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Older Canadians’ timely access to health care ranked last by survey

More than 30 per cent of the older Canadian respondents to a survey said they had to wait six or more days to see a primary-care provider.

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More than half of Canadians 55 and over have to wait at least two days to see their doctors when they are ill, according to a new survey of wealthy countries that ranks Canada dead last when it comes to timely access to health care.

More than 30 per cent of the Canadian respondents had to wait six or more days to see a primary-care provider. Older Canadians also waited longer than their counterparts in 10 other countries to see a specialist and found it more difficult to get the care they needed on nights and weekends, the survey found.

"These are actually the worst results from all the countries surveyed," said Jeremy Veillard, vice-president of research and analysis at the Canadian Institute for Health Information (CIHI).

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"Access to primary health care and to specialists remains a challenge in this country and it has not improved since 2007. … That's despite substantial investments in the health system."

Older Canadians reported difficulties in seeing their doctors on short notice no matter where they live. At least 50 per cent of the respondents in every province reported having to wait at least two days to see their doctor or nurse, compared with the 11-country average of 32 per cent. France fared best on timely access to primary care, followed by New Zealand and Germany.

The survey of older residents in 11 countries was conducted by the Commonwealth Fund, a private U.S. foundation that regularly rates the quality of health care in developed countries, including the United States, Australia, New Zealand and seven European nations. CIHI, which is the Commonwealth Fund's national partner on the study, released the detailed Canadian results on Thursday.

The Canadian findings were based on telephone interviews conducted last year with 5,269 Canadians 55 and older.

Swift access to primary care has been a long-standing challenge in Canada, one that a steady increase in the number of doctors, including family physicians, has not managed to solve.

The number of physicians per 100,000 Canadians has climbed to 220 in 2013 from 173 in 1986, according to CIHI figures provided by the Canadian Medical Association, which represents the country's doctors.

CMA president Chris Simpson said part of Canada's problem is a lack of national co-ordination when it comes to health-care human resources.

"A lot of the provinces have tried to get the right matches – the right number of [health-care] providers in the right places – but because there's so much interprovincial migration of health-care providers, that's been less than successful," he said.

He also pointed out that today's doctors are working fewer hours than their predecessors, although they still put in more hours than workers in many other professions.

"The days when doctors worked 90 and 100 hours a week and were on call 24/7, well that's just not a healthy way for somebody to practise," he said "I think that the work-life balance has been a little bit different for younger physicians and rightly so."

(The CMA later followed up to say that physicians of all ages in Canada are working fewer hours today than in the past.)

Once Canadians over the age of 55 managed to get in to see their doctors, they generally gave the system high marks for quality of care. Eighty-seven per cent of the respondents said their doctors knew their medical history well; 70 per cent said they were encouraged to ask questions during appointments; and 80 per cent said a health-care professional had reviewed their medications in the past 12 months.

On all those counts, Canada fared better than the average among the 11 countries.

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