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(1)

Central LHIN Health Service Needs Assessment

and Gap Analysis:

(2)
(3)

Canadian Rehab Statistics and Highlights

•

Clients in the brain dysfunction, spinal cord injury and burn RCGs, among others, were much more likely to be admitted to a specialty facility than to a general facility, whereas clients in the orthopaedic, debility and arthritis RCGs, among others, were much more likely to be admitted to a general facility.

•

Clients admitted with spinal cord dysfunction had the longest median length of stay (43 days), while clients admitted with orthopaedic conditions had the shortest median length of stay (12 days).

•

Among clients admitted for stroke, the median length of stay was 34 days, with 25% of clients being discharged within 18 days and 75% of clients being discharged within 51 days.

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Overall, 84% of all clients that lived at home prior to admission returned home upon discharge. Ninety-two percent of clients admitted for major multiple trauma and 89% for orthopaedic conditions returned home, compared with 79% for medically complex, 78% for brain dysfunction and 75% for stroke.

(4)
(5)

Central LHIN Patient Age Groups Using Hospital Rehab Services (2006/07)

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Rehab services are used more predominately by females with spikes in Rehab utilization by ages greater than 65.

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Greater likelihood of Osteoporosis may account for Females.

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The greatest volumes (12.7% of all cases) are in the aged 75-84 category.

Age Group Total % Female % Male

15-19 9 0.1% 0.1% 20-24 29 0.4% 0.3% 25-34 57 0.4% 0.9% 35-44 69 0.8% 0.7% 45-54 281 3.4% 2.9% 55-64 601 7.7% 5.8% 65-74 1159 16.6% 9.4% 75-84 1572 22.6% 12.7% 85+ 671 10.8% 4.3% Total 4448 62.8% 37.2%

(6)

Rehab Hospitals Used by Central LHIN Patients (2006/07)

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Central LHIN residents predominantly used 3 hospitals for rehab services, St. John’s, York Central and Southlake.

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Most Central LHIN residents sought rehab treatments within the Central LHIN.

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Complex cases are most likely to receive treatment outside of the Central LHIN.

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The top 10 hospitals for rehab services are listed below.

Rank Institution Name Cases Percent

1 ST JOHN'S REHABILITATION HOSPITAL 1062 23.9%

2 YORK CENTRAL HOSPITAL 626 14.1%

3 SOUTHLAKE REGIONAL HEALTH CENTRE 507 11.4%

4 HUMBER RIVER REGIONAL HOSP-HUMBER MEM 305 6.9% 5 TORONTO REHABILITATION INST-QUEEN ELIZAB 266 6.0% 6 WEST PARK HEALTHCARE CENTRE (YORK CITY) 247 5.6%

7 MARKHAM STOUFFVILLE HOSPITAL 247 5.6%

8 PROVIDENCE HEALTHCARE (SCARBOROUGH) 196 4.4%

9 SUNNYBROOK HEALTH SCIENCES CENTRE-ORTHOP 156 3.5%

(7)
(8)

Central LHIN Rehab Patient Groups by RCG Codes (2006/07)

Description Assessments Percent

Cumulative Percent

ORTHOPAEDIC CONDITIONS - STATUS POST UNILATERAL

KNEE REPLACEMENT 997 22.4% 22.4%

ORTHOPAEDIC CONDITIONS - STATUS POST UNILATERAL

HIP REPLACEMENT 690 15.5% 37.9%

ORTHOPAEDIC CONDITIONS - STATUS POST UNILATERAL

HIP FRACTURE 364 8.2% 46.1%

ORTHOPAEDIC CONDITIONS – OTHER 262 5.9% 52.0%

STROKE - LEFT BODY INVOLVEMENT (RIGHT BRAIN) 190 4.3% 56.3% STROKE - RIGHT BODY INVOLVEMENT (LEFT BRAIN) 188 4.2% 60.5% ORTHOPAEDIC CONDITIONS - STATUS POST BILATERAL

KNEE REPLACEMENT 173 3.9% 64.4%

MEDICALLY COMPLEX - OTHER 146 3.3% 67.7%

CARDIAC 122 2.7% 70.4%

ORTHOPAEDIC CONDITIONS - STATUS POST REVISION OF

UNILATERAL HIP REPLACEMENT (CIHI CATEGORY) 108 2.4% 72.8%

(9)
(10)

Central LHIN Rehab Patient Groups (by DHC Codes)

Diagnostic Health Condition Code Description

Admit

Assessment Percent

Cumulative Percent

MUSKULOSKELETAL SYSTEM ARTHRITIC AND CONNECTIVE TISSUE

DISORDERS - OSTEOARTHRITIS AND ALLIED DISORDERS 1564 35.8% 35.8% INJURY AND TRAUMA FRACTURES AND DISLOCATIONS - FRACTURE OF

NECK OF FEMUR/HIP, UNILATERAL 455 10.4% 46.2%

CIRCULATORY SYSTEM VASCULAR - CEREBRAL INFARCTION 215 4.9% 51.1% MUSKULOSKELETAL SYSTEM DISORDERS OF JOINT REPLACEMENT

-STATUS POST JOINT REPLACEMENT-KNEE, UNILATERAL 175 4.0% 55.1% MUSKULOSKELETAL SYSTEM DISORDERS OF JOINT REPLACEMENT

-STATUS POST JOINT REPLACEMENT-HIP, UNILATERAL 97 2.2% 57.3%

SYMPTOMS, SIGNS AND ILL-DEFINED CONDITIONS - COMPLICATIONS OF

MEDICAL AND SURGICAL CARE, NOT ELSEWHERE CLASSIFIED 91 2.1% 59.4% INJURY AND TRAUMA FRACTURES AND DISLOCATIONS – FRACTURE OF

PELVIS 50 1.1% 60.6%

RESPIRATORY SYSTEM - CHRONIC OBSTRUCTIVE PULMONARY

DISEASE-UNSPECIFIED 44 1.0% 61.6%

CIRCULATORY SYSTEM VASCULAR - INTRACEREBRAL HAEMORRHAGE 43 1.0% 62.5% CIRCULATORY SYSTEM VASCULAR - OCCLUSION OF CEREBRAL

ARTERIES 43 1.0% 63.5%

(11)
(12)

Central LHIN Rehab Patient Length of Stay (LOS) (2006/07)

Description Discharges

Total LOS

(for Discharged Cases) Average LOS

ORTHOPAEDIC CONDITIONS - STATUS POST

UNILATERAL KNEE REPLACEMENT 945 8030 8.5

ORTHOPAEDIC CONDITIONS - STATUS POST

UNILATERAL HIP REPLACEMENT 649 7227 11.1

ORTHOPAEDIC CONDITIONS - STATUS POST

UNILATERAL HIP FRACTURE 332 6075 18.3

STROKE - LEFT BODY INVOLVEMENT (RIGHT BRAIN) 174 5968 34.3 STROKE - RIGHT BODY INVOLVEMENT (LEFT BRAIN) 169 5541 32.8

ORTHOPAEDIC CONDITIONS – OTHER 241 4666 19.4

MEDICALLY COMPLEX - OTHER 135 2694 20.0

ORTHOPAEDIC CONDITIONS - STATUS POST HIP

FRACTURE 60 1963 32.7

MAJOR MULTIPLE TRAUMA - OTHER 48 1884 39.3

ORTHOPAEDIC CONDITIONS - STATUS POST

REVISION OF UNILATERAL HIP REPLACEMENT (CIHI

CATEGORY) 104 1857 17.9

(13)

Central LHIN Rehab Patient Length of Stay (LOS) (2006/07)

Description Discharges

Total LOS (for Discharged Cases)

Average LOS (Days)

NONTRAUMATIC SPINAL CORD DYSFUNCTION

-QUADRIPLEGIA, INCOMPLETE C5-8 Less than 5 539 134.8

TRAUMATIC SPINAL CORD DYSFUNCTION

-PARAPLEGIA, INCOMPLETE Less than 5 167 83.5

NONTRAUMATIC SPINAL CORD DYSFUNCTION

-QUADRIPLEGIA, INCOMPLETE C1-4 Less than 5 206 68.7

NONTRAUMATIC SPINAL CORD DYSFUNCTION

-PARAPLEGIA, UNSPECIFIED Less than 5 67 67.0

TRAUMATIC SPINAL CORD DYSFUNCTION

-QUADRIPLEGIA, INCOMPLETE C5-8 Less than 5 197 65.7

NONTRAUMATIC SPINAL CORD DYSFUNCTION

-PARAPLEGIA, INCOMPLETE 13 828 63.7

BRAIN DISFUNCTION TRAUMATIC - OPEN INJURY Less than 5 63 63.0 TRAUMATIC SPINAL CORD DYSFUNCTION

-PARAPLEGIA, COMPLETE Less than 5 176 58.7

TRAUMATIC SPINAL CORD DYSFUNCTION

-QUADRIPLEGIA, COMPLETE C5-8 Less than 5 108 54.0

NEUROLOGICAL CONDITIONS – POLYNEUROPATHY Less than 5 103 51.5

Central LHIN Rehab Top 10 RCGs by Average LOS (Days)

(14)

Central LHIN Rehab Patient Length of Stay (LOS) (2006/07)

Description Discharges

Total LOS (for Discharged Cases)

Average LOS (Days)

ORTHOPAEDIC CONDITIONS - STATUS POST KNEE

REPLACEMENT 33 385 11.7

ORTHOPAEDIC CONDITIONS - STATUS POST

BILATERAL KNEE REPLACEMENT 160 1856 11.6

BRAIN DYSFUNCTION - OTHER Less than 5 23 11.5

ORTHOPAEDIC CONDITIONS - STATUS POST

UNILATERAL HIP REPLACEMENT 649 7227 11.1

ARTHRITIS - OTHER ARTHRITIS Less than 5 21 10.5

ORTHOPAEDIC CONDITIONS - STATUS POST REVISION OF UNILATERAL KNEE REPLACEMENT (CIHI

CATEGORY) 64 600 9.4

ORTHOPAEDIC CONDITIONS - STATUS POST

UNILATERAL KNEE REPLACEMENT 945 8030 8.5

ARTHRITIS - OSTEOARTHRITIS Less than 5 31 7.8

AMPUTATION OF LIMB - SINGLE UPPER EXTREMITY

ABOVE THE ELBOW (AE) Less than 5 7 7.0

NEUROLOGICAL CONDITIONS - PARKINSONISM Less than 5 10 5.0

(15)

Central LHIN Patient Rehab Discharge Reasons

•

Over 85% of service goals were met and released to the community. Slightly higher than the national average.

•

A further 8% met their service goals and were released/transferred to another facility.

•

Note: 6.2 % of service goals are NOT met. An additional 0.5% withdraws, die during rehab treatment, or move.

Discharge Reason Code Description Discharges %

SERVICE GOALS MET AND DISCHARGED TO COMMUNITY

(PERMANENT LIVING SETTING) 3509 85.3%

SERVICE GOALS MET AND REFERRAL/TRANSFER TO OTHER

UNIT/FACILITY 328 8.0%

SERVICE GOALS NOT MET AND REFERRAL/TRANSFER TO OTHER

UNIT/FACILITY OR DISCHARGED 255 6.2%

PERSON WITHDREW (AGAINST PROFESSIONAL ADVICE) 11 0.3%

PERSON DECEASED 9 0.2%

PERSON MOVED Less Than 5 0.0%

(16)

Central LHIN Rehab Transfers

•

The table below reflects volumes of transfers of Central LHIN patients from hospital settings to a rehab institute. Toronto hospitals reflect the more

complex patients being transferred.

Institution

Type Hospital Name

Transfer

Counts %

Acute SOUTHLAKE REGIONAL HEALTH CENTRE 629 14.1%

Acute YORK CENTRAL HOSPITAL 624 14.0%

Acute NORTH YORK GENERAL HOSPITAL 585 13.1%

Acute SUNNYBROOK HEALTH SCIENCES CENTRE 495 11.1%

Acute HUMBER RIVER REGIONAL HOSP-HUMBER MEM 364 8.2%

Acute MARKHAM STOUFFVILLE HOSPITAL 311 7.0%

Acute ST MICHAEL'S HOSPITAL 189 4.2%

Acute UNIVERSITY HEALTH NETWORK 189 4.2%

Acute HUMBER RIVER REGIONAL HOSP-YORK-FINCH 184 4.1%

References

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