Joint replacement a growing challenge
March 19, 2013—In 2012, more than 538,000 Canadians had priority surgical procedures and specialized treatments, according to the Canadian Institute for Health Information (CIHI). That’s more procedures than have been performed in any other year in Canada and an increase of nearly 21,000 over 2011.
This record number emerges from CIHI’s latest annual report, Wait Times for Priority Procedures in Canada, 2013. However, the report also shows that, although more Canadians are undergoing priority procedures, in 2012, there was no overall reduction in the length of time patients waited. The report includes three-year trends and provides a cross-Canada perspective.
“Hospitals across Canada continue to provide more procedures to more patients,” says CIHI’s Jeremy Veillard, Vice President, Research and Analysis. “At the same time, this growing volume presents a challenge to efforts to reduce the time that each individual patient waits.”
In 2004, governments committed to reducing waits in five priority areas and set benchmarks for radiation therapy, cardiac bypass surgery, hip and knee replacements, hip fracture repair and cataract surgery.
While all patients would ideally receive treatment within the set benchmark time frames, this may not be achievable or practical. Providing care to 90% of patients within the benchmark may be a reasonable target. CIHI’s report shows that, as the 10-year strategy nears its end in 2014, radiation therapy is the only area that has surpassed that 90% target, with 97% of patients receiving care within the recommended 28-day period.
Higher demand for joint replacement surgery particularly challenging
One area of major investment in recent years has been joint replacement surgery. The number of hip and knee replacements performed in Canada increased by 15% between 2010 and 2012, costing more than $100 million to the health care system—$40 million for hip replacements and $61 million for knee replacements. At the same time, the percentage of patients who received joint replacement surgery within the benchmark did not improve. In 2012, 80% of patients received hip replacements within the benchmark wait time, compared with 84% of patients in 2010. The proportion of patients receiving knee surgery within the benchmark also declined during this period, from 79% to 75%.
Waits for these procedures vary greatly across provinces. More than half the provinces—Prince Edward Island, New Brunswick, Quebec, Manitoba, British Columbia and Saskatchewan—saw a reduction in the percentage of procedures meeting the benchmark time frames over a three-year period.
Although the 10-Year Plan is coming to an end, provinces continue their work to better track wait times with the development of common definitions for measuring waits for cancer surgery and chemotherapy.
Some provincial initiatives directed at continued reduction of wait times are wait list management, models for centralizing patient assessments and wait lists, and streamlining the provision of care, including operating room utilization.
Progress on reducing waits can be tracked using CIHI’s interactive graphics at http://waittimes.cihi.ca/, which displays numerous years of provincial data.