Section B: Vital Statistics and Health

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R.D. Fraser, Queen's University

Vital Statistics (Series B1-81)
Health (Series B82-543)

Statistics in the tables of Section B are in two divisions. Series Bl-81 contain data on vital statistics and series B82-543 on health. Data on social welfare, formerly contained in this section, are presented separately in Section C.

The principal sources for vital statistics (series B1-81) are: Statistics Canada, Vital Statistics, 1921 to 1970, (Ottawa, Queen's Printer); Statistics Canada, Vital Statistics, vol. I, Births; vol. II, Marriages and Divorces; vol. III, Deaths; all three volumes published annually since 1971 (Ottawa, Queen's Printer). Additional sources on historical series are given in the first edition of Historical Statistics of Canada, p. 30.

The principal sources for health (series B82-543) are: Department of National Health and Welfare, Canada Health Manpower Inventory, annual (Ottawa, Department of National Health and Welfare); Statistics Canada, Hospital Statistics, vols. I-VII, (Ottawa, Queen's Printer); Statistics Canada, Mental Health Statistics, vols. I-III, annual (Ottawa, Queen's Printer); Department of National Health and Welfare, National Health Expenditures in Canada, 1960-1973, updated every two years (Ottawa, Department of National Health and Welfare).

The tables are available as comma separated value files (csv). They may be viewed using a variety of software. You may have to create an association between your software application and the csv files. The pdf files should be used to verify table formats. For example, footnotes appear in a column to the right of the cell they reference in the csv files; while in the pdf files footnotes appear as superscript numbers.

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Vital Statistics (Series B1-81)

General note

Data for the Yukon Territory and the Northwest Territories are included in all tables unless otherwise noted.

Data for Newfoundland, which entered Confederation in 1949, are included in all historical tables unless otherwise specified. Available figures prior to 1949 were extracted from the appropriate provincial reports. Similarly, 1921 to 1925 data for Quebec, which entered the vital statistics system in 1926, have been extracted from the reports of the provincial health department.

Population figures for 1921, 1931, 1941, 1951, 1956, 1961, 1966 and 1971, are those of the census at 1 June; for 1926, 1936 and 1946, for the provinces of Manitoba, Saskatchewan and Alberta, the figures are those of the quinquennial censuses of 1 June; for all other years they are estimates as of 1 June.

Causes of death are classified according to the appropriate revision of the International Statistical Classification of Diseases, Injuries and Causes of Death and since 1969 they have been classified according to the 8th (1965) Revision which was put into effect on 1 January 1969. Tables on causes of death use the International Intermediate "A" List of 150 categories, unless otherwise specified; those for perinatal deaths use the International "P" List.

Prior to 1959 the following definitions of 'live birth' and 'stillbirth' were incorporated in the vital statistics legislation of the provinces.

Subsequently, the above definitions were revised to conform to new definitions of 'live birth' and 'fetal death' recommended by the World Health Organization. At the same time the compulsory registration of stillbirths was extended to 20 weeks' gestation. Following are the new definitions adopted by each province, with minor modification of the stillbirth definition in one province.

Following is the month and year in which the new definitions were implemented: Nova Scotia, March 1959; Manitoba, August 1959; Alberta, January 1960 and January 1963; Quebec and Saskatchewan, January 1961; Ontario, December 1961; New Brunswick, January 1962; British Columbia, July 1962; Prince Edward Island, January 1964.

Hospital: an institution operated for the regular accommodation of in-patients in which medical or obstetrical care is provided and which is recognized as a hospital by a federal agency or by the provincial government in which the hospital is located, or by a municipality duly authorized under the laws of that province. The term 'hospital' includes institutions for tuberculosis and mental diseases, but excludes institutions which provide custodial or domiciliary care only.

Since 1944 births and stillbirths have been classified according to the residence of the mother; deaths by the residence of the deceased; marriages by the place in which the marriage was solemnized. Prior to 1944 all events were classified by place of occurrence. Except for marriages, events occurring in the United States to Canadian residents are included and events occurring in Canada to United States residents are excluded.

Definitions

Population: de jure (resident) population as enumerated in census years or estimated for intercensal years.

Births: unless otherwise indicated, infants born alive (excluding stillbirths).

Stillbirths: unless otherwise indicated, foetal deaths of 28 or more weeks' gestation.

Deaths: unless otherwise indicated, exclude stillbirths. Types of deaths are as follows: infant, deaths under one year of age; neonatal, deaths under 28 days of age; postneonatal, deaths between 28 days and one year of age; maternal, deaths due to delivery and complications of pregnancy, childbirth and the puerperium (categories 630-678 International List); perinatal, foetal deaths of 28 or more weeks' gestation plus infant deaths under seven days of age.

Natural increase: excess of births over deaths.

Crude rates: birth, marriage, death and natural increase rates per 1,000 population.

Total births: live births and stillbirths.

Age: completed ages in years, months, etc. Average age is the arithmetic mean and median age is the age above and below which half of the total events occur.

Table B1-14
Live births, crude birth rate, age-specific fertility rates, gross reproduction rate and percentage of births in hospital, Canada, 1921 to 1974

Source: for 1921 to 1974, Statistics Canada, Vital Statistics, vol. I, Births, (Catalogue 82-204).

B1. The criteria adopted for defining live births and stillbirths were changed in 1955. Before this date a live birth was defined as the birth of a child who breathes after the body of the foetus is outside the body of the mother. Since 1955, following the definition of the World Health Organization, a live birth is the complete expulsion from its mother of a product of conception which, after such separation, breathes or shows any other evidence of life. See above for the dates when the provinces implemented these new definitions.

B2-3. Illegitimate births are births for which parents reported themselves as not having been married to each other at the time of birth or registration. In the case of Ontario, since 1949, they are births for which the marital status of the mother was reported as single.

B5-11. The age-specific fertility rates are the annual number of births to women in a specified age group per 1,000 female population in that age group.

B12. The total fertility rate is the sum of the fertility rates of women at each year of age. This sum represents the number of children that a thousand women would have throughout their lifetime, assuming no mortality, if they experienced at each age the fertility observed during the year for which the age-specific fertility rates have been calculated.

B13. The gross reproduction rate is similar to the total fertility rate except that only female children are considered. It represents the number of daughters a cohort of a thousand women would have during their lives under the same hypotheses as for the total fertility rate.

Table B15-22
Total number of deaths, crude and standardized death rates by sex, natural increase and rate, Canada, 1921 to 1974

Source: for 1921 to 1974, Statistics Canada, Vital Statistics, vol. III, Deaths, (Catalogue 84-206).

B19-20. Standardized death rates are death rates corrected for differences in age composition. See definitions above.

Table B23-34
Average age-specific death rates, both sexes, Canada, for five-year periods, 1921 to 1974

Source: same as series B15-22. Death rates by age groups are published annually, for the current year and for each province.

Table B35-50
Average annual number of deaths and death rates for leading causes of death, Canada, for five-year periods, 1921 to 1974

Source: same as in series B15-22. Number of deaths and death rates by cause and sex are published annually for the current year for each province on the basis of the intermediate international list of causes of deaths. They are also published for Canada by sex and age groups.

Comparison of rates between years should be made with caution. The system of classification of deaths by cause has to change from time to time to be consistent with current medical knowledge and terminology and discontinuities are introduced into the time trends of death rates for certain causes of death.

Table B51-58
Stillbirths and rate, infant deaths and rate by sex, neonatal death rate and maternal mortality rate, Canada, 1921 to 1974

Source: same as series Bl-14 and B15-22. In the same publications, these data are also given for each province; for the current year, infant deaths are given by sex and month of death for selected causes of death, and by sex and age for selected causes of death. Neonatal deaths and rates are also given for selected causes of death, as well as maternal mortality.

B51-52. Since 1955, stillbirths are defined as the birth of a foetus, after at least 28 weeks of pregnancy, which, after complete separation from the mother, does not show any sign of life. Prior to this date a stillbirth was defined as the birth of a foetus, after at least 28 weeks of pregnancy, which after complete separation from the mother, does not breathe (see general note). The registration of stillbirths is probably less complete than for live births and the criteria for defining a stillbirth are more or less subject to medical practice.

B53-57. Neonatal deaths are included in infant deaths. Neonatal deaths until 1950 included deaths under one calendar month; since 1951, they include deaths under 28 days.

Table B59-64
Average annual infant death rates for selected causes, Canada, for five-year periods, 1931 to 1970, and single years, 1971 to 1975

Source: same as series B15-22. Numbers and rates of infant deaths by cause are published annually for the current year and for each province.

The same caution as the one given for series B35-50 would apply here, probably with greater emphasis on the lack of comparability of rates between periods, particularly for immaturity.

Table B65-74
Life expectancy by sex, at selected ages, Canada, census years, 1871 to 1971

Source: same as series B15-22.

The life expectancy at a specified age is the average number of years to be lived by members of a hypothetical cohort of individuals, assumed to be subject throughout the remainder of their lives to the age-specific mortality rates observed in a given time period. Figures for 1871, 1881 and 1921 are interpolated from original figures which were not given for the ages appearing in our table. They are to be interpreted with caution because of difficulties in registration of deaths in these early years.

Table B75-81
Number of marriages and rate, average age at marriage for brides and bridegrooms, number of divorces and rate, net family formation, Canada, 1921 to 1974

Source: Vital Statistics, vol. I, Births, (Catalogue 84-205). In this publication, these series are also given for each province. Source of net family formation: for 1951 to 1975, Central Mortgage and Housing Corporation, Canadian Housing Statistics; for 1921 to 1950, O.J. Firestone, Canada's Economic Development 1867-1953, pp. 240 and 241.

Net family formation is the number of marriages, plus married female immigrants, less deaths of married persons, less married female emigrants, less divorces. Marriages, married female immigrants and deaths of married persons and divorces are obtained from registration statistics; married female emigrants are assumed to be one-fifth of the total number of emigrants (see O.J. Firestone, Residential Real Estate in Canada, (Toronto, 1951), pp. 436-437).

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Health (Series B82-543)

General note

The framework within which the data on the health care sector are presented follows as closely as was deemed possible to that of 'inputs', 'production processes' and 'outputs'. Data on physicians, dentists and nurses are presented first. In the case of the number of physicians, the series has been redeveloped starting with the year 1951. In addition, data on the immigration of physicians to Canada and the emigration of physicians to the United States has been included, starting with the years 1946 and 1950, respectively.

Presented in the second and principal part of the data on health is information on hospitals in Canada. These data provide an indication of inputs, production processes, and outputs. It should be noted that these data series represent a major rebuilding of the historical information on hospitals in Canada. The basic classification system has been changed from that of the 'type of service', as was used in the first edition of Historical Statistics of Canada, to that of 'type of ownership' and then, within type of ownership, type of service.

The three categories of type of ownership are public, private, and federal hospitals. A public hospital is 'one which is not operated for profit, accepts all patients regardless of their ability to pay, and is recognized as a public hospital by the province in which it is located', Statistics Canada, Hospital Statistics, 1956, vol. 1, (p. 10). Private hospitals are those set up with restrictions on admissions; usually they are established for profit and accept paying patients only. Federal hospitals are those set up and operated by departments of the federal government for the care of special groups of patients. Included are such facilities as internment camp hospitals, military hospitals, veterans homes, quarantine hospitals, Indian hospitals, military camp hospitals, and health and occupational centres.

Within type of ownership, hospitals are classified by type of service. There are four principal types: general, including paediatric; allied special; mental; tuberculosis.

When hospitals offer more than one type of service, the predominant type is applied to the entire hospital with one exception: if an institution contains a 'general' unit, it will be classed as general. 'Allied special' category includes: chronic, communicable disease, convalescent, maternity, orthopaedic hospitals and unclassified hospitals. Almost all mental and tuberculosis beds are in public hospitals. The great majority of 'general beds' are also in public hospitals but a significant amount are in federal hospitals. 'Allied special' beds is the only category where there is a significant proportion of beds in private hospitals (approximately 20 per cent).

Data on public and private mental hospitals include psychiatric units. These are units, within a hospital or sanatorium, which are organized for the treatment of patients with psychiatric disorders. Treatment in these units is generally more intensive and shorter than in mental hospitals.

These newly reconstructed historical data for the years 1932 to 1975 are presented in 15 tables each one of which, to the extent the availability of data permitted, involves the classification of hospitals by type of ownership and within that, by type of service. Data for the grand total of all hospitals and that for all hospitals of a given type of ownership are also presented.

For historical data describing the hospital sector prior to 1932, the reader is referred to the provincial data on hospitals in Ontario for the period 1900 to 1935 and that on hospitals in Quebec for quinquennial years 1885 to 1930, as presented in series B182-194 and series B195-215, respectively, in the original Historical Statistics of Canada.

Data on expenditures on health care by type of expenditure completes the presentation of evidence on the inputs.

Selected data on the growth of enrolment in non-profit health insurance plans supplement the data on the nature of the hospital system.

The last group of data provide some evidence on the nature of the 'outputs' of the health care sector. Included in this group are data on annual rates of notifiable diseases and on hospital morbidity by major diagnosis.

Table B82-92
Number of physicians, dentists and nurses, population per physician, dentist and nurse, number of graduates of medical and dental schools and nursing programs, immigration and emigration of physicians, Canada, 1871 to 1975

B82-84. Physicians and graduates.

Source: for 1968 to 1974, computer tapes purchased from Sales Management Systems, Don Mills, Ontario, and provincial sources of data on interns and residents in 1973 and 1974; for 1962 to 1967, Department of National Health and Welfare, Review of Health Services in Canada, 1973 and 1974; for 1951 to 1961, S. Judek, Medical Manpower in Canada, (Ottawa, Queen's Printer, 1964); for 1901 to 1950, Department of National Health and Welfare, Survey of Physicians in Canada, 1954, pp. 10 and 18; for the years 1881 and 1891, Census of Canada, 1921, vol. IV, p. 6; for 1871, Census of Canada, 1871, vol. II, p. 341.

Figures on physicians for 1943 to 1950 are based on individual records of Canadian doctors kept by the Department of National Health and Welfare; for other years, they are census figures. In the Survey of Physicians, the distribution of physicians is given by province, sex, age groups, nature of major work and urban concentration. The records of the Department of National Health and Welfare are checked periodically by surveys; six were made between 1943 and 1954. Much more detailed data are now available for recent years from the Department of National Health and Welfare, and the computer tapes mentioned above. For example, as of 31 December 1974, there were in Canada 1,643 interns, 4,546 residents, 15,565 specialists, and 15,543 general or family practitioners; there were 33,467 registered physicians and 3,830 not registered; there were 24,896 physicians in fee practice and 6,212 not in fee practice, excluding interns and residents.

In particular, other data on physicians, from 1968 and for each year after that, appear in the annual Canada Health Manpower Inventory. Included, for example, in the 1973 inventory, are the number of active physicians by province; physicians to population ratios, from 1963; number of general practitioners and specialists by province; number of graduates of Canadian medical schools and year of graduation for 1961 to 1972; number of Canadian graduates and graduates of foreign universities, by specialty and province of practice, 1971 and 1972.

The Canada Health Manpower Inventory series also contain data on dentists, nurses and other health personnel. This publication is intended to present much of the available basic data on all categories of health manpower. Furthermore, detailed data for registered nurses, physicians and surgeons, radiological technicians, and physiotherapists and for eleven occupational groups associated with hospitals are presented in the four-volume series, Health Manpower, (Catalogues 83-220 and 83-223 to 83-225), and in the eleven-volume series, Health Manpower in Hospitals, (Catalogues 83-508 through 83-518).

For graduates of Canadian medical schools, for 1951 to 1974, see Association of Canadian Medical Colleges, Forum, vol. 7, no. 5 (September-October, 1974).

B85-86. Immigrant physicians and emigrants to the United States.

Source: for immigrant physicians, for 1962 and 1975, Department of Manpower and Immigration; for 1946 to 1961, S. Judek, Medical Manpower in Canada, table 2-6, (Ottawa, Queen's Printer, 1964); for physicians emigrating to the United States, for 1972 to 1974, Department of National Health and Welfare, Health Manpower Directorate; for 1953 to 1971, R. Stevens and J. Vermeulen, Foreign Trained Physicians and American Medicine, Department of Health, Education and Welfare Publication No. (NIH) 73-325, table A5, (Washington, United States Department of Health, Education and Welfare, June, 1972); for 1950 to 1952, S. Judek, Medical Manpower in Canada.

Data on emigration of physicians to other countries are not available but are not thought to be significant compared to emigration to the United States.

B87-89. Dentists and graduates.

Source: for 1961 to 1974, Bureau of Dental Statistics, Canadian Dental Association; for number of dentists, 1947 to 1960. "Statistical Data re Dentists"; for other years, Census of Canada, 1941, vol. VII, p. 32; Census of Canada, 1931, vol. VII, p. 72; Census of Canada, 1921, vol. IV, p. 6; Census of Canada, 1871, vol. II, p. 337; for number of graduates, Canadian Dental Students Register.

In the publications of the Canadian Dental Association, data are presented on distribution of dentists by province, sex, specialty, on deaths, retirements, additions, relocations of dentists, on distribution of students by province and university, and on average cost for a four-year course.

B90-92. Nurses and graduates.

Source: for graduates from initial Canadian nursing programs for 1950 to 1974 and for nurses for 1961 to 1973, Canadian Nurses Association, Countdown; for nurses for 1951 to 1959, Facts and Figures About Nursing; for 1941 to 1950, Information on Nurses and Nursing; for other years, Census of Canada, 1931, vol. VII, p. 72; Census of Canada, 1921, vol. IV, p. 6. Other data on distribution by province, sex, major field, institutions, students and nurse migrations are given in Facts and Figures About Nursing.

B93-503. Number of hospitals operating and reporting, rated bed capacity, number of patient days, number of separations, percentage occupancy, and average length of stay, total paid hours of employees, number of full-time and part-time personnel, number of graduate nurses, costs per patient day and operating expenditures and revenues by type of ownership and by service, Canada, 1932 to 1975

Source: special tabulations and historical tables prepared by Statistics Canada at the beginning of the 1960s; annual listing of hospitals; and annual publications on hospitals, mental institutions, and tuberculosis facilities. Most of these figures are published, albeit sometimes in another form, in the following publications of Statistics Canada: List of Canadian Hospitals and Related Institutions and Facilities, (Catalogue 83-201); Hospital Statistics, six volumes on beds, services, personnel, balance sheets, revenues, and expenditures, (Catalogues 83-210 through 83-215); Mental Health Statistics, three volumes, on admissions and separations, on facilities, services and finances, and on patients, (Catalogues 83-204, 83-205, and 83-208); Tuberculosis Statistics, two volumes on morbidity and mortality and on facilities, services, and finances, (Catalogues 83-206 and 83-207). Both provincial data and much more detailed data on patient characteristics, manpower, and facilities are provided in these publications.

The figures for rated bed capacity, number of patient days, number of separations, percentage occupancy, and average length of stay refer to adults and children.

B93-140. Operating and reporting hospitals, by type and service, Canada, 1932 to 1975

Table B93-140a
Public Hospitals

Table B93-140b
Private Hospitals

Table B93-140c
Federal Hospitals

Table B93-140d
Total Hospitals

From 1932 to 1955, federal hospitals reported irregularly and since many small base hospitals opened and closed during and after the wars, there were large variations in the numbers reporting.

B141-188. Rated bed capacity in reporting hospitals, Canada, 1932 to 1975

Table B141-188a
Public Hospitals

Table B141-188b
Private Hospitals

Table B141-188c
Federal Hospitals

Table B141-188d
Total Hospitals

Rated bed capacity is defined as the number of beds which the hospital is designed to accommodate on the basis of established standards of floor area per bed as at 31 December of the reporting year. It is, therefore, a theoretical number, representing the number of beds that could be placed on a given hospital structure if a standard number of square feet were allowed for each bed. This number may be equal to, or be greater or less than the actual number of beds in regular use (referred to as beds set up) .... It is not possible to ascertain to what extent standards have been scrupulously applied (by province or hospitals) but it is known that their application is becoming more general (see Hospital Statistics, 1956, p. 9).

It must be pointed out that, except for most recent years, data on bed capacity were collected for beds set up and not for rate capacity. Moreover, beds set up were usually overestimated. In these conditions, the Statistics Canada estimates of rated bed capacity should be interpreted cautiously.

B189-236. Patient-days (adult and children) in reporting hospitals, Canada, 1932 to 1975

Table B189-236a
Public Hospitals

Table B189-236b
Private Hospitals

Table B189-236c
Federal Hospitals

Table B189-236d
Total Hospitals

A patient-day is defined as the period of service to an in-patient between the census-taking hours on two successive days; the day of admission is counted as a patient-day but the day of separation is not.

B237-260. Number of separations (adult and children) in reporting hospitals, Canada, 1932 to 1975

Table B237-260a
Public Hospitals and Private Hospitals

Table B237-260b
Federal Hospitals and Total Hospitals

In general and allied special hospitals, a separation is defined as the number of discharges and deaths of in-patients. In tuberculosis sanatoria, it is defined as the number of direct discharges on or against medical advice, discharges to continue treatment, reviews out, discharges for disciplinary reasons, and transfers out and deaths. In mental health institutions, a separation is defined as the number of deaths, discharges and transfers out.

B261-284. Percentage occupancy (adult and children) in reporting hospitals by type, Canada, 1932 to 1975

Table B261-284a
Federal Hospitals and Total Hospitals

Table B261-284b
Federal Hospitals and Total Hospitals

Percentage occupancy is defined as the number of actual patient-days recorded during the year expressed as a percentage of the potential patient-days in that year based either on rated bed capacity or actual beds set up.

Table B285-297
Average length of stay of separated patients (adult and children) in reporting hospitals, Canada, 1939 to 1975

Average length of stay is defined as the mean number of days' stay in hospital from the date of admission of patients separated during the reporting year.

Table B298-303
Total paid hours of all employees in reporting public hospitals, Canada, 1952 to 1975

B304-351. Total personnel (full- and part-time) in reporting hospitals, Canada, 1932 to 1975

Table B304-351a
Public Hospitals

Table B304-351b
Private Hospitals

Table B304-351c
Federal Hospitals

Table B304-351d
Total Hospitals

The figures are for personnel employed on 31 December of the reporting year and include: all nursing staff, all paid medical staff, interns and residents, professional and technical staff, and all other staff.

B352-399. Total full-time personnel in reporting hospitals, Canada, 1951 to 1975

Table B352-399a
Public Hospitals

Table B352-399b
Private Hospitals

Table B352-399c
Federal Hospitals

Table B352-399d
Total Hospitals

Personnel are as defined in series B304-351 and include persons employed on a full-time basis, that is, regularly employed throughout the hospital's full work week.

B400-431. Total part-time personnel employed by reporting hospitals, Canada, 1947 to 1975

Table B400-431a
Public Hospitals and Private Hospitals

Table B400-431b
Federal Hospitals and Total Hospitals

Personnel are as defined in series B304-351 and include persons employed on a part-time basis, that is, regularly employed on selected days or partial days in the hospital's work week.

B432-455. Total number of graduate nurses (full- and part-time) in reporting hospitals, Canada, 1932 to 1975

Table B432-455a
Public Hospitals and Private Hospitals

Table B432-455b
Federal Hospitals and Total Hospitals

Graduate nurses are persons who have graduated from a recognized formal nursing educational program. These nurses can be registered according to appropriate provincial legislation, or non-registered.

Table B456-460
Reporting public hospitals, operating expenditure per patient-day, Canada, 1942 to 1975

Included in expenditures are the costs on an accrual basis, of operating and maintaining the hospital during the year, per patient-day.

Table B461-475
Operating expenditures of reporting public hospitals, by salary and non-salary expenditures, Canada, 1943 to 1975

Operating expense is defined as the cost, on an accrual basis, of operating and maintaining the hospital during the year, regardless of the amounts of disbursements made during the year.

Salary expenditures include the gross salaries and wages earned during the year by all hospital personnel except those engaged in special research projects, ambulance service, and ancillary operations, whether or not actually paid during the year. Gross salaries and wages comprise the following:

1. Salaries, wages and other remuneration earned by paid personnel, including special allowances paid and perquisites supplied to such personnel; also any earned fees or other remuneration, perquisites, and special allowances to physicians for services rendered to the hospital.

2. The value of contributed services of regular staff members working without pay, and of perquisites supplied to such personnel, calculated on the basis of salary scales for similar services in the community and supported by regular payroll records.

The distribution of the gross salary or wages of an employee working in more than one department of a hospital, including allowances for student nurses and interns, normally are made proportionately to the numbers of paid hours of work done by the employee in each of the several departments; however, if the employee received separate remuneration for services in each department, these amounts are charged to the departments concerned.

Non-salary expenditures are the difference between operating expense and salary expense.

Table B476-499a
Operating expenditures of public general and allied special hospitals by selected services, Canada, 1943 to 1975 PART 1

Table B476-499b
Operating expenditures of public general and allied special hospitals by selected services, Canada, 1943 to 1975 PART 2

Nursing services consist of: nursing administration, nursing units, newborn nursery, delivery room, operating room, emergency unit and central supply services.

Special services consist of organized out-patient department, special clinics, electrocardiogram¹, electroencephalogram¹, radioisotope services¹, pharmacy, physical medicine and rehabilitation, special research projects, and other services².

Laboratory consists of laboratory services.

Radiology consists of radiology services.

Educational services consist of: medical education, nursing education, laboratory technologist training, radiology technician training, and other student training services.

General services³ consist of general administration, medical records and medical library, dietary, laundry, linen service and housekeeping⁴, plant operation and hospital security and plant maintenance⁴, and other services.

From 1959 to 1973, "Other" did not exist. Prior to 1959, "Other" consisted of those gross salaries and wages which were not distributed to any of the departments.

Table B500-503
Operating revenue of reporting mental institutions by source, Canada, 1933 to 1975

Operating revenue is defined as income that accrues during the year for the purpose of operation and maintenance of the hospital.

Table B504-513
Health expenditures, Canada, 1926 to 1975

Source: for 1960 to 1973, Department of National Health and Welfare, National Health Expenditures in Canada, 1960-1973, tables 1, 12, 37, 42 and 47, and their basic data; for 1957 to 1959, Department of National Health and Welfare, Expenditures on Personal Health Care in the Provinces of Canada, 1957-69; for 1953 to 1956, Department of National Health and Welfare, Expenditures on Personal Health Care in Canada, 1953-1961, tables 1, 5, 12, 16, 20 and 25; for 1926 to 1952, Royal Commission on Health Services 1964, vol. I (Ottawa: Queen's Printer, 1964), table 11-1, pp. 426-427.

Table B514-516
Estimated enrolment in non-profit medical insurance plans, Canada, at 31 December, 1937 to 1975

Source: for 1961 to 1968, data are summarized in the annual series, Health and Welfare Services in Canada, comparable with the annual series contained in the Canada Year Book, and in more detail in Survey of Voluntary Health Insurance in Canada, an annual series prepared by the Canadian Health Insurance Association; for 1954, 1959 and 1960, unpublished compilation, Department of National Health and Welfare, Research and Statistics Division; for 1955 to 1958, annual issues of Voluntary Hospital and Medical Insurance in Canada; for 1937 to 1953, Department of National Health and Welfare, Voluntary Medical Care Insurance, A Study of Non-Profit Plans in Canada, pp. 29, 47, 187. Public medical care insurance plans had supplanted most of the voluntary sector by 1970.

The material relating to enrolment has been assembled in co-operation with the non-profit plans. The first plan was introduced in 1937, in Ontario. A comprehensive plan is one which provides a wide range of benefits, including payments for each of the following services: physicians' calls in office, home and hospitals consultations; surgical operations and procedures; confinements; anaesthesia; X-ray, laboratory and other diagnostic procedures. A limited plan is one which provides only a limited selection of these benefits such as surgical and obstetrical care, with or without medical (non-surgical) care in hospital (see Department of National Health and Welfare, Voluntary Medical Care Insurance, p. 24).

The figures give the number of persons covered. In addition to enrolments in non-profit plans which are covered in the data of series B514-516 there were private plans carried, in the main, with insurance companies. In 1968 the number in such private plans, reported in the annual series Survey of Voluntary Health Insurance in Canada was 5,303,000 persons. A total of 4,870,000 were enrolled in comprehensive plans covering both surgical and medical care, and another 433,000 in limited plans comprising 'major medical' or 'extended' health benefits. A small proportion of the 433,000 would be duplicated in the 5,303,000 count.

Provincial data on the enrolment in government insurance plans for hospital services and medical care separately are available from Health and Welfare Canada for census years, 1941 to 1961, and on an annual basis from 1968.

Table B517-525
Annual rates of notifiable diseases, Canada, 1926 to 1975

Source: Statistics Canada, Annual Report of Notifiable Diseases, (Catalogue 82-201), especially the 1969 edition which contains historical data for the years 1921 to 1969.

These rates are based on reports to their respective provincial governments of local medical officers of health on notifiable diseases reported to them. Each provincial officer of health consolidates these reports and submits them to Statistics Canada. The reporting of notifiable diseases on a national level was affected by provincial differences in lists of reportable diseases, variations between provinces concerning exact international categories associated with each reportable disease and the proportion of cases reported by physicians.

There is evidence that the number of cases reported is far from being complete. In the national survey on sickness conducted in Canada during 1950 and 1951, the number of persons reporting illness as commencing during the survey year for the same diseases as those reported here is much greater. The ratio of the number of cases reported in the survey is as follows: measles, 13.8 per cent; whooping cough, 10.9 per cent; chickenpox, 17.3 per cent; mumps, 13.9 per cent; German measles, 17.1 per cent (see Lossing, 'Reporting of Notifiable Diseases', pp. 444-448; also, Canadian Sickness Survey, 1950-51, no. 10, table 7). At least the figures in the table presented here may represent the evolution of each disease. But in the paper quoted above, the author says that reporting is probably more incomplete during epidemic periods than during periods of lesser incidence. It should be noted that revised figures and analysis of the principal findings of the Canadian Sickness Survey have been assembled in Illness and Health Care, 1950-51, (Catalogue 82-518), a joint study of Statistics Canada and the Department of National Health and Welfare.

Table B526-543
Separations and days of stay by major diagnosis, 1967 to 1975

Source: Statistics Canada, Hospital Morbidity, (Catalogue 82-206); Hospital Morbidity, Canadian Diagnostic List, (Catalogue 82-209); and Hospital Morbidity, Historical Summary, Canada, 1964, 1966 and 1968, (Catalogue 82-532).

This information on hospital morbidity, like that on annual rates of notifiable diseases, provides some indication of the health care needs toward which the manpower and facilities of the health care sector are being directed. Care must be exercised in interpreting changes from 1967 and 1968 to 1969 and later years since the former data are classified according to the 7th Revision of the International Classification of Diseases Adapted (ICDA) and the latter according to the 8th Revision of the ICDA. Similar information for males and females taken separately and for the 188 diagnostic subcategories of the 8th ICDA, namely the Canadian List, are also available. Selected data are available back to 1960.

Detailed information on patients treated, medical services rendered, and rates and costs per patient by diagnostic group has been assembled for the province of Saskatchewan in 1971 and is presented in Medical Services and Associated Diagnosis, Saskatchewan, 1971, (Catalogue 82-533), a joint publication of Statistics Canada and the Saskatchewan Medical Care Insurance Commission.

With regard to the numbers of actual services rendered, some data are available in Statistics Canada publications, Surgical Procedures and Treatments, (Catalogue 82-208), and Surgical Procedures and Treatments, 1968, (Catalogue 82-529).

Notes

1. In some instances these services may be provided by other departments.
2. Includes ambulance service and office of the medical staff.
3. Definitions or components of departments for all years are based on information given for 1973, in the "Hospital Statistics" publications. Differences in organization have resulted in changes in department names and components. Because of this it was necessary to extract components and to recombine them in order to be comparable with information given in 1973. It was decided to list, for the years in which department names and components were changed, 1973 department names and their historical components, in order to give a better understanding of how the figures were arrived at. Prior to 1969 an expense under the name of "Other Non-Departmental Expenses", which is now included in "General Services" under "General Administration" and "Plant Operation, Hospital Security and Plant Maintenance", was listed separately under "General Services". This expense was also called "Other Revenue Fund Expense".
4. These are separate departments but have been combined for purposes of consistence with tabular presentations.

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