Sunday, December 2, 2007

Jim Bradley and the entropy of Ontario's health care

Here’s a story by James Wallace, “Troubling mortality rates in Ontario hospitals, St. Catharines General among highest mortality rates in the province”, (St. Catharines Standard, Dec.1, 2007):

“Take any two patients with similar conditions and complications and separate them by geography.
One in Ontario, one in Alberta.
Which one is most likely to die in hospital?
A new national review of Canadian hospitals published this week by the Canadian Institute for Health Information (CIHI) provides a discouraging answer - the Ontario patient.
You are also generally more likely to die in a hospital here than in Saskatchewan, British Columbia or New Brunswick.
In fact, hospital mortality rates in this province, at best, are run-of-the-mill.
"Ontario is pretty average, that's the message I see," Dr. Ross Baker, a leading researcher on patient safety, said after reviewing the CIHI report.
This despite the fact that Ontario's health-care spending hovers near $38 billion this year (or 46 cents of every dollar it spends) and dwarfs health-care spending by most other provinces outside of Quebec.
Our average performance comes despite a 30 per cent increase in health-care spending by Ontario's Liberal government since 2003 and a boost in direct hospital funding of $2.7 billion to $17.5 billion over that same time.
Nationally, the study found considerable variation in mortality rates not only between hospitals but among provinces.
This is cause for concern.
CIHI spent two years refining the statistical measuring tool it used to create an apples-to-apples comparison among Canadian hospitals.
The "hospital standardized mortality ratio," or HSMR, is not a perfect measuring tool but broadly compares the actual number of deaths in individual hospitals and regions to expected and national numbers.
An HSMR ratio of 100 is equal to the national average.
The study found the lowest mortality ratios in Saskatchewan (which had regional ratios as low as 69) and the western provinces (along with New Brunswick). The highest regional ratios at 121 were in the Maritimes.
Put another way, mortality rates for patients in Newfoundland were 21 per cent higher than the national average and 52 per cent higher than for Saskatchewan patients.
In Ontario, there was considerable variation among individual hospitals and regions.
Hospitals in northwestern Ontario had a ratio of 85 and showed reduced fatalities during the past three years.
The Erie St. Clair health region, including Sarnia and Chatham, was more typical with a ratio of 102 and saw an increase in death rates.
The ratio in southwestern Ontario was 105, it was 101 in Waterloo Region, including Cambridge, ranged between 97 and 102 in and around Toronto, 108 in the Central East (including Peterborough and some of the Greater Toronto Area's east end), a point under 100 in the Kingston, Belleville and South East region, 90 in Cornwall and surrounding areas, about the same in Collingwood and North Simcoe and 93 in northeastern Ontario including North Bay, Sudbury, Timmins and the Sault.
Ratios for individual hospitals, however, varied greatly.
At the high end, Kitchener's Grand River hospital had a ratio of 142; the Niagara Health System's St. Catharines General site was 135; the Scarborough Hospital general site 134 and the London Health Sciences Centre at 112.
Again, the numbers mean mortality rates at the St. Catharines hospital, for example, are 35 per cent higher than the national average.
Among the best were Hamilton's Health Science's facility with a mortality ratio of 84, Sault area hospitals at 86 and Sudbury Regional Hospital at 88.
By way of comparison, the Moncton Hospital in New Brunswick had a ratio of 56.
The CIHI study revealed other interesting facts on death and hospitals - the odds of a man dying in hospital is nine per cent higher than for a woman. You are more likely to die in hospital if you are an emergency patient, if you are transferred from another hospital, if you are in hospital for more than nine days or suffer from chronic conditions.
More than a quarter-million Canadians died in hospital between April 2004 and March 2007.
And the most common causes of death in hospital include respiratory failure, infection (septicaemia), lung cancer, heart attack and disease, pneumonia, stroke and hip fractures.
We are not, however, doing a good enough job of preventing needless deaths by reducing medical errors, prescription mistakes, adopting best care practices and other measures to lower patient death rates closer to levels achieved by the best hospitals in this country, the study suggests. That's particularly the case in Ontario.
"Hopefully the report will spark some investigation into disparity among Canadian hospitals," Baker said. "There is a general trend toward improved quality and safety.
"But I don't think we should be satisfied with a general trend." "

Liberal MPP Jim Bradley has some explaining to do, doesn't he? Remember how his Liberal 's so-called Commitment to the future of medicare act was supposed to solve all of Ontario's healthcare problems?

Well, St. Catharines General, the major hospital in all of Niagara Region, the main hospital in Jim Bradley's own riding , is among the worst in Ontario for mortality rates.

Will Jim Bradley blame others for this shameful healthcare performance in his own riding, or will he admit his own authoritarian health policies are failing? Jim Bradley is quiet about these results. No loud rhetoric and puffery being decanted from Jim Bradley on this, yet another, oh-so-proud, stellar Liberal healthcare achievement.

Jim Bradley and his entrenched left-wing liberal beliefs have guided St. Catharines, and Ontario, to healthcare entropy.

Remember all the healthcare debate and discussion Jim Bradley engaged in prior to the Oct. 2007 election? Neither do I, because there was none. Bradley pretended all was well with healthcare. He briefly mentioned that his Liberals socialized some diagnostic clinics and well, here we are ! All's good! (Was he refering to the MRI clinics which McGuinty and Co. nationalized, for no good reason, in 2004?)

When we voted, did we know Bradley was running the Dead Zone hospital system? And, the worst thing is, there is absolutely NO OTHER CHOICE AVAILABLE to us. There is nowhere to turn to BUT the Bradley/Smitherman/McGuinty Liberal death-trap monopoly health system. Patients in Niagara have no other private parallel system to turn to when in need and when Bradley's government fails to deliver. Take it, or leave it, say the Liberals, like they have said to many Ontarians in the past, including Suzanne Aucoin (at whose memorial service Jim Bradley had the shameless audacity to speak).

This report is a ringing endorsement, yet again, of the failures of no-choice, non-competitive, government-run health care.

Will this report 'spark investigations'? Yeah, sure. It'll be buried and dismissed by the Liberals. Or, will St. Cathariners proudly sit back, put on their blinders, and say, 'well now, we elected good ol' Jim Bradley here, and we're satisfied with what he's done. We're not exactly sure what he actually has done, but we're supporting him doing more of it. Jim's got nothing to do with all these problems...why, Jim's here to fix them for us - he's been fixin' 'em for thirty years' !

It looks likely that four more years of suffering and death is in store for Ontarians under Bradley's and the rest of the Liberals ideological healthcare haze.

Wallace writes that healthcare spending in Ontario is at 46% of all government spending . During the televised leaders' debate in Sept. 2007, McGuinty said health spending was half of our budget. Was McGuinty already fudging figures on his costliest ministry? A 4% variance on some 38 billion tax-payer dollars is nothing to take lightly.

By the results we're seeing, is that tax-money being well utilized by the government, or should patients have more control of how and where we spend our own taxed health-dollars?

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