[URBAN NOTE] Kelly Grant in The Globe and Mail on demographic pressures of downtown Toronto hospital

[rfmcdonald]

Kelly Grant's article in The Globe and Mail, "State of emergency", underlines the extent to which a booming downtown Toronto needs infrastructure investments--here, specifically in the health sector--to match.

Toronto’s marquee hospitals face some unique challenges. As teaching hospitals and referral centres for the Greater Toronto Area and the rest of Ontario, they provide some of the most complex surgeries and treatments in medicine while also absorbing emergency patients. They are also disadvantaged by a Byzantine hospital-funding formula that is not nimble enough to respond to such an extraordinary spike in traffic at one cluster of hospitals, according to a June, 2016, report commissioned by the local health authority that oversees Toronto.

“EDs can’t survive in this way,” Dr. Chopra said. “You’ll have staff dissatisfaction, patient dissatisfaction, poor patient outcomes. We have been extremely lucky that somebody hasn’t died.”

For a glimpse of what the downtown emergency departments are up against, just look to the tower-filled skylines to their south and west.

In Toronto’s core and the nearby neighbourhoods of King and Queen West and Liberty Village, the population increased by 48 per cent from 2006 to 2015. In the rest of the old city of Toronto, growth was 4 per cent.

More people are working downtown too. Nearly half a million were employed in the area in 2015, up 32 per cent from 2005.

The population boom is reverberating especially loudly down University Avenue’s hospital row, where, from 2006-07 to 2014-15, annual emergency department visits increased by 43 per cent at the Hospital for Sick Children, 45 per cent at Mount Sinai Hospital and 59 per cent at Toronto General Hospital, which is also part of the University Health Network. Nearby, emergency visits to Toronto Western and St. Michael’s Hospital grew by 43 per cent and 31 per cent, respectively, in the same period. (Sunnybrook Health Sciences Centre was the only acute-care Toronto hospital outside downtown to see a similar spike.)