Access to care and lengthy wait times affect all Canadians

April 2017

Access to care and lengthy wait times affect all Canadians and play a large role in patients’ experiences with their health care systems. The national discussion around wait times has many layers, and the length of time people wait depends greatly on what kind of care they require and where they live.

We track and report on waits in different parts of Canada’s health systems with the aim of providing as complete a picture as possible.

Priority area procedures

We have reported on wait times for priority procedures — hip replacement, knee replacement, cataract surgery, hip fracture repair and radiation therapy — for more than a decade now.

Our latest update shows that, in general, 3 out of 4 Canadians received their procedure within the medically recommended wait time in 2016, though this varied by procedure.

Our online tool allows us to monitor wait time trends over time for these procedures, providing a historical overview, as well as the current scenario.

The patient’s perspective

We released the latest results from The Commonwealth Fund’s International Health Policy Survey this past February, which showed that Canadian patients are not seeing improvements in timely access to physician care.

At least 3 out of 4 Canadians have their procedure done within medically acceptable wait times, but this varies with the procedure they have and where they live. Hip fracture repair has a medically acceptable wait time of 48 hours.  86% of Canadians had their hip fracture repair surgery within 48 hours in 2016; this was an improvement from 81% in 2012. Cataract surgery has a medically acceptable wait time of 112 days, or approximately 4 months.  Fewer Canadians received cataract surgery within 4 months in 2016 (73%) than in 2012 (83%). Joint replacement has a medically acceptable wait time of 182 days, or approximately 6 months.  About 75% of Canadians waited 6 months or less for a hip or knee replacement, but this varied widely across provinces, from 38% to 85%. Radiation therapy has a medically acceptable wait time of 28 days, or approximately 1 month.  97% of Canadians waited about 1 month or less to receive radiation therapy. Use CIHI’s Wait Times eTool to get detailed information on wait times in Canada waittimes.cihi.ca.  In fact, Canadians reported some of the longest wait times for doctors, specialists and emergency department visits, compared with citizens in peer countries. Even though the majority (93%) of Canadians have a regular doctor or place of care, Canada continues to perform below the international average on 7 out of 8 measures of timely access to medical care.

Less than half of Canadians could get a same- or next-day appointment with their family doctor or at their regular place of care the last time they needed medical attention.

Access to after-hours care is also more difficult in Canada than in most other countries, with only 1 out of 3 patients able to receive medical care in the evenings, on weekends or on holidays without going to the emergency department.

Canadians visit emergency departments more often than people in other countries and have the longest reported waits there as well.

Canadians also report the longest wait times for specialists, with more than half waiting longer than 4 weeks to see a specialist, compared with the international average of 36%.

Physicians contribute to the conversation

In 2015, The Commonwealth Fund surveyed physicians, who reported an improvement in their patients’ access to regular and after-hours care. The physicians surveyed did, however, note that wait times were still a challenge for Canadian patients.

The report noted that the proportion of doctors who thought their patients often experienced long wait times to get treatment after diagnosis decreased between 2009 and 2015.

The proportion of doctors who said that most of their patients could get same- or next-day appointments increased between 2009 and 2015, while 40% of Canadian primary care doctors thought their patients often experienced difficulty getting specialized diagnostic tests (e.g., CT and MRI scans, mammograms).

Looking beyond our borders

Reducing wait times is a priority for everyone working in Canada’s health systems. International comparisons allow us to see not only where Canadian jurisdictions have made progress, but where peer countries have gone even further. That larger perspective helps inform future actions to potentially address this aspect of Canadian care.

CIHI continues its work on international comparisons to contribute valuable information to the discussion. By analyzing and reporting on data from important organizations like the Organisation for Economic Co-operation and Development, as well as The Commonwealth Fund, issues like wait times can be addressed from a position of knowledge.