paul rosebush

8/17/2019 Paul Rosebush

1/17

Operational Challenges of

Providing Services to a Small Community

A Small, Rural and Remote Health PerspectivePaul Rosebush, President and CEO, South Bruce Grey Health Centre


2/17

South West Ontario


3/17

∙Kincardine

∙Chesley

∙Durham

∙Walkerton

GreyBruce


4/17

Catchment Population

2001

(actual)

2006

(actual)

2011

(actual)

2016

(estimate)

2021

(estimate)

Bruce County 66,400 65,349 66,102 68,870 70,050

Grey County 92,600 92,411 92,568 99,590 102,310

Actual and Forecast Population Growth in Bruce and Grey Counties

Municipality 2006 population 2011 population 5-year growth

Kincardine 11,173 11,174 0.0%

Brockton 9,641 9,432 -2.2%

Southgate 7,072 7,190 1.7%

Huron-Kinloss 6,515 6,790 4.2%

South Bruce 5,939 5,685 -4.3%Durham 2,768 2,823 2.0%

Chesley 2,010 2,015 0.2%

West Grey 12,288 12,286 0.0%

Arran-Elderslie 6,747 6,810 0.9%

5-Year Growth Rates for SBGHC’s Catchment Area Communities (2006-2011)


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6/17

Population Estimates Age 45-64 and 65+

Grey and Bruce County 2013

30.80% 31.14%

21.70% 21.89%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

Grey Bruce

45-64 65+


7/17

Population Estimates Age 45-64 and 65+

Grey and Bruce County 2020

28.16%

26.64%

25.83%

26.72%

24.50%

25.00%

25.50%

26.00%

26.50%

27.00%

27.50%

28.00%

28.50%

Grey Bruce

45-64 65+


8/17

INPATIENT VOLUMES

37.9%42.4% 40.2%

12.6%

15.5%

12.3%

20.2%

19.0%

16.2%

23.4%

18.0%

23.2%

5.9% 5.2% 8.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

SBGHC GBHS HDH

90+

80 to 89

70 to 79

60 to 69


9/17

INPATIENT DISPOSITION

Patients Aged 60+

Disposition Separations Avg LOS % ALC

Days

Avg HIG

Wt*

Transfer to Acute 1030 6.1 4.6% 1.36

Transfer to Continuing Care 814 16.0 42.6% 2.27

Transfer to Other 56 4.1 0.0% 0.92

Home or home setting with support 2829 7.8 4.7% 1.55

Home 2632 4.3 1.3% 1.03

Left AMA (against medical advice) 22 6.9 0.0% 1.17

Died 573 10.3 25.6% 2.05

Patients who do not return from a pass 1 3.0 0.0% 0.48


10/17

Emergency Department Volumes

70.4% 70.1% 69.5%

12.7% 12.2%10.6%

9.6% 9.7%9.8%

6.2% 6.7%8.2%

1.2% 1.3% 1.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

SBGHC GBHS HDH

90+

80 to 89

70 to 79

60 to 69


11/17

ALL EMERGENCY DEPARTMENT VISITS

By CTAS and Age Group

(1) LifeThreatening

(2)Emergent

(3) Urgent (4) LessUrgent

(5) NonUrgent

Unknown/Blank

Total

Total 203 5394 16732 19402 4673 170 46574

60 to 69 years 69 1832 6320 8507 2165 79 18972

70 to 79 years 74 1792 5364 6182 1564 57 15033

80 to 89 years 40 1429 4166 3977 837 32 10481

90+ years 20 341 882 736 107 2 2088

% Total Visits 55.9% 43.7% 31.9% 26.3% 28.9% 25.6% 29.9%


12/17

So What?

Healthcare in rural settings is increasingly

becoming seniors focused care


13/17

Health System Barriers to Developing

Age-Friendly Communities

1. Access to Primary Care

2. Access to Specialists3. Fragmented Care

4. Changing Direction of Care

5. Transportation Costs (Non urgent)


14/17

6. Weather and Geography

7. Lack of Rehabilitation and Personal Support

8. Lack of Public Fitness Centres9. Income Disparity

Additional Factors


15/17

How Hospitals and Health System can Help

Reduce ER Visits Better Care

Reduce ALC Quality of Life

Improve Transitions in Care Better Care

Increase Home Support Quality of Life


16/17

Moving Forward

• Break Down Health Silos

• Better Coordination

•

One Brand• Hubs or Links


17/17

Thank-You

Paul Rosebush

President and CEO

South Bruce Grey

Health Centre

519-370-2400 ext. 2417

[email protected]
mailto:[email protected]:[email protected]

paul rosebush

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