Comparing the Health of Canadian Hospitals: Paying Attention to the Mix of Planned and Unplanned Admissions.

Canadian hospitals are being placed under increasing scrutiny for both performance and safety in some cases with a threat of financial consequences for failure. However, there are no accepted standards for comparing the relative context in which hospitals must operate; the unstated assumption being that all are starting from the same place and have equal opportunities for success. A "healthy hospital" should be able to meet the needs of its community with a mix of both planned (scheduled) and unplanned (emergency) services. The proportion of admissions that are planned has been falling in most Canadian hospitals and unplanned admissions have been rising, creating an unhealthy state with added costs. Canadian Institute for Health Information's databases give us a way to monitor these changes, but it is not routinely done. Making this information more available would help to identify hospitals most in need of support.