13.5%, 15.0% and 9.5% of total diabetes discharges;
Sioux Lookout Meno Ya Win Health Centre saw 28, 45 and 54 discharges with most responsible
diagnosis of diabetes in 2009/10, 2010/11 and 2011/12 respectively.
Diabetes and Amputations
Complications from diabetes can lead to amputation of limbs in some cases. The North West LHIN had
almost three times the rate of major amputations among diabetics than the provincial average in fiscal
7
year 2009/10, based just on amputations done in Ontario hospitals.
The following graph shows the distribution of these discharges by hospital location and fiscal year.
7
PwC. North West LHIN: Health Services Blueprint: Building Our Future Final Report. Feb. 2012.
Diabetes and Amputation Intervention by Hospital Location and Fiscal Year
# of Discharges
Inpatient Discharges with Most Responsible Diagnosis of
Diabetes and Amputation Intervention
60
50
40
30
20
10
0
CoTB IDN
Other North West
Other LHINs
Manitoba
LHIN IDNs
Hospital Location
2009-2010
2010-2011
2011-2012
Data Source: DAD, CIHI Portal, extracted Jan. 29, 2013
Key Findings
 There were 80 discharges to North West LHIN residents in 2011/12 for patients with a most
responsible diagnosis of diabetes and a principal intervention of amputation;
 The majority of these interventions were done at Thunder Bay Regional Health Sciences Centre
(63.78%), while 12.5% were done in Manitoba facilities and 21.3% at hospitals in other IDNs in
the North West LHIN;
 Less than five of these discharges occurred at Sioux Lookout Meno Ya Win Health Centre.
The following graph shows the number of discharges to North West LHIN residents that involved a most
responsible diagnosis of diabetes and an amputation intervention.
Diabetes and Amputation Intervention by Patient Residence and Fiscal Year
40
35
30
25
20
15
10
5
0
50
40
30
20
10
0
Northern IDN Kenora IDN Rainy River CoTB IDN
IDN
Pt. Residence IDN
2009-2010
2010-2011
TBayDt IDN
2011-2012
% LHIN 2011 Census Population
# Discharges
Diabetes and Amputation Discharges by Patient Residence
(IDN)
% LHIN pop.
Data Source: DAD, CIHI Portal; extracted Jan. 29, 2013
Key Finding:
 Residents of the Northern IDN account for 21.25% (17 of 80) of these discharges in 2011/12,
more than double the IDN’s 9.3% population proportion.
Dementia Patient Population
The number of dementia patients in acute care is projected to increase by 19% from 284 (in 2009/10) to
8
338 (in 2019/20) .
Table 15: Inpatient Acute Care Dementia Patients, North West LHIN, Fiscal Year 2009/10
Dementia
Cases
Area – Patient Residence
Average Total
Length of Stay
(LOS)days
29
ALC Avg. LOS
days
Kenora District (Kenora and
Northern IDNs)
Rainy River IDN
98
19
63
13
7
27
46
30
City of Thunder Bay
95
27
16
284
26
16
Source: PwC. North West LHIN: Health Services Blueprint: Building Our Future Final Report. Feb. 2012.
Key Finding:

In 2009/10 Northern IDN patients with dementia had slightly longer total lengths of stay and ALC
lengths of stay than the broader North West LHIN.
Hospital Use at the End of Life (In-Hospital Palliative Care)
The following table shows the number of discharges for North West LHIN residents over 2009/10 –
2010/11 that involved any palliative care diagnosis (ICD-10 code Z51.5).
Table 16: Acute Care Discharges with Diagnosis of Palliative Care, Fiscal Years 2009/10&2010/11
Combined
Received Palliative Care
8
All
Integrated District Network Discharges
of Patient Residence
(Total Acute
Care)
Expected #
Discharges
discharges
with diagnosis
Actual over Difference in
with diagnosis
of palliative
Expected
Discharges
of palliative
care (Actual)
care
Rainy River IDN
4,485
204
234
0.87
-30
5,709
185
253
0.73
-68
24,824
1,286
1,116
1.15
170
PwC. North West LHIN: Health Services Blueprint: Building Our Future Final Report. Feb. 2012.
Received Palliative Care
All
Integrated District Network Discharges
of Patient Residence
(Total Acute
Care)
Expected #
Discharges
discharges
with diagnosis
Actual over Difference in
with diagnosis
of palliative
Expected
Discharges
of palliative
care (Actual)
care
Kenora IDN
7,490
304
360
0.84
-56
Northern IDN
3,755
85
149
0.57
-64
46,263
2,064
2,112
0.98
-48
Source: Preyra Solutions Group. Palliative Care in the North West LHIN. June 2012.
Key Findings:


Access to hospital-based palliative care for the North West LHIN population is at the provincial
average, controlling for case mix;
Within the North West LHIN, Northern IDN residents had much less access to hospital-based
palliative care, after adjusting for case mix (Actual over Expected = 0.57).
9
The following table shows the actual number of discharges with a diagnosis of palliative care (most
10
responsible diagnosis or other) for North West LHIN residents in fiscal year 2010/11.
Table 17: Acute Care Discharges with Diagnosis of Palliative Care, Fiscal Year 2010/11
All
Discharges
Any Secondary Dx of
Palliative Care
Kenora
#
Discharges
4,566
Most Responsible
Diagnosis (MRDx) of
Palliative Care
#
% All
Discharges Discharges
53
1.2
#
Discharges
90
% All
Discharges
2.0
All Discharges with Dx of
Palliative Care (MRDx or
Co-morbidity)
#
% All
Discharges Discharges
143
3.1
Northern
2,975
18
0.6
28
0.9
46
1.5
Rainy
River
2,769
53
1.9
47
1.7
100
3.6
Thunder
Bay
District
City of
Thunder
Bay
LHIN
Total
3,464
28
0.8
50
1.4
78
2.3
15,038
181
1.2
489
3.3
670
4.5
28,812
333
1.2
704
2.4
1,037
3.6
IDN Area
Source: Preyra Solutions Group. Palliative Care in the North West LHIN. June 2012.
9
Most Responsible Diagnosis is the primary reason for the hospital stay.
Key Finding:

Northern IDN residents had the lowest % of discharges with a diagnosis of palliative care of all
North West LHIN residents in 2010/11 (1.5% vs. 3.6%).
The following figure shows the distribution of discharge destinations for those patients with a diagnosis of
palliative care and discharged from acute care over the last five fiscal years.
Figure 10: Discharge Destination of Acute Care Discharges with Diagnosis of Palliative Care
Discharge Destination of Palliative Care
Acute Care Patients, North West LHIN
100%
% discharged elsewhere
% Palliative Care Patients
90%
80%
% discharged to other type of
facility
70%
60%
% discharged to continuing
care facility
50%
% discharged to home with no
support services
40%
30%
% discharged to home with
support services
20%
10%
0%
2006
2007
2008
Fiscal Year
2009
2010
% PC patients who died in
hospital
Data Source: Inpatient Discharge Main Table,
intelliHEALTH Ontario; extracted April 4, 2012.
Key Findings:


The percentage of palliative care patients dying in hospital has been decreasing over the last few
years with 42.5% of palliative care patients dying in hospital in 2010/11;
Just under one-third (30.4%) of palliative care patients were discharged home (with or without
support).
End of life services at home, provided by the North West CCAC, and were discussed earlier in the profile.
Discharges from the Local Health Hub’s Acute Care Hospital - Sioux Lookout
Meno Ya Win Health Centre
The following table shows the number of discharges by most responsible diagnosis (MRDx) categories for
people discharged from Sioux Lookout Meno Ya Win Health Centre over the last three fiscal years.
Table 18: Most Responsible Diagnoses for Acute Care Discharges from Sioux Lookout Meno Ya
Win Health Centre - 2009/10 – 2011/12
2009/10
2010/11
2011/12
2009/102011/12
#
#
#
%
ICD10 Chapter
Discharges Discharges Discharges Discharges
Factors influencing health status and contact
513
534
618
26.53%
with health services (Z00-Z99)
Pregnancy, childbirth and puerperium (O00348
341
418
17.64%
O99)
176
203
199
9.21%
168
108
146
119
218
129
8.48%
5.67%
114
109
121
5.48%
106
94
117
5.05%
Diseases of the genitourinary sys (N00-N99)
70
53
78
3.20%
Endocrine, nutritional and metabolic diseases
(E00-E90)
Certain conditions originating in the perinatal
period (P00-P96)
Certain infectious and parasitic diseases
(A00-B99)
Neoplasms (C00-D48)
Diseases of the skin and subcutaneous tissue
(L00-L99)
Diseases of musculoskeletal system and
connective tissue (M00-M99)
Diseases of the blood and blood-forming
organs involving the immune mechanism (D50D89)
Diseases of the ear and mastoid process (H60H95)
Congenital malformations, deformations and
chromosomal abnormalities (Q00-Q99)
Number of Discharges
55
71
74
3.19%
44
61
53
55
100
71
3.14%
2.98%
43
44
44
2.09%
29
27
38
28
38
50
1.67%
1.67%
26
33
39
1.56%
24
15
24
1.00%
12
9
16
9
18
<5
0.73%
0.35%
7
7
<5
0.29%
<5
1,942
0
<5
2,366
--*
Symptoms, signs and abnormal clinical and
laboratory findings (R00-R99)
Injury, poisoning and other consequences of
1,968
100.0%
Data Source: Inpatient Discharge Main Table, intelliHEALTH Ontario; extracted Dec. 27, 2012.
Alternate Level of Care (ALC) Length of Stay (LOS)
The following table shows the indicators related to Alternate Level of Care (ALC) length of stay (LOS) at
Wilson Memorial General Hospital.
Table 19: Annual Alternate Level of Care (ALC) Indicators for Discharges (excluding newborns
and stillborns) from Sioux Lookout Meno Ya Win Health Centre, Fiscal Years 2009/10 – 2011/12
Indicator
Total # Discharges (excluding
newborns and stillborns)
Total LOS (Days)
ALC LOS (Days)
% ALC
# ALC Discharges
2009/10
1,587
2010/11
1,615
2011/12
1,939
8,865
3,063
34.6
118
11,666
5,032
43.1
94
12,312
3,445
28
95
Data Source: DAD, CIHI Portal; extracted Jan. 2, 2013.
Key Findings:






The % ALC days rate has fluctuated over the last three years but has been consistently above
the North West LHIN’s target. The target was 15.40% for 2011/12 and is 19.0% for 2012/13.
There was an average of 102 ALC patients over last three fiscal years, accounting for an annual
average of 3,847 ALC days.
In 2011/12, 95 ALC patients accounted for 3,445 ALC days, equivalent to the complete
occupancy of more than 9 acute care beds;
Of the 95 ALC patients discharged in 2011/12, 62.1% were discharged home and accounted for
1,361 ALC days (39.5% of ALC days);
A further 11 cases were discharged to a home setting with support services (Home Care),
accounting for 450 ALC days (13.1% of ALC days);
Ten ALC cases died in hospital, with 511 ALC days (14.8% of ALC days).
ALC Designation Within Two Days
13.5% of ALC cases over the last three years were designated ALC within two days of admissions. The
11
majority of these cases (29 of 41) were discharged home .
Re-admissions for Select Conditions
Reduction in avoidable hospitalizations--of which hospital readmissions play an important part --is a key
strategic focus of the Ministry’s Excellent Care for All Strategy in Ontario. Readmissions also contribute
12
to increased emergency room pressures and wait times .
The cases included in this indicator are discharges for patients age >=45 with diagnosis of stroke, chronic
obstructive pulmonary disease (COPD) or congestive heart failure (CHF), those age >= 40 with select
cardiac conditions, all ages with pneumonia, diabetes and gastro-intestinal disorders. The following table
shows the re-admission rates of these cases for Sioux Lookout Meno Ya Win Health Centre and for all
North West LHIN hospitals combined for fiscal year 2011.
11
12
CIHI Portal. DAD. Jan. 2013.
MOHLTC. MLPA Indicators Technical Documentation. December 2010.
Table 20: Re-admissions Within 30 days for Select Conditions, Calendar Year 2011, Sioux Lookout
Meno Ya Win Health Centre
# Readmitted
Index
% ReTo Any
Cases
admits
Facility
Hospital
Sioux Lookout Meno Ya Win
Health Centre
371
40
10.78%
North West LHIN
5,198
850
16.35%
Source: HAB. MLPA Supplemental Information. Nov. 2012.
Key Findings:

Over the calendar year 2011 the North West LHIN was very close to its target value of 16.0%
for 2011/12 while Sioux Lookout Mena Ya Win Health Centre was significantly lower.

The North West LHIN target value for 2012/13 is 16.86%.
13
Analysis of Ambulatory Care Visits
Emergency (ED) Visits
Table 21 shows the volume of ambulatory care visits to Sioux Lookout Meno Ya Win Health Centre by
fiscal year and type of ambulatory care visit.
Table 21: Ambulatory Care Visits by Visit Type to Sioux Lookout Meno Ya Win Health Centre
Ambulatory Care Visit Type
Emergency
Day Surgery
Clinic
Oncology Clinic
General Specialty Day/Night
Care
Other Ambulatory Care
Total
2009/10
13,929
1,293
0
108
0
2010/11
13,849
1,202
167
174
0
2011/12
15,287
1,551
0
185
256
112
15,442
0
15,392
0
17,279
Data Source: NACRS, CIHI Portal; extracted Dec. 27, 2012.
Key Finding:
 The number of emergency visits and total ambulatory visits has fluctuated over the last three
years, but there was a 10% increase in emergency visits between 2010/11 and 2011/12 and a
12%increase in all ambulatory care visits.
The following figure shows who went to Sioux Lookout Meno Ya Win Health Centre for emergency visits
(unscheduled, unplanned), for fiscal years 2009/10 to 2011/12.
13
The MLPA indicator is known as Readmissions within 30 days for Selected CMGs. Case Mix Groups (CMGs)
methodology assigns hospital discharges into categories based on diagnosis and patient characteristics.
Figure 11: % of Emergency Visits to Sioux Lookout Meno Ya Win Health Centre by Patient
Residence
Distribution of Emergency Visits to
Sioux Lookout Meno Ya Win Health Centre
by Patience Residence and Fiscal Year
100.0%
% of Emergency Visits
90.0%
3.4%
3.5%
3.5%
3.2%
3.2%
3.8%
Kenora IDN
80.0%
70.0%
Out of Province/
Other LHIN
60.0%
50.0%
40.0%
91.6%
91.3%
91.3%
30.0%
TBayDt/CoTB/RR
IDNs
Sioux Lookout LHH
20.0%
10.0%
0.0%
2009/10
2010/11
Registration Fiscal Year
2011/12
Data Source: NACRS,
CIHI Portal; extracted
Mar. 6, 2013.
Key Finding:

Approximately 91% of unscheduled emergency visits to Sioux Lookout Meno Ya Win Health
Centre over the last three fiscal years were by residents of the Sioux Lookout LHH.
The following table shows the distribution of all emergency visits to Sioux Lookout Meno Ya Win Health
Centre by Main Problem (ICD10 Chapter, listed in decreasing order of visits in 2011/12.
Table 22: Emergency Visits to Sioux Lookout Meno Ya Win Health Centre by Main Problem (%
Visits)
Rank
(2011/12)
1
2
3
4
5
6
7
8
9
ICD10 Chapter
Injury, poisoning and certain other consequences of
Factors influencing health status and contact with health
services (Z00-Z99)
Symptoms, signs and abnormal clinical and laboratory
findings, not elsewhere classified (R00-R99)
Diseases of the skin and subcutaneous tissue (L00-L99)
Diseases of the musculoskeletal system and connective
tissue (M00-M99)
Diseases of the genitourinary system (N00-N99)
2009/10
16.04%
2010/11
15.55%
2011/12
16.45%
15.55%
14.44%
15.44%
13.25%
13.79%
13.51%
11.56%
5.39%
6.96%
10.65%
5.90%
6.54%
9.99%
6.96%
6.33%
6.04%
5.10%
4.24%
6.77%
5.26%
4.49%
5.86%
5.46%
4.46%
Rank
(2011/12)
10
11
12
13
14
15
16
ICD10 Chapter
Certain infectious and parasitic diseases (A00-B99)
Diseases of the ear and mastoid process (H60-H95)
Endocrine, nutritional and metabolic diseases (E00-E90)
Pregnancy, childbirth and the puerperium (O00-O99)
Diseases of the blood and blood-forming organs and
18 certain disorders involving the immune mechanism (D50D89)
19 Neoplasms (C00-D48)
Certain conditions originating in the perinatal period (P0020
P96)
Congenital malformations, deformations and
21
chromosomal abnormalities (Q00-Q99)
Total # Emergency Visits
2009/10
4.23%
2.23%
2.08%
1.72%
1.72%
1.47%
1.02%
0.28%
2010/11
4.18%
2.52%
1.91%
1.62%
1.85%
1.50%
1.13%
0.38%
2011/12
3.86%
2.11%
2.06%
1.62%
1.56%
1.54%
1.12%
0.44%
0.18%
0.11%
0.32%
0.09%
0.20%
0.07%
0.08%
0.06%
0.05%
13,929
13,849
15,287
Key Findings:



Injury, poisoning and certain other consequences of external causes accounted for 16.5% of
emergency visits in 2011/12. This category includes open wounds, superficial and unspecified
injuries, fractures, sprains, dislocations and poisoning;
Factors influencing health status and contact with health services accounted for 15.4% of
emergency visits in 2011/12. This category includes attention to surgical sutures and dressings,
chemotherapy, follow-up exams and counselling;
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
accounted for 13.5% of emergency visits in 2011/12. This category includes pains, nausea and
vomiting.
The following table shows the leading problems in the leading chapter in terms of volume of emergency
visits for fiscal year 2011/12.
Table 23: Leading Problems in Injury, poisoning and certain other consequences of external
causes Chapter, Fiscal Year 2011/12
Problem
Number
of Visits
% Chapter
Visits
% All
Visits
Open wounds
Fractures
Superficial injuries/contusions
471
420
317
18.7%
16.7%
12.6%
3.1%
2.7%
2.1%
Sprains/strains/dislocations
Total Visits classified as Injury, poisoning and
certain other consequences of external causes
283
11.3%
1.9%
2,522
16.5%
Key Finding:

Open Wounds accounted for 18.7% of visits in this category, 3.1% of all emergency visits.
As noted in Table 22, 5.9% of unscheduled emergency visits to Sioux Lookout Meno Ya Win Health
Centre are for Mental and Behavioural Disorders (ICD10 Codes F00-F99).
The following table shows the number of repeat visits within 30 days for mental health (F00-F09, F20F99) and Substance Abuse (F10-19) conditions.
Table 24: Repeat Visits within 30 Days for Mental Health and Substance Abuse Conditions to
Sioux Lookout Meno Ya Win Health Centre
Emergency Visits for Mental Health Conditions
2010/11
2011/12
2010/11
2011/12
Total #
# of
% Emergency
North West
Emergency Repeat
Visits for this
LHIN target
Visits for
Visits
condition
this 467
13.7%
82
17.6%
condition
391
17.4%
74
18.9%
Emergency Visits for Substance Abuse Conditions
22.2%
458
107
23.4%
496
29.1%
108
21.8%
North West
LHIN actual
19.3%
18.2%
32.3%
28.4%
Data Source: Health Analytics Branch. MLPA Supplemental Information – MH and SA conditions.
Jan. 2013.
Key Findings:



The repeat visit rate within 30 days for mental health and substance abuse conditions is high in
the North West LHIN;
Sioux Lookout Meno Ya Win Health Centre’s repeat visit rate for mental health conditions
increased somewhat in 2011/12 to be higher than the North West LHIN’s target rate of 17.4%;
Sioux Lookout Meno Ya Win Health Centre’s repeat visit rate for substance abuse decreased in
2011/12 to below the North West LHIN target rate.
The North West LHIN’s 2012/13 target for repeat visits within 30 days for mental health conditions is
16.4% and for substance abuse conditions – 26.6%. The provincial targets have not yet been
determined.
Emergency Visits Related to Diabetes
The following table outlines the number of unscheduled visits to Sioux Lookout Meno Ya Win Health
Centre with diabetes as the main problem. The first section breaks the visits down by type of diabetes
(type I, type II or unspecified) and the second section breaks the visits down by type of complication.
Table 25: Emergency (unscheduled) Visits to Sioux Lookout Meno Ya Win Health Centre with
Diabetes as Main Problem, Fiscal Years 2009/10 to 2011/12
2009/10
2010/11
2011/12
<5
<5
By Type of Diabetes Mellitus (DM)
E100-E109 - Type I DM Visits
10
2009/10
2010/11
2011/12
153
141
191
19
27
<5
(E10-E14) DM Total Visits
182
172
197
Number of Patients
By Type of Complication
117
109
146
DM with Foot Ulcer, DM with Foot Ulcer with
Gangrene, DM with other Multiple Complications
70
65
58
DM other complications
80
107
130
DM no (mention of) complications
32
31
30
182
172
197
117
109
146
E110-E119 - Type II DM Visits
E140-E149 –Unspecified/Other Specified DM Visits
(E10-E14) DM Total
Number of Patients
Data Source: Ambulatory Care Main Table, intelliHEALTH ONTARIO; extracted March 14 2013.
Key Finding:
 The number of emergency visits to Sioux Lookout Meno Ya Win Health Centre for Diabetes
related problems has fluctuated between 172 and 197 visits over the last three fiscal years, with
an average of 124 unique individuals accounting for the visits.
Non-Urgent Emergency Visits
Sioux Lookout Meno Ya Win Health Centre accounts for 7.2% of the emergency visits in the North West
LHIN and 62.9% of these emergency visits in 2011/12 were classified as CTAS IV&V (non-urgent on noncomplex).
The % of emergency visits that were classified as CTAS IV & V levels at Sioux Lookout Meno Ya Win
Health Centre has decreased over the last three fiscal years from 84.8% to 70.2% to 62.9% but is still
much higher than the overall North West LHIN and provincial rates.
For all facilities in the North West LHIN in 2011/12, CTAS IV & V emergency visits accounted for 46.5% of
unscheduled emergency visits. Provincially, 41.2% of emergency visits are classified as CTAS IV &V in
fiscal year 2011/12.
ED Wait Times
There are three provincial indicators related to emergency room wait times that all LHINs and their
th
respective hospitals are accountable for. These indicators are 90 percentile ER length of stay for
th
admitted patients, 90 percentile ER length of stay for non-admitted complex patients (CTAS I-III) and
th
90 percentile ER length of stay for non-admitted minor/uncomplicated patients (CTAS IV-V).
The following table shows the indicator values for Sioux Lookout Meno Ya Win Health Centre along with
the overall North West LHIN’s target time and the provincial target time.
Table 26: ED Visit (unscheduled, emergency) Wait Times at Sioux Lookout Meno Ya Win Health
Centre
th
# of Visits
90 percentile
North West LHIN
Ontario
wait time (hours)
Target
Target
Emergency Visit Wait Times for Admitted Patients
2009/10
853
12.1
2010/11
893
8.9
2011/12
1,054
8.8
8 hrs. (interim 25.0 hrs.)
8 hrs. (interim 25.0 hrs.)
25.0 hrs.
25.0 hrs.
Emergency Visit Wait Times for Non-Admitted Patients, Complex (CTAS I-III)
2009/10
1,539
6.5
2010/11
6.6 hrs.
3,373
5.4
2011/12
6.5 hrs.
7.0 hrs.
4,750
5.1
Emergency Visit Wait Times for Non-Admitted Patients, non-complex (CTAS IV-V)
2009/10
2010/11
2011/12
11,355
9,481
9,386
3.3
2.9
3.2
4.0 hrs.
4.0 hrs.
4.0 hrs.
4.0 hrs.
Data Sources: NACRS, CIHI Portal; extracted Jan.31, 2013.
Key Findings:
 The emergency visit wait times at Sioux Lookout Meno Ya Win Health Centre for nonadmitted patients are below the North West LHIN’s annual targets.
th
 The 90 percentile wait time for admitted patients is slightly above the target value of 8 hours,
but well below the interim provincial target of 25 hours.

Sioux Lookout LHH Profile

Transcription

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