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Progress cutting hospital wait times has stalled; in some cases, ground lost

03/22/2012 03:07 EDT | Updated 05/22/2012 05:12 EDT
TORONTO - Progress towards cutting the time Canadians have to wait to get critical operations and health procedures has stalled, a new update on the wait-times initiative suggests.

Though there were early gains after provinces committed themselves to attacking wait times in 2004, there has been little progress since 2009, said Jeremy Veillard, vice president of research and analysis for the Canadian Institutes for Health Information, which monitors the wait times data and issues an annual report.

This year's report suggests that the situation isn't necessarily bad, but may not be getting better either. And for some patients, the waits are still excessive.

"These results may seem generally positive, but some patients are still waiting too long for care relative to benchmarks," Veillard said.

The report suggests about 80 per cent of patients who needed one or another of the seven priority procedures covered by the wait-time guarantees received care within the specified time.

The vast majority of patients — 97 per cent — receive radiation therapy within the recommended time frame of four weeks. Knee replacements had the longest wait times, with only 75 per cent of patients getting the procedure within the agreed-upon time frame.

An equal percentage of patients — 82 per cent — underwent hip replacement and cataract surgery within the wait time benchmark but only 79 per cent of people needing operations to repair hip fractures were cared for within that set time.

Those numbers might actually look better than the reality patients experienced, said Steven Lewis, a health policy consultant based in Saskatchewan.

That's because under this initiative, the clock starts ticking from when a specialist orders a procedure. But in some cases, getting to see the specialist in the first place is a major part of the wait — and this initiative isn't designed to attack that problem, Lewis said.

"This is a classic systems-centred measurement. If you had a really patient-centred measurement, you would focus on what part of that experience is meaningful to the patient," he said.

"And the patient thinks he or she is waiting from the time the GP (general practitioner) estimates that a procedure is warranted to the time it's actually done."

"It's cold comfort for a patient to have the procedure done three months after they've seen the specialist when it took them eight months to see the specialist in the first place."

Lewis said in Britain, a program aimed at capping wait times starts the clock from the time a patient sees his or her family doctor, and aims to have the needed procedure completed within three months.

For patients admitted to hospital, the British system hits the target in 91.4 per cent of the cases, according to government statistics released last week. For patients not admitted to hospital, the success rate is even higher, 97.1 per cent.

In Canada, officials acknowledge it may be impossible to aim for 100 per cent success. Some patients will need to defer surgery for personal reasons and some become ill with other conditions when they wait for surgery. Given that reality, it's estimated that 90 per cent is a more realistic goal to try to achieve.

And even that is proving tough. In fact, some provinces have lost ground over the last year. British Columbia, New Brunswick and Prince Edward Island now have longer waits for knee replacements, and P.E.I. also has longer waits for hip replacements and cataract surgeries.

"It is difficult for provinces to reach the 90 per cent threshold. Reports like this identify that there are still opportunities to improve access to care," said Tracy Johnson, manager of emerging issues at the Canadian Institute for Health Information.

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