It is unclear how much money taxpayers could have saved if patients the Yukon government says did not need emergency department care were able to find help elsewhere.
In the fall of 2018, the Yukon government released a performance review, which states that 61 per cent of all emergency department visits could have been avoided.
It appears the Department of Health and Social Services (HSS) and the Yukon Hospital Corporation (YHC) don’t keep track of the dollar amount associated with this figure.
In a written statement, YHC spokesperson Matthew Davidson said, “Emergency department visits are complex and varied so it’s tough to speculate on a hypothetical figure.
“What matters most,” he continued, “is Yukoners receive safe, excellent care if and when they need it. Sometimes this care happens in our emergency departments.”
Physicians who staff emergency departments are paid by the Yukon government based on the services they provide, not the number of patients they see, Davidson added. Contracts for this work are predicated on an agreement between the Yukon Medical Association (YMA) and the territorial government.
The News reached out to Dr. Alex Poole, president of the YMA for comment, but didn’t receive a response.
Clarissa Wall, spokesperson with Health and Social Services, echoed Davidson’s statement:
“We don’t have a dollar figure for avoidable emergency room visits as it’s more about ensuring patients receive the best possible care than it is about saving money.”
Wall said some Yukoners could be better assisted by family physicians or nurse practitioners.
The Liberals have promised a comprehensive review of the health department — which takes up the largest portion of the territorial budget — by the end of the year.
“Our comprehensive review is looking into all the options to ensure Yukoners get the right care, at the right time, in the right place,” Wall said.
NDP House Leader Kate White told the News that it doesn’t make sense a dollar amount cannot be provided, considering this work spearheaded by HSS.
The 61 per cent represents an admission of an “inefficiency” for a government that pledges to be doing the opposite, she said.
“There should be an understanding of what the cost of someone walking into an emergency room before any other service happen. There’s got to be a base cost.”
The third party has raised the issue three times between March 21 and April 2. During question period on March 21, HSS Minister Pauline Frost said the issue was being “contemplated” as part of the health care review.
“When we look at the major cost-drivers as noted by the member opposite, we are seeing pressures at the emergency room. We have looked at services and supports. We are working with our partners and trying to eliminate the major pressures that we are seeing. We are doing that in full collaboration,” she said.
On April 1, White again asked how the 61 per cent translates to costs during a general debate.
HSS Minister Pauline Frost didn’t provide a number.
“I don’t have that information available,” she said. “I think that is very difficult to get. It really depends on the type of care that is required and the duration of time the individual spends there.”
White made a few suggestions of ways in which to offset emergency department visits.
Because of there are no family doctors currently accepting patients in Whitehorse, she said, drop-in clinics could help alleviate pressure on the hospital.
In response, Frost noted some of the strategies that Liberals are undertaking or planning to do so.
“We’ve seen significant reduction in emergency room visits here at the main Whitehorse General Hospital since we opened up the Whitehorse Emergency Shelter, so we are tracking that very closely with our EMS partners and the RCMP,” she said.
“… We supported the referred care clinic, ensuring that we provide additional supports for those clients who don’t have a physician and who require some specialized support.”
The Whitehorse hospital has 17 emergency beds after an expansion in 2018.
“As part of these 17, there are specialized rooms including two trauma bays, one bariatric room, one safe room, one OB-GYN room and one isolation room,” Davidson said.
The NDP says there will be more visits this year than previously anticipated, according to a 2014 needs assessment report based off figures from eight years ago.
Roughly 19,900 emergency room visits were expected in 2019 if non-emergency issues were to be treated at community-based services instead, it says, and 17 spaces would be required to accommodate these patients.
The actual number of visits to the emergency department are higher than predicted.
Citing more recent numbers in HSS’s supplementary budget information for 2018-19, the third party says 35,000 visits are anticipated at the Whitehorse hospital’s emergency room this year, 40,400 across the Yukon.
A third document, the 2019-2020 estimates, predicts 33,000 visits at the city’s emergency room and 5,300 at Watson Lake and Dawson City hospitals.
Davidson said that annual emergency department visits have been fairly consistent over five years, averaging in the low 30,000 range at the Whitehorse hospital.
“This range,” he said, “is well within what the emergency department was built to safely and effectively accommodate today. Based on demographic trends and population growth, and in the event non-emergency patients continue to seek care at the emergency department, the number of annual visits is expected to increase over the next decade.”
Davidson said community hospitals each average between 2,000 and 3,000 visits per year.
Contact Julien Gignac at julien.gignac@yukon-news.com
