Unprecedented patient numbers that aren't dropping off are putting relentless pressure on Interior Health's budget and resources.
"We're seeing nine and 10 per cent increases in volumes at the door," said Donna Lommer, IHA vice-president residential services and chief financial officer.
"Our biggest challenge is we're seeing such pressure on the acute-care hospitals. Our pressures in patient days and emergency room visits are growing at rates we haven't seen in the past. It's a concern. It's something we can't control."
Lommer said Wednesday at least part of the pressure is due to the aging population. But there are other factors, too, like more young people developing chronic diseases.
The other side of the problem is the health authority's annual budget increase isn't keeping pace with the fast-swelling demand.
"Our budget is sitting at $1.9 billion. That's a 3.9 per cent funding increase for 2013/14 over the previous year," she said. Next year, that increase falls to 2.9 per cent.
"We typically see about a five per cent increase. So we know we have some challenges we're working through."
B.C.'s health authorities are not allowed to run deficits. Last year's surplus was around $9 million; slightly more than the $8-million-a-day price tag to run IHA.
"We'll always have a surplus. Our goal is to keep it within that five- to ten-million-dollar mark. But there are always things at year end that we need to cushion for," said Lommer.
With a shrinking annual increase, the pressure is on for IHA to find efficiencies and cut costs; the growing demand of patients is making that challenge even larger.
Right now, the budget has an $11-million hole that IHA management has to fill.
"We couldn't cover all the cost increases with that 3.9 per cent. So we're looking at increasing revenues, being more efficient to cover the gap."
On top of that, the Health Ministry requires hospitals to meet certain performance standards. If those targets aren't met, money is clawed back by Victoria.
"At this point, we're working to keep our business support costs as low as possible, zeroing in on travel expenses, attending conferences, things like that that are more discretionary so we protect programs as much as possible," she said.
"The only thing we can do is focus on prevention, support people in their homes in communities longer. We're doing that, but it's difficult to keep up with the front doors at the hospital."
Even with all the effort to find efficiencies, at a certain point, more beds have to be added.
That's happened in Kamloops, where 20 acute-care beds are being added at Royal Inland Hospital.
"It's a problem across the country."