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Most Canadians get timely medical treatment, but not all have equal access: report​

health

Most Canadians get timely medical treatment: report

A report from the Canadian Institute for Health Information suggests that three of every four people in the country receive priority procedures within the recommended time frames

A new report suggests three out of four Canadians are getting treated within recommended time frames when it comes to certain priority procedures. However, the numbers also show regional differences, indicating that not all Canadians are getting equal access to these procedures.

The report from the Canadian Institute for Health Information (CIHI) looked at whether patients were receiving treatment within a time frame deemed medically acceptable for procedures including hip replacement, hip-fracture repair, knee replacement, cataract surgery and radiation therapy. It also tabulated wait times for cancer surgeries, MRI and CT scans.

Benchmark wait times depended on the procedure. For example, with hip replacements and knee replacements, it's 182 days.

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While some of the report's figures show improvements, priority procedures are just a small fraction of all the procedures done in Canada on a yearly basis, warned Tracy Johnson, director of health system analysis and emerging issues at CIHI.

"There are a lot of other procedures and when we bulk all of the procedures together, patients report that they are waiting longer in Canada for all elective procedures than when you're just looking at priority procedures," she said. "So I would say there is a mixed bag here."

CIHI collected data from April to September, 2016, for all 10 provinces (but none of the territories) and then used these to calculate changes since 2012. Researchers defined wait time as the time elapsed from when a doctor and a patient agreed on a procedure, up until when the procedure happened. It does not include how long a person waited to see a doctor.

On a national scale, 97 per cent of patients are receiving radiation therapy within the benchmark time frame of 28 days. This has remained consistent over the past four years and across provinces.

"While we might like to be at 100 per cent, a practical percentage is probably in the range of 90 per cent and certainly we've reached 90 per cent in radiation therapy," said Ms. Johnson.

Wait times for hip-fracture repair are also improving with 86 per cent of patients receiving care within the benchmark of 48 hours.

But patients receiving cataract surgery are waiting longer. The percentage meeting the benchmark in Canada has declined from 83 per cent in 2012 to 73 per cent in 2016.

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When breaking down the numbers by province, there are wide variations in meeting benchmarks, especially looking at knee- and hip-replacement procedures. Across provinces, it varied from 38 per cent to 85 per cent in 2016.

According to Ms. Johnson, one of the reasons for the variation depends on a backlog of patients in some provinces.

"Some of the provinces in the east and in B.C. were trying to focus for a number of years on their long-waiters [patients]," Ms. Johnson said. "So if you've got people who are waiting longer than six months, it means that your waits for everybody else on the list are by extension also going to get longer."

Some of the provinces with smaller populations also tend to have poorer numbers when it comes to hitting benchmarks, such as Nova Scotia with its 38-per-cent knee-replacement procedures. Ms. Johnson says that's due to a lack of resources: "If you lose a surgeon in a small province like Nova Scotia, that can make a big impact on their wait list and increase those wait lists significantly."

While Nova Scotia has struggled to hit its benchmarks for these procedures in the past, the 2016 numbers are an improvement over what they were four years ago.

The report also looked at wait times for cancer surgeries and diagnostic imaging (MRI and CT scans).

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For these procedures, because of the variety of medical issues being treated, there is no wait-time benchmark, so CIHI measured the average wait time in days of the 90th percentile of patients. For example, for breast-cancer surgery, 90 per cent of people waiting get their procedure within 38 days in Canada.

Overall, wait times for cancer surgeries in Canada have remained consistent since 2013.

The data also show patients with slower-growing cancers will wait longer. On average, nine out of 10 patients received surgery for prostate cancer in 88 days, while nine out of 10 patients with breast cancer received treatment in 38 days.

When it comes to wait times for MRI and CT scans, only six provinces provide data for these procedures and their data show that waits are getting longer. For CT scans, nine out of 10 patients are waiting between 71 days and 92 days across the country. Whereas MRI waits are significantly longer: Patients can wait anywhere between 99 days and 242 days, depending on the province.

While the figures vary from procedure to procedure and province to province, Ms. Johnson says the most important thing is that they are actually being tracked. "Our perspective here at CIHI is that you can't manage what you don't measure," she said. "[This report] gives you some acceptable wait times with the benchmarks, so for patients I think it's a nice place to start a conversation with your physician."

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