Report slams private care homes
Says seniors there more likely to die in hospital
VICTORIA — B.C.’s seniors advocate has ignited a fiery debate over the types of elder care facilities in B.C., with a report that says seniors who live in privately run care homes are far more likely to die in hospital than those who live in publicly run care homes.
The report, released Wednesday, said a senior in a facility run by a private company, a non-profit or a religious organization was 32 per cent more likely to be sent to an emergency department and 54 per cent more likely to die while there.
The seniors advocate, Isobel Mackenzie, called the discrepancy “stunning” and wrote that private operators appear to be persistently failing compared to publicly run facilities when it comes to keeping seniors out of hospital emergency rooms, where their health is threatened by stress, a lack of mobility and hospital-acquired infections.
Reducing the rate of ER visits could save B.C.’s health system $16 million a year, free up 15,481 beds and fund half a million additional care hours a year, she estimated.
The research intrigued B.C.’s health minister, led to calls of caution from academic experts and sparked an immediate backlash from the group that represents private care providers.
“Hospitals are not the best place for the frail elderly,” Mackenzie said in a statement. “We also know that most people want to die at home and for many of our frail and elderly seniors, ‘home’ is the residential care facility. With a rate more than double the public facilities, we really need to ask why contracted care facilities are seeing their residents die in the hospital.”
Almost 28,000 seniors in B.C. live in 293 publicly subsidized facilities. Roughly onethird of beds are operated by a public health authority. The rest are run by contractors who receive funding from the government.
Private care homes attacked the report, suggesting the research should be peer-reviewed for accuracy and accusing Mackenzie of instilling “fear and uncertainty” with questionable suppositions. Mackenzie said advisers from two B.C. universities helped her staff with analytical models that were independently verified as producing accurate figures.
“I caution the media and the public to really look hard at this report and make sure the source data and where it’s come from are accurate,” said Daniel Fontaine, CEO of the B.C. Care Providers Association, which represents most of B.C.’s private contractors.
Fontaine said the report only looked at a small number of visits by seniors to six emergency departments and is not representative of rural and remote areas and did not substantiate whether the visits to the ER were inappropriate or not.
Health Minister Adrian Dix said the research has raised important issues.
“I think the numbers shown, that is pretty clear. But to draw too many conclusions, is not. I’m not, for example, saying the fact we’re understaffing private care homes is the cause of this. But it is a quality of care issue — that is beyond any doubt.”
Why private facilities have such higher hospitalization rates was not answered in Mackenzie’s research. She questioned whether factors could include the skill mix of private staff, a lack of stable clinical leadership, and generally lower pay rates.