New report shows St. Joe's lives our Mission, Vision and Values in service of our local communityJune 5, 2012 Hospital Care for All, released by St. Michael's Hospital, shows that higher and lower income patients are hospitalized for different reasons and that different hospitals in the Toronto Central Local Health Integration Network (TC LHIN) serve different income groups.
"This report is intended to provide data to better understand the socio-economic status (SES) of our patients so that hospitals in the TC LHIN can provide excellent care for all patients regardless of who they are, where they live and what they earn," said Rick Edwards, Director, Patient, Family and Community Engagement at St. Joe's. He was also part of the working group that advised on the report.
Edwards explains that from a St. Joe's perspective the data show that we serve a relatively higher proportion of lower income people, mostly those living within the TC LHIN.
"The data show this especially with mental health patients – the pattern is what we would expect based on our catchment area," he said. "The report confirms what we would expect as a community hospital - that we are serving the local community and that the SES profile of people coming through our doors is pretty much the profile of that community. It does raise some questions, however, in the context of assumptions about the relationship between need and income."
While this Report is descriptive only – it just describes the SES profile of hospital visits; it does not say whether or not this is the 'right' profile - it does prompt questions about equitable access to service. "For example, key findings for hospitals overall showed that higher income earners received day surgeries more than low income patients. Yet we know that lower income people tend to be less healthy than higher income people, so we would expect them to need more surgery as well. That higher income patients receive a higher proportion of day surgeries leads to more questions about what barriers lower income patients might face to access this type of service (i.e. they may not be able to take a day off work, may work multiple jobs to make ends meet, there is no family support to bring them to/from procedures)," said Edwards. Data also showed that a higher number of lower income patients sought care for mental health issues, used Emergency Departments for non-urgent care and remained in acute care beds longer. Again, barriers that lower income patients face – such as dealing with stress of everyday life, poorer living/social conditions, lower literacy levels, less social support – all might contribute to the pattern of health care access and use for these individuals.
From a provincial and LHIN perspective, the report is an important stepping stone to address concerns with access to care for all people. Currently all we really know about patients who come to the hospital are their age and gender and the medical needs they present with, Edwards explains. We have not known whether access to hospital care differs by race or ethnicity, education or income, disability, or living in various geographic localities, all factors that might influence how equitable is the access to service. Now at least information on the income profile and LHIN of residence of patients using Toronto hospitals is available.
"Certainly more research needs to be done to understand the patterns found in this report, but now we can ask data-based questions," said Edwards.
Serving all in our community, especially those populations who are marginalized and disenfranchised, is the core of our Mission, Vision and Values at St. Joe's. "We know that lower income individuals tend to be more sick and have more health complications, therefore would access health care services more frequently. But this is a system-wide concern, not something one hospital can address on its own. The report will be helpful for all hospitals in the TC LHIN, as we are committed to working together to address health equity issues across the system," says Edwards.
Page last updated: March 25, 2011