Health Services in Niagara

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Number of Specific Health Facilities in Niagara

The Ontario Ministry of Health and Long-Term Care (MOHLTC) mandate to transform and integrate the health system with the patient in mind is resulting in changes to the health care system in Niagara.

The MOHLTC Patients First discussion paper was released in the Fall of 2015 and consultations were held Winter/Spring 2016. The Ontario Patients First Act was introduced in June, 2016 and passed in December, 2016.  Notable changes to the system include:

  • Sub-Regions have been created within the Hamilton, Niagara, Haldimand, Brant (HNHB) Local Health Integration Network (LHIN), “to better understand and address patient needs at the local level”.  In the Niagara region, there are two HNHB LHIN sub-regions: Niagara North West (geographic area including Town of Lincoln, Town of Grimsby and Township of West Lincoln); and Niagara (geographic area including City of St. Catharines, City of Niagara Falls, Town of Fort Erie, Town of Pelham, City of Welland, City of Port Colborne and Township of Wainfleet).

LHIN Sub-Region Anchor tables are being formed, to:

  • Assess local population health needs, patient access and health provider capacity
  • Identify and implement priorities for sub-region collaborative initiatives to address gaps and improve patient experience and outcomes
  • Create opportunities for providers and patients to interact and provide input into integrated health system plans

A directory of service providers (Public Health; Primary Care; Home and Community Care; Hospitals; Long-term Care Homes; Hospice) in the two HNHB LHIN Sub-regions within the Niagara region is available at the following links:  

Retrieved from: http://www.health.gov.on.ca/en/ms/ecfa/healthy_change/ and http://www.hnhblhin.on.ca/

Health statistics reported from Canadian health units, including Niagara Region Public Health, can be found through the Canadian Institute for Health Information Health Indicators Interactive Tool, at: http://yourhealthsystem.cihi.ca/epub/

A directory of health services for the Hamilton, Niagara, Haldimand, Brant (HNHB) Local Health Integration Network (LHIN) can be found at the HNHB Health Line website at: http://www.hnhbhealthline.ca/.  Following is a list of Niagara-based health organization websites:

The Indigenous Diabetes Health Circle (formerly Southern Ontario Aboriginal Diabetes Initiative) is based on Schmon Parkway in Thorold. IDHC’s vision is: Indigenous peoples have the tools, knowledge and ability to make health choices free of diabetes, now and in future generations. IDHC achieves this vision by supporting Indigenous communities, families and individuals by:

  • Promoting holistic wellness models;
  • Building on traditional teachings and best practices to develop and provide programs, education and resources; and
  • Building relationships and community capacity.

Source:  Indigenous Diabetes Health Circle
Retrieved from: http://soadi.ca/

CASTLE’s Community Health Brokers (CHBs), based at Niagara Region Public Health, work in identified priority neighbourhoods to support and advocate for residents as they navigate health, employment, social service, and legal systems. CHBs aim to improve social connectedness through community development, skill development, and self-advocacy skills, improving the health and wellbeing of the community and region as a whole. CHBs connect residents with agencies and resources through referrals, partnerships, and on-site programming.

Source: HNHB LHIN
Retrieved from:  http://www.hnhbhealthline.ca/displayService.aspx?id=164088 & http://nr-escribe.esolutionsgroup.ca/%5Cfilestream.ashx?DocumentId=1651

The Niagara Aging Strategy and Action Plan was launched in 2015 by the Age-Friendly Niagara Network. (AFNN). The Aging Strategy and Action Plan is a “living document” that serves as a template for planning by service agencies, different levels of government, businesses and the community at large.

The Aging Strategy and Action Plan document summarizes input from over 500 individuals to:

  • Validate older adults’ needs as perceived by older adults, advocacy groups, service providers and others
  • Identify new or emerging needs of older adults, as the population and society changes

Provide insights into existing and emerging needs that will help communities and organizations within communities to become more age-friendly and advance to achieve age-friendly community characteristics as outlined by the World Health Organization (WHO).

Companion documents include an Action Plan Toolkit and an Implementation Template.

In 2017, the AFNN received OTF funding over 28 months, to advance implementation of the Niagara Aging Strategy and Action Plan’s five goals, and to build a sustainability plan to ensure ongoing development of Niagara as an age-friendly community.

Source:  Age Friendly Niagara Network
Retrieved from: http://www.agefriendlyniagara.com/

The above information is also included in the Community Belonging Sector of this report.

Hospital Standardized Mortality Ratio and Hospital Readmissions

The following table shows the Hospital Standard Mortality Ratio (HSMR) and the rate of hospital deaths following major surgery in the Niagara Health System (NHS). HSMR is calculated by dividing the number of observed hospital deaths by the number of expected hospital deaths, and multiplying the quotient by 100.

NHS Indicator 2010–2011 2011–2012 2012–2013 2013–2014 2014–2015 2015-2016
Hospital Deaths (HSMR) 115 107 101 100 100 84
Hospital Deaths Following Major Surgery 2.6% 2.1% 2.1% 2.0% 1.9% 1.7%

 

Source: Canadian Institute for Health Information. Your Health System.
Retrieved from: https://yourhealthsystem.cihi.ca/hsp/indepth?lang=en#/theme/6794e9fe9a7636e41b30a98ed23570449a61750b/4/

The following table shows several rates hospital readmission within 30 days of release in the NHS.

NHS Indicator 2010–2011 2011–2012 2012–2013 2013–2014 2014–2015 2015-2016
All Patients Readmitted to Hospital 7.7% 8.1% 8.2% 7.7% 8.0% 8.2%
Medical Patients Readmitted to Hospital 12.3% 12.7% 12.5% 11.8% 12.7% 12.2%
Obstetric Patients Readmitted to Hospital 1.8% 1.7% 1.8% 1.1% 1.6% 1.4%
Patients 19 and Younger Readmitted to Hospital 5.5% 5.8% 5.6% 4.4% 5.1% 5.3%
Surgical Patients Readmitted to Hospital 5.5% 6.1% 6.2% 6.2% 5.4% 7.0%

 

Source: Canadian Institute for Health Information. Your Health System.
Retrieved from: https://yourhealthsystem.cihi.ca/hsp/indepth?lang=en#/theme/6794e9fe9a7636e41b30a98ed23570449a61750b/4/

Number of Physicians and Specialists

The Ontario Physician Human Resources Data Centre (OPHRDC) publishes reports on the number of family medicine physicians and specialists in Ontario by census subdivision. The following table provides a breakdown of 2016 figures by municipality. Figures are not provided by the data source for Wainfleet.

Number of Family Physicians and Specialists by Municipality, 2016
Municipality Family Physicians Specialists Total
Fort Erie 17 3 20
Grimsby 23 11 34
Lincoln 23 0 23
Niagara-on-the-Lake 12 3 15
Niagara Falls 61 66 127
Pelham 7 1 8
Port Colborne 14 1 15
St. Catharines 142 184 326
Thorold 10 9 19
Welland 48 40 88
West Lincoln 9 0 9
Total 366 318 684

 

Source: Ontario Physician Human Resources Data Centre. 2016 Physicians in Ontario by County and Census Subdivision.
Retrieved from: http://www.ophrdc.org/wp-content/uploads/2017/09/2016-Physicians-in-ONTARIO-by-County-and-Census-Subdivision.pdf

The Niagara Physician Recruitment and Retention Program was established in 2001 to promote family practice opportunities and to attract and retain physicians in Niagara.  The program works in collaboration with the municipalities of St. Catharines, Niagara Falls, Welland, Thorold, Fort Erie, Niagara-on-the-Lake, Port Colborne, Wainfleet, Pelham, Grimsby, Lincoln and West Lincoln and operates under the Organizational and Foundational Standards Division of Niagara Region Public Health.  Several local municipalities in Niagara are classified as Areas of High Physician Need by the Ontario Ministry of Health and Long-Term Care.  

Since 2011, over 70 new family physicians have been recruited to Niagara.  Given that more than 30% of the family doctors in the region are over 60 years of age, developing succession planning strategies to support primary care renewal in Niagara is a high priority.

Areas of High Physician Need in the Hamilton Niagara Haldimand Brant Local Health Integration Network (HNHB LHIN)
Municipality (Census Subdivision) City / Town / Community
Brant Brant
Fort Erie Fort Erie
Grimsby Grimsby – specific postal codes
Haldimand County Haldimand County
Hamilton Hamilton – specific postal codes
Norfolk County Norfolk County
Pelham Pelham
Port Colborne Port Colborne
Six Nations (Part) 40 Six Nations (Part) 40
St. Catharines St. Catharines
Thorold Thorold
Wainfleet Wainfleet
Welland Welland

 

Source: Ontario Ministry of Health and Long-Term Care; and Niagara Region Public Health
Retrieved from: http://www.health.gov.on.ca/en/pro/programs/highneed/ and http://www.niagaradocs.ca/

Wait Times for Emergency Room Visits, Diagnostic Imaging and Surgeries in Niagara

The Ontario Ministry of Health and Long-Term Care provides information about wait times in Emergency Rooms and for surgeries and diagnostic imaging across the province. http://www.health.gov.on.ca/en/pro/programs/waittimes/default.aspx

Health Quality Ontario provides information about wait times to see a specialist in Ontario. http://www.hqontario.ca/System-Performance/Wait-Times-for-Surgeries-and-Procedures?utm_source=gov.on.ca&utm_medium=Referral&utm_campaign=WT%20Referral

The following table shows the average wait time for a physician in Niagara Health System emergency departments, and total time spent in an emergency department after admission, both based on the 90th percentile. This table also shows the percent of hip fracture patients receiving surgery within 48 hours of hospital admission.

Indicator 2010–2011 2011–2012 2012–2013 2013–2014 2014–2015 2015-2016
Emergency Department Wait Time for Physician Initial Assessment (Hours, 90th Percentile) 4.6 4.4 4.4 3.3 3.1 3.3
Total Time Spent in Emergency Department for Admitted Patients (Hours, 90th Percentile) 46.7 50.9 50.4 49.7 44.1 38.8
Hip Fracture Surgery Within 48 Hours 84.9% 81.4% 72.5% 73.7% 84.0% 89.8%

Source: Canadian Institute for Health Information. Your Health System.
Retrieved from: https://yourhealthsystem.cihi.ca/hsp/indepth?lang=en#/theme/6794e9fe9a7636e41b30a98ed23570449a61750b/4/

Emergency Response Times in Niagara

The table below illustrates the number of unique events responded to by Emergency Medical Services (EMS) in Niagara, three other municipalities for comparison (Durham, Halton, Hamilton), and the median among 12 municipalities that report data to the Municipal Benchmarking Network Canada.

Unique EMS Responses per 1,000 Population
2013 2014 2015
Niagara 123 128 138
Durham 87 87 98
Halton 74 78 78
Hamilton 102 105 110
Median 110 116 116

Source: Municipal Benchmarking Network Canada. 2015 Performance Measurement Report.
Retrieved from: http://www.niagaraknowledgeexchange.com/wp-content/uploads/sites/2/2017/09/MBNCanada_2015_Performance_Measurement_Report.pdf

Unique EMS Responses

The following tables summarize Niagara EMS response times. Response times are defined by the Canadian Triage Acuity Score (CTAS), a commonly-used system that prioritizes patient care based on severity, signs, and symptoms.

SCA (Sudden Cardiac Arrest) refers to the time from dispatch receiving the call to the arrival of any trained/qualified person to provide defibrillation. CTAS 1 through 5 refers to the time when dispatch receives the call to the arrival of a Niagara EMS paramedic.

Response Time Standards for Niagara Emergency Medical Services

Source: Niagara Region Public Health. Response Time Standards for Niagara Emergency Medical Services.
Retrieved from: https://www.niagararegion.ca/government/departments/health/ems-response-times.aspx

The above Measure links to similar information in the Crime, Safety and Security Sector.

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