At the start of the 20th century, 75 per cent of Canadians died before age 65. Back then, survival was largely determined by the three Ls — lifestyle, lineage and luck.
Infectious diseases like diphtheria, tuberculosis and pneumonia were the big killers, and medicine could do little about those.
But a century later, the picture is rapidly changing. Nearly 75 per cent of us live beyond our 65th birthday. And medical care plays an increasingly important role.
That’s because the two leading causes of death in our time, cancer and heart disease, are becoming treatable. The struggle for survival today depends less on good fortune than on how well our hospitals perform.
And on that front, there is qualified good news. According to the Canadian Institute for Health Information, hospital mortality rates are falling.
In British Columbia, and across Canada as a whole, fewer patients with curable conditions are dying. Over the last four years, the Vancouver Island Health Authority has improved the survival rate for these patients by 10 per cent.
That may not sound like a lot, but 3,000 people die in hospital each year on Vancouver Island. Not all were treatable. But of those who were, about 200 now recover and go home, who would previously have lost their battle.
We’re calling this qualified good news, however, because there’s quite a bit more to the story. While most hospitals in B.C. have improved, some are doing better than others.
Nanaimo Regional General Hospital has brought its mortality rate down to the national average. That’s a step in the right direction.
But provincewide, most of the larger hospitals are much better than the national average. In part, that’s because bigger facilities tend to have lower mortality rates than small ones. They’re better equipped, and their specialists have more experience.
Victoria General and Royal Jubilee are seven points below the national average. Vancouver General is 18 points below, and Lions Gate Hospital in North Vancouver beats the Canadian average by a whopping 29 per cent.
These are enormous variations. And they have serious implications. Patients with a treatable illness in Lions Gate are measurably more likely to survive than patients at Nanaimo General.
The reason has nothing to do with the age, gender or overall health of patients at the various facilities. Those are levelled out in calculating mortality rates.
Infection control is likely one factor. Nanaimo General has a history of superbug outbreaks.
These are bacteria that have gained immunity to most antibiotics. Every hospital in Canada has superbugs, but some do a better job than others of keeping them under control.
And management plays a huge role. Modern hospitals are increasingly devoted to care of the critically ill.
Less-sick patients are treated at day clinics and sent home. Only those with serious conditions are admitted. A sense of crisis is never far removed.
Hospitals with good scores rise above that. They stay two steps ahead of the others.
Vancouver General, which has one of the lowest mortality rates in the country, recently introduced a novel technology to prevent infections.
Patients going into surgery have a form of dye sprayed inside their nose.
The dye is activated by a light source and smothers harmful bacteria. A hospital spokeswoman says the procedure has reduced infections 39 per cent and freed up surgery beds.
This is a long way from the life-extending customs of earlier times — an apple a day, early to bed and all that. But it is, literally, the shape of our future.
As the baby boomers approach old age, their survival will depend increasingly on hospital leadership and innovation. Those mortality figures suggest we’re in reasonably good hands. But there is clearly room for improvement.
© Copyright 2013