Survey of physicians continues to find unhealthy waits for service
Contacts: Dr. Michael Walker (604) 688-0221, ext. 545
Ms. Cynthia Ramsey (604) 688-0221, Ext. 318
For release June 26, 1995
MEDIA RELEASE
Vancouver, British Columbia>>>>The Fraser Institute released today the results of a nation-wide survey of specialist and hospital waiting lists. The measurements of waiting times for medical care are a result of information provided by 2,639 specialists in a survey undertaken during the latter part of 1994. The results published by the independent research organization show that some 183,659 Canadians are waiting for surgical procedures, a slight increase from last year' s estimate of 183 ,528. The survey is the fifth conducted by The Fraser Institutethe first survey dealt with only British Columbia, the second with a sample of five provinces, and the last two with all ten provincesand represents an effort to measure the extent of health care rationing in the different provinces from year to year.
The waiting times for appointments to see specialists are shown in Chart 1. One to two months is the standard waiting time. However, there are a number of 3 month waits: to see a neurosurgeon in Ontario and New Brunswick, to see an orthopaedic surgeon in Manitoba and the Northwest Territories, and to see a plastic surgeon in Newfoundland.
According to the study's director, Dr. Michael Walker, "The data show that Canada's ten provinces do not have a uniform standard of access to surgical procedures. In Prince Edward Island, the province with the longest median waiting times, patients wait 13 weeks (see Chart 1) for surgical procedures compared with Newfoundland, the province with the shortest median waiting times, where patients wait 4.4 weeks for treatment. Among the provinces there is also wide variability (see Chart 2) in access to the types of surgeries for which waiting lists are most frequent, such as reconstructive plastic surgery, eye surgery (including cataract removal), orthopaedics (including hip replacement), and especially elective cardiovascular surgery."
The survey also measured what specialists consider to be clinically reasonable amounts of time to wait for surgical procedures. In almost every instance, the responding specialists felt that the times being waited for treatment were excessive. Chart 3 compares the actual median waiting times to the clinically reasonable waiting times for the different specialties. The largest difference in these two periods is for orthopaedic surgery where the actual waiting time is more than 5 weeks longer than what is considered reasonable by specialists. The smallest divergence is in medical oncology, where the actual waiting time is less than the clinically reasonable waiting time by about one day.
"This comparison of actual waits with clinically acceptable waits shows that we are seeing more than a desirable, efficient lag between diagnosis and treatment," said Dr. Walker. "The data show that a very large number of physicians believe that Canadians are having to wait longer for care than is healthy."
The study looked at the waits for various diagnostic tests: computerized tomography (CT) scan, magnetic resonance imaging (MRI), and ultrasound. The median wait for an MRI in Canada of 8.8 weeks is more than twice that for a CT scan (3.5 weeks). The longest wait for an MRI is in Alberta (10.9 weeks). MRIs are not available in Manitoba, Prince Edward Island, and New Brunswick and many provinces have only one operational MRI. Ultrasound tests are quite common and many specialists have their own machines, which resulted in an median wait for ultrasound in Canada of only 1.7 weeks.
"One plausible explanation for the waiting times is that governments are using them as a way of rationing access to health care as a means of cost control. If that 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 (shown in Chart 4) is consistent with this view but the correlation is far from perfect. "Generally, those provinces that spend less per capita on health care than the national average have waiting times that are above the national median," Walker concluded.
Complete copies of the 50-page report are available by contacting Ms. Beverley Horan at (604) 688-0221, ext. 582.
Click here to view Chart 1: Total Waiting by Province in 1994 -- Weeks Waited from G.P Referral to Treatment
Click here to view Chart 2: Median Wait (Specialist to Treatment) -- Longest and Shortest Median Weeks Waited
Click here to view Chart 3: Actual Versus Reasonable Waiting by Specialty for Canada -- Time Waited from Appointment with Specialist to Treatment in 1994
Click here to view Chart 4: Comparison Between Weighted Average Cost and Median Waiting Times (Divergence from the Canadian Average)
Click here to view Table 1: Median 1994 Patient Wait to see a Specialist after Referral from G.P. (in Weeks)
Click here to view Table 2: Median Wait to Receive Treatment by Selected Specialties in 1994 (in Weeks)
Click here to view Table 3: Estimated Number of Patients Waiting by Specialty in 1994
Click here to view Table 4: Reasonable Number of Weeks to Receive Treatment by Selected Specialties
Click here to view Table 5: Waiting for Technology -- Median Number of Weeks Waited to Receive Selected Diagnostic Tests in 1994