Long Wait Times, Good Care, Dedicated Caregivers

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Results From The Commonwealth Fund 2014 International Health Policy Survey of Older Adults

Two things were very clear in How Canada Compares: Results From The Commonwealth Fund 2014 International Health Policy Survey of Older Adults.

First, older Canadians wait longer to see a physician than the average of the 11 countries surveyed. Second, when they finally get an appointment, results are more positive for many aspects of their care.

Those 2 seemingly contradictory statements were among the many illuminating findings released January 29 by CIHI and the Canadian Institutes of Health Research (CIHR).

What’s more, older Canadians spend more time making plans for the end of their lives—and more time taking care of loved ones at the end of their lives—than their counterparts abroad.

Provincial-level results

The 2014 International Health Policy Survey included people age 55 and older from 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States.

All told, close to 5,300 Canadians completed the survey. This report allows us to see how Canada compares with the other countries surveyed. And for the first time, we can also see how individual provinces compare with each other and with the international average, through provincial-level results.

In the end, that is the greatest benefit of this report. It provides important perspective not only in how a province’s health care system is performing relative to its provincial neighbours, but also how the system on a larger scale rates among the world’s developed countries.

As a result, we have an intriguing snapshot of older Canadians’ experiences in terms of access to health care, the quality of care they receive and end-of-life planning and care.

Access to care remains an issue

“Older Canadian patients are telling us where our system is meeting—or not meeting—their needs,” said CIHI’s president and CEO David O’Toole. “The conclusion, based on the evidence, is that we don’t meet their needs when it comes to timely access to doctors and nurses.”

In fact, Canadians wait longer to see their family doctors and specialists, and have fewer options for after-hours care outside of emergency departments, than older people in the other surveyed countries.

“Accessing care in a timely fashion has been a challenge for a long time now,” said Jeremy Veillard, CIHI’s vice president of Research and Analysis. “In fact, I think the biggest surprise in this report is that it hasn’t gotten any better, despite consistent efforts to decrease wait times.”

For some older Canadians, cost can also be a barrier to accessing those health services not universally covered under provincial public insurance plans. This includes access to prescription drugs, particularly for those younger than 65, dental care and home care support services.

Quality of care gets positive reviews

Once older Canadians get in to see their providers, they generally report having an experience on par with, and sometimes better than, the experience had by older people in other surveyed countries.

“In this older age group, respondents are more likely to have chronic conditions that require treatment, and this is where Canada has above average results,” Veillard said.

In fact, the survey showed that older Canadians are more likely than patients in most of the other surveyed countries to have their medications reviewed by a health professional and more likely to have discussions with their providers about treatment goals for chronic conditions and healthy life habits.

End-of-life planning takes centre stage

Older Canadians are considerably more likely than older people in other countries to be planning for end-of-life care, with a written plan outlining their wishes. What’s more, respondents from Canada are also more likely to discuss those wishes with loved ones.

In addition, while the ratio of older Canadians acting as informal caregivers is on par with the international average, Canadians spend more time taking care of loved ones than the average.

“Whether it’s by choice or by necessity, it is often friends and family members who become the main caregivers of people at the end of their lives,” said Veillard. “In Canada, our older population is spending more time in that caregiver role than those in other countries.”

See for yourself

With so much data to share and so many different storylines, we have created a suite of comprehensive materials—from infographics to public summaries—to help share the knowledge and tell the most complete story possible.

For a complete look at How Canada Compares: Results From The Commonwealth Fund 2014 International Health Policy Survey of Older Adults, visit www.cihi.ca .