ROLES of the HOSPITAL and PHA CLASSIFICATION
Hospitals
The Ontario Public Hospitals Act (PHA) is a piece of legislation that deals with the regulation and operation of public hospitals (not private hospitals or independent health facilities) in the province. The PHA defines a hospital as: "Any institution, building or other premises or place established for the treatment of persons afflicted with or suffering from sickness, disease or injury, or for the treatment of convalescent or chronically ill persons.”
Roles of the Hospital
Hospitals in Canada fulfill the following four main roles: Patient Care, Health Education and Wellness Promotion, Research and Public Health.
Patient Care involves the diagnosis and/or treatment of illness and/or injury, preventive medicine, rehabilitation, convalescent care and personalized services.
Health Education and Wellness Promotion includes the maintenance and circulation of newsletters and bulletins as well as formal and informal in-service training for staff members as well as psychiatric, social, physical, occupational and pharmaceutical education for patients.
Research achieves two main purposes. First, the advancement of medical knowledge against disease and secondly, improvement of services. Areas of research in larger hospitals entail formal investigation involving animal research, specialized equipment and highly trained personnel. Medium or smaller sized hospitals may contribute to research by maintaining records for evaluation of methods and procedures and by implementing quality assurance programs.
Public Health programs are developed to assist the community in reducing the incidence of sickness and increasing the wellness of the population. This is done by providing programs that detect communicable diseases (e.g. tuberculosis, HIV) as well as providing programs that detect non-communicable disease (e.g. diabetes, breast cancer). Other public health initiatives include programs for information on prevention and intervention of disease, fitness programs and poison control centres.
Classification of Hospitals
Hospitals can be classified in a number of ways as defined under the Public Hospitals Act. They include, Teaching or non-teaching hospitals, Length of Stay, Ownership, Bed Capacity, Care/Service Provided and Accreditation (discussed in Week 2).
Teaching Hospitals are those that are affiliated with a faculty of medicine. They are members of the CAHO, as discussed earlier. These types of hospitals provide clinical instruction of medical students, a referral centre for seriously ill patients allowing for student observation, post-graduate training for medical students in specialty areas (e.g. internal medicine, radiology), and practical instruction for other health care professionals including, pharmacists, pharmacy technicians, dietitians, physiotherapists and occupational therapists.
Length of stay in a hospital is typically described as short or long term. Short term is considered a stay of less than 30 days with an average length of 6.6 days (e.g. surgery). Long term is considered a stay of 30 or more days (e.g. psychiatric or chronic conditions).
Ownership of hospitals in Ontario can be either private or public. Private hospitals offer services and procedures covered under OHIP (Medicare) as well as non-insured services. They are legislated under the Private Hospitals Act, usually modeled as “for-profit” centres (e.g. Shouldice Hernia Centre) and are owned by individuals or corporations. Public hospitals are non-profit organizations which offer services to all eligible residents of Canada. Owned/operated by the municipality/province or Owned/operated by a religious order
Bed capacity of hospitals is typically categorized as those under 50 beds, 50 - 99 beds, 100 - 199 beds, 200 - 299 beds, 300 – 499 beds, and 500 beds and over.
Care and service provided refers to hospitals that provide general care (i.e. short term, acutely ill, medical/surgical treatments, obstetrical/new born care and convalescence), or pediatric care, or cancer care, or chronic care, or psychiatric care, or rehabilitation, or orthopedic care, and those that provide acute care.
Public Hospitals Act Classification
The PHA classifies hospitals into categories for administrative purposes. An individual hospital may fall under just one or a number of different categories. The MOHLTC explains each Group and what they mean as follows:
A General + Teaching → e.g. St. Joseph's Healthcare Centre, London Health Sciences Centre
B General >100 beds → e.g. St. Thomas Elgin General Hospital
C General <100 beds → e.g. St. Mary's General Hospital
D Cancer Care + Medical Students → e.g. Sunnybrook Health Sciences Centre
E General Rehab → e.g. SJHC - Parkwood site
F Chronic >200 beds→ e.g. SJHC - Parkwood site
G Chronic <200 beds → e.g. STEGH - Chronic Care Unit
H Psychiatric Care + Teaching → e.g. SJHC - Parkwood site
I Alcohol/Drug Addiction → none listed
J Special Rehabilitation → e.g. SJHC - Parkwood site
K Diagnostics/Treatment for Disabled Persons → e.g. Thames Valley Children Centre
L Alcohol/Drug Addiction + Teaching → e.g. Centre for Addiction and Mental Health - Donwood site
M Computerized Axial Tomography → e.g. LHSC
N Magnetic Resonance Imaging → e.g. SJHC
O Transplantation → e.g. LHSC – University Hospital site
P Lithotripsy → e.g. SJHC
Q In vitro → e.g. LHSC – University Hospital site
R Continuing Care Centres → e.g. St. Peters
S Biosynthetic Growth Hormone → e.g. LHSC – Victoria Hospital (Westminster Site)
T Cystic Fibrosis → e.g. LHSC – Victoria Hospital (Westminster Site)
U Thalassemia → e.g. Hospital for Sick Children
V Ambulatory Care → e.g. Women’s College
CHECKPOINT Question TWO: Read the Globe and Mail article entitled "Private-public debate erupts anew over sale of Shouldice Hospital." What are the issues mentioned in this article? Is there room for private, for-profit healthcare facilities in Ontario? Do you agree with the author? Why or why not?
Hospitals
The Ontario Public Hospitals Act (PHA) is a piece of legislation that deals with the regulation and operation of public hospitals (not private hospitals or independent health facilities) in the province. The PHA defines a hospital as: "Any institution, building or other premises or place established for the treatment of persons afflicted with or suffering from sickness, disease or injury, or for the treatment of convalescent or chronically ill persons.”
Roles of the Hospital
Hospitals in Canada fulfill the following four main roles: Patient Care, Health Education and Wellness Promotion, Research and Public Health.
Patient Care involves the diagnosis and/or treatment of illness and/or injury, preventive medicine, rehabilitation, convalescent care and personalized services.
Health Education and Wellness Promotion includes the maintenance and circulation of newsletters and bulletins as well as formal and informal in-service training for staff members as well as psychiatric, social, physical, occupational and pharmaceutical education for patients.
Research achieves two main purposes. First, the advancement of medical knowledge against disease and secondly, improvement of services. Areas of research in larger hospitals entail formal investigation involving animal research, specialized equipment and highly trained personnel. Medium or smaller sized hospitals may contribute to research by maintaining records for evaluation of methods and procedures and by implementing quality assurance programs.
Public Health programs are developed to assist the community in reducing the incidence of sickness and increasing the wellness of the population. This is done by providing programs that detect communicable diseases (e.g. tuberculosis, HIV) as well as providing programs that detect non-communicable disease (e.g. diabetes, breast cancer). Other public health initiatives include programs for information on prevention and intervention of disease, fitness programs and poison control centres.
Classification of Hospitals
Hospitals can be classified in a number of ways as defined under the Public Hospitals Act. They include, Teaching or non-teaching hospitals, Length of Stay, Ownership, Bed Capacity, Care/Service Provided and Accreditation (discussed in Week 2).
Teaching Hospitals are those that are affiliated with a faculty of medicine. They are members of the CAHO, as discussed earlier. These types of hospitals provide clinical instruction of medical students, a referral centre for seriously ill patients allowing for student observation, post-graduate training for medical students in specialty areas (e.g. internal medicine, radiology), and practical instruction for other health care professionals including, pharmacists, pharmacy technicians, dietitians, physiotherapists and occupational therapists.
Length of stay in a hospital is typically described as short or long term. Short term is considered a stay of less than 30 days with an average length of 6.6 days (e.g. surgery). Long term is considered a stay of 30 or more days (e.g. psychiatric or chronic conditions).
Ownership of hospitals in Ontario can be either private or public. Private hospitals offer services and procedures covered under OHIP (Medicare) as well as non-insured services. They are legislated under the Private Hospitals Act, usually modeled as “for-profit” centres (e.g. Shouldice Hernia Centre) and are owned by individuals or corporations. Public hospitals are non-profit organizations which offer services to all eligible residents of Canada. Owned/operated by the municipality/province or Owned/operated by a religious order
Bed capacity of hospitals is typically categorized as those under 50 beds, 50 - 99 beds, 100 - 199 beds, 200 - 299 beds, 300 – 499 beds, and 500 beds and over.
Care and service provided refers to hospitals that provide general care (i.e. short term, acutely ill, medical/surgical treatments, obstetrical/new born care and convalescence), or pediatric care, or cancer care, or chronic care, or psychiatric care, or rehabilitation, or orthopedic care, and those that provide acute care.
Public Hospitals Act Classification
The PHA classifies hospitals into categories for administrative purposes. An individual hospital may fall under just one or a number of different categories. The MOHLTC explains each Group and what they mean as follows:
A General + Teaching → e.g. St. Joseph's Healthcare Centre, London Health Sciences Centre
B General >100 beds → e.g. St. Thomas Elgin General Hospital
C General <100 beds → e.g. St. Mary's General Hospital
D Cancer Care + Medical Students → e.g. Sunnybrook Health Sciences Centre
E General Rehab → e.g. SJHC - Parkwood site
F Chronic >200 beds→ e.g. SJHC - Parkwood site
G Chronic <200 beds → e.g. STEGH - Chronic Care Unit
H Psychiatric Care + Teaching → e.g. SJHC - Parkwood site
I Alcohol/Drug Addiction → none listed
J Special Rehabilitation → e.g. SJHC - Parkwood site
K Diagnostics/Treatment for Disabled Persons → e.g. Thames Valley Children Centre
L Alcohol/Drug Addiction + Teaching → e.g. Centre for Addiction and Mental Health - Donwood site
M Computerized Axial Tomography → e.g. LHSC
N Magnetic Resonance Imaging → e.g. SJHC
O Transplantation → e.g. LHSC – University Hospital site
P Lithotripsy → e.g. SJHC
Q In vitro → e.g. LHSC – University Hospital site
R Continuing Care Centres → e.g. St. Peters
S Biosynthetic Growth Hormone → e.g. LHSC – Victoria Hospital (Westminster Site)
T Cystic Fibrosis → e.g. LHSC – Victoria Hospital (Westminster Site)
U Thalassemia → e.g. Hospital for Sick Children
V Ambulatory Care → e.g. Women’s College
CHECKPOINT Question TWO: Read the Globe and Mail article entitled "Private-public debate erupts anew over sale of Shouldice Hospital." What are the issues mentioned in this article? Is there room for private, for-profit healthcare facilities in Ontario? Do you agree with the author? Why or why not?