8
Local Health Hub Profile – Dryden
Kenora Integrated District Network
Spring 2013
North West LHIN  RLISS du Nord-Ouest
Local Health Hub Profile – Dryden 2
North West LHIN  RLISS du Nord-Ouest
Table of Contents
INTRODUCTION........................................................................................................................................... 4
DEMOGRAPHICS AND POPULATION CHARACTERISTICS ................................................................... 5
DEMOGRAPHICS........................................................................................................................................................5
LHIN FUNDED HEALTH SERVICES ........................................................................................................... 8
ACUTE CARE.............................................................................................................................................................8
LONG-TERM CARE (LTC) .........................................................................................................................................8
COMPLEX CONTINUING CARE (CCC) ......................................................................................................................9
INPATIENT REHABILITATION ......................................................................................................................................9
INPATIENT MENTAL HEALTH ...................................................................................................................................11
COMMUNITY BASED CARE......................................................................................................................................15
Primary Care ....................................................................................................................................................15
Home Care .......................................................................................................................................................15
ANALYSIS OF ACUTE CARE HOSPITAL DISCHARGES ....................................................................... 17
MARKET SHARE OF ACUTE CARE DISCHARGES ....................................................................................................17
HOSPITALIZATIONS RELATED TO DIABETES ...........................................................................................................20
DIABETES AND AMPUTATIONS ................................................................................................................................22
DEMENTIA PATIENT POPULATION ..........................................................................................................................23
HOSPITAL USE AT THE END OF LIFE (IN-HOSPITAL PALLIATIVE CARE) ................................................................24
DISCHARGES FROM THE LOCAL HEALTH HUB’S ACUTE CARE HOSPITAL - DRYDEN REGIONAL HOSPITAL.........26
ALTERNATE LEVEL OF CARE (ALC) LENGTH OF STAY (LOS) ..............................................................................27
RE-ADMISSIONS FOR SELECT CONDITIONS ...........................................................................................................28
ANALYSIS OF AMBULATORY CARE VISITS.......................................................................................... 29
EMERGENCY (ED) VISITS .......................................................................................................................................29
EMERGENCY VISITS RELATED TO DIABETES .........................................................................................................32
NON-URGENT EMERGENCY VISITS ........................................................................................................................33
ED W AIT TIMES ......................................................................................................................................................34
Local Health Hub Profile – Dryden 3
North West LHIN  RLISS du Nord-Ouest
Dryden Local Health Hub Profile
Introduction
This profile is one of a series of 14, corresponding to each of the 14 Local Health Hubs (LHHs) in the
North West LHIN. The Dryden LHH is one of three LHHs that are part of the Kenora Integrated District
Network (IDN), which in turn is one of the five IDNs in the North West LHIN’s new integrated health
system model.
The map below illustrates the location of the Local Health Hub communities and the Integrated District
Networks.
Figure 1: Map of the North West LHIN
Local Health Hub Profile – Dryden 4
North West LHIN  RLISS du Nord-Ouest
Demographics and Population Characteristics
Demographics
The following table lists the communities (census subdivisions (CSDs)) that are aligned to the Dryden
Local Health Hub, as well as their respective population counts from the 2006 and 2011 censuses and
the percentage population change over that time period.
Table 1: Dryden Local Health Hub Communities, 2006 and 2011 Census
CSD/Community
Type of CSD
Dryden
City
Wabigoon Lake 27
2006
Census
2011
Census
% Change
8195
7617
-7.1
Indian Reserve
147
184
25.2
Machin
Township
978
935
-4.4
Eagle Lake 27
Indian Reserve
232
227
-2.2
Ignace
Township
1431
1202
-16.0
10,983
10,165
-7.4
Dryden LHH Total
Data Source: Statistics Canada. 2011 Census and 2006 Census.
The following table presents some of the demographic characteristics of all three LHHs in the Kenora
IDN, including the Dryden LHH, with comparisons to the overall North West LHIN population.
Table 2: Population Characteristics, 2011 Census
Indicator
Total Population
% Age 65+
% Age 75+
2
% Aboriginal Identity
% Francophone
Red Lake
LHH
5,465
11.4%
Kenora
LHH
27,495
15.5%
Dryden
LHH
10,170
17.7%
Kenora
IDN
43,130
15.5%
North West
LHIN
1
231,120
16.0%
4.6%
6.9%
8.1%
6.9%
7.3%
13.4%
25.6%
14.2%
21.8%
19.2%
4.5%
2.3%
3.4%
2.9%
3.4%
Data Source: Statistics Canada. 2011 Census and 2006 Census.
1
Adjusted for incompletely enumerated Indian Reserve Census Subdivisions.
2
Based on 2006 Census; questions on Aboriginal identity not included in 2011 Census.
Key Findings:
 The population of the Dryden LHH is older than in the broader Kenora IDN and North West
LHIN;
 The proportion of the residents who are francophone is reflective of the North West LHIN as a
whole;
 The proportion of the residents who self-identify as aboriginal is lower than in the broader Kenora
IDN and North West LHIN overall.
The following table shows the latest health behaviour indicators from the Canadian Community Health
Survey (CCHS) for the Northwestern Health Unit (NWHU), Thunder Bay District Health Unit (TBDHU),
Local Health Hub Profile – Dryden 5
North West LHIN  RLISS du Nord-Ouest
North West LHIN and Ontario. Note that residents living on Indian Reserve census subdivisions are not
1
included in the CCHS.
Table 3: Self-Reported Health Behaviours/Practices, Canadian Community Health Survey
2009/2010, age 12+
Thunder Bay Northwestern
North
Indicator
District Health Health Unit
West
Unit (TBDHU)
(NWHU)
LHIN
Overweight or obese, age 18+ (%)
60.2
65.5
61.7
Pain or discomfort that prevents activities (%)
18.8
19.6
19.0
Current smoker; daily or occasional (%)
24.6
22.4
23.9
Heavy drinking (%)
20.4
22.2
20.9
Leisure-time physical activity; moderately active or active (%)
57.3
59.7
58.0
Regular medical doctor (%)
84.4
81.3
83.5
Contact with a medical doctor in the past 12 months (%)
80.2
77.4
79.3
Source: Statistics Canada. 2011. Health Profile. Statistics Canada Catalogue no. 82-228-XWE. Ottawa. Released
2011. http://www12.statcan.gc.ca/health-sante/82-228/index.cfm?Lang=E
ON
52.0
13.5
18.9
15.9
50.5
91.1
82.2
June 28
Key Finding:
 The rates of heavy drinking and being overweight in the NWHU area are slightly higher than in
the TBDHU area, and higher than provincial rates.
The following table gives an indication of the burden of chronic disease in the North West LHIN, based on
self-reported chronic conditions.
Table 4: Self-Reported Prevalence of Chronic Conditions, Canadian Community Health Survey,
2009/10
Indicator
Thunder Bay
District Health
Unit (TBDHU)
Northwestern
Health Unit
(NWHU)
North
West
LHIN
ON
Canadian Community Health Survey, 2009/10: % report being diagnosed by health professional
1
20.5%
26.6%
Arthritis -age 15+
57.8%
-age 65+
49.2%
Diabetes -age 12+
6.7%
7.3%
-age 65+
19.2%
25.9%
21.6%
High blood pressure -age 12+
19.2%
57.9%
-age 65+
53.6%
Chronic obstructive pulmonary disease
(COPD) -age 35+
7.3%
3.5%
14.2%
-age 65+
4.6%
Mood disorders - age 12+
8.8%
7.1%
- age 65+
9.8%
9.0%
1. Bolded estimates are significantly different from the provincial estimate.
22.4%
51.6%
6.9%
21.1%
19.9%
56.7%
6.2%
11.5%
17.3%
46.7%
6.8%
19.6%
17.4%
49.7%
4.2%
7.2%
8.3%
9.5%
6.8%
6.0%
Source: Statistics Canada. Table 105-0502 - Health indicator profile, two year period estimates, by age group and
sex, Canada, provinces, territories, health regions (2011 boundaries) and peer groups, occasional CANSIM
(database). (Accessed January 30, 2013).
1
There are two public health units in the North West LHIN area – Northwestern Health Unit (NWHU) and Thunder
Bay District Health Unit (TBDHU). The Northwestern Health Unit area corresponds to the Northern, Kenora and
Rainy River IDN areas of the North West LHIN. The Thunder Bay District Health Unit area corresponds to the City of
Thunder Bay and the Thunder Bay District IDN areas of the North West LHIN.
Local Health Hub Profile – Dryden 6
North West LHIN  RLISS du Nord-Ouest
Key Finding:
 Rates of arthritis are higher in the North West LHIN, particularly in the Northwestern Health Unit
area.
Diabetes
The table below shows the estimated number of adults (age 18 years and over) in North West LHIN with
2
diabetes and the percentage that have had the recommended testing for diabetics.
Table 5: Diabetes Prevalence, age 18+ and Testing Status based on Ontario's Baseline Diabetes
Dataset Initiative (BDDI), as of March 31, 2011
% of Patients with Diabetes
Area - Patient Residence
All 3 tests AIC within
All patients
1
past 6
with Diabetes done
months
LDL-C
within past
year
2
Retinal eye
exam within
past 2 yrs
Kenora District (Kenora and
Northern IDNs)
6,146
31
48
55
64
Rainy River IDN
1,770
34
54
56
74
Thunder Bay District IDN
2,592
16
53
26
70
City of Thunder Bay IDN
10,817
40
60
66
69
North West LHIN Total
21,325
34
55
57
68
Ontario Total
989,212
40
57
69
68
Source: HAB. Chronic conditions, prevalence, mortality, hospitalizations (2012-07-25) data product. July
2012.
Individuals are identified as having diabetes if they have had at least one hospitalization or two physician service claims
over a two-year period with a diabetes related diagnostic code. Women with gestational diabetes are not included.
Prevalence numbers are refined based on feedback from physicians who review patient lists and provide validation on
diabetes status.
1. Testing rates for HbA1c and LDL-C only include tests conducted in community labs and captured in the
Claims History Database (CHDB). Lab tests for A1C or LDL-C conducted in hospitals are not individually
submitted and therefore cannot be analysed for diabetes patients. Analysis of Eye Exams is also based on
CHDB. Only retinal eye exams where a fee-for-service claim was submitted are included. Exams that were
paid out-of-pocket by the patient are not included. Some providers (i.e., ophthalmologists in alternate payment
plans) may not submit claims. The percent of patients receiving exams may be underestimated in areas where
there are a larger proportion of non-FFS providers conducting retinal eye exams
Key Findings:
 The North West LHIN has a higher prevalence of diabetes at 11.3% of the adult population (age
18 and over) vs. 9.3% provincially;

As of March 31, 2012, the number has increased to 22,345, 11.8% of the adult population
compared to 9.7% provincially.
2
The Baseline Diabetes Database Initiative (BDDI) was created by the Ministry using a validated algorithm to identify
Ontario residents, age 18+, with diabetes based on administrative data sources.
Local Health Hub Profile – Dryden 7
North West LHIN  RLISS du Nord-Ouest
LHIN Funded Health Services
Acute Care
The Dryden Local Health Hub has one acute care hospital –Dryden Regional Hospital. Other acute care
hospitals in Kenora IDN are located in Red Lake and Kenora. Dryden Regional Health Centre is the only
hospital in the Kenora IDN that has been identified as providing French Language Services (FLS).
In addition to acute care beds, there are a number of other inpatient bed types located in the acute care
facilities in the Kenora IDN.
Table 6: Bed Types in Acute Care Hospitals
Hospital
Acute
Inpatient
Rehab
CCC
Red Lake Margaret Cochenour
Memorial Hospital
14
4
Lake of the Woods District Hospital
55
10
Dryden Regional Hospital
31
10
Kenora IDN
100
24
Mental
Health
Newborn
Bassinets
ELDCAP
2
19
6
4
19
14
Source: Web Enabled Reporting System (WERS); extracted Jan. 2012.
Long-Term Care (LTC)
The following table shows the names and locations of long-term care homes in the Kenora IDN, along
with the number of beds in each home.
Table 7: Long-Term Care Homes
LTC Home
Community
# of LTC Beds
Birchwood Terrace Nursing Kenora
Home
96
Kenora
Pinecrest Home for the Aged
126*
Northwood Lodge Home for Red Lake
the Aged
32
Dryden
Princess Court
97
Kenora IDN Total
351*
Data Source: North West LHIN. Health Profile – Kenora IDN.
* 10 of 126 LTC beds at Pinecrest Home for the Aged are slated to close in
summer 2013
Local Health Hub Profile – Dryden 8
North West LHIN  RLISS du Nord-Ouest
Complex Continuing Care (CCC)
The type of patient occupying CCC beds varies from hospital to hospital within the LHIN and across the
province and is reflected in the CCC bed rate per population 75+. The table below shows the 2010 bed
rate in each Integrated District Network area within the North West LHIN.
Table 8: CCC Bed Rate per Population Age 75+, 2010
Beds per 1,000
Population 75+
IDN Area
Thunder Bay District IDN
City of Thunder Bay City IDN
Kenora IDN
Northern IDN
31
17
9
9
16
16.1
6.6
Rainy River IDN
North West LHIN
Ontario
Data Source: Preyra Solutions Group. Complex Continuing Care in
the North West LHIN. June 2012.
Key Findings:
 In 2010, the CCC bed rate in the North West LHIN was more than twice the provincial average of
7 beds per 1,000 seniors age 75+;

Kenora and Northern IDNs had the lowest CCC bed rate of all IDNs within the North West LHIN;

The average frailty of acute discharges to CCC in North West is lower than the provincial
3
average .
Inpatient Rehabilitation
St. Joseph’s Care Group (SJCG), located in the city of Thunder Bay has 50 Inpatient Rehabilitation beds
which service all residents of the North West LHIN.
The following tables show where patients admitted to SJCG for general rehab episodes and specialty
rehab episodes live within the North West LHIN.
Table 9a: Number of General Rehab Episodes for Inpatient Rehabilitation by Rehabilitation Client
Group (RCG) and Patient Residence, Fiscal y\Years 2009/10 to 2011/12 Combined
General Rehab Episodes at SJCG, fiscal years 09/10 - 11/12 combined, by RCG Category
Rehab Client
Group
AMPUTATION OF
LIMB
ARTHRITIS
PAIN SYNDROMES
ORTHOPAEDIC
3
Dryden
LHH
TBay Dt
IDN
<5
7
0
<5
12
27
3
45
CoTB
IDN
Northern
IDN
32
69
10
806
<5
32
5
12
Kenora
IDN
Rainy
River
IDN
7
8
0
6
<5
17
<5
16
North
West
LHIN
Total
SJCG
59
153
20
885
Preyra Solutions Group. Complex Continuing Care in the North West LHIN. June 2012.
Local Health Hub Profile – Dryden 9
61
154
22
910
North West LHIN  RLISS du Nord-Ouest
General Rehab Episodes at SJCG, fiscal years 09/10 - 11/12 combined, by RCG Category
Rehab Client
Group
Dryden
LHH
TBay Dt
IDN
CoTB
IDN
Northern
IDN
Kenora
IDN
Rainy
River
IDN
North
West
LHIN
Total
SJCG
0
<5
16
<5
0
<5
20
21
12
88
933
55
21
40
1137
1168
CONDITIONS
OTHER
All RCGs
Data Source: Inpatient Rehabilitation Main Table, intelliHEALTH ONTARIO; extracted Jan. 2013.
Key Findings:

Dryden LHH residents accounted for 1.0% of general rehab episodes at SJCG;

Residents of Kenora IDN accounted for 1.8% of general rehab episodes.
Table 9b: Number of Specialty Rehab Episodes for Inpatient Rehabilitation by Rehabilitation Client
Group (RCG) and Patient Residence, Fiscal Years 2009/10 to 2011/12 Combined
Special Rehab Episodes at SJCG, fiscal years 09/10-11/12, by RCG Category
Rehab Client
Group
STROKE
BRAIN
DYSFUNCTION
NEUROLOGICAL
CONDITIONS
SPINAL CORD
DYSFUNCTION
OTHER
All RCGs
Dryden
LHH
TBay Dt
IDN
CoTB
IDN
Northern
IDN
Kenora
IDN
Rainy
River
IDN
North
West
LHIN
Total
SJCG
14
50
251
21
42
15
379
385
<5
9
42
9
<5
5
69
73
0
5
28
<5
0
<5
36
36
0
<5
5
0
8
<5
<5
<5
0
<5
<5
0
15
6
15
16
69
333
34
47
22
505
515
6
Key Findings:

Dryden LHH residents accounted for 3.1% of specialty rehab episodes at SJCG, 87.5% of them
for stroke;

Residents of Kenora IDN accounted for 9.1% of specialty rehab episodes;

Of all rehab episodes for Kenora IDN residents, the majority were for stroke (89.4%).
The table below shows the breakdown of discharges and average length of stay for St. Joseph’s Care
Group discharges by Rehab Client Group (RCG) for fiscal year 2010/11.
Local Health Hub Profile – Dryden 10
North West LHIN  RLISS du Nord-Ouest
Table 10: Rehab Discharges from St. Joseph’s Care Group, fiscal year 2010/11
Rehab Client Group
(01.1) STROKE - LEFT BODY
INVOLVEMENT (RIGHT BRAIN)
(08.11) ORTHOPAEDIC CONDITIONS
- STATUS POST UNILATERAL HIP
FRACTURE
(01.4) STROKE - NO PARESIS
(03.1) NEUROLOGICAL CONDITIONS
- MULTIPLE SCLEROSIS
(02.22) BRAIN DYSFUNCTION TRAUMATIC - CLOSED INJURY
(02.1) BRAIN DYSFUNCTION - NONTRAUMATIC
(02.2) BRAIN DYSFUNCTION –
TRAUMATIC
(08.61) ORTHOPAEDIC CONDITIONS
- STATUS POST UNILATERAL KNEE
REPLACEMENT
(08.51) ORTHOPAEDIC CONDITIONS
- STATUS POST UNILATERAL HIP
REPLACEMENT
(08.53) ORTHOPAEDIC CONDITIONS
- STATUS POST REVISION OF
UNILATERAL HIP REPLACEMENT
(CIHI CATEGORY)
(08.3) ORTHOPAEDIC CONDITIONS STATUS POST PELVIC FRACTURE
(04.130) NON-TRAUMATIC SPINAL
CORD DYSFUNCTION – OTHER
(08.63) ORTHOPAEDIC CONDITIONS
- STATUS POST REVISION OF
UNILATERAL KNEE REPLACEMENT
(CIHI CATEGORY)
Total
#
Discharge
s
Total
Days
NW
Provincial North West
Weighted
Average Average
'Excess'
Cases
LOS
LOS
Days
48
2,371
80
49
37
614
57
2,016
63
35
25
597
31
1,367
42
44
27
542
6
680
16
113
41
436
5
563
21
113
41
357
8
679
26
85
41
350
6
649
25
108
66
252
115
1,359
55
12
10
184
77
1,235
48
16
14
152
23
604
15
26
20
149
8
320
9
40
22
143
<5
233
8
58
27
127
10
245
5
25
13
115
565
16,963
589
30
25
2838
Source: Preyra Solutions Group. Inpatient Rehabilitation in the North West LHIN. June 2012.
Key Findings:

St. Joseph’s Care Group rehab patients have longer lengths of stay than the provincial average,
controlling for case mix (complexity of case) using RCGs;

SJCG focuses on post-acute inpatient rehabilitation for hip and knee replacement patients and
stroke patients.
Inpatient Mental Health
There are no designated Inpatient Mental Health beds in the Dryden LHH area but there are acute
psychiatric beds within the Kenora IDN. The following table contains the location of the Inpatient Mental
Health beds in the North West LHIN.
Local Health Hub Profile – Dryden 11
North West LHIN  RLISS du Nord-Ouest
Table 11: Designated (Adult) Mental Health Beds in North West LHIN
Mental
Health
Beds
19
Provider Name
IDN Area
Type
Lake of The Woods District Hospital
Kenora
Acute Psych.
Thunder Bay Regional Health Sciences Centre
City of Thunder Bay
Acute Psych.
30
Thunder Bay Regional Health Sciences Centre
City of Thunder Bay
Forensic
20
St Joseph's Care Group (SJCG)
City of Thunder Bay
M.H. Rehab
71
North West LHIN Total
4
140
Source: PwC. Draft North West LHIN Blueprint Project Report. Dec. 2011.
The graphs in Figure 2 (a and b) show the distribution of patient residence for patients admitted to Lake of
the Woods District Hospital and Thunder Bay Regional Health Sciences Centre (Acute Psychiatric beds).
Figure 2a: Utilization of Designated (Adult) Mental Health Acute Psychiatric Beds in North West
LHIN by Patient Residence
Number of Patients
Patients Admitted to LOTW District Hospital
Acute Mental Health by IDN: 2009-10 - 2011-12
180
160
140
120
100
80
60
40
20
0
Kenora
Source: IP Adult MH Assessment,
Treatment, Diagnosis, intelliHealth
Ontario; extracted March 22, 2013
Rainy River
2009/2010
Northern
2010/2011
Other
City of Thunder
Bay
District of
Thunder Bay
2011/2012
4
The number of beds at SJCG is being reduced to 38. These mental health rehabilitation beds and related
outpatient and outreach programs will serve people with serious mental illness, concurrent disorders, acquired brain
injury, dual disorders and/or geriatric psychiatric illness.
Local Health Hub Profile – Dryden 12
North West LHIN  RLISS du Nord-Ouest
Figure 2b: Utilization of Designated (Adult) Mental Health Acute Psychiatric Beds in North West
LHIN by Patient Residence
Number of Patients
Patients Admitted to TBRHSC Acute Mental
Health by IDN: 2009-10 - 2011-12
1500
1000
500
0
City of Thunder
District of
Bay
Thunder Bay
Source: IP Adult MH Assessment,
Treatment, Diagnosis, intelliHealth
Ontario; extracted March 22, 2013
2009/2010
Northern
2010/2011
Kenora
Rainy River
Other
2011/2012
Key Findings:

Most patients admitted to inpatient mental health acute psychiatric beds at Lake of the Woods
District Hospital in Kenora and Thunder Bay Regional Health Sciences Centre are from the same
IDN as where the hospital is located;

Kenora IDN residents accounted for 64.0%, 58.4% and 66.7% of admissions to Lake of the
Woods adult psychiatric beds in 2009/10, 2010/11 and 2011/12 respectively.
The following graphs show the distribution of admissions to inpatient adult mental health beds, by primary
reason for admission, over the three most recent years for which there is complete information.
Local Health Hub Profile – Dryden 13
North West LHIN  RLISS du Nord-Ouest
Figure 3a: Reasons for Admission to Designated (Adult) Mental Health Acute Psychiatric Beds at
Lake of the Woods District Hospital
Number of Unique Patients
Patients Admitted to LOTW Hospital Acute
Mental Health by Primary Diagnosis: 2009-10 2011-12
80
70
60
50
40
30
20
10
0
2009/2010
2010/2011
2011/2012
Source: IP Adult MH Assessment,
Treatment, Diagnosis, intelliHealth
Ontario; extracted March 22, 2013
Figure 3b: Reasons for Admission to Designated (Adult) Mental Health Acute Psychiatric Beds at
Thunder Bay Regional Health Sciences Centre
Number of Unique Patients
Patients Admitted to TBRHSC Acute Mental
Health by Primary Diagnosis: 2009-10 - 2011-12
500
450
400
350
300
250
200
150
100
50
0
2009/2010
2010/2011
2011/2012
Source: IP Adult MH Assessment,
Treatment, Diagnosis, intelliHealth
Ontario; extracted March 22, 2013
Local Health Hub Profile – Dryden 14
North West LHIN  RLISS du Nord-Ouest
Key Findings:

Mood disorders accounted for the highest number of admissions at TBRHSC while schizophrenia
and other psychotic disorders accounted for the most admissions at LOTW;

Substance-related disorders accounted for the second most number of admissions at TBRHSC
while adjustment disorders accounted for the second most admissions at LOTW.
Community Based Care
Primary Care
The table below shows the distribution of active physicians (as of December 2011) in the North West
LHIN area.
Table 12: 2011 Active Physicians in North West LHIN by Integrated District Network
Integrated District Network
(IDN)
Number of Family Medicine
Physicians
Number of
Specialists
Kenora IDN
56
13
Rainy River IDN
22
2
Thunder Bay District IDN
25
0
City of Thunder Bay IDN
140
165
Northern IDN
37
3
North West LHIN Total
280
183
Data Source: Ontario Physician Human Resources Data Centre Active Physician Registry, December
31, 2011.
Key Findings:




Within the Kenora IDN, as of Dec. 31, 2011, there were 14 active family medicine physicians in
the Dryden LHH, 12 in the Red Lake LHH and 30 in the Kenora LHH;
In addition to solo family physicians, there are Family Health Teams in each LHH in the Kenora
IDN, with locations in Dryden, Ear Falls, Vermillion Bay, Red Lake and Kenora;
The Mary Berglund Community Health Centre, located in Ignace, provides services to the Kenora
IDN area;
There is a satellite clinic of the Waasegiizhig Nanaandawe’iyewigamig Health Access Centre in
Kenora.
Home Care
The following graph shows the number of distinct clients receiving Home Care services by fiscal year for
each of the Integrated District Networks in the North West LHIN.
Local Health Hub Profile – Dryden 15
North West LHIN  RLISS du Nord-Ouest
Figure 4: Number of Home Care Clients by Integrated District Network
Number of Home Care (CCAC) Clients
25.0
# of distinct clients
6,000
20.0
5,000
4,000
15.0
3,000
10.0
2,000
5.0
1,000
0
% Population Age 65+
7,000
0.0
TBayDt IDN
CoTB IDN Rainy River IDN Kenora IDN
Integrated District Network Area
2008/09
2009/10
2010/11
Northern IDN
%Age 65+
Data Source: Home Care Main Table, intelliHEALTH ONTARIO;extracted fall 2012.
Key Findings:

Kenora IDN residents accounted for 16.8%,16.9% and 16.2% of North West CCAC’s clients in
these three fiscal years respectively;

640 Dryden LHH residents received service in 2010/11.
The following table shows the distribution of CCAC clients living in the Dryden LHH by service goals in
fiscal year 2010/11.
Table 13: CCAC Clients from Dryden LHH by Service Goal, fiscal year 2010/11
Service Goal
Acute (in-home)
End of Life (In-home)
Long-Term Care Placement
Long-Term Supportive
(in-home)
Maintenance (in-home)
Rehabilitation (in-home)
Short Stay Respite
# Distinct
Clients
% Clients with
Service Goal
( >= 1 goal)
Service Time
(Hours)
162
25.3%
1,864.50
16
2.5%
383.50
98
15.3%
249.00
92
14.4%
11,853.00
216
33.8%
21,465.25
207
32.3%
3,320.75
16
2.5%
37.00
Total
39173.00
Data Source: Home Care Main Table, intellIHEALTH ONTARIO; extracted Jan. 9, 2013.
Local Health Hub Profile – Dryden 16
North West LHIN  RLISS du Nord-Ouest
Each client may have more than one service goal, accounting for the total number of distinct clients for
each service goal being higher than the actual number of unique individuals receiving service (807
compared to 640). The average service time for Dryden LHH clients is highest for palliative care clients
(End-of-Life service goal).
Service Activity by Service Goal
For patients with an End-of-Life service goal, 45.9% of service time was for nursing visits followed by
42.9% for “combined personal support and homemaking service”.
For clients with an acute (in-home) goal, the majority of service time was for nursing visits (85.5%) with
10.5% for case management.
For clients with a service goal of long-term support (in-home), the majority of service time was for
combined personal support and homemaking services (87.1%), followed by 9.6% for nursing visits.
Similarly for clients with a maintenance (in-home) service goal, the majority of service time is for personal
support and homemaking services (75.7%), followed by 19.5% for nursing visits.
For CCAC clients with a rehabilitation (in-home) service goal, just over one-half (51.0%) of service time
was for personal support and homemaking services. In terms of therapy services, 13.8% of service time
was for speech language therapy, 7.7% for occupational therapy and 7.2% for physiotherapy. Nursing
visits accounted for another 11.7% of service time for clients with a rehabilitation service goal.
Analysis of Acute Care Hospital Discharges
Market Share of Acute Care Discharges
The following figure shows where residents of the Dryden LHH went for acute care in fiscal years 2009/10
– 2011/12.
Figure 5: Distribution of Inpatient Acute Care Discharges for Dryden LHH residents
# of Discharges
1800
Acute Care Discharges forDryden LHH Residents by Fiscal Year
and Location of Hospital
1500
37
197
1200
299
33
169
284
52
145
Other Prov.
350
Other Kenora IDN
Other NW LHIN
Other LHIN
900
600
MB
1070
1026
1105
TBRHSC
Dryden Regional
300
Data Source: DAD, CIHI
Portal; extracted Jan. 14,
0
2009-2010
2010-2011
Discharge Fiscal Year
2011-2012
Local Health Hub Profile – Dryden 17
North West LHIN  RLISS du Nord-Ouest
Key Findings:

Dryden Regional Hospital accounted for approximately 65% of discharges to Dryden LHH
residents over the three year fiscal period;

TBRHSC accounted for 20.4% of discharges to Dryden LHH residents in 2011/12 compared to
8.4% for Manitoba facilities.
In terms of discharges from the hospital located in the Dryden Local Health Hub—Dryden Regional
Hospital—the following graph shows the distribution of discharges by patient residence and fiscal year.
Figure 6: Distribution of Inpatient Acute Care Discharges from Dryden Regional Hospital by
Patient Residence and Fiscal Year
Dryden Regional Hospital Discharges by Patient
Residence and Fiscal Year
1400
58
162
# of Discharges
1200
59
171
46
192
Other LHIN
1000
Out of Province
800
Other NW LHIN
600
1088
1047
1130
400
Other Kenora/ Northern
IDN
Dryden LHH
200
0
2009/10
2010/11
Discharge Fiscal Year
2011/12
Data Source: Inpatient Discharge Main Table, intelliHEALTH ONTARIO; extracted Jan. 4, 2013.
Key Finding:

The majority of the discharges were from Dryden LHH residents, ranging from 81.7% in
2009/10 to 80.8% in 2010/11 and 2011/12.
The following table illustrates the extent of acute care service received by Dryden LHH residents from
Thunder Bay Regional Health Sciences Centre.
Local Health Hub Profile – Dryden 18
North West LHIN  RLISS du Nord-Ouest
Table 14: % Acute Care Discharges for Dryden LHH residents from TBRHSC by Most Responsible
Diagnosis Chapter, fiscal years 2009/10 – 2011/12 combined
ICD10 Chapter
Injury, poisoning and other consequences of external
causes (S00-T98)
Diseases of musculoskeletal system and connective
tissue (M00-M99)
Total # Acute Care
Discharges for
LHH Residents
(all hospitals)
% Discharges from
TBRHSC
386
43.8%
312
34.3%
344
33.4%
58
29.3%
20
25.0%
227
22.5%
107
19.6%
94
18.1%
Certain infectious and parasitic diseases (A00-B99)
129
17.1%
Diseases of the circulatory system (I00-I99)
Symptoms, signs and abnormal clinical and
laboratory findings (R00-R99)
Endocrine, nutritional and metabolic diseases (E00E90)
Factors influencing health status and contact with
health services (Z00-Z99)
744
15.7%
354
14.4%
118
12.7%
648
12.5%
Diseases of the ear and mastoid process (H60-H95)
17
--*
Pregnancy, childbirth and puerperium (O00-O99)
Diseases of the skin and subcutaneous tissue (L00L99)
352
11.6%
45
11.1%
Diseases of the digestive system (K00-K93)
518
10.8%
Diseases of the respiratory system (J00-J99)
Diseases of the blood and blood-forming organs and
certain disorders involving the immune mechanism
(D50-D89)
Diseases of the eye and adnexa (H00-H59)
399
9.0%
48
--*
20
--*
4940
18.9%
Neoplasms (C00-D48)
Diseases of the nervous system (G00-G99)
Congenital malformations, deformations and
chromosomal abnormalities (Q00-Q99)
Diseases of the genitourinary system (N00-N99)
Certain conditions originating in the perinatal period
(P00-P96)
Mental and behavioural disorders (F00-F99)
All Discharges
* - Number of discharges from TBRHSC <5.
Data Source: DAD, CIHI Portal; extracted Jan. 4, 2013.
Key Finding:

Over the last three complete fiscal years, 18.9% of all discharges for Dryden LHH residents
(including those out-of-province and out of North West LHIN) were from TBRHSC (933
discharges);
Local Health Hub Profile – Dryden 19
North West LHIN  RLISS du Nord-Ouest
Hospitalizations Related to Diabetes
The number of discharges and total length of stay for North West LHIN patients with a most responsible
diagnosis of diabetes have consistently been double that of the province, based on crude rates as
illustrated in the following table.
Table 15a: Discharges and Total Length of Stay for Diabetes (Most Responsible Diagnosis) in
Ontario Hospitals, Fiscal Years 2008/09 – 2010/11
North West LHIN
Ontario
#
Discharges
Discharge
Rate
Length of
Stay
(Days)
IP_Days
Rate
Discharge
Rate
IP_Days
Rate
2008
513
214.0
5,179
2,160.5
97.8
1,002.9
2009
2010
508
497
212.4
208.2
5,342
4,944
2,233.7
2,070.6
96.3
93.1
988.4
923.9
Source: HAB. Chronic conditions, prevalence, mortality, hospitalizations (2012-07-25) data product. July
2012.
Key Finding:

The hospitalization rate for diabetes in the North West LHIN is more than double that of the
province.
The table below shows the distribution of discharges and length of stay for fiscal year 2010/11 by IDN
area.
Table 15b: Discharges and Total Length of Stay for Diabetes (Most Responsible Diagnosis), Fiscal
Year 2010/11 by Patient Residence
Area - Patient Residence
Inpatient
Discharges
Inpatient Length of Stay
(Days)
Kenora District (Kenora and Northern IDNs)
140
1,757
Rainy River IDN
60
590
Thunder Bay District IDN
69
745
City of Thunder Bay IDN
228
1,852
North West LHIN Total
497
4,944
Source: HAB, MOHLTC. Chronic conditions, prevalence, mortality, hospitalizations (2012-07-25)
data product. July 2012.
Key Findings:

Fifteen of these discharges were from Dryden Regional Hospital and a further 48 from the other
hospitals in the Kenora IDN;
Local Health Hub Profile – Dryden 20
North West LHIN  RLISS du Nord-Ouest


The majority of discharges were from Thunder Bay Regional Health Sciences Centre (270 or
5
54.3%);
Of the 497 discharges from Ontario hospitals in 2010/11, with a most responsible diagnosis of
diabetes, 58 of those involved amputations, accounting for 1,203 days length of stay.
The following graph shows the distribution of discharges with most responsible diagnosis by hospital
location (including all of Canada) by the last three fiscal years 2009/10 to 2011/12.
Figure 7: Distribution of Inpatient Acute Care Discharges with Most Responsible Diagnosis of
Diabetes by Hospital Location and Fiscal Year
300
Inpatient Discharges with Most Responsible
Diagnosis of Diabetes by
Hospital Location and Fiscal Year
# of Discharges
250
2009-2010
200
2010-2011
150
2011-2012
100
50
0
Kenora Rainy Northern CoTB IDN TBayDt
IDN River IDN IDN
IDN
Other
LHINs
Other
Prov.
Hospital Location
Data Source: DAD, CIHI Portal: extracted Jan 29, 2013
Key Findings:




5
If the 88 diabetes discharges (most responsible diagnosis) from hospitals across Canada for
North West LHIN residents is included, the number of diabetes discharges for North West LHIN
residents increases 17.7 %, from 497 in 2010/11 to 585;
During fiscal year 2011/12 there were 496 discharges from Ontario facilities and 548 overall;
The majority of out-of-province discharges occur in Manitoba. Out-of-province discharges
accounted for 13.5%, 15.0% and 9.5% of total diabetes discharges;
Kenora IDN hospitals saw 84, 63 and 51 discharges with most responsible diagnosis of diabetes
in 2009/10, 2010/11 and 2011/12 respectively. The corresponding values for Dryden Regional
Hospital specifically were 18, 15 and 16.
Inpatient Discharge Main Table, intellIHEALTH ONTARIO; extracted July 20, 2012.
Local Health Hub Profile – Dryden 21
North West LHIN  RLISS du Nord-Ouest
Diabetes and Amputations
Complications from diabetes can lead to amputation of limbs in some cases. The North West LHIN had
almost three times the rate of major amputations among diabetics than the provincial average in fiscal
6
year 2009/10, based just on amputations done in Ontario hospitals.
The following graph shows the distribution of these discharges by hospital location and fiscal year.
Figure 8: Distribution of Inpatient Acute Care Discharges with Most Responsible Diagnosis of
Diabetes and Amputation Intervention by Hospital Location and Fiscal Year
Inpatient Discharges with Most Responsible Diagnosis of
Diabetes and Amputation Intervention
60
# of Discharges
50
40
30
20
10
0
CoTB IDN
Other North West
Other LHINs
LHIN IDNs
Hospital Location
2009-2010
2010-2011
Manitoba
2011-2012
Data Source: DAD, CIHI Portal, extracted Jan. 29, 2013
Key Findings:

There were 80 discharges to North West LHIN residents in 2011/12 for patients with a most
responsible diagnosis of diabetes and a principal intervention of amputation;

The majority of these interventions were done at Thunder Bay Regional Health Sciences Centre
(63.78%), while 12.5% were done in Manitoba facilities and 21.3% at hospitals in other IDNs in
the North West LHIN;

Ten of these discharges occurred in Kenora IDN hospitals.
The following graph shows the number of discharges to North West LHIN residents that involved a most
responsible diagnosis of diabetes and an amputation intervention.
6
PwC. North West LHIN: Health Services Blueprint: Building Our Future Final Report. Feb. 2012.
Local Health Hub Profile – Dryden 22
North West LHIN  RLISS du Nord-Ouest
Figure 9: Distribution of Inpatient Acute Care Discharges with Most Responsible Diagnosis of
Diabetes and Amputation Intervention by Patient Residence and Fiscal Year
Diabetes and Amputation Discharges by Patient
Residence (IDN)
35
50
30
40
25
% LHIN 2011 Census Population
# Discharges
40
30
20
15
20
10
10
5
0
0
Northern
IDN
Kenora IDN Rainy River CoTB IDN TBayDt IDN
IDN
Pt. Residence IDN
2009-2010
2010-2011
2011-2012
% LHIN pop.
Data Source: DAD, CIHI Portal; extracted Jan. 29, 2013
Key Finding:

Residents of Kenora IDN account for 18.8% of these discharges in 2011/12, the same as the
IDN’s proportion of the North West LHIN’s population (18.7%).
Dementia Patient Population
The number of dementia patients in acute care is projected to increase by 19% from 284 (in 2009/10) to
7
338 (in 2019/20) .
Table 16: Inpatient Acute Care Dementia Patients, North West LHIN, Fiscal Year 2009/10
Kenora District (Kenora and
Northern IDNs)
Rainy River IDN
98
Average Total
Length of Stay
(LOS)days
29
63
13
7
Thunder Bay District IDN
27
46
30
City of Thunder Bay IDN
95
27
16
North West LHIN Total
284
26
16
Area – Patient Residence
Dementia
Cases
ALC Avg. LOS
days
19
Source: PwC. North West LHIN: Health Services Blueprint: Building Our Future Final Report.
Feb. 2012.
7
PwC. North West LHIN: Health Services Blueprint: Building Our Future Final Report. Feb. 2012.
Local Health Hub Profile – Dryden 23
North West LHIN  RLISS du Nord-Ouest
Key Finding:
 In 2009/10 Kenora IDN patients with dementia had similar lengths of stay to the broader North
West LHIN.
Hospital Use at the End of Life (In-Hospital Palliative Care)
The following table shows the number of discharges for North West LHIN residents over 2009/10 –
2010/11 that involved any palliative care diagnosis (ICD-10 code Z51.5).
Table 17: Acute Care Discharges with Diagnosis of Palliative Care, Fiscal Years 2009/10&2010/11
Combined
Received Palliative Care
All
Integrated District Network Discharges
of Patient Residence
(Total Acute
Care)
Expected #
Discharges
discharges
with diagnosis
Actual over Difference in
with diagnosis
of palliative
Expected
Discharges
of palliative
care (Actual)
care
Rainy River IDN
4,485
204
234
0.87
-30
Thunder Bay District IDN
5,709
185
253
0.73
-68
City of Thunder Bay IDN
24,824
1,286
1,116
1.15
170
Kenora IDN
7,490
304
360
0.84
-56
Northern IDN
3,755
85
149
0.57
-64
North West LHIN Total
46,263
2,064
2,112
0.98
-48
Source: Preyra Solutions Group. Palliative Care in the North West LHIN. June 2012.
Key Findings:

Access to hospital-based palliative care for the North West LHIN population is at the provincial
average, controlling for case mix;

Within the North West LHIN, Kenora IDN residents had less access to hospital-based palliative
care, after adjusting for case mix (Actual over Expected = 0.84).
8
The following table shows the actual number of discharges with a diagnosis of palliative care (most
9
responsible diagnosis or other) for North West LHIN residents in fiscal year 2010/11.
8
Most Responsible Diagnosis is the primary reason for the hospital stay.
Local Health Hub Profile – Dryden 24
North West LHIN  RLISS du Nord-Ouest
Table 18: Acute Care Discharges with Diagnosis of Palliative Care, Fiscal Year 2010/11
All
Discharges
Most Responsible
Diagnosis (MRDx) of
Palliative Care
Any Secondary Dx of
Palliative Care
All Discharges with Dx of
Palliative Care (MRDx or
Co-morbidity)
Kenora
#
Discharges
4,566
#
Discharges
53
% All
Discharges
1.2
#
Discharges
90
% All
Discharges
2.0
#
Discharges
143
% All
Discharges
3.1
Northern
2,975
18
0.6
28
0.9
46
1.5
Rainy
River
Thunder
Bay
District
City of
Thunder
Bay
North
West
LHIN
Total
2,769
53
1.9
47
1.7
100
3.6
3,464
28
0.8
50
1.4
78
2.3
15,038
181
1.2
489
3.3
670
4.5
28,812
333
1.2
704
2.4
1,037
3.6
IDN Area
Source: Preyra Solutions Group. Palliative Care in the North West LHIN. June 2012.
Key Finding:

Kenora IDN residents had a slightly lower % of discharges with a diagnosis of palliative care
compared to all North West LHIN residents in 2010/11 (3.1% versus 3.6%).
The following figure shows the distribution of discharge destinations for those patients with a diagnosis of
palliative care and discharged from acute care over the last five fiscal years.
Local Health Hub Profile – Dryden 25
North West LHIN  RLISS du Nord-Ouest
Figure 10: Discharge Destination of Acute Care Discharges with Diagnosis of Palliative Care
Discharge Destination of Palliative Care
Acute Care Patients, North West LHIN
100%
% discharged elsewhere
% Palliative Care Patients
90%
80%
% discharged to other type of
facility
70%
60%
% discharged to continuing
care facility
50%
% discharged to home with no
support services
40%
30%
% discharged to home with
support services
20%
10%
0%
2006
2007
2008
Fiscal Year
2009
2010
% PC patients who died in
hospital
Data Source: Inpatient Discharge Main Table,
intelliHEALTH Ontario; extracted April 4, 2012.
Key Findings:

The percentage of palliative care patients dying in hospital has been decreasing over the last few
years with 42.5% of palliative care patients dying in hospital in 2010/11;

Just under one-third (30.4%) of palliative care patients were discharged home (with or without
support).
End of life services at home, provided by the North West CCAC, were discussed earlier in the profile.
Discharges from the Local Health Hub’s Acute Care Hospital - Dryden Regional
Hospital
The following table shows the most responsible diagnosis (MRDx) categories for people discharged from
Dryden Regional Hospital over the last three fiscal years.
Table 19: Most Responsible Diagnoses for Acute Care Discharges from Dryden Regional Hospital
- % of Discharge, 2009/10 – 2011/12 combined
%
ICD10 Chapter
Discharges
Factors influencing health status and contact with health services
(Z00-Z99)
13.54%
Diseases of the circulatory system (I00-I99)
13.22%
Diseases of musculoskeletal system and connective tissue (M00M99)
Diseases of the digestive system (K00-K93)
Diseases of the respiratory system (J00-J99)
Symptoms, signs and abnormal clinical and laboratory findings (R00R99)
10.34%
10.16%
9.81%
8.17%
Local Health Hub Profile – Dryden 26
North West LHIN  RLISS du Nord-Ouest
ICD10 Chapter
Pregnancy, childbirth and puerperium (O00-O99)
Injury, poisoning and other consequences of external causes (S00T98)
Neoplasms (C00-D48)
Diseases of the genitourinary system (N00-N99)
Certain infectious and parasitic diseases (A00-B99)
%
Discharges
8.02%
4.72%
4.62%
4.07%
2.78%
Endocrine, nutritional and metabolic diseases (E00-E90)
Mental and behavioural disorders (F00-F99)
Certain conditions originating in the perinatal period (P00-P96)
2.46%
2.19%
2.14%
Diseases of the nervous system (G00-G99)
Diseases of the skin and subcutaneous tissue (L00-L99)
Diseases of the blood and blood-forming organs and certain
disorders involving the immune mechanism (D50-D89)
Diseases of the ear and mastoid process (H60-H95)
Diseases of the eye and adnexa (H00-H59)
Congenital malformations, deformations and chromosomal
abnormalities (Q00-Q99)
1.07%
1.02%
0.99%
0.50%
0.12%
--*
Annual Average Number of Discharges
1,342
* - Number of discharges <5.
Data Source: Inpatient Discharge Main Table, intelliHEALTH Ontario; extracted Dec. 27, 2012.
Alternate Level of Care (ALC) Length of Stay (LOS)
The following table shows the indicators related to Alternate Level of Care (ALC) length of stay (LOS) at
Wilson Memorial General Hospital.
Table 20: Annual Alternate Level of Care (ALC) Indicators for Discharges (excluding newborns
and stillborns) from Dryden Regional Hospital, Fiscal Years 2009/10 – 2011/12
Indicator
Total # Discharges (excluding
newborns and stillborns)
Total LOS (Days)
ALC LOS (Days)
% ALC
# ALC Discharges
2009/10
2010/11
2011/12
1,233
10,262
2,383
23.2
62
1,190
10,918
4,604
42.2
101
1,300
10,681
3,231
30.2
84
Data Source: DAD, CIHI Portal; extracted Jan. 2, 2013.
Key Findings:

There was an annual average of 82 patients over last three fiscal years; those cases accounted
for one-quarter (24.4%) of total length of stay days.

In 2011/12, 16 ALC patients discharged to a nursing home accounted for 1,251 ALC days( 38.7%
of ALC days and 19% of ALC cases);
Local Health Hub Profile – Dryden 27
North West LHIN  RLISS du Nord-Ouest

Of the other ALC patients discharged in 2011/12, 29 died in hospital and accounted for 23.6% of
ALC days. Twenty cases discharged to home care accounted for 25% of ALC days.
ALC Designation Within Two Days
Only 17of 247 ALC cases within the last three years were designated ALC within 2 days at Dryden
Regional Hospital. Eight of these cases died in hospital and eight were discharged home or to a home
10
setting with support services .
Re-admissions for Select Conditions
Reduction in avoidable hospitalizations--of which hospital readmissions play an important part --is a key
strategic focus of the Ministry’s Excellent Care for All Strategy in Ontario. Readmissions also contribute
11
to increased emergency room pressures and wait times .
The cases included in this indicator are discharges for patients age >=45 with diagnosis of stroke, chronic
obstructive pulmonary disease (COPD) or congestive heart failure (CHF), those age >= 40 with select
cardiac conditions, all ages with pneumonia, diabetes and gastro-intestinal disorders. The following table
shows the re-admission rates of these cases for hospitals in the Kenora IDN and for all North West LHIN
hospitals combined for fiscal year 2011.
Table 21: Re-admissions Within 30 days for Select Conditions, Calendar Year 2011, Kenora IDN
Hospitals
Facility
Dryden Regional Health Centre
Index
Cases
# Readmitted To
Any Hospital
% Readmits
278
42
15.11%
Lake of the Woods District Hospital
453
61
13.47%
RED LAKE Margaret Cochenour
Memorial Hospital
84
15
17.86%
5,198
850
16.35%
North West LHIN
Source: HAB. MLPA Supplemental Information. Nov. 2012.
Key Findings:
10
11
12

Over the calendar year 2011 the North West LHIN was very close to its target value of 16.0%
for 2011/12;

The re-admission rates vary somewhat between hospitals in the Kenora IDN: Dryden Regional’s
rate was in between the other two Kenora IDN hospitals and below the North West LHIN’s target
value;

The North West LHIN target value for 2012/13 is 16.86%.
CIHI Portal. DAD. Jan. 2013.
MOHLTC. MLPA Indicators Technical Documentation. December 2010.
The MLPA indicator is known as Readmissions within 30 days for Selected CMGs. Case Mix Groups (CMGs)
methodology assigns hospital discharges into categories based on diagnosis and patient characteristics.
12
Local Health Hub Profile – Dryden 28
North West LHIN  RLISS du Nord-Ouest
Analysis of Ambulatory Care Visits
Emergency (ED) Visits
Table 22 shows the volume of ambulatory care visits to Dryden Regional Hospital by fiscal year and type
of ambulatory care visit.
Table 22: Ambulatory Care Visits by Visit Type to Dryden Regional Hospital
Ambulatory Care Visit Type
Emergency
Day Surgery
Endoscopy
Total
2009/10
18,353
1,361
0
20,110
2010/11
17,120
1,461
0
19,022
2011/12
17,197
1,125
339
19,045
Data Source: NACRS, CIHI Portal; extracted Dec. 27, 2012.
Key Finding:
13
 The number of emergency visits and total ambulatory visits decreased between 2009/10 and
remained at a similar level in 2011/12.
The following figure shows who went to Dryden Regional Hospital for emergency visits (unscheduled,
unplanned), for fiscal years 2009/10 to 2011/12.
Figure 11: % of Emergency Visits to Dryden Regional Hospital by Patient Residence
90%
20,000
80%
18,000
70%
16,000
14,000
60%
12,000
50%
10,000
40%
8,000
30%
6,000
20%
4,000
10%
2,000
0%
0
2009/2010
2010/2011
2011/2012
Dryden LHH
Total Emergency Visits
Emergency Visits (%)
% of Emergency Visits to Dryden Regional Hospital
by Patient Residence and Fiscal Year
Other Kenora
IDN
Other LHIN/
Out of Prov.
Northern IDN
Other NW
LHIN
13
The coding of ambulatory care visits has become more specific to better reflect the type of care being received in
the emergency department. Endoscopy visits now are separated from other Day Surgery visits. This provides a
better basis for understanding current utilization and future needs.
Local Health Hub Profile – Dryden 29
North West LHIN  RLISS du Nord-Ouest
Key Findings:

Approximately 82% of unscheduled emergency visits to Dryden Regional Hospital were by
residents of the Dryden LHH;

A further 8% of visits were from other Kenora IDN residents, 1.8% from Northern IDN residents
and 1.6% from other North West LHIN residents.
The following table shows the distribution of all emergency visits to Dryden Regional Hospital by Main
Problem (ICD10 Chapter, listed in decreasing order of visits in 2011/12.
Table 23: Emergency Visits to Dryden Regional Hospital by Main Problem (% Visits)
Rank
(2011/12)
ICD10 Chapter
Injury, poisoning and certain other consequences of
1 external causes (S00-T98)
2 Diseases of the respiratory system (J00-J99)
Symptoms, signs and abnormal clinical and laboratory
3 findings (R00-R99)
Factors influencing health status and contact with health
4 services (Z00-Z99)
Diseases of the musculoskeletal system and connective
5 tissue (M00-M99)
6 Diseases of the skin and subcutaneous tissue (L00-L99)
7 Diseases of the genitourinary system (N00-N99)
8 Diseases of the digestive system (K00-K93)
9 Certain infectious and parasitic diseases (A00-B99)
10 Mental and behavioural disorders (F00-F99)
11 Diseases of the ear and mastoid process (H60-H95)
12 Diseases of the circulatory system (I00-I99)
13 Diseases of the eye and adnexa (H00-H59)
14 Diseases of the nervous system (G00-G99)
15 Endocrine, nutritional and metabolic diseases (E00-E90)
16 Pregnancy, childbirth and the puerperium (O00-O99)
17 Neoplasms (C00-D48)
Diseases of the blood and blood-forming organs and
certain disorders involving the immune mechanism (D5018 D89)
19 NOT APPLICABLE
Certain conditions originating in the perinatal period (P0020 P96)
Congenital malformations, deformations and chromosomal
21 abnormalities (Q00-Q99)
Total # Emergency Visits
2009/10
2010/11
2011/12
14.66%
15.92%
16.76%
13.80%
17.46%
12.71%
12.59%
12.75%
12.44%
11.29%
10.52%
12.04%
8.61%
6.32%
5.12%
4.55%
5.50%
3.08%
3.48%
2.93%
1.80%
1.54%
0.76%
0.77%
0.53%
8.67%
6.48%
5.37%
4.64%
5.11%
3.74%
3.05%
2.69%
1.92%
1.52%
0.89%
0.88%
0.52%
8.66%
6.35%
5.05%
4.72%
4.48%
3.93%
3.45%
2.65%
1.73%
1.38%
0.90%
0.83%
0.65%
0.31%
0.19%
0.32%
0.26%
0.30%
0.17%
0.05%
0.08%
0.07%
0
18,353
--*
17,120
--*
17,197
* - Number of visits less than 5.
Data Source: NACRS, CIHI Portal; extracted Dec. 27, 2012.
Key Findings:

Injury, poisoning and certain other consequences of external causes accounted for 17.5% of
emergency visits in 2011/12. This category includes open wounds, superficial and unspecified
injuries, fractures, sprains, dislocations and poisoning;
Local Health Hub Profile – Dryden 30
North West LHIN  RLISS du Nord-Ouest

Diseases of the respiratory system accounted for 12.71% of emergency visits in 2011/12;

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
accounted for 12.4% of emergency visits in 2011/12 and “Factors influencing health status and
contact with health services” also accounted 12.0% of emergency visits.
The following table shows the leading problems in the top chapter in terms of volume of emergency visits
for fiscal year 2011/12.
Table 24: Top Problems in Injury, poisoning and certain other consequences of external causes
Chapter, Fiscal Year 2011/12
Problem
Number
of Visits
% Chapter
Visits
% All
Visits
Sprains/dislocations
660
22.0%
3.8%
Open Wounds
634
21.1%
3.7%
Superficial injuries/contusions
411
13.7%
2.4%
Fractures
363
12.1%
2.1%
Total Visits classified as Injury, poisoning and
certain other consequences of external causes
3,003
17.5%
Data Source: NACRS, CIHI Portal; extracted Dec. 27, 2012.
Key Findings:

Sprains and dislocations accounted for 22.0% of visits in this category, 3.8% of all emergency
visits;

Open Wounds account for 21.1% of visits in this category (634 visits in 2011/12), 3.7% of all
emergency visits.
As noted in Table 23, 3.9% of unscheduled emergency visits to Dryden Regional Hospital are for Mental
and Behavioural Disorders (ICD10 Codes F00-F99).
The following table shows the number of repeat visits within 30 days for mental health (F00-F09, F20F99) and Substance Abuse (F10-19) conditions.
Local Health Hub Profile – Dryden 31
North West LHIN  RLISS du Nord-Ouest
Table 25: Repeat Visits within 30 Days for Mental Health and Substance Abuse Conditions to
Dryden Regional Hospital
Emergency Visits for Mental Health Conditions
2010/11
% Emergency
North West
Visits for this
LHIN target
condition
167
38.5%
13.7%
434
295
34
11.5%
17.4%
Emergency Visits for Substance Abuse Conditions
56
30.8
22.2%
182
2011/12
193
2010/11
2011/12
52
26.9
North West
LHIN actual
19.3%
18.2%
32.3%
29.1%
28.4%
Data Source: Health Analytics Branch. MLPA Supplemental Information – MH and SA conditions.
Jan. 2013.
Key Findings:



The repeat visit rate within 30 days for mental health and substance abuse conditions is high in
the North West LHIN;
Dryden General Hospital’s repeat visit rates for mental health conditions decreased substantially
in 2011/12. There was an average of 9 repeat visits per quarter in 2011/12 compared to 42 in
2010/11;
Dryden General Hospital’s repeat visit rate for substance abuse decreased between 2010/11 and
2011/12., a 12.7% decrease.
The North West LHIN’s 2012/13 target for repeat visits within 30 days for mental health conditions is
16.4% and for substance abuse conditions – 26.6%. The provincial targets have not yet been
determined.
Emergency Visits Related to Diabetes
The following table outlines the number of unscheduled visits to Dryden Regional Hospital with diabetes
as the main problem. The first section breaks the visits down by type of diabetes (type I, type II or
unspecified) and the second section breaks the visits down by type of complication.
Table 26: Emergency (unscheduled) Visits to Dryden Regional Hospital with Diabetes as Main
Problem, Fiscal Years 2009/10 to 2011/12
2009/10
2010/11
2011/12
By Type of Diabetes Mellitus (DM)
E100-E109 - Type I DM Visits
5
10
11
E110-E119 - Type II DM Visits
20
27
20
E130-E149 –Unspecified DM/ Other Specified Visits
42
33
38
(E10-E14) DM Total Visits
67
70
69
Number of Patients
By Type of Complication
54
41
47
Local Health Hub Profile – Dryden 32
North West LHIN  RLISS du Nord-Ouest
2009/10
DM with Foot Ulcer, DM with Foot Ulcer with
Gangrene, DM with other Multiple Complications
DM other complications
2010/11
19
25
18
42
39
41
6
6
10
67
70
69
54
41
47
DM no (mention of) complications
(E10-E14) DM Total
Number of Patients
2011/12
Data Source: Ambulatory Care Main Table, intelliHEALTH ONTARIO; extracted March 14 2013.
Key Findings:

There has been an average of 69 visits by an average of 47 individuals to Dryden Regional
Hospital for diabetes related problems;

Almost one-third (30.1%) of the diabetes related visits were for complications involving foot
ulcers.
Non-Urgent Emergency Visits
The following graph shows the high percentage of emergency visits that are non-urgent in the District of
Kenora IDN hospitals.
Figure 12: % of Emergency Visits (Unscheduled) that are Minor/uncomplicated (CTAS IV & V)
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
25,000
20,000
15,000
10,000
5,000
Number of ED Visits
% ED Visits
Non-Urgent Emergency Visits
% CTAS IV & V
0
Dryden Regional
Health Centre
Lake of the Woods
District Hospital
Red Lake Margaret
Cochenour Memorial
Hospital
Hospital
% ED Visits
2009/10
2010/11
2011/12
2009/10
2010/11
2011/12
Local Health Hub Profile – Dryden 33
North West LHIN  RLISS du Nord-Ouest
Key Findings:

At Dryden Regional Hospital, the % of emergency visits that were classified as CTAS IV & V
levels has decreased in 2011/12 from the previous two years from 68.3% to 69.2% to 59.2% in
2009/10, 2010/11 and 2011/12 respectively;

For all facilities in the North West LHIN in 2011/12, CTAS IV & V emergency visits accounted for
46.5% of unscheduled emergency visits;

TBRHSC accounts for over half of the emergency visits in the North West LHIN and 30.3% of
emergency visits are classified as CTAS IV&V;

Provincially, 41.2% of emergency visits are classified as CTAS IV &V in fiscal year 2011/12.
ED Wait Times
There are three provincial indicators related to emergency room wait times that all LHINs and their
th
respective hospitals are accountable for. These indicators are 90 percentile ER length of stay for
th
admitted patients, 90 percentile ER length of stay for non-admitted complex patients (CTAS I-III) and
th
90 percentile ER length of stay for non-admitted minor/uncomplicated patients (CTAS IV-V).
The following table shows the indicator values for Dryden Regional Hospital along with the overall North
West LHIN’s target time and the provincial target time.
Table 27: ED Visit (unscheduled, emergency) Wait Times at Dryden Regional Hospital
# of Visits
th
90 percentile
wait time (hours)
North West LHIN
Target
Ontario
Target
Emergency Visit Wait Times for Admitted Patients
2009/10
2010/11
771
9.9
733
9.1
8 hrs. (interim 25.0 hrs.)
25.0 hrs.
2011/12
8 hrs. (interim 25.0 hrs.)
25.0 hrs.
794
9.8
Emergency Visit Wait Times for Non-Admitted Patients, Complex (CTAS I-III)
2009/10
4,664
5.2
2010/11
6.6 hrs.
4,564
5.2
2011/12
6.5 hrs.
7.0 hrs.
5,309
5.6
Emergency Visit Wait Times for Non-Admitted Patients, non-complex (CTAS IV-V)
2009/10
2010/11
2011/12
11,908
11,525
8,617
3.4
3.3
3.4
4.0 hrs.
4.0 hrs.
4.0 hrs.
4.0 hrs.
Data Sources: NACRS, CIHI Portal; extracted Jan.31, 2013.
Key Finding:
 The emergency visit wait times for admitted patients are slightly above the North West LHIN’s
target value of 8 hours, while wait times for non-admitted patients are slightly below the LHIN
target values.
Local Health Hub Profile – Dryden 34