Far too few patients at many rural hospitals
At the Big Country Hospital in Oyen, near the Saskatchewan border, the facility’s 10 in-patient beds are not full.
Indeed, the hospital’s occupancy rate is just 35.1 per cent, the lowest in the province, according to Alberta Health Services statistics. That means, on average, about six of the 10 beds are not being used every day.
The situation is virtually the same at the Elk Point Healthcare Centre, which has an occupancy rate of 35.6 per cent for its 12 beds.
Meanwhile, at the Hardisty Healthcare Centre, a mere 1,995 people showed up to its emergency department in 2012-13. That’s just five or six people every 24 hours. Last year, the number jumped to 2,724 visits, yet still an average of only seven or eight per day.
As the Alberta government faces increasing maintenance costs around the province at its hospitals, how much the facilities are being used — and whether that usage justifies their expensive operational costs — needs to be a consideration when determining whether to repair or rebuild the aging structures, or close them.
An Edmonton Journal analysis shows that of Alberta’s 82 rural hospitals, 47 have an average occupancy rate of less than 75 per cent. That means at least a quarter of their in-patient beds are not being used on a typical day. Among that group, 25 hospitals have an occupancy rate of less than 60 per cent.
In contrast, almost every urban hospital has an occupancy rate well over 90 per cent.
The analysis further shows there are about 15 rural hospitals that receive, on average, fewer than one in-patient per day. Around 40 hospitals receive fewer than two.
Similarly, while the busier urban emergency departments typically handle more than 200 visits per day, there are 21 rural ERs that see fewer than 20 patients daily.
And Alberta Health reports suggest about three-quarters of the visits at these rural ERs are for semi or non-urgent issues that could potentially be handled in a doctor’s office or clinic.
The statistics match what some experts argue, that many rural hospitals are mostly serving as glorified walk-in clinics.
“The statistics are that most rural people, even if they are only a few miles or blocks away from their hospitals, oftentimes bypass those hospitals and go to the city if they have got an emergency,” says Donna Wilson, a University of Alberta nursing professor who conducted a study in 2009 that looked at admission trends in small hospitals.
“And even if they do go into the emergency department in their town, they are immediately transferred to the big city hospital,” says Wilson, who also ran for the Liberal party in the recent Edmonton-Whitemud byelection.
“People have a real sense of safety if there is a hospital nearby, but it’s not clear they are actually using it that often.”
Yet, as with all trends, there are a few startling exceptions. The hospital in Strathmore, a fast-growing area about 50 kilometres east of Calgary, is one of the busiest rural sites in Alberta with close to 85 patients a day visiting the emergency department. It has an occupancy rate of 92 per cent, which means its 23 in-patient beds are almost always close to being full.
AHS says an $85-million expansion and redevelopment is now urgently required and is currently listed one of the health authority’s top 15 infrastructure priorities.
“The greatest risks of not doing this project are already evident in Strathmore’s current struggle to provide adequate emergency care to the community and its surrounding rural residents,” a recent AHS internal report on the project says.
Cold Lake, in northeastern Alberta, is another example of a growing community with an increasingly crowded emergency room that may need to be expanded in the near future. Unlike Strathmore, it has three operating rooms and does about 1,000 surgeries a year, which contributes to its above-average occupancy rate. It’s also one of only five rural sites with an MRI machine.
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