Hospitals

Questions And Answers


Questions And Answers

Who is responsible for hospitals?

Hospitals are independent corporations run by their own board of directors. The boards are responsible for day-to-day operational decisions on how to allocate the public funding they receive. They are accountable to their Local Health Integration Network (LHIN) and the government for the quality and efficacy of the care they provide.


How are public hospitals funded and administered in Ontario?

In 2006, the government divided the province into 14 regions called Local Health Integration Networks (LHINs).

The Local Health System Integration Act, 2006 (LHSIA), establishes the mandate and powers of the LHINs as follows:

  • Plan -LHINs must develop an Integrated Health Service Plan that is consistent with provincial strategic directions. A LHIN must engage their community (including providers, patients, health care workers, etc.) when developing this plan.
  • Fund -LHINs are responsible for funding their health service providers and may reallocate this funding based on local health system needs and priorities within parameters set by the ministry.
  • Integrate -LHINs and health service providers are required to identify opportunities to integrate and coordinate services in order to provide appropriate, effective and efficient services.

Under LHSIA, LHINs are required to enter into service accountability agreements with their health service providers.

Health System Funding Reform

Historically, hospitals received global, or base funding (an across-the-board increase each year). In April 2012, Ontario initiated funding reform, moving to a patient-based funding model that reflects the needs of the patients served by each hospital and its surrounding community.

This funding model compensates health care organizations based on how many patients they look after, the services they deliver, the evidence-based quality of those services, and the specific needs of the broader population they serve.

For more information on Health System Funding Reform :

Stakeholders in the health care sector may access a password protected site for additional background material. Instructions to access this site can be found at www.hsimi.on.ca

Hospitals also receive separate funding for renovation and construction projects to allow them to provide the programs and services their community needs.

How many hospitals are there?

As of May 9, 2014, there are 155 public, private and specialty psychiatric hospital corporations in Ontario which operate on 238 sites.

  • 145 public hospital corporations with 224 sites;
  • 6 private hospitals with 6 sites; and
  • 4 specialty psychiatric hospitals with 8 sites.

Note: There is also 1 private psychiatric facility which is funded by the ministry.


What are provincial psychiatric hospitals?

Hospitals commonly referred to as "provincial psychiatric hospitals" were owned and funded by the government and operated by the ministry under the Mental Hospitals Act.

By December 2008, all ten provincial psychiatric hospitals were absorbed into the public hospital system and are now governed under the Public Hospitals Act.


What does the ministry pay if I need to go to a public hospital in Ontario?

For insured persons under the Health Insurance Act, insured hospital services are paid, including all physician services, nursing care and diagnostic services such as laboratory tests and X-rays. Medications provided to hospital in-patients and out-patients are covered and certain limited medications are provided to out-patients for use at home. Once an in-patient is discharged, however, the costs of prescribed medications are not covered. Hospital visits solely for the administration of drugs or vaccines are also not covered.

Accommodation, including meals, for hospital in-patients is covered at the public ward level. However, individuals or private insurance would have to pay some or all of the fees the hospital charges for private or semi-private rooms.


How do I make a complaint about a public hospital?

Hospitals are required to have a patient relations process that reflects the hospital's Patient Declaration of Values, which outlines what patients and their families can expect when they visit the hospital. For any complaint or concern about the care provided, patients or families may contact the Patient Advocate or Patient Relations Office of the hospital directly. In smaller hospitals where there may be no such role, the President or Chief Executive of the hospital would handle complaints.


What if I need hospital services outside of Canada?

The Ontario Health Insurance Plan only pays for limited coverage for hospital services outside of Canada. Unless approved in advance, individuals are responsible for paying the difference between what is charged and what is covered.

Hospital care outside Canada can cost much more than the ministry pays. It is therefore advisable for Ontario residents to get private health insurance when travelling outside of Canada. For more information, contact a private insurance company directly, or call the Canadian Life and Health Insurance Association Inc. at 1-800-268-8099 or 416-777-2344 for Toronto.

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