HSN readmission rate among Ontario's highest, data shows

Ontario has the highest hospital readmission rate of any province, excluding Quebec, and the numbers in Sudbury are especially high, says the Ontario Council of Hospital Unions.

“We're (Ontario) the worst in the country,” said Michael Hurley, president of the Ontario Council of Hospital Unions, which bargains collective agreements on behalf of Canadian Union of Public Employee (CUPE) hospital workers.

Hurley and his colleagues gathered the statistics from the Canadian Institute for Health Information, which draws its numbers from hospital databases.

Between 2009 and 2014, the number of Ontario patients readmitted to hospital increased from 8.3 per cent to 9.1 per cent.

The increase was the highest of any province, said the Ontario Council of Hospital Unions.

At Health Sciences North, 8.8 per cent of patients were readmitted to hospital in 2009, and 9.7 per cent were readmitted in 2013. In 2014, readmission was down slightly to 9.6 per cent of patients.

Hospital inpatient days per capita in Ontario dropped by 13.4 per cent over the last four years.

In the rest of Canada (again excluding Quebec which doesn't submit its statistics to the Canadian Institute for Health Information), inpatient days per capita increased 8.4 per cent over the same period.

Hurley said a provincewide funding freeze — which has entered its fourth year — was to blame for Ontario's higher readmission rates and shorter inpatient hospital stays.

He said the two are related, since fewer inpatient days can lead to complications after a patient is discharged from hospital, which means they eventually have to be readmitted.

Hurley added Ontario hospitals have lost 20 per cent of their budgets in real terms, because many costs – for drugs and equipment for instance – have increased beyond the rate of inflation over the past four years.

But Dr. Chris Bourdon, Health Sciences North chief of staff, said the readmission question is not so black and white, and a higher rate can't be linked solely to early discharges.

“This is a very complicated problem,” he said. “(But) I wholeheartedly agree this is a metric that needs to be tracked so we know how we're doing and continue to minimize potential risk to our most vulnerable.”

Bourdon said the hospital has a number of programs in place to identify patients with chronic conditions who might be at risk of readmission, and give them the support they need to receive care in the community after they are discharged.

For instance, when a patient is discharged after congestive heart failure, staff with the hospital's congestive heart failure clinic will follow up with them from home.

But even with more programs in place, Bourdon said hospital readmissions will always exist.

“We're still in an era where sometimes the patient preference is just to be in the hospital,” he said.

And while palliative care, for example, is often preferable in a home or hospice setting, Bourdon said Health Sciences North will do its best to accommodate patients who want that care in hospital instead.

But Bourdon added he expects readmission rates at Health Sciences North to decrease as the hospital continues to form more partnerships with home and community care providers.