November 29, 2012—While progress has been made in some areas—most notably priority surgeries—people continue to wait at nearly all points of their journey through the health care system, concludes two new reports from the Canadian Institute for Health Information (CIHI).
Health Care in Canada, 2012: A Focus on Wait Times looks at people’s experiences in accessing care across the health system. Seniors and Alternate Level of Care provides further insight into hospitalized patients waiting for long-term care or home care services.
CIHI’s data reveals that after entering an emergency department (ED), 1 person in 10 is there for eight hours or more. The overall average length of stay is longer than four hours.
Compared with countries such as Australia, the United Kingdom and the United States, Canada actually has the highest percentage of patients waiting four hours or more in the ED before being treated.
Waits occur not only in emergency rooms but throughout the patient journey. They start with primary care: more than half of Canadians surveyed say they can’t get an appointment with their family physician on the same or next day—but only a small proportion (15%) of Canadians report that they find this wait unacceptable.
Dissatisfaction with the wait to see a specialist, however, is nearly double that: 29% find their wait unacceptable; 14% of patients waited more than three months for their appointment.
Regarding elective surgery, 25% of people reported waiting four or more months. As for priority surgeries—in cancer care, cardiac care, joint replacement and sight restoration—wait times have been reduced since 2004–2005, largely because of targeted investment in these areas.
Some people remain in hospital beds while they wait for transfers to more appropriate settings such as long-term care facilities or home with services. On any given day, about 5% of patients in acute hospital beds across the country are waiting to move. One in five of them wait more than a month; most of these patients are age 65 or older. Patients with dementia or receiving palliative care are among those most likely to wait.
The Seniors and Alternate Level of Care report shows that among seniors who waited for care in a more appropriate setting, more than half (54%) were discharged to a long-term care facility. The median wait for placement in residential care was almost a month (26 days). Those discharged home with home care services in place have shorter waits, at about a week.
“Wait times have improved for certain types of care, but more can still be done,” said John Wright, President and CEO, CIHI. “Some strategies that could have wide-ranging impact include looking at how care is organized, at patient flow across sectors of care, and at implementing successful pilot projects more broadly.”
The Health Care in Canada, 2012 report highlights several specific initiatives that have demonstrated some success at reducing waits by focusing on financial incentives, human resources and information management. Examples include advanced access models implemented in British Columbia, Saskatchewan and New Brunswick, and the role of clinical nurse leaders in Yukon.
A Comparison of Wait Times for Specialists and Family Physicians, Canada