Cost versus care

Finding cost efficiencies have become a necessary part of health care delivery. But how much is too much?

The consolidation of medical services seems a logical progression of a regionalized health care system. Rather than individual hospitals offering a full complement of programs,  different services are concentrated at different locations. The result is a bigger bang for the buck;  A few strong departments, rather than several weak ones.

At least that’s how it looks on paper.

The reality will be played out at Chilliwack General Hospital after the Fraser Health Authority decided last week to close CGH’s six-year-old rehab clinic. Instead of offering in-hospital care, the unit will provide out-patient resources. Those patients requiring in-hosptial support will be transferred to hospitals in Port Moody, Surrey or Abbotsford.

According to the FHA, the change is being done because of successful results elsewhere.  Not only do patients recover faster, the health authority argues, but the out-patient model allows the program to treat more people.

More than a few in Chilliwack are a little skeptical.

The reality is that health care eats up roughly 40 per cent of every dollar spent by the Province of B.C. Lowering that number has been the pursuit of hospitals and health authorities for decades. And one of the best ways to reduce costs is to reduce the length of hospital stays.

Granted, most people would choose home over hospital as a place to recover. However that scenario only works if there are sufficient resources in the community to provide that care.

And there’s the rub.

Without that, the responsibility for caring for patients who were previously recovering in hospital falls to the family, who may be unable or incapable of providing that support.

It would be unfair to suggest decisions prompting the rehab unit’s closure were based purely on economics.

However, when dollars become tight, as they have been for years, finding cost efficiencies have become a necessary part of health care delivery. They are an integral part of an evaluation process that tries to balance patient care with available resources.

The challenge is ensuring money does not become the overriding factor.