2015 environmental scan summary

2015 Environmental Scan Summary

2015 ENVIRONMENTAL SCAN SUMMARY

2015 ENVIRONMENTAL SCAN SUMMARY:An environmental scan offers a review of information impacting a specific setting or situation. In 2015 all 14 LHINs collaborated to build an environmental scan of factors related to health care in support of developing the 2016-19 Integrated Health Service Plan. The following is a summary of information taken from the environmental scan related to the Waterloo Wellington LHIN area.


Demographics and Census:• Waterloo Wellington LHIN is home to 778,700 people, or 5.6%

of the population of Ontario.• Approximately 78% of LHIN residents lived in a large urban

population centre (100,000+), while 11% lived in a rural area. • Just over 14% of LHIN residents were seniors aged 65 years

and over, higher than that in 2010 (11.6%). • The population of the LHIN is projected to increase by 5.6%

between 2015 and 2020 and 11.5% between 2015 and 2025. • Almost 2% of residents reported French as their mother tongue

in 2011. • 1.4% of residents reported Aboriginal identity.• In 2011, immigrants accounted for 20.5% of the Waterloo

Wellington LHIN population. 2.6% of residents were recent immigrants, having arrived in Canada between 2006 and 2011.

• Nearly 14% of the people living in the LHIN were visible minorities.

• Waterloo Wellington LHIN had the highest labour force participation rate among people age 15+ (69.8%) and the lowest unemployment rate of all LHINs.

• Waterloo Wellington had the lowest proportion of residents living in low-income households (11.5%). The rate for Ontario was 13.9%.

Births and Mortality:• In FY 2011/12, there were 7,973 births in Waterloo Wellington

LHIN hospitals.• 3.1% of women who gave birth were under 20 years of age

(similar to the provincial result) and 17.9% were aged 35 or older (lower than the provincial average of 22.0%).

• The rate of caesarean deliveries was the third lowest in the province (25.4%) and below the provincial rate of 28.4%.

• 81.2% of hospital births were attended by obstetricians, 7.2% by family physicians, and 9.2% by midwives. The Waterloo Wellington LHIN had the second highest proportion of midwife-attended hospital births in the province, which was almost twice the provincial average (5.2%).

• The rate of pre-term births (less than 37 weeks) was the lowest in the province at 5.7%.

• The rate of exclusive breastfeeding (72.9%) was the second highest rate among all LHINs.

• 91.0% of the women were nonsmokers at time of admission for birth. The rate has increased slightly since the first prenatal visit (increase of 1.7 percentage points).

• The women who reported drinking alcohol and using drugs during pregnancy were 1.6% and 1.5%, compared to 1.6% and 2.0% for the province, respectively.

3.1% OF WOMEN WHO GAVE BIRTH WERE UNDER 20 YEARS OLD

similar to the provincial result

17.9% WERE AGED

35 OR OLDER

lower than the provincial average of 22.0%

In 2011:

IMMIGRANTS ACCOUNTED FOR 20.5% OF THE POPULATION

NEARLY 14% OF THE PEOPLE LIVING

IN THE LHIN WERE VISIBLE MINORITIES

WATERLOO WELLINGTON LHIN IS HOME TO 778,700 PEOPLE

5.6% OF THE POPULATION OF ONTARIO

IN F/Y 2011-12 THERE WERE7,973 BIRTHS

IN WATERLOO WELLINGTON LHIN HOSPITALS

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General Health, Risk Factors, and Prevention: • Approximately 61% of Waterloo Wellington LHIN residents

reported very good or excellent health, and 71% reported very good or excellent mental health.

• Approximately 15% of LHIN residents usually experienced moderate or severe pain/discomfort, and 35% experienced activity limitations because of long-term physical or mental health problems.

• Among Waterloo Wellington LHIN residents, the rate of smoking (19%) was similar to the provincial average. Approximately 21% of LHIN residents were heavy drinkers and this proportion was slightly larger than the provincial average.

• Compared with the province, Waterloo Wellington LHIN residents had slightly lower rates of overweight/obesity (52%) and physical inactivity (43%).

Chronic Conditions:• In 2013, 35% of Waterloo Wellington residents (aged 12+) had

a chronic condition and 12% had multiple conditions. Waterloo Wellington LHIN had the third lowest rate of residents with multiple chronic conditions among all LHINs.

• Waterloo Wellington LHIN had the lowest prevalence of high blood pressure in the province and this rate was significantly lower than the provincial average. Since 2009-2010, the prevalence of arthritis and heart disease increased and the prevalence of high blood pressure and asthma decreased for Waterloo Wellington LHIN residents.

• In Waterloo Wellington LHIN, 16% of residents had arthritis, 5.1% had heart disease, 14.8% had high blood pressure and 7.1% had asthma.

• Chronic conditions such as cancer, heart disease and diabetes accounted for 61% of deaths, 20% of acute discharges from hospital, and 26% of total acute days for Waterloo Wellington LHIN residents.

• Although the prevalence of cancer in Waterloo Wellington LHIN was only 1.5%, these conditions were a leading cause of mortality, acute change to discharges from separation and total acute days. Cancer accounted for 8% of all acute hospital days for LHIN residents.

61% OF RESIDENTS REPORTED

VERY GOOD OR EXCELLENT HEALTH

35% OF RESIDENTS (AGED 12+) HAD A CHRONIC CONDITION

AND 12% HAD MULTIPLE CONDITIONS

71% OF RESIDENTS REPORTED

VERY GOOD OR EXCELLENT MENTAL HEALTH

WATERLOO WELLINGTON LHIN HAD THE THIRD LOWEST RATE

OF RESIDENTS WITH MULTIPLE CHRONIC CONDITIONS AMONG ALL LHINS

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Health Care Utilization:• There were 45,465 acute discharges, 212,227 acute days and

241,364 total days from Waterloo Wellington LHIN hospitals in 2013/14. Residents from outside the LHIN accounted for 7.1% of the acute discharges from Waterloo Wellington LHIN hospitals in 2013/14.

• 16.5% of acute discharges for Waterloo Wellington LHIN residents were from hospitals outside the Waterloo Wellington LHIN in 2013/14.

• Between 2010/11 and 2013/14 acute discharges increased by 6.7% and acute days by 5.9% for Waterloo Wellington LHIN hospitals. During the same period, there was 4.9% growth in acute discharges and 3.2% growth in acute care days for Ontario hospitals overall and total days remained stable.

• There were 3,486 ALC discharges from Waterloo Wellington LHIN hospitals, with an average ALC length of stay of 8.4 days in 2013/14. Between 2010/11 and 2013/14, ALC days decreased by 30.0% for Waterloo Wellington LHIN hospitals, while ALC discharges increased by 18.4%.

• Waterloo Wellington LHIN hospitals had the 2nd lowest average acute and total lengths of stay and the lowest average ALC length of stay in the province in 2013/14.

• In 2013/14, Waterloo Wellington LHIN residents had the shortest ALC length of stay in the province, which was 7.9 days shorter than the average for Ontario residents.

Emergency Department (ED) Visits:• In 2013/14, there were 259,429 ED visits to Waterloo Wellington

LHIN hospitals and 5.4% of these visits were by residents from outside the LHIN.

• Between 2010/11 and 2013/14 in Waterloo Wellington LHIN hospitals, the number of visits in the lower acuity levels declined while those in the higher acuity levels increased.

• There were 277,151 ED visits by Waterloo Wellington LHIN residents in 2013/14 and 11.4% of these visits occurred in hospitals outside the LHIN. Both the number and rate of ED visits for LHIN residents increased between 2010/11 and 2013/14.

• The ED visit rate for Waterloo Wellington LHIN residents was lower than the provincial average.

• The rate of ED visits best treated in alternative primary care settings was lower for Waterloo Wellington LHIN residents compared to Ontario residents in 2013/14.

• The leading conditions for ED visits in Waterloo Wellington LHIN hospitals were injuries and poisonings; symptoms, signs and abnormal clinical findings; respiratory system diseases; diseases of the musculoskeletal system; and factors influencing health status and contact with health services.

IN 2013-14, WATERLOO WELLINGTON LHIN RESIDENTS HAD THE SHORTEST ALC LENGTH OF STAY IN THE PROVINCE

WHICH WAS 7.9 DAYS SHORTER THAN THE AVERAGE FOR ONTARIO RESIDENTS

IN 2013-14, THERE WERE:

259,429 ED VISITS TO WATERLOO WELLINGTON

HOSPITALS

5.4% of these visits were by

residents outside of the LHIN

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Day Surgery:• In 2013/14, there were 63,771 day surgery and ambulatory

cardiac catheterization visits to Waterloo Wellington LHIN hospitals. Residents from outside the LHIN accounted for 8.5% of the visits in 2013/14.

• Between 2010/11 and 2013/14, day surgery visits to Waterloo Wellington LHIN hospitals declined by 1.7%.

Inpatient Rehab: • In 2013/14, there were 1,007 admissions to inpatient

rehabilitation units in Waterloo Wellington LHIN hospitals and residents from outside the LHIN accounted for 4.1% of those admissions.

• In 2013/14, there were 1,107 rehabilitation admissions for Waterloo Wellington LHIN residents, and 12.7% were treated in hospitals outside the LHIN. While the number of admissions increased there was a slight decrease in the admission rate for LHIN residents between 2010/11 and 2013/14.

• Waterloo Wellington LHIN residents had the lowest rehabilitation admission rate in the province in 2013/14.

Mental Health and Substance Abuse (MH/SA): • In 2013/14, there were 10,667 unscheduled ED visits for

Waterloo Wellington residents where the main problem was a MH/SA condition.

• Between 2010/11 and 2013/14, there was 12.4% growth in visits with a MH/SA main problem diagnosis.

• The MH/SA ED visit rates for Waterloo Wellington LHIN residents were lower than the provincial average.

• Visits to ED where MH/SA was the main problem diagnosis accounted for 3.8% of all ED visits for Waterloo Wellington LHIN residents.

• In 2013/14 and 2014/15, support within housing, counselling/treatment, and case management had the longest median wait times among the community MH services provided in Waterloo Wellington LHIN.

IN 2013-14, THERE WERE 63,771 DAY SURGERY VISITS

IN 2013-14, THERE WERE 10,667

UNSCHEDULED ED VISITS FOR WATERLOO WELLINGTON RESIDENTS WHERE THE MAIN PROBLEM WAS

A MH/SA CONDITION

8.5% of the visits were by residents outside of

the LHIN

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Complex Continuing Care:• In 2013/14, there were 1,352 CCC active cases treated in

Waterloo Wellington LHIN hospitals and residents from outside the LHIN accounted for 5.1% of these active cases. There were 1,119 admissions and 1,095 discharges from Waterloo Wellington LHIN hospitals in 2013/14. The average CCC length of stay (67.4 days) for Waterloo Wellington LHIN hospitals was less than the provincial average in 2013/14.

• Between 2010/11 and 2013/14, active cases, admissions, discharges, and total days declined for Waterloo Wellington LHIN hospitals.

• The active case rate for Waterloo Wellington LHIN residents was lower than the provincial rate.

Home Care:• In 2013/14, there were 36,630 active home care clients in the

Waterloo Wellington LHIN. • Waterloo Wellington LHIN had a higher rate of active clients

than the provincial average in 2013/14.• Between 2010/11 and 2013/14, the number of home care

clients in the LHIN increased by 14.7%.• In Waterloo Wellington LHIN, there were 521,524 home care

visits and 1,457,452 service hours in 2013/14. • Between 2010/11 and 2013/14, there was a 3.0% increase

in all home care visits and a 30.1% increase in all service hours in Waterloo Wellington LHIN. During this period, the service types with the largest increases in visits/hours were personal support work and homemaking (30.4%), nursing shift (25.7%), and physiotherapy (12.6%), while there was a 19.8% reduction in case management visits.

IN 2013-14, THERE WERE: BETWEEN 2010/11 AND 2013/14, THERE WAS A 3.0% INCREASE IN ALL HOME CARE VISITS AND

A 30.1% INCREASE IN ALL SERVICE HOURS. THE SERVICE TYPES WITH THE LARGEST INCREASES IN VISITS/HOURS WERE:

1,352 CCC ACTIVE CASES TREATED IN WATERLOO WELLINGTON

LHIN HOSPITALS

RESIDENTS FROM OUTSIDE THE

LHIN ACCOUNTED FOR 5.1%1,119

ADMISSIONS

AVERAGE LENGTH OF STAY = 67.4 DAYS

1,095 DISCHARGES THERE WERE

521,524 HOME CARE VISITSAND 1,457,452 SERVICE HOURS IN 2013-14

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PERSONAL SUPPORT WORK

AND HOMEMAKING (30.4%)

NURSING SHIFT (25.7%)

PHYSIOTHERAPY (12.6%)

Long Term Care (LTC):• In 2013/14, the LTC bed supply rate (81.4 per 1,000 population

age 75+) for Waterloo Wellington LHIN was similar to the provincial average (82.6 per 1,000 population age 75+).

• While the LTC resident rate for Waterloo Wellington LHIN was comparable to that for the province the waitlist rate was slightly lower than the Ontario rate. The LTC demand rate in Waterloo Wellington LHIN, which includes residents and waitlist, was lower than the provincial average.

Primary Care:• In 2014, 96.5% of Waterloo Wellington adults (aged 16 and

older) had a primary care provider – this was the second highest attachment rate among the LHINs.

• 42.6% of adults in the Waterloo Wellington LHIN were able to see a primary care provider on the same day or next day when they were sick.

• While 50.9% of Waterloo Wellington LHIN adults were aware that their provider offers an after-hours clinic (the highest proportion in the province), 54.1% had difficulty accessing after-hours care without going to an emergency department.

• 86.7% of adults who were attached reported that their primary care provider always or often gives them the opportunity to ask questions, and 83.6% reported that their provider always or often spends enough time with them.

IN 2013/14, THE LTC BED SUPPLY RATE(81.4 PER 1,000 POPULATION AGE 75+)

FOR WATERLOO WELLINGTON LHIN WAS SIMILAR TO THE PROVINCIAL AVERAGE

96.5% OF WATERLOO WELLINGTON ADULTS (AGED 16 AND OLDER)

HAD A PRIMARY CARE PROVIDER THIS WAS THE SECOND HIGHEST ATTACHMENT RATE AMONG

THE LHINS IN 2014

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42.6% OF ADULTS WERE ABLE

TO SEE A PRIMARY CARE PROVIDER ON THE SAME DAY

OR NEXT DAY WHEN THEY WERE SICK


Health Human Resources• From 2010 to 2013, the total number of physicians in Waterloo

Wellington LHIN increased by 8.6% to a total of 1,169. Over the same time period, the Waterloo Wellington population grew by only 1.9%.

• The total rate of physicians (per 100,000 population) increased from 144.0 physicians in 2010 to 153.3 in 2013.

• The rate of both family physicians and specialists per population in Waterloo Wellington was lower than the province in 2013.

• From 2011 to 2014, the total number of nurses in Waterloo Wellington increased by 11.9% reaching a total of 7,865.

• Compared to the province, Waterloo Wellington had similar RPNs and NPs rates per 100,000 population in 2014.

• The number of NPs in Waterloo Wellington increased by 38% and RPNs by 21% between 2011 and 2014.

To read the full environmental scan, please go to wwlhin.on.ca under 2016/19 IHSP.

OVER THE SAME TIME PERIOD

The Waterloo Wellington population grew by only 1.9%

FROM 2010-2013, THE TOTAL NUMBER OF PHYSICIANS IN WATERLOO WELLINGTON LHIN

INCREASED BY 8.6%TO A TOTAL OF 1,169

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Waterloo Wellington Local Health Integration Network

50 Sportsworld Crossing Road, East Building, Suite 220, Kitchener, Ontario N2P 0A4Local: 519-650-4472 • Toll-Free: 1-866-306-LHIN (5446) • Fax: 519-650-3155

Website: wwlhin.on.ca • Email: [email protected]

2015 environmental scan summary

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