Hospital waiting lists longer; more Canadians waiting
Contact:
Martin Zelder, Director, Health Policy Research
The Fraser Institute, (604) 714-4548 Email: martinz@fraserinstitute.caRelease Date: 12 August 1998
VANCOUVER, BC>>> The Fraser Institute released today the updated edition of Waiting Your Turn: Hospital Waiting Lists in Canada (8th ed.), which presents the only comprehensive measures of hospital waiting lists across Canada.
The results show that more Canadians were waiting to receive medical treatment in 1997 than in 1996. According to the study, 187,416 Canadians were waiting for surgical procedures (table 1), an increase from 1996's estimate of 172,766. According to Cynthia Ramsay, co-author of the report, "There were more Canadians waiting for treatment than there were in 1996, and those waiting were waiting longer -- 11.9 weeks from referral to a specialist by a general practitioner (GP) to the receipt of treatment, compared to 10.9 weeks in 1996."
The measurement of waiting times for medical care is the result of information provided by 2,263 specialists nation-wide in a survey undertaken during the latter part of 1997. The survey represents an effort to measure the extent of health care rationing in the different provinces from year to year.
GP to Specialist
The waiting times for appointments to see specialists are shown in chart 1 and table 2. Manitoba and British Columbia had the shortest waits in the country for appointments with specialists, while Nova Scotia had the longest. "In almost every province, the waiting time to see a specialist has increased since 1996," said Michael Walker, Executive Director of the Fraser Institute. "For Canada, the waiting time to see a specialist increased by 8.5 percent from 1996 to 1997. This is why it is important to measure not only the waits from specialist to treatment but also from GP to specialist. Care is being rationed increasingly at the GP level."
Specialist to Treatment
Once patients have seen a specialist, they then have to wait to receive medical treatment. Ms. Ramsay reports that the number of people on surgical waiting lists and the amount of time they are waiting for treatment varies substantially from province to province. "While many Canadians believe that there are national standards in health care, the reality is that equal access to health care does not exist in Canada." In Saskatchewan, the province with the longest median waiting times, patients waited 12.4 weeks (chart 2 and table 3) for surgical procedures, 7 weeks longer than people in Ontario, the province with the shortest waiting times, where the median wait for treatment was 5.4 weeks. For Canada, the wait for treatment after having seen a specialist increased from 6.2 weeks in 1996 to 6.8 weeks in 1997.
Total Wait from GP to Treatment
Canadians wait more than two months for relief of their ailments after seeing their GP, from 10.2 weeks in Ontario to 17.1 weeks in Saskatchewan (chart 3 and table 4). As shown in chart 4, the longest waits for treatment tended to be for three specialties where the total wait exceeded four-and-a-half months: ophthalmology (24.6 weeks), orthopaedic surgery (20.7 weeks), and elective cardiovascular surgery (18.2 weeks). The shortest wait was for cancer patients being treated with chemotherapy. These patients waited approximately 3.5 weeks to receive treatment.
Clinically Reasonable Waits from Specialist to Treatment
The survey also measured what specialists consider to be clinically reasonable amounts of time to wait for surgical procedures (table 5). In most cases, responding specialists thought patients were waiting too long for treatment. For example, the median actual wait for ophthalmology in Manitoba was 16.2 weeks. A clinically reasonable amount of time to wait, according to Manitoba specialists, was about 5.3 weeks. In Newfoundland, the actual time to wait for an elective cardiovascular procedure was about 52 weeks, whereas Newfoundland specialists felt that a wait of about 19 weeks was clinically reasonable. "This comparison of actual waits with clinically acceptable waits shows that most specialist physicians believe that their patients are having to wait longer for care than is acceptable given their condition. Since it is people's health which is at stake, this situation should be a cause for concern," said Dr. Walker.
Chart 5 compares the weighted actual median waiting times to the weighted clinically reasonable waiting times for the different specialties in Canada. For elective cardiovascular surgery, the median actual waiting time was 8.9 weeks longer than the clinically reasonable waiting time. The smallest divergence between actual and reasonable waiting times was for medical oncology: the actual waiting time was only 0.2 weeks longer than the clinically reasonable waiting time.
The Wait for Diagnostic Testing
In addition to waiting to see a specialist and to receive treatment, patients must wait to receive diagnostic testing (table 6). Across Canada, patients experienced an increase in the waiting times for various tests: computerized tomography (CT) scans, magnetic resonance imaging (MRI), and ultrasound. The median wait for an MRI in Canada of 9.6 weeks was more than twice that for a CT scan (4.1 weeks). The median wait for ultrasound in Canada was only 2.6 weeks in 1997, a relatively short wait compared to those for CT scans and MRIs, but a 36.8 percent increase from 1996.
Rationing through Waiting
"One explanation for the existence of waiting lists is that governments are using them in an attempt to control health care costs by limiting or rationing access to health care," concluded Dr. Walker. "If this were the case, longer waits would be associated with lower rates of provincial spending on health care." An analysis of per capita costs adjusted for the age of the population and waiting times (chart 6) is consistent with this view, but the correlation is far from perfect.
Established in 1974, The Fraser Institute is an independent public policy organization based in Vancouver.
For further information:
Suzanne Walters, Director of Communications,
The Fraser Institute, (604) 714-4582,
Email suzannew@fraserinstitute.ca
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