Public Policy Sources #28:
British Columbia Compared with Washington and Oregon

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Comparison of High-tech University Hospitals

University teaching hospitals are among the best-equipped health care institutions because they have a leading role in research and in training the physicians of the future. Therefore, university teaching hospitals in Oregon and Washington were surveyed to find which leading-edge medical technologies they possessed. Then, the hospitals at the University of British columbia (UBC) were asked whether they possessed those technologies. The comparison reveals that the UBC hospital system is technologically deficient. Table 7 enumerates which technologies were entirely absent in British Columbia at the time of the survey but were found in the Washington and Oregon systems. Furthermore, none of the technologies absent from the UBC system was available at any other institution in British Columbia.

Comparison of Community and Regional Hospitals11

Community and regional hospitals are not often equipped with leading-edge technology to the same extent university hospitals are. Ten community and regional hospitals were surveyed to assess the availability of standard technology and services. Hospitals were selected by matching facilities by numbers of beds and admissions. Data from the American Hospital Association's annual survey 12 was compared to data extracted from Canadian sources 13 and the British Columbia Ministry of Health. Areas examined include diagnostic imaging, advanced technological equipment, cardiac and transplant procedures, and intensive care services. These represent areas of technological growth in the hospital setting and are responsible for a majority of capital expenditures. The comparison of diagnostic imaging and other high-tech equipment (see figure 4 and figure 5) found that hospitals in British Columbia, Washington, and Oregon were similarly equipped with CT scanners, ultrasound machines, and nuclear-medicine services but that there was a large deficit in the availability of MRIs and lithotripters in British Columbia.

Hospitals in Oregon and Washington also provide specialized services not often found in the equivalent facilities in British Columbia (figure 6). Angio-plasty to dilate obstructed coronary arteries was only available at one regional hospital in British Columbia, while it was widely available in facilities in Washington and Oregon. Cardiac catheterization facilities to assess the degree of blockage of coronary arteries were available at only 20 percent of the matched hospitals in British Columbia but at 80 percent of facilities in the United States. There was also a significant difference between the specialized intensive-care services available at regional and community hospitals in British Columbia and those available in the United States (figure 7). While intensive-care facilities were available at all hospitals in the matched groupings in both countries, units dedicated to cardiac, pediatric, and neonatal care were available at a lower rate in British Columbia. While these types of patients may be adequately treated in a general intensive-care unit, the services and technology provided in specialized centres are superior. A specialized unit providing pediatric and cardiac care would have more specially trained personnel and a much wider spectrum of specialty equipment to monitor and manage these particular groups of patients.

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