New LHIN report says chronic disease, not graying population driving regional health care
A new report by the South East Local Health Integration Network (LHIN), the regional planning and coordinating health care agency, shows that while the population of Southeastern Ontario is getting older, the aging trend itself will not be a major cost driver in health care. Instead, chronic diseases, such as diabetes, cancer and heart disease, are the determining factor in health care costs. Many of these patients are being cared for in hospitals and often end up as Alternate Level of Care (ALC) patients – those who remain in hospital beds because they cannot return home or access a long-term care bed. The region has the third highest ALC rates in Ontario.
The report, called Regional Capacity & Assessment Projections, says the region’s 65+ population is expected to increase by approximately 21,000 from 2006 to 2011, representing a 4.3% increase. Data projections suggest that both the 65- 74 and 75+ age groups will increase in volume, but only the 65-74 age group will increase in percentage growth. Although the per capita health spending for persons aged 65+ averaged three to five times more than for younger individuals, the aging of the population is too gradual a process to rank as a major cost driver in health care.
Compared to the rest of Ontario, the region has a higher frequency of chronic diseases. Arthritis/rheumatism, diabetes, asthma, heart disease, cancer and high blood pressure are all found in higher frequency. In fact, the prevalence of chronic disease has been steadily increasing over the recent years (2001 to 2005). As expected, older age groups have higher prevalence of chronic diseases with the 65+ having the highest prevalence. Overall, these diseases account for slightly less than 90% of all deaths. Health Canada predicts that deaths from chronic diseases will likely increase – most markedly, deaths from diabetes will increase by 44%.
The report says the rate of Alternate Level of Care or ALC days (as a percentage of total hospital days) is an important indicator of health system performance. High numbers of ALC patients occupying hospital beds can result in surgical cancellations and a high number of admitted patients in the Emergency Department waiting for a bed in the hospital. For the region 17.2% of total acute inpatient bed days were ALC days in 2007, which compared to the provincial average of 14%. The South East LHIN rate was actually the third rate among all 14 LHINs in the province. The province target for 2009-2010 is 13%. The report says the greatest number of ALC “separations”, or patient stays, was at KGH. In 2007, KGH had 35% of all ALC separations. QHC–Belleville site had the second highest separations. Collectively these two hospitals accounted for two-thirds of the ALC patients.
