April 2018 — Fewer Canadians received surgery for cataracts and hip and knee replacements within the recommended wait times last year compared with 3 years ago, CIHI analysis shows. However, wait times for more urgent procedures such as radiation therapy and hip fracture repair remained stable over this same time period.

“We know Canadians are concerned about wait times — they want access to surgeries and diagnostics as quickly as possible,” said Kathleen Morris, CIHI’s vice-president of Research and Analysis. “Wait times are an ongoing challenge for health systems, and the ability to deliver timely care is influenced by several factors.”

2 important factors are the need for surgery and the number of surgeries performed. Canada’s aging population may be influencing the rising need for cataract and joint surgeries; increases in disease incidence and prevalence may also have an effect. Improvements in surgical practice, procedures and devices also expand the number of people eligible for surgery. The number of procedures performed may be affected by the number of surgeons, incentive systems and available resources like operating room time and post-operative beds.

5% fewer Canadians received hip replacements within the recommended wait time in 2017 compared with 2015.

Across the country, 76% of patients received a hip replacement within the recommended wait time of 182 days (6 months), compared with 81% in 2015. The number of procedures performed increased by 7% during this time period, meaning that, while some Canadians might be waiting longer for a hip replacement, more of them are undergoing the procedure.

6 provinces showed a decline in the proportion of patients who received a hip replacement within the recommended wait time during this 3-year period.

8% fewer Canadians received knee replacements within the recommended wait time in 2017 compared with 2015.

69% of patients who had a knee replacement had their procedure within the benchmark time frame of 6 months in 2017, compared with 77% in 2015. The number of knee replacements performed across Canada increased, with 6% more procedures in 2017 than in 2015. The percentage of patients treated within the benchmark declined in all but 3 provinces over the 3-year period.

7 of 10 provinces saw cataract surgery wait times increase between 2015 and 2017.

Longer wait times were also reported for cataract surgery. 71% of Canadians received cataract surgery within the recommended wait time of 16 weeks in 2017 — a decrease of 5% since 2015. The proportion of patients having cataract surgery within the benchmark declined in 7 provinces during this period. The number of procedures increased 3% over the 3-year period.

87% of Canadians received hip fracture repair within the recommended wait time in 2017.

Canadians did not wait longer for all procedures. The proportion of Canadians who had hip fracture repair surgery within the benchmark time frame of 48 hours remained stable at 87% in 2017 — the same as in 2015.

Timely surgery for hip fracture repair is associated with a reduced death rate, as well as with shorter lengths of stay in hospital, better overall recovery and reduced risk of complications Reference 11.

97% of Canadians received radiation therapy within the recommended wait time in 2017.

The vast majority of Canadians continued to receive radiation therapy within the recommended wait time; the proportion remained stable from 2015 to 2017. In all provinces, more than 90% of patients were treated within the benchmark of 28 days.

Prompt radiation therapy is important because delayed treatment can lead to poor outcomes. For example, a recent study linked longer wait times for radiation therapy to an increased likelihood of recurrence for patients with certain types of breast cancer Reference 22.

Cancer surgery results

Cancer surgery results showed shorter wait times for some types of the disease. There are no agreed-upon pan-Canadian benchmarks available to evaluate these cancer wait times. Instead, the point at which half of people (median) and 90% of people (90th percentile) received their surgery is used to assess wait times.

Learn more about wait times for cancer surgery and other procedures, such as CT and MRI scans, using CIHI’s Wait Times web tool.

More information on wait times

This analysis of current wait time data does not reflect the entire patient journey; for example, wait times to see a specialist are not included. Results from The Commonwealth Fund’s 2016 International Health Policy Survey of Adults showed that wait times for specialist appointments were highest in Canada among 11 countries. According to the results, 30% of Canadians waited 2 months or more for a specialist appointment Reference 33 Reference 44. These access challenges are also highlighted in the recently released results of The Commonwealth Fund’s 2017 International Health Policy Survey of Seniors (age 65+) Reference 55.

The time spent in the emergency department (ED) can also be a significant component of a patient’s wait, particularly for hip fracture repair. CIHI data recently showed that the length of stay for ED patients who were admitted to hospital has continued to increase in recent years Reference 66. CIHI’s Wait Times web tool also contains information specific to hip fracture repair that includes the ED segment in 3 provinces Reference 77.


Featured resources

Wait Times web tool

Learn more about benchmarks for treatment and wait times for priority procedures across Canada

Emergency department visits: Quick Stats web tool

Find info on volumes and median lengths of stay for ED visits by triage level, visit disposition and age/sex group

OECD Interactive Tool: International Comparisons

Compare results for Canada’s provinces with those for OECD countries in 6 dimensions of care