The pandemic highlighted a problem that has been plaguing Canada’s healthcare system for years: a serious lack of hospital beds.
A 2021 study by the Organisation for Economic Co-operation and Development (OECD) comparing hospital bed availability in 37 developed countries ranked Canada near the bottom of the pack, with an average 2.5 beds per 1,000 citizens. Comparatively, South Korea held the top spot with 12.7 beds per 1,000 citizens.
According to the OECD, Canada also has fewer intensive care beds than almost every other developed country, coming in 30th of 34 countries, ahead only of Chile, Sweden, and Colombia. Of all provinces, Ontario has the most residents per hospital bed, with 800, compared to Newfoundland, with 446 residents per bed.
Before the pandemic hit, a number of Ontario’s biggest hospitals were filled beyond 100 percent occupancy on a regular basis, with overcrowding so commonplace, patients are routinely placed in hallways, storage rooms and conference spaces. Once the first wave arrived, Canada’s already strained system was overwhelmed, with hospitals in the Greater Toronto Area so full, they had to transfer patients to facilities across the province.
The constant overcrowding has not only exhausted the healthcare workforce, it has shaken the public’s confidence in Canada’s healthcare system. A recent poll found that during the pandemic, more than 42 percent of Canadians believed their local hospital was so overwhelmed, they wouldn’t trust it to take care of them if they suddenly needed medical care. Another 39 percent of respondents knew someone who had treatment for a serious illness postponed, while 33 percent knew someone who could not access any treatment for medical issues due to COVID.
Solution for a System Under Strain
To ease the strain on the system and ensure beds remain free for acute patients, many provinces and healthcare networks are adopting ‘Hospital at Home’ models, where qualifying patients are admitted to the hospital, but sent home to receive treatment or recover, while still being closely monitored by their healthcare team. Often, the model entails patients wearing devices that monitor vital signs and other important health indicators, and includes a mix of in-person, virtual, or telephone check-ups with their care team to ensure recovery remains on track.
In 2020, British Columbia announced it was investing $42 million in its Hospital at Home pilot project to help relieve pressure on bricks-and-mortar facilities resulting from the COVID-19 pandemic.
Montreal’s Jewish General Hospital also adopted a hospital at home model in response to COVID. Under their COVID@HOME initiative, patients who were recovering well were discharged to a ‘virtual ward.’ Once at home, patients remain closely monitored by their care team, with regular communication done virtually and in-person as needed. The project is now being expanded to include patients from additional units within the hospital.
Similar programs have been piloted in the UK, the US, and Australia and have shown positive results, including reduced patient loads at hospitals, fewer readmissions, and improved health outcomes. One study found that providing care to patients at home helped reduce cost of care by up to 40 percent compared to traditional hospitalization.
The model also greatly benefits patients. A 2021 study of patients with chronic illnesses recovering at home versus within a hospital found that patients at home had a 26 percent lower risk for long-term care readmission and lower depression and anxiety scores.
Adopting the Hospital of Tomorrow
Ensuring patients receive the same level of care at home as they would within hospital walls requires careful planning and collaboration between a spectrum of healthcare workers. Adopting this new model will also put more reliance on technology. VirtualCare, remote monitoring devices, and integrated EMRs will serve as key pieces to the future of healthcare.
Thankfully, the pandemic has expedited our adoption – and comfort – with digital healthcare technologies, as both patients and healthcare providers embraced virtual solutions to ensure continuance of care throughout the pandemic. Between 27 percent and 57 percent of physician services were provided virtually in five provinces throughout the pandemic, with 90 percent of patients reporting they were satisfied with the level of care they received.