Operational Challenges of

Providing Services to a Small Community

A Small, Rural and Remote Health Perspective
Paul Rosebush, President and CEO, South Bruce Grey Health Centre

South West Ontario

Chesley
Kincardine

Durham

Walkerton

Bruce

Grey

Catchment Population
Actual and Forecast Population Growth in Bruce and Grey Counties

Bruce County
Grey County

2001
(actual)
66,400
92,600

2006
(actual)
65,349
92,411

2011
(actual)
66,102
92,568

2016
(estimate)
68,870
99,590

2021
(estimate)
70,050
102,310

5-Year Growth Rates for SBGHCs Catchment Area Communities (2006-2011)

Municipality
Kincardine
Brockton
Southgate
Huron-Kinloss
South Bruce
Durham
Chesley
West Grey
Arran-Elderslie

2006 population
11,173
9,641
7,072
6,515
5,939
2,768
2,010
12,288
6,747

2011 population
11,174
9,432
7,190
6,790
5,685
2,823
2,015
12,286
6,810

5-year growth
0.0%
-2.2%
1.7%
4.2%
-4.3%
2.0%
0.2%
0.0%
0.9%

Population Estimates Age 45-64 and 65+

Grey and Bruce County 2013
35.00%
31.14%

30.80%
30.00%

25.00%
21.89%

21.70%
20.00%

15.00%

10.00%

5.00%

0.00%
Grey

Bruce
45-64

65+

Population Estimates Age 45-64 and 65+

Grey and Bruce County 2020
28.50%
28.16%
28.00%

27.50%

27.00%
26.72%

26.64%
26.50%

26.00%

25.83%

25.50%

25.00%

24.50%
Grey

Bruce
45-64

65+

INPATIENT VOLUMES
100%
5.9%

5.2%

8.1%

90%
18.0%
80%

23.4%

23.2%

70%
19.0%
60%

20.2%

16.2%

90+
80 to 89

50%

15.5%
12.3%

12.6%

60 to 69

40%

<60

30%

20%

70 to 79

37.9%

42.4%

40.2%

GBHS

HDH

10%

0%
SBGHC

INPATIENT DISPOSITION
Patients Aged 60+
Disposition

Transfer to Acute
Transfer to Continuing Care
Transfer to Other
Home or home setting with support

Home
Left AMA (against medical advice)
Died
Patients who do not return from a pass

Separations

Avg LOS

% ALC
Days

Avg HIG
Wt*

1030

6.1

4.6%

1.36

814

16.0

42.6%

2.27

56

4.1

0.0%

0.92

2829

7.8

4.7%

1.55

2632

4.3

1.3%

1.03

22

6.9

0.0%

1.17

573

10.3

25.6%

2.05

3.0

0.0%

0.48

Emergency Department Volumes

100%

90%

1.2%
6.2%

1.3%
6.7%

9.6%

9.7%

1.9%
8.2%
9.8%

80%
12.7%

12.2%

10.6%

70%

60%

90+
80 to 89

50%

70 to 79
60 to 69

40%
70.4%

70.1%

69.5%

SBGHC

GBHS

HDH

30%

20%

10%

0%

<60

ALL EMERGENCY DEPARTMENT VISITS

By CTAS and Age Group
(1) Life
Threatening

Total

(2)
Emergent

(3) Urgent

(4) Less
Urgent

(5) Non
Urgent

Unknown
/Blank

Total

203

5394

16732

19402

4673

170 46574

60 to 69 years

69

1832

6320

8507

2165

79 18972

70 to 79 years

74

1792

5364

6182

1564

57 15033

80 to 89 years

40

1429

4166

3977

837

32 10481

90+ years

20

341

882

736

107

55.9%

43.7%

31.9%

26.3%

28.9%

% Total Visits

2088

25.6% 29.9%

So What?
Healthcare in rural settings is increasingly
becoming seniors focused care

Health System Barriers to Developing

Age-Friendly Communities
1.
2.
3.
4.
5.

Access to Primary Care

Access to Specialists
Fragmented Care
Changing Direction of Care
Transportation Costs (Non urgent)

Additional Factors
6.
7.
8.
9.

Weather and Geography

Lack of Rehabilitation and Personal Support
Lack of Public Fitness Centres
Income Disparity

How Hospitals and Health System can Help

Reduce ER Visits
Reduce ALC

Better Care
Quality of Life

Improve Transitions in Care

Increase Home Support

Better Care
Quality of Life

Moving Forward

Break Down Health Silos

Better Coordination
One Brand
Hubs or Links

Thank-You
Paul Rosebush
President and CEO
South Bruce Grey
Health Centre
519-370-2400 ext. 2417
prosebush@sbghc.on.ca