This document summarizes population trends and their impact on health services in South Eastman, Manitoba. It finds that South Eastman has experienced rapid population growth, increasing over 8 times the provincial rate since 1997. This growth is projected to continue through 2025, bringing significant challenges due to an aging population and increasing demand for services. Specifically, the region will require more acute care beds, personal care home beds, and physician services to meet the needs of a growing elderly segment. Overall, the substantial population increases are expected to profoundly impact the health service needs and funding requirements for South Eastman over the coming decades.

1. South Eastman Health/Santé Sud-Est. Inc.
Health/Santé Sud-
South Eastman

3. South Eastman population
relatively healthy
relatively prosperous
close to Winnipeg
growing
since 1997, growth >8 x provincial rate
projected to keep on growing at same or
greater rate to 2025

4. actual RHA growth
1997 - 2001
5.2%
2.2%
2.0%
1.6%
1.5%
1.0%
0.8%
0.6%
Manitoba Winnipeg South Brandon Interlake Central Marquette South WM Parkland Norman Burntwood Churchill North
Eastman Eastman
-1.8%
-2.2%
-3.0%
-5.0%
-6.3%
Source: Manitoba Health 1997-2002

5. actual South Eastman growth
1997 - 2001
South Western Northern Central Southern
Manitoba
Eastman District District District District
0.6% 5.2% 0.4% 2.3% 9.5% 7.5%
growth factors
high birth rate
high in-migration rate
Source: Manitoba Health 1997-2002

6. projected RHA growth
1998 - 2025
44%
38%
26%
20%
14%
13%
8%
6%
5% 4% 3%
Manitoba Winnipeg South Brandon Interlake Central Marquette South WM Parkland Norman Burnt/Chur North
Eastman Eastman
-6%
Source: MB Bureau of Statistics, 1999

7. projected South Eastman growth
2001 - 2025
38%
80000
7%
7%
7%
70000
7%
5%
60000 5%
50000
40000
30000
54759
61165
52031
57405
65080
68920
72400
20000
10000
0
1998 2001 2005 2010 2015 2020 2025
Source: MB Bureau of Statistics, 1999

8. differential impacts of population growth
65+ population increase
1991-1997 projected 1998-2025
Manitoba 5% Manitoba 52%
South Eastman 12% South Eastman 82%
in South Eastman,
2025 population age 75+ = current population age 65+
Source: Manitoba Health, 1991-2000

9. projected growth 65+
South Eastman 2001 - 2025
14000
12%
21%
12000
82%
25%
10000
16%
8000
8%
6000
4000
11000
12300
6300
9100
5830
7300
2000
0
2001 2005 2010 2015 2020 2025
Source: MB Bureau of Statistics, 1999

10. projected growth 75+
South Eastman 2001 - 2025
6000
6%
22%
74%
5000
24%
4000
10%
12%
3000
2000
2669
5000
3060
3300
4100
5300
1000
0
2001 2005 2010 2015 2020 2025
Source: MB Bureau of Statistics, 1999

11. projected birth rate increase
South Eastman 2001 - 2025
highest projected % annual rate increase in MB
1200
27% 9% -1% -3%
1000 13%
6%
800
600
400
756
980
970
940
800
900
200
0
2001 2005 2010 2015 2020 2025
Source: MB Bureau of Statistics, 1999

12. projected growth 0-4
South Eastman 2001 - 2025
6000
21%
3% -1%
10%
5000
5%
2%
4000
3000
2000
4002
4325
4100
4775
4925
4825
1000
0
2001 2005 2010 2015 2020 2025
Source: MB Bureau of Statistics, 1999

13. profound impact on health service needs
acute care – primary beds
South Eastman 2001 - 2025
guide: 2.0 per 1,000 population
current: 1.35 per 1,000 population
20% increase in primary bed needs by 2015, 38% by 2025
year # primary beds
actual needed according to guide
2001 74 110
2005 - 115
2010 - 122
2015 - 130
2020 - 138
2025 - 145
Source: MB Bureau of Statistics, 1999; South Eastman RHA 2001

14. use of primary bed days, by age group
South Eastman hospitals
11%
79%
64%
25% 20%
1%
% population % use South Eastman
primary bed days
Source: MCHP 2001; South Eastman RHA 2001

15. projected use of primary bed days
Bethesda Hospital 2001 - 2025
25000
94%
20000
annual days used
15000
100% occupancy
10000
11454
13046
15826
18720
20769
10683
5000
0
2001 2005 2010 2015 2020 2025
Source: MB Bureau of Statistics, 1999; MCHP 2000; South Eastman RHA 1997-2001; Bagust, Place, Posnett 1999.

16. PCH beds
South Eastman 2001 - 2025
beds per 1,000 population 75+:
guide: 120 PCH + 10 supportive housing
current: 125 PCH + 0 supportive housing
year # beds
actual needed according to guide
2001 334 + 0 320 + 27
2005 - 360 + 30
2010 - 396 + 33
2015 - 492 + 41
2020 - 600 + 50
2025 - 636 + 53
Source: MB Bureau of Statistics, 1999; South Eastman RHA 2001

17. obstetrics
South Eastman 2001 - 2025
500 9%
27% -1% -3%
13%
450
6%
births in South Eastman facilities*
400
350
300
250
200
150
355
461
442
376
423
456
100
50
0
2001 2005 2010 2015 2020 2025
* approximately 47% of all births
Source: MB Bureau of Statistics, 1999; South Eastman RHA 2001

18. demands on RHA services increasing
2 key factors:
population growth
repatriation of services to RHA

19. hospital services
South Eastman 1995/96 – 2000/01
overall population hospitalization rates
steady, regardless of where hosp. occurs
modest increase in % hospitalizations taking
place in RHA (vs. Winnipeg)
95/96 96/97 97/98 98/99 99/00 00/01
58% 59% 60% 61% 61% 60%
Source: Manitoba Health, 1997-2001

20. medical services
South Eastman 1995/96 – 2000/01
noticeable increase in % family physician
services occurring in RHA (vs. Winnipeg)
95/96 96/97 97/98 98/99 99/00 00/01
74% 75% 74% 76% 78% 80%
Source: Manitoba Health, 1997-2001

21. medical services
South Eastman 1995/96 – 2000/01
26% increase in # family physician services
provided in RHA since 95/96
95/96 96/97 97/98 98/99 99/00 00/01
201,302 196,264 194,529 216,999 229,193 253,750
Source: Manitoba Health, 1997-2001

22. emergency room visits
South Eastman hospitals 1995/96 – 2000/01
45000
60%
40000
35000
30000
25000
20000
26232
30204
34207
38396
41854
15000
10000
5000
0
96/97 97/98 98/99 99/00 00/01
Source: South Eastman RHA 1997-2001

23. lab & diagnostic services
South Eastman hospitals 1995/96 – 2000/01
lab workload units
22%
1.4
1.2
workload units (millions)
1
0.8
0.6
1.171
1.205
1.305
1.067
1.071
0.4
0.2
0
96/97 97/98 98/99 99/00 00/01
Source: South Eastman RHA 1997-2001

24. surgery
South Eastman hospitals 1995/96 – 2000/01
major
minor
1000
900
37%
800
700
53%
600
500
400
300
869
920
693
530
903
810
540
820
950
589
200
100
0
96/97 97/98 98/99 99/00 00/01
Source: South Eastman RHA 1997-2001

25. funding implications

26. Rural Health Authorities Of Manitoba
Total MB Funding and Total Population
98,271
100,000,000 100,000
80,000,000 80,000
74,919
Total Funding
Population
60,000,000 60,000
54,759
$ 99,391,983
44,806
42,551
39,320
40,000,000 40,000
37,284
33,673
$ 68,718,061
$ 55,395,260 25,012
$ 44,813,767
$ 42,700,733
20,000,000 20,000
$ 37,461,818
$ 33,985,600 33,318,960
$
$ 24,205,707
0 0
SE SW I-LK NE PKLD
BWD CTRL MQT NOR
Rural Health Authority
Source: RHA Annual Reports 2001
Manitoba Health Population – CFO Audit Committee

27. Rural Health Authorities Of Manitoba
Total Expenditure and Total Population
120,000,000 120,000
98,271
100,000,000 100,000
80,000,000 80,000
Expenditures ($)
74,919
Population
60,000,000 60,000
$ 119,944,000
54,759
44,806
42,551
39,320
$ 80,691,000
37,284
40,000,000 40,000
33,673
$ 64,607,000
25,012
$ 54,125,000
$ 52,877,000
$ 49,505,000
$ 42,579,000$ 41,379,000
20,000,000 20,000
$ 29,478,000
0 0
SE SW I-LK NE PKLD
BWD CTRL MQT NOR
Rural Health Authority
Source: RHA Annual Reports 2001
Current Total Expenses Population – CFO Audit Committee

28. Rural Health Authorities Of Manitoba
Average MB Health Funding Per Capita
1,800 180%
South Eastman decreases from 65.9% of average 165.39%
funding per capita to 63.6%
1,600 160%
% of Average Per Capita Funding
MB Health Funding per Capita ($)
153.38%
1,400 140%
$ Increase
129.87%
123.09%
1,200 120%
103.58%
100.00%
1,000 100%
122
232
108
800 80%
160
76.15% 75.72%
52 76
63.56% 63.04%
600 60%
59 23
29 86
400 40%
SE SW I-LK NE PKLD
BWD CTRL MQT NOR TOTAL
Rural Health Authority
Source: RHA Annual Reports 2001
– CFO Audit Committee
Note: excludes % of avg MB Brandon, Wpg 2001
Churchill, Funding per Capita
MB Health Funding Per Capita 2000 MB Health Funding Per Capita 2001

29. Rural Health Authorities Of Manitoba
Total Average Expenditure Per Capita
271
2,000 200%
SE decreases from 67.9% of average to 135
65.5% of average.
% of Average Expenditure per Capita
1,800 180%
166.64%
Expenditure per Capita ($)
159.66%
1,600 160%
84
Increase 138
1,400 140%
132.21%
122.22%
78
92
1,200 120%
102.76%
100.00%
1,000 100%
112
47
77.75%
51
800 80%
74
72.61%
65.47%
63.12%
600 60%
SE SW I-LK NE PKLD
BWD CTRL MQT NOR TOTAL
Rural Health Authority
Source: RHA Annual Reports 2001 note: excludes Churchill, Brandon, Wpg
– CFO Audit Committee
Total expenditure per capita 2000 Total expenditure per capita 2001 % of avg exp per Capita 2001

30. South Eastman RHA
Adjusted Total Expenditure Per Capita
South Eastman expenses adjusted for out of region $ 1,188
1,200
hospitalizations @ avg $467 per patient day.
1,100
35% of Acute care patient days estimated at $6.85M
1,000 or 16% of expenses.
Expenditure per Capita ($)
900
$ 840
$ 778
800
$ 726
700
Adjusted
600
500
400
300
200
Adjusted per capita to 50% of the above effect re:
100 assumption that all RHA's have out of region
hospitalizations (e.g. surgery).
0
100% adjustment = $903/capita
note: Provincial average excludes Churchill,
Rural Health Authority
Brandon, Wpg
SE 2000 Actual SE 2001 Actual
SE 2001 Adjusted Provincial 2001 Actual Average

31. Rural Health Authorities Of Manitoba
Admin Cost % Of Operating Cost
7,000,000 5.72%
WRHA = 7.2%
All RHA's = 6.9%
6,000,000
7.08%
Total Admin Costs ($)
5,000,000
7.72%
4,000,000 6.91%
5.23%
3,000,000 5.59%
6.18%
10.55%
4.25%
2,000,000
1,000,000
0
SE SW I-LK NE PKLD
BWD CTRL MQT NOR
Rural Health Authority
Source: MB Health MIS Database
report (final audit) reporting year
2001 distributed April 8, 2002

32. Rural Health Authorities Of Manitoba
Admin Expense Per Capita
140 14%
WRHA = 7.2% of operating
WRHA = $117.68 per capita
120 12%
% of Total Operating Costs
Expenditure per Capita ($)
10.55%
100 10%
80 8%
7.72%
7.08%
6.91%
6.30%
6.18%
125.30
60 6%
5.72% 5.59%
116.55
5.23%
105.65
98.96
4.25%
40 4%
71.25
67.81
59.89
56.71
20 2%
41.92
33.19
0 0%
SE SW I-LK NE PKLD
BWD CTRL MQT NOR TOTAL
Rural Health Authority
Source: MB Health MIS
database report April, 2002
Per Capita Admin Costs % Admin costs of Operating Costs

33. Rural Health Authorities Of Manitoba
Admin Cost as % of Operating Exp
1,000,000 876,000
Source: MB Health MIS database
676,000 643,000
report April, 2002
Admin Expenditures Inc/(Dec) ($)
500,000
338,000
320,000
50,000
0
(138,000)
(277,000)
(324,000)
(500,000) (485,000)
(589,000)
(720,000)
(839,000)
(1,000,000) (948,000)
(1,019,000)
(1,239,000)
(1,381,000)
(1,500,000)
Only South Eastman would increase admin expenses at the (1,568,000)
guideline 5% of operating.
(2,000,000)
SE SW I-LK NE PKLD
BWD CTRL MQT NOR
Rural Health Authority
@ Actual Avg 6.3% of Operating @ Guideline Avg 5.0% of Operating

34. MB ANNUAL REPORT 2001
Net MB Health Funding
8,000,000
7,485,059
Wpg = $110,563,000 (77.1%)
6,972,650 Total = $143,453,000
6,000,000
Incremental Funding ($)
4,000,000
3,619,909
2,982,652 2,931,612 2,867,189
2,737,789
2,257,034
2,000,000 1,719,008
1,535,870
402,516
0
BDN CTRL I-LK NOR PKLD SW
BWD CHCL MQT NE SE
Regional Health Authority Source: MB Health Annual Report
2001

35. MB HEALTH ANNUAL REPORT 2001
Net MB Health Funding
16.00%
14.25%
14.00%
12.00% 11.51%
% Increase/(Decrease)
10.10%
9.92%
10.00% 9.30%
8.57%
8.51%
8.04% 7.82%
8.00% 7.52%
6.00% 5.36%
4.00% 3.46%
2.99%
2.00%
0.00%
BDN CTRL I-LK NOR PKLD SW TOTAL
BWD CHCL MQT NE SE WPG
Regional Health Authority
Source: MB Health Annual Report
2001

36. South Eastman Health/Santé Sud-Est Inc
Daily Average Cash Balances
$2,000,000
$1,000,000
Daily Average Cash Balance ($)
$0
($1,000,000)
Approved Line of credit = $1.7M
($2,000,000)
($3,000,000)
Exceed line of credit and unable to meet
payroll.
($4,000,000)
($5,000,000)
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Month
2001 2002