The cost of a standard hospital stay in Alberta has risen by almost 30%, an analysis of data released by the Canadian Institute for Health Information has revealed. This coincides with an increase in population for Alberta of nearly 12%.

The data shows an increase in the cost of a standard hospital stay, up by 26% between 2011-2012 and 2015-2016. Census data collected by Statistics Canada shows that Alberta’s population has increased by 11.6%—the highest of any province or territory— between the 2011 census and the most recent 2016 census.

According to John Church, a political science professor at the University of Alberta who studies health care in Canada, there are a number of reasons for this increase. The first reason is the lack of an integrated healthcare option outside of the hospital setting, which means “that everybody gets driven into the hospital setting, whether they need to be there or not.” And the hospital setting, Church said, is the most expensive setting for a patient to receive medical services.

“If you have a situation in which I don’t need to be hospitalized… then my hospital care is going to look pricier” said Dr. Raisa Deber from the University of Toronto’s Institute of Health Policy, Management and Evaluation. Deber said that it’s where and how the money is being spent as opposed to the fact that money is being spent.

It’s the issue of “what exactly am I paying for in the hospital as opposed to what am I paying for in other settings?” said Deber. She pointed to chemotherapy as an example, saying that if the drugs are delivered in a hospital, as opposed to an outpatient clinic, the cost of the drugs count towards the hospital’s budget.

The second reason that Church pointed to is the lack of a single patient record system, which can result in patients undergoing tests which other healthcare workers have already administered.

Church also pointed to the fact that wages in Alberta are typically higher than other healthcare workers across the country. A separate report from CIHI states that the average gross clinical payment to Alberta physicians was $380 000, the highest in the country.

And given Alberta’s rising population, Church says that this issue is poised to get more expensive. “More people means more people potentially needing health services” Church said. Church said that the demand on Alberta’s healthcare system will increase, both in numbers and in demand on its services, that as the population ages it will require more health services that can handle the more complex health issues inherent with age.

Church pointed out that elderly people often require the most amount of healthcare, that most people consume the most health services in terms of cost in the last few months of their lives. Deber concurred, stating that “if [the] population [is] going to be younger and healthier, then you would expect [the cost of an average hospital stay] to be smaller.”

A report from the Alberta Auditor-General has identified these three reasons for expensive healthcare in Alberta as “pervasive barriers” that prevents Albertans from “receiving the quality of care they could receive.”

“Unless there are fundamental changes… people will continue to flood to the emergency room” Church said. Church identifies timely access to healthcare outside of hospitals as necessary to alleviating this costly issue. This includes “everything from seeing your family doctor to seeing a range of service providers that provide services to seniors, [to services] that provide access to community-based mental health service [and services that are] providing sufficient access to things like home care.”