OTTAWA — More than 51,000 Canadians in one year alone were treated in a hospital in a province other than their own, according to a new report. The study released Tuesday by the Canadian Institute for Health Information shows there were 51,092 out-of-province patients who stayed in hospitals in 2007-2008.
This is the first time CIHI has tracked how many Canadians get cross-border health-care, for what procedures, and among which provinces there is the greatest movement.The 51,092 patients who had a hospital stint in a place where they didn't live represents just two per cent of all hospitalizations in Canada that year."I don't think that's unreasonable, especially considering how much people travel across the country," said Kira Leeb, director of health systems analysis at CIHI. As the report notes, most of the out-of-province hospital admissions — 63 per cent — were for urgent cases. That suggests most patients weren't purposely leaving home for treatment, but may have been away for work, school or vacation when a medical emergency happened.
In other cases, patients flow between jurisdictions because in border cities the closest hospital may be in the province next-door, or, specialized services may not be offered close to home. The latter is often the case with patients from the territories, who regularly travel to British Columbia, Alberta, Manitoba and Ontario for hospital services, the report said. The conditions for which patients were treated in a province other than their own varied. In Manitoba, for example, pregnancies and childbirth accounted for the majority of out-of-province hospitalizations whereas in Alberta, circulatory conditions were the top reasons behind non-resident hospitalizations.
The CIHI report found that maternal and newborn hospital stays accounted for almost one-quarter of the total number of out-of-province hospitalizations and 64 per cent of those were planned admissions. The Champlain region in Ontario, the Prairie North region in Saskatchewan and the Winnipeg region in Manitoba accounted for half of the childbirth-related stays.Leeb said it makes sense for patients to travel outside of provincial borders for certain services, but for other patient populations, such as pregnant women and newborns, it may make more sense to try to treat them closer to home. "If the provinces are aware of patients that are going out to receive care, they can look at ways to repatriate them and look at ways to provide the service at home," she said.Alberta took in the highest number of non-resident patients, at 25 per cent, followed by Ontario, which saw an inflow of 20 per cent of all of the out-of-province hospital stays. A large majority of those Ontario hospitalizations were patients from the Outaouais region of Quebec, which borders the Champlain region of eastern Ontario."A shortage of family physicians and overcrowding in Quebec hospitals are believed to be responsible for this phenomenon," the report said.Another hotspot for cross-border health care was Lloydminster, where residents on the Alberta side of the city regularly cross to the Saskatchewan side where the Lloydminster Hospital is located.The highest outflow of patients came from the territories. More than half of Nunavut residents, for example, that were hospitalized in 2007-2008 traveled to a hospital outside of Nunavut.
How far patients were from home depended on the reason for hospitalization, the report noted. Pregnant women and newborns were an average of 78 kilometres from home while patients in an intensive care unit were four times further away.Alberta and Ontario not only took in the most out-of-province patients, they also hosted close to half of all the patients who had expensive procedures done, including a transplant or pacemaker insertion.The pricetag for the provinces paying each other to treat non-residents totaled about $313 million in 2007-2008, but that figure excludes Quebec. Under the Canada Health Act, Canadians can receive hospital care when temporarily absent from the province that issued them a health card and the provinces and territories have agreements in place to bill each other for the services.