Wait times for primary and specialist care longest in Canada, among 11 countries

How Canada Compares: Results From The Commonwealth Fund 2014 International Health Policy Survey of Older Adults

January 29, 2015—Older Canadians report having longer waits and more difficulties seeing a doctor or nurse when they need medical attention than older people in 10 comparator countries. When they do see their doctor, however, results are more positive for many aspects of their care.

This type of information is included in How Canada Compares: Results From The Commonwealth Fund 2014 International Health Policy Survey of Older Adults, released today by the Canadian Institute for Health Information (CIHI) and the Canadian Institutes for Health Research (CIHR).

“In terms of wait times, Canada’s position among the 11 surveyed countries has not improved at all,” said CIHI President and CEO David O’Toole. “Older Canadian patients are telling us where our system is meeting—or not meeting—their needs. We definitely don’t meet their needs when it comes to timely access to doctors and nurses.”

The 2014 International Health Policy Survey included patients 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. More than 5,300 Canadians completed the survey. The companion report, How Canada Compares, provides provincial-level results for the first time as well as new analysis to highlight where Canadian results are significantly different from the international average.

Access to care

The report shows that waits for primary and specialist care in Canada have not improved since they were first reported on in 2007. Among surveyed countries, Canada continues to have the longest wait times for older people waiting to see a doctor or nurse when they need medical attention, with more than half waiting more than 2 days, and nearly one-third (30%) waiting 6 or more days.

Older Canadians also have the longest reported wait times to see a specialist, with 25% waiting 2 months
or more for a specialist visit. Despite some variation across the country, wait times in every province were significantly higher than the international average.

Older Canadians also report more difficulties (51%) in getting care after-hours or on weekends than older people in any other country. As a result, 37% reported a visit to an emergency department for a condition that could have been treated by their regular doctor.

Quality of care

When older Canadians do get in to see a doctor, they report receiving quality care that is on par with, or better than, the international average.

Older Canadians are more likely to get their medications reviewed by a health professional (80%) than older people in other countries. They are also more likely to have discussions with their providers about treatment goals for chronic conditions and healthy life habits.

However, there’s room for improvement in terms of continuity of care between regular doctors and specialists, as 25% of older Canadians said their regular doctor did not seem up to date about their specialist visit.

Caregiving and end-of-life care

Older Canadians spend longer hours as caregivers and spend more time planning for end-of-life care.

About 1 in 5 older Canadians is an informal caregiver—similar to the international average—but a higher proportion of Canadian caregivers (47%) spend 10 hours or more per week looking after a loved one.

About one-third of caregivers say they have experienced distress, depression or anger while providing care to a loved one. Distress was more common among those providing care for 10 or more hours a week.

Older Canadians were also more likely than older people in other countries to have discussions about end-of-life care or to make written plans. However, end-of-life planning varied significantly across the country, with 44% of Ontarian respondents saying they had written plans while just 18% in Newfoundland and Labrador said the same.

About The Commonwealth Fund 2014 International Health Policy Survey
of Older Adults

The Commonwealth Fund is a private foundation that aims to promote a high-performing health care system that achieves better access, improved quality and greater efficiency, particularly for society’s most vulnerable.

The Commonwealth Fund 2014 International Health Policy Survey of Older Adults received core funding from The Commonwealth Fund and co-funding from the following organizations outside of Canada: Haute Autorité de santé (France); Caisse nationale de l’assurance maladie des travailleurs salariés (France); BQS Institute for Quality and Patient Safety; the German Federal Ministry of Health; the Dutch Ministry of Health, Welfare and Sport; the Scientific Institute for Quality of Healthcare, Radboud University Nijmegen (the Netherlands); the Norwegian Knowledge Centre for the Health Services; the Swedish Ministry of Health and Social Affairs; the Swiss Federal Office of Public Health; the NSW Bureau of Health Information (Australia); and many other country partners.

Within Canada, the following organizations provided funding for an expanded Canadian sample: the Canadian Institute for Health Information; the Canadian Institutes of Health Research; the Health Quality Council of Alberta; the Commissaire à la santé et au bien-être du Québec; and Health Quality Ontario.