Wait times for medical care costly: Study

Employers need to lobby governments on health care: CMA president

Singer Tom Petty once crooned that waiting is the hardest part. It’s also a pretty expensive part, at least when it comes to medical procedures.

The economic impact of patients waiting above and beyond medically recommended wait times for four common procedures last year was $14.8 billion, according to The Economic Cost of Wait Times in Canada, released by the Canadian Medical Association (CMA). The report also found the extra wait cost governments $4.4 billion.

“Canadians are literally paying to keep people waiting,” said Brian Day, president of the CMA.

The study included data on patients waiting for hip and knee replacements, coronary bypass surgeries, MRIs and cataract surgeries. Patients who waited longer than the recommended maximum ended up waiting nearly twice as long, ranging from three months for MRIs and bypass surgeries to seven months for cataract surgeries to one year for joint replacements.

The report looked at three factors: the economic impact of the patient not working, which included lost productivity and reduced spending; the economic impact of loved ones taking time off work to care for the patient; and the cost to the health-care system, which included extra appointments and medication.

The figures in the report are only the tip of the iceberg, said Day. The report didn’t look at the emotional costs of waiting for treatment or the costs of deterioration.

When a patient has to wait too long for a procedure, her condition will deteriorate, making the procedure more complicated, and she will probably need more care afterward, said Day.

The report also only looked at four out of thousands of medical procedures and didn’t look at two major causes of absenteeism — mental health and back pain, said Day.

“We’re looking to expand the study to look at those two areas, which will make the $14.8 billion seem small,” he said.

Canadian organizations can no longer ignore the costs of keeping people waiting for health care and need to start lobbying governments to make changes, said Day.

This is why the Ontario Chamber of Commerce has compiled a health-care strategy report with recommendations to improve the health-care system, said Amy Terrill, a spokesperson for the Toronto-based chamber.

“The business community is very concerned about the escalating cost of health care,” said Terrill. “Overall, our recommendation is that we need to have a really frank and open discussion about the health-care system with all options on the table.“

Politicians are reluctant to consider certain options, such as privatizing some health-care services, because they’re afraid of a public backlash, said Terrill. The chamber would also like to see governments work to reduce wait times for all medical procedures, not just those identified in the 2004 First Minister’s Accord (the four in the CMA study plus cancer surgeries).

However, there is some good news. The CMA report shows the provincial wait time strategies have been working because the median patient has been getting treatment for the four procedures before the maximum recommended wait time limit.

“The data is very optimistic that we’ve had an impact, but that’s only (a few) conditions,” said Pamela Fralick, the president and chief executive officer of the Canadian Healthcare Association. “Other areas have suffered for lack of attention.”

Part of the solution to wait times is ensuring there are enough doctors, said Day. A recent CMA survey found 4.5 million Canadians don’t have a family doctor. To make matters worse, nearly 4,000 doctors plan to retire in the next few years.

Canada has also been hemorrhaging home-trained doctors. Between 1991 and 2004, the equivalent of two full medical schools of graduates left Canada each year, said Day.

Canada is far behind many Organisation for Economic Co-operation and Development (OECD) countries. The OECD average doctor ratio is three physicians for every 1,000 people, but Canada, with 70,000 doctors, needs an additional 26,000 doctors to achieve that ratio, said Day.

For Canada to have enough doctors, governments need to create more medical school spaces, do a better job of repatriating Canadians who study medicine abroad and retain Canadian-trained doctors, he said.

Another way to reduce wait times is to focus on preventative care and health promotion, said Fralick.

“It’s an investment. The more we can keep people off the acute care system, the healthier we’ll be as a nation,” she said.

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