Eight out of 10 Canadians receive priority area procedures within recommended wait times

Where you live in Canada can make a difference in how long you wait for care

What: Wait Times in Canada—A Comparison by Province, 2011

At least 8 out of 10 Canadian patients are receiving priority area procedures, such as hip replacements, cataract surgery and cancer radiation treatment, within medically recommended wait times, according to a new study from the Canadian Institute for Health Information (CIHI). The study provides the first comprehensive national picture of how long Canadians wait for care in priority areas as compared with evidence-based benchmarks of acceptable waits. In 2010, more than 80% of Canadian patients received hip replacements (84%) and cataract surgery (83%) within wait time benchmarks, while the proportion of patients receiving knee replacements and hip fracture repairs within recommended waits was slightly lower, at 79% and 78%, respectively. Almost all (98%) Canadians who needed radiation treatment received it within the clinically recommended time frame.

In 2004, Canada’s first ministers agreed to reduce wait times in five priority areas: cancer treatment, cardiac care, diagnostic imaging, joint replacement and sight restoration. They also agreed to work towards meeting evidence-based benchmarks—or targets—for medically acceptable waits, which were established in late 2005 for some priority procedures. CIHI was mandated to collect wait times information and monitor provincial progress in meeting benchmarks. Wait Times in Canada—A Comparison by Province, 2011 is CIHI’s sixth annual report in this series.

“Many programs and initiatives have been put in place across Canada to lower wait times for patients and improve access to care in priority areas,” says Jeremy Veillard, CIHI’s Vice President of Research and Analysis. “The good news is that the majority of Canadians are now getting priority area procedures within recommended wait times, though how long you wait for care can often depend on where you live.”

Wait times for priority procedures vary widely across the provinces

CIHI’s report shows that wait times tend to be shorter in Canada’s three largest provinces (Ontario, Quebec and British Columbia). Across the country, however, there is wide variation in how long Canadians wait for care. In some provinces, more than half of knee replacement and cataract patients wait longer than the recommended time frames for their procedures, while in others, almost 9 out of 10 patients receive surgical treatment within the wait time benchmark. The proportion of patients who received knee replacement surgery within the recommended six-month wait ranged from 42% in Nova Scotia and 57% in Manitoba to 83% in Quebec and 89% in Ontario. For cataract surgery, 48% of patients in Alberta and 62% of patients in Saskatchewan received their surgery within the recommended 16 weeks, compared with 88% of patients in Ontario and 89% of patients in New Brunswick.

Wait times for hip fracture repair and radiation therapy do not vary as widely across Canada. Provinces performed between 72% (Saskatchewan) and 82% (Manitoba) of hip fracture repairs within the recommended 48 hours of a patient’s admission to hospital, while 85% (Nova Scotia) to 100% (Manitoba) of patients received radiation treatment within the 28-day benchmark of being ready to receive care.

“Significant progress has been made in developing a common understanding of how to measure waits across the provinces,” says Kathleen Morris, Head of Emerging Issues at CIHI. “Through their collaboration, we now have more comparable information that the provinces can use to learn from one another.”

Highlights of three-year trends by priority procedure

Provinces have shown improvements in wait times since the priority areas were identified in 2004, but meaningful trend information has not always been available because of the work being done to refine definitions and reporting. As of 2010, CIHI can report more consistently on trends by province for each priority area. Comparable information shows that over the last three years, improvements were not seen consistently across all procedures or across all provinces.

• Hip replacements: There have been improvements in the percentage of patients receiving hip replacement surgery within benchmarks in Nova Scotia, New Brunswick and Saskatchewan. Quebec, Ontario and Prince Edward Island reported that 90% or more of patients received surgery within the recommended 182 days.
• Knee replacements: Over three years, seven of nine provinces where data was available showed no change or a decrease in the percentage of patients who received knee replacement surgery within the benchmark time frame. Only New Brunswick and Saskatchewan showed improvements.
• Hip fracture repair: Across Canada, 78% of patients received surgery to repair a hip fracture within the benchmark in 2010. Trending for waits for hip fracture surgery will start in 2012, once data for three years becomes available.
• Radiation therapy: In the nine provinces where data is available, 85% to 100% of patients received radiation treatment within 28 days of being ready to receive care. This is unchanged from a year ago.
• Cataract surgery: Three of nine provinces where data is available reported improvements in the proportion of patients receiving cataract surgery within the benchmark (P.E.I., New Brunswick and Saskatchewan), while others had waits that remained unchanged or increased over the past three years.
• Bypass surgery: At least 95% of patients received bypass surgery within benchmarks in all nine provinces where data is available, but the picture may be too favourable. There is no consistency, as of yet, in how urgency levels are applied across jurisdictions.
• Diagnostic imaging: Though wait times information is more limited for diagnostic imaging than for other priority area procedures, the study found that waits for magnetic resonance imaging (MRI) scans were longer than for computed tomography (CT) scans. Currently, no pan-Canadian benchmarks exist for CT and MRI scans.

Media contacts

Angela Baker
416-549-5402
Cell: 416-459-6855
anbaker@cihi.ca

Jennie Hoekstra
519-453-5990
Cell: 519-317-1105
jhoekstra@cihi.ca

About CIHI

Established in 1994, CIHI is an independent, not-for-profit corporation that provides essential information on Canada’s health system and the health of Canadians. Funded by federal, provincial and territorial governments, CIHI is guided by a Board of Directors made up of health leaders across the country. Our vision is to improve Canada’s health system and the well-being of Canadians by being a leading source of unbiased, credible and comparable information that will enable health leaders to make better-informed decisions.

The report and the following figure and tables are available from CIHI’s website, at www.cihi.ca.

• Figure 1 Percentage of Patients Receiving Care Within Benchmarks by Province, 2010 (Figure 1 in the report)
• Table 1 Trending for the Proportion of Patients Receiving Joint Replacements, Cataract Surgery and Radiation Therapy Within Benchmarks, 2008 to 2010 (Table 1 in the report)
• Table 2 Wait Time Trends for Joint Replacements, Cataract Surgery, Bypass Surgery and Radiation Therapy, 2008 to 2010 (Table A1 in the report)