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Wednesday, April 12, 2017
Sick and tired (and in
pain) over health-care wait times
The Canadian Institute for Health
Information annual tracking of waits for priority procedures is a reminder of
how little has changed and how far we have to go
FOR PUBLICATION IN: Vancouver, Victoria, Calgary, Edmonton,
Regina, Winnipeg, Toronto, Ottawa and Montreal
to the CIHI news
release's sugar-coated headline that "Most Canadians receive priority
procedures within medically acceptable wait times," the report is actually
another reminder of how little has changed and how far we have to
there's value in CIHI's measurement, its report focuses primarily on patient
wait times for only five "priority procedures," and in a very limited sense. For
example, the report doesn't include the time it takes to get an appointment with
a specialist. And it uses remarkably long benchmarks for acceptable time frames
(six months for hip and knee replacements, for example).
the report concludes that only three out of four Canadians received treatment
within the medically recommended wait time. This means that one out of four
Canadians - 25 per cent - did not receive treatment within the generous
benchmarks used in the report. Worse, the situation has deteriorated since last
year when "only" one out of five Canadian patients - 20 per cent - didn't
receive timely treatment.
news: the report's five-year trend analysis shows deterioration in access for
three of five procedures (hip replacement, knee replacement and cataract
surgery) since 2012. Only wait times for hip fracture repair have improved over
the five-year period, although they were actually slightly worse in 2016 than to
the only legitimate silver lining is that 97 to 98 per cent of patients
consistently received radiation therapy treatment within 28 days. So,
thankfully, patients waiting for cancer treatment seem to receive therapy within
four weeks (not including delays in seeing a specialist).
about everyone else?
governments in Canada still don't generally report comprehensive and
inter-provincially comparable information on wait times for most
medically-necessary procedures, more detailed statistics are available. For
example, the Fraser Institute's most recent annual
survey of physicians in Canada found that patients could expect to wait 20
weeks from general practitioner referral to treatment for medically-necessary
treatments across 12 specialties (including orthopedics, neurosurgery, urology
and otolaryngology). This wait time was the longest ever measured by the survey
and more than twice as long as the waits in 1993 (9.3 weeks), when the first
national estimate of wait times was produced.
when compared to other universal health-care systems around the world, Canada
consistently ranks last or next to last on several important indicators of
timely access to care. For example, the U.S.-based Commonwealth Fund (in
conjunction with CIHI) recently released the results of their survey of adults
in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway,
Sweden, Switzerland, the United Kingdom and the United States - all countries
with universal health-care systems (except, arguably, the U.S.). Canada ranked
worst in terms of the ability to get a same-day or next-day appointment when
sick, the wait for treatment in an emergency department, the wait to see a
specialist and the overall wait for all elective surgery.
Yet in the
face of this failure, patients in Canada have no recourse. Due to federal and
provincial laws, it's extremely difficult for patients to escape these
inordinately long wait times. Instead, they're often faced with the unhappy
choice of waiting in pain while their situation deteriorates or leaving the
country to access timely treatment.
have become the Canadian health-care system's defining feature. This despite years
of spending increases and continued promises from provincial and federal
governments to do something about it.
headlines pretending otherwise do Canadians a disservice.
we all got honest about health care and started exploring policy options to
improve our system.
Barua is an analyst at the Fraser Institute.