Wait times shorter in Ontario, Quebec, B.C. for priority area procedures

Improvements inconsistent across provinces: CIHI

Eight out of 10 Canadian patients are receiving priority area procedures, such as hip replacements, cataract surgery and cancer radiation treatment, within medically recommended wait times, according to a study from the Canadian Institute for Health Information (CIHI).

In 2010, more than 80 per cent of Canadian patients received hip replacements (84 per cent) and cataract surgery (83 per cent) within wait time benchmarks, while the proportion of patients receiving knee replacements and hip fracture repairs within recommended waits was slightly lower, at 79 per cent and 78 per cent, respectively. Almost all (98 per cent) Canadians who needed radiation treatment received it within the clinically recommended time frame.

In 2004, Canada’s first ministers agreed to reduce wait times in five priority areas: cancer treatment, cardiac care, diagnostic imaging, joint replacement and sight restoration. They also agreed to work towards meeting evidence-based benchmarks — or targets — for medically acceptable waits, which were established in late 2005 for some priority procedures.

“Many programs and initiatives have been put in place across Canada to lower wait times for patients and improve access to care in priority areas,” said Jeremy Veillard, CIHI’s vice-president of research and analysis. “The good news is that the majority of Canadians are now getting priority area procedures within recommended wait times, though how long you wait for care can often depend on where you live.”

Wait times vary widely across provinces

Wait times tend to be shorter in Canada’s three largest provinces (Ontario, Quebec and British Columbia), found Wait Times in Canada — A Comparison by Province, 2011. Across the country, however, there is wide variation. In some provinces, more than one-half of knee replacement and cataract patients wait longer than the recommended time frames for their procedures while, in others, almost nine out of 10 patients receive surgical treatment within the wait time benchmark.

The proportion of patients who received knee replacement surgery within the recommended six-month wait ranged from 42 per cent in Nova Scotia and 57 per cent in Manitoba to 83 per cent in Quebec and 89 per cent in Ontario. For cataract surgery, 48 per cent of patients in Alberta and 62 per cent of patients in Saskatchewan received their surgery within the recommended 16 weeks, compared with 88 per cent of patients in Ontario and 89 per cent of patients in New Brunswick, found CIHI.

Wait times for hip fracture repair and radiation therapy do not vary as widely across Canada. Provinces performed between 72 per cent (Saskatchewan) and 82 per cent (Manitoba) of hip fracture repairs within the recommended 48 hours of a patient’s admission to hospital, while 85 per cent (Nova Scotia) to 100 per cent (Manitoba) of patients received radiation treatment within the 28-day benchmark of being ready to receive care.

“Significant progress has been made in developing a common understanding of how to measure waits across the provinces,” says Kathleen Morris, head of emerging issues at CIHI. “Through their collaboration, we now have more comparable information that the provinces can use to learn from one another.”

Highlights of three-year trends

Over the last three years, improvements were not seen consistently across all procedures or across all provinces.

Hip replacements: There have been improvements in the percentage of patients receiving hip replacement surgery within benchmarks in Nova Scotia, New Brunswick and Saskatchewan. Quebec, Ontario and Prince Edward Island reported 90 per cent or more of patients received surgery within the recommended 182 days.

Knee replacements: Over three years, seven of nine provinces where data was available showed no change or a decrease in the percentage of patients who received knee replacement surgery within the benchmark time frame. Only New Brunswick and Saskatchewan showed improvements.

Hip fracture repair: Across Canada, 78 per cent of patients received surgery to repair a hip fracture within the benchmark in 2010. Trending for waits for hip fracture surgery will start in 2012, once data for three years becomes available.

Radiation therapy: In the nine provinces where data is available, 85 per cent to 100 per cent of patients received radiation treatment within 28 days of being ready to receive care. This is unchanged from one year ago, said the report.

Cataract surgery: Three of nine provinces where data is available reported improvements in the proportion of patients receiving cataract surgery within the benchmark (P.E.I., New Brunswick and Saskatchewan), while others had waits that remained unchanged or increased over the past three years.

Bypass surgery: At least 95 per cent of patients received bypass surgery within benchmarks in all nine provinces where data is available, but the picture may be too favourable. There is no consistency, as of yet, in how urgency levels are applied across jurisdictions.

Diagnostic imaging: Though wait times information is more limited for diagnostic imaging than for other priority area procedures, waits for magnetic resonance imaging (MRI) scans were longer than for computed tomography (CT) scans, found CIHI. Currently, no pan-Canadian benchmarks exist for CT and MRI scans.

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