Waiting for care
Waiting for Care
What’s the Issue?
Public opinion polls tell us that Canadians’ big concerns with the healthcare system are waiting times and access to care. But how bad are wait times really? And what will it cost to improve the situation? The following three points will help shape the issue:
First of all, not all waits are or should be equal. For example, studies demonstrate that Canadians generally have rapid access to emergency and essential care. Whereas, wait times for joint replacement could use improvement.
Second, many issues contribute to wait times. This is good news because it means that improving wait times is not just about pouring money into the system. Many long wait times are due to a failure to use appropriate management tools, rather than insufficient resources. For instance, moving from every surgeon their own “list” to a single organized list across surgeons is an important first step in reducing wait times. Ensuring appropriateness of care (e.g. is this MRI necessary?) and priorizing patients according to their relative urgency is another.
Third, several approaches exist for minimizing wait times. Some of these strategies are already working successfully across Canada. For example, the Ontario Wait Times Strategy has been particularly effective. It has demonstrated significant reductions in wait times for joint replacements, cataract surgery, and other elective procedures.
- See our infographic on 2011 wait times in Canada: Still waiting, by Lindsay Jolivet.
- 47% of physicians say most or almost all of their patients get same-day or next-day appointments. Also, 46% of physicians have made arrangements for their patients to see a physician or nurse (other than at the ER) when their practice is closed. The Health Council of Canada presents How do Canadian primary care physicians rate the health system?, a report that examines physicians’ perspectives on the performance of the health care system based on their experiences with access to care, coordination of care, use of information technology, and practice improvement and incentives. (See infographic).
- Wait time performance has slipped in the past year, the Wait Time Alliance, a consortium of 14 medical groups, says in its 2012 annual report. Although some provinces have shown improvement, the overall trend is downward, the WTA adds. The WTA has been measuring wait times for six years, and the five procedures First Ministers identified as priorities in the 2004 health accord. These are cancer (radiation therapy); heart (bypass surgery); joint replacement (hip and knee); sight restoration (cataract) and diagnostic imaging (CT and MRI scans). Benchmark wait times were subsequently set by health ministers.
Is Physician Shortage a Driver of Wait Times?
- Increases in physician supply slowed in the 1990′s and several provinces, particularly Ontario, experienced a decline. However, in most provinces, the declines have been reversed and the number of physicians has climbed steeply to the highest levels ever in the past several years. View a province by province graph on physician supply.
Needed: Better Data
Needed: Better Management
Needed: Agreement On – Is the Care Appropriate? What Is A Reasonable Wait Time?
Needed: More Resources (At Least Sometimes)
- While we have reviewed several aspects of improving wait times which don’t necessarily require more resources, sometimes more resources are indeed what is necessary.
International Efforts To Improve Wait Times
Wait Times In Canada
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Premiers’ priority should be home and community care
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