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PROVINCE WIDE SERVICES
Activities and Outcomes
2005 Annual Report
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Province Wide Services
Working Group
October 2006
Health and Wellness
Preface
This 2005 Annual Report on the Province Wide from Capital Health and the Calgary Health
Services (PWS) program has been authored by Region. There is also additional information on
the Health Authority Funding and Financial changes to the programs during the year, and key
Accountability Branch of Alberta Health and decisions of the Province Wide Services Working
Wellness. Group, the advisory committee that assists in
overseeing these programs.
For the 2006/2007 fiscal year, funding is
established at $545 million, so it i s important to
demonstrate the types of services being delivered The Special Features Report section for the 2005
and the outcomes achieved through this Annual Report highlights the Northern and
investment. Southern Alberta Renal Programs (NARP and
SARP), Calgary’s Prevention of End Stage Renal
This publication includes activity data from the Disease Program, and the Northern Alberta
2004/2005 fiscal year, as well as the funding Neonatal Intensive Care Program (NANICP). We
allocated for 2005/2006 and 2006/2007. The would like to express our thanks to those people
primary sources for most information are the who have committed significant time and effort to
Province Wide Services Annual Reports received produce these feature articles.
For inquiries on the information in this report, contact:
Alberta Health and Wellness
Health Authority Funding and Financial Accountability
19th Floor, 10025 Jasper Avenue
Edmonton, Alberta T5J 2N3
Phone: (780) 427-7040
You can find this document on Alberta Health and Wellness' Internet website - www.health.gov.ab.ca
Table of Contents
Overview of Province Wide Services 1 HIV Clinics 36
Province Wide Services Mission Statement 2 Poison and Drug Information Service
2005 Inventory of Province Wide Services 2 (PADIS) 37
Province Wide Services Working Group 3 Home Enteral Nutrition Programs
Province Wide Services Highlights (HENP) 38
2004/2005 Results 4 Craniofacial Osseointegration and
Maxillofacial Prosthetic Rehabilitation Unit
2006/2007 Budget 4
(COMPRU) 38
Children with Complex Health Needs
ACTIVITIES AND OUTCOMES 5
(CCHN) 39
Inpatient Services 6 Visudyne Therapy 40
Organ and Bone Marrow Transplants 8 Pediatric Transport 40
Heart and Lung Transplants 9
Kidney Transplants 10 HIGH COST DRUGS 41
Liver Transplants 11
Bone Marrow T ransplants 12 HIGH COST DEVICES 43
Trauma and Burns 13
Cochlear Implants 44
Neurosurgery 14 Cranioplasts 44
Cardiovascular Services 15
Implantable Cardioverter Defibrillators
Cardiac Waitlists 16 (ICDs) 45
Neonatology 17
Oncology 18 OTHER PROVINCE WIDE SERVICES 46
Rosehaven 47
SPECIAL FEATURES REPORTS 19 Equipment 47
Feature Article 1 Alberta Provincial Project for Outcomes
Northern and Southern Alberta Renal Programs Assessment in Coronary Heart Disease
(APPROACH) 48
(joint submission) 20
Feature Article 2
Northern Alberta Neonatal Intensive Care APPENDICES 49
Program (Capital Health) 24
APpropveinndciex WAi de Services Working Group
Feature Article 3
(2004/2005) 50
Prevention of End-Stage Renal Disease
Program (Calgary Health Region) 26 APpropveinndciex WBi de Services Working Group
Terms of Reference (Charter) 51
CLINICS AND HOME SERVICES 28
Renal (Kidney) Dialysis 29 APpropveinndciex WCi de Services 2006/2007 Budget 54
Dialysis Delay/Prevention 32
Pre and Post Transplant 32
Islet Cell T ransplant 33
Medical Genetics 34
Digitized by the Internet Archive
in 2016
https://archive.org/details/annualreportonac2005albe
Overview of Province Wide Services
Province Wide Services refer to a g roup of key specialized services made available to them.
medical life-saving interventions which are
specialized in a l imited number of sites in the The Province Wide Services Working Group
province but available to all Albertans. They (PWSWG) is the provincial advisory committee
include organ transplants, major heart surgery, overseeing PWS. Committee members include
kidney dialysis and many other important medical representatives from the Calgary and Capital
services. The full list of specific Province Wide health regions who deliver these services, a rural
Services is contained on page 2. health region, and Alberta Health and Wellness.
The committee utilizes its clinical and financial
Unlike the majority of hospital and community expertise to recommend on service levels and
regional health services, a special provincial budget. The committee also reviews emerging
governance structure has been put in place for technologies and proposals for new Province
Province Wide Services. This helps ensure these Wide Services.
key life-saving interventions are provincially
planned, employ the best proven technologies, Given the mandate of Province Wide Services to
and are adequately funded so they will be there ensure equitable service access to all Albertans,
for all Albertans when they need them. Albertans this Annual Report presents extensive information
can be proud of the quality of these highly on region of residence for patients receiving
these services.
Figure 1: Hospital Discharges - P WS Cases vs. All Other Cases, 2004/2005
Province Wide Services
10,945 Total Inpatient Cases
3.1% of total Inpatient Cases
$23,862 Average Cost / C ase
All Other Cases
345,789 Total Inpatient Cases
96.9% of total Inpatient Cases
$5,359 Average Cost / C ase
Figure 1 shows how the average cost of the specialized PWS inpatient services are nearly 4 t imes
higher than the cost of other hospital-based care. (Note: the costs shown are those incurred by the
regional health authorities and exclude any physician fee-for-service claims).
PWS Activities and Outcomes - 2 005 Annual Report 1
Province Wide Services Mission Statement
Province Wide Services (PWS) is intended to fund a narrow band of high cost services that, because of
their nature, can only be effectively provided at one or two sites in Alberta. PWS activities are planned
collaboratively between Alberta Health and Wellness, the Calgary and Capital health authorities, and all
health regions to ensure these highly specialized services are provided in the best interests of the
province as a whole, with proper medical and financial accountability. PWS is p atient-focused and
equitably accessed by all Albertans.
2005 Inventory of Province Wide Services
Inpatient Services High-Cost Drugs
• Organ and Bone Marrow Transplants • Immunosuppressants (Cyclosporine,
Tacrolimus, Sirolimus, Mycophenolate,
• Selected Tertiary Services for:
Basiliximab, Daclizumab, IKT-3, ATGAM,
— Trauma and Burns
Ondansetron and Filgrastim)
- Neurosurgery • HIV Antiretrovirals
- Cardiovascular Procedures
• Human Growth Hormone for Chronic Renal
- Neonatology (low birthweight infants) Failure and Growth Hormone Deficiency
- Oncology
• Pulmozyme for Cystic Fibrosis
Clinics and Home Services • * P ediatric Crohn’s Medication (Remicade)
• Dialysis and Renal Program • * P ediatric Multiple Sclerosis Medications
(Copaxone, Avonex, Rebif, Betaseron)
• Dialysis Prevention
• Flolan and Tracleer for Primary Pulmonary
• Pre-and-Post T r ansplant Activities
• Medical Genetics Hypertension
• Islet Cell Transplantation • - d enotes new additions to PWS for 2006/2007
• HIV Clinics
High-Cost Devices
• STD/TB Clinics
• Cochlear Implants
• 1-800 AIDS Hotline
• Implanted Cardiac Defibrillators
• Poison and Drug Information Services • Cranioplasty
(PADIS)
• Home Enteral Nutritional Therapy Rosehaven Provincial Program
• Craniofacial Osseointegration (COMPRU) • Located in Camrose, this program provides
special behavioural care within the continuing
• Children with Complex Healthcare Needs
care system throughout Alberta
• Education Resource Centre
• Pediatric Transport Ocular Photodynamic (Visudyne) Therapy
• Laser-activated drug (Visudyne) treatment of
classic wet age-related macular degeneration
Alberta Provincial Project for Outcomes
Assessment in Coronary Heart Disease
(APPROACH)
2
PWS Activities and Outcomes - 2 005 Annual Report
Province Wide Services Working Group (PWSWG)
Originally created as the Province Wide Services • Chair appointed by the Minister of Health and
Advisory Committee in 1997, this group is tasked Wellness
with advising the Ministry on all aspects of the
• Chief Medical Officers for Calgary Health
delivery of services. This included developing
Region and Capital Health
annual budget recommendations, screening
proposals for new or expanded programs, and • Chief Financial Officers for Calgary Health
monitoring the performance and outcomes of Region, Capital Health, and one non-urban
health region
existing programs.
• A ssistant Deputy Minister of Finance and
Although scaled down to a smaller group in 2002, Corporate Services for Alberta Health and
the newly named Province Wide Services Wellness
Working Group maintained much of the same
• Secretariat and staff support by Alberta Health
mandate as its predecessor, consisting of the and Wellness
following membership:
A f ull listing of the members of the Province Wide
Services Working Group (PWSWG) can be found
in Appendix A.
PWS Activities and Outcomes - 2 005 Annual Report 3
Highlights
2004/2005 Results CAPITAL HEALTH - a t otal of 5,979 PWS
inpatient cases provided to Albertans in
Inpatient Services: 2004/2005, a d rop of 67 total procedures from the
CALGARY HEALTH REGION - D uring previous year and 92 procedures less than
2004/2005 fiscal year, the Calgary Health Region projected for 2004/2005. As with Calgary, a
provided 4,975 PWS-funded inpatient surgeries, significant decrease was seen in cardiac bypass
which is slightly less than the 4,994 procedures surgery volumes and neurosurgery, but these
performed in 2003/2004. Estimates prior to the decreases were offset by higher than expected
year had predicted a t otal of 5,444 surgeries, coronary angioplasty procedures. Organ
which is j ust over 9 p ercent higher that what was transplants performed in Edmonton, however,
actually provided. Some of the most significant had somewhat mixed results, with higher volumes
areas where volumes dropped off below of kidney transplants than the previous few years,
expectations are in cardiac bypass surgery and but lower heart, lung, and liver transplants than
neurosurgery. Kidney and bone marrow
expected.
transplants also experienced lower volumes than
anticipated. Calgary did, however, see a sharp
rise in the number of extremely small infants born 2006/2007 Budget
with birthweights less than 750 grams (1.65
pounds), who can tend to be among the most A P WS budget totaling $545 million for
complex patients served by the health system 2006/2007 was announced in March 2006,
today. representing a 7 p er cent increase from the
previous year.
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PWS Activities and Outcomes - 2 005 Annual Report
PROVINCE WIDE SERVICES
Activities and Outcomes
PWS Activities and Outcomes - 2 005 Annual Report
Activities and Outcomes
Inpatient Services
In relation to the broad range of procedures that many of these cases, these specialized sites also
can be performed in a h ospital, the PWS Inpatient serve many other Canadians from neighbouring
Services are a relatively small, but specialized provinces and territories who do not have
sufficient population to establish an effective
list. The word “inpatient”, for the purposes of this
report, refers to someone who must stay program, especially in areas like transplants and
overnight in a h ospital for the duration of their neonatology (high-risk newborn babies). In such
care. Generally, what makes the PWS inpatient circumstances, it i s the responsibility of the
services unique from other hospital-based care is person’s home province or territory to cover the
the heavy reliance on specialized staffing, cost of caring for their resident in Alberta.
expensive equipment, or usually both. There is
also a requirement that centralized, provincial Attention is g iven to ensuring equitable access to
planning of these services is beneficial for clinical these services by all residents of Alberta,
and financial reasons when compared to regardless of their geographic proximity to the
regionally planned hospital care. specialized program.
The list of PWS-funded Inpatient Services Figure 2 i llustrates the percent of PWS-funded
includes: bone marrow transplants, organ inpatient services received by residents of each
transplants, heart surgeries, selected health region in Alberta, compared to the percent
neurosurgical procedures, neonatology (low of the provincial population that region comprises.
birthweight infants), and selected oncology This is only for illustration purposes, as there are
services. many factors like average age and social
These key services are funded under the premise determinants that would impact on one region
that only one or two sites in Alberta should requiring more services than another.
conceivably be offering them, for reasons of
safety, provider proficiency, and efficiency. In
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PWS Activities and Outcomes - 2 005 Annual Report
