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Better budgets

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Manitoba's hospitals spend more on patients than the national average, a good reason to examine where the expenses are racking up. The analysis by the Canadian Institute for Health Information shows the province and the Winnipeg region rack up more "nursing" hours per case than do other jurisdictions.

This is not a new story. Manitoba's hospital costs have outstripped national averages for years. This province for years has kept patients in hospital much longer, which naturally hikes that cost overall.

The CIHI study says the average cost to treat a patient in Canada was $5,231 in 2010; Manitoba's average was $5,459. In Winnipeg, this ranged from Health Sciences Centre's $6,091 to Seven Oaks' $5,043. These averages take into account the kind of case -- condition and age of patient -- the hospitals admits.

In particular, the hospitals scored high in the number of nursing unit -- nurses, therapists, managers and supervisors -- hours spent per patient. In Winnipeg, only Concordia hospital compared well for "nursing" hours. (Oddly, Brandon General Hospital has a lower cost per case than the national average, but a higher number of nursing hours.)

The WRHA notes that it may be batting above national averages on its costs, but that's the cost of good hospital care, pointing to CIHI results in which Winnipeg hospitals compared well on mortality and readmission rates. At the same time, it concedes that there is work to be done in cutting lengths of stay -- the real driver on costs.

Manitoba's hospitals are funded primarily with global budgets, a lump sum that is increased each year to keep up with inflation. Other jurisdictions have moved to funding on volume, or a cash per procedure reimbursement, which focuses on productivity.

Applied haphazardly, volume funding can hurt small hospitals where baseline costs naturally push up cost per patient. But applied judiciously, it can get hospitals away from thinking they can bank on annual hikes to budgets, but must earn their cash in productivity and good care.

Editorials are the consensus view of the Winnipeg Free Press’ editorial board, comprising Catherine Mitchell, David O’Brien and Paul Samyn.

Republished from the Winnipeg Free Press print edition May 7, 2013 A8

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