Canadians waiting longer than ever for surgery

Getting the right diagnosis can be tricky enough — but getting treatment is another story. Canadians are waiting longer than ever before for surgery, warns a new report from policy think-tank, the Frasier Institute.

In the 21st annual Waiting Your Turn: Wait Times for Health Care in Canada, the institute found that the median wait time for surgery across Canada’s 10 provinces rose to an all time high of 19 weeks in 2011 – that’s 104 per cent higher than in 1993 when the Fraser Institute started tracking the numbers.

To compile the data, the institute polled physicians working in 12 specialties (including plastic surgery, gynaecology and ophthalmology). Median weight times were calculated for each province as well as the 10 provinces as a whole. Canada’s three territories weren’t included, and about 16 per cent of specialists responded to the survey overall.

From referral to treatment

The results? In 2011, patients seeking surgery waited about 19 weeks from the time their general practitioner referred them to a specialist to when they actually received the surgery. That’s up from 18.2 weeks in 2010 and beat the previous record high of 18.3 weeks set in 2007.

“Canadians are being forced to wait almost four-and-a-half months, on average, to receive surgical care, prolonging the pain and suffering patients and their families are forced to endure,” said Mark Rovere, associate director of health policy research at theFraser Institute and co-author of the report, in a recent press release.

“Despite significant increases in government health spending, Canadians are still waiting too long to access medically necessary treatment.”

Which province do you want to be in if you need surgery? Ontario still has the shortest wait time at 14.3 weeks — that’s up from 14 weeks in 2010 but still a month less than the national median.

Unfortunately, the numbers only go up from there. British Columbia has the second shortest wait time of 19.3 weeks (up from 18.8 weeks in 2010), followed by Quebec at 19.9 weeks (also up from 18.8) and then Alberta at 21.1 weeks (down from 22.1 weeks).

Which other provinces also saw improvement? Newfoundland and Labrador’s median wait time dropped from 29.1 weeks in 2010 to 22.8 weeks in 2011. New Brunswick dropped from 33.6 weeks to 27.5 weeks over the past year.

Unfortunately, there were some not-so-modest increases as well. The median wait time in Manitoba jumped from 17.5 weeks in 2010 to 25 weeks in 2011. Saskatchewan saw a rise from 26.5 weeks to 29 weeks during the same time period. Nova Scotia’s gains weren’t huge — the province saw its median wait time rise from 28.5 weeks to 29 weeks in 2011.

Which province has the worst weight times? Prince Edward Island received the worst ranking: 43.9 weeks (down slightly from 44.4 weeks in 2010). However, experts warn not to read too much into those numbers because this small province had the fewest survey respondents. In other words, wait times could be lower or higher than what the participants reported.

Wait time differs by specialty, not just location

Of course, not all surgeries are treated equally: wait times differ according to specialty. For instance, patients dealing with cancer waited the shortest amount of time for treatment: just 4.2 two weeks for “medical oncology” and 4.6 weeks for “radiation oncology”. Patients waiting for elective cardiovascular surgery waited about 10.3 weeks in 2011.

Who waited the longest? Not surprisingly, patients expecting plastic surgery had significantly longer wait times — a median of 41.6 weeks. Next in line were people waiting for orthopedic surgery (like a joint replacement) with a median wait time of 39.1 weeks, followed by neurosurgery at 38.3 weeks.

How long is too long to wait? Specialists were also asked about “clinically reasonable” versus “actual” wait times. In nearly three quarters of the categories, actual wait times were greater than the clinically reasonable wait times. In other words, the majority of people waited longer than even doctors felt was reasonable.

As you might expect, the provinces that had lower wait times came closer to meeting the clinically reasonable wait time versus provinces with longer wait times. The biggest gap was seen with plastic surgery and orthopedic surgery.

Overall, people waited for over 941,321 surgeries in 2011, up 14 per cent from 2010’s total of 825,827. If you figure one surgery per person, then 2.76 per cent of all Canadians were waiting for surgery in 2011.  Of course, the demand for surgery isn’t the same in all provinces either. For instance, Ontario had the least demand — 1.95 per cent of its population — compared to Saskatchewan, which has the greatest demand at 5.74 per cent. The Fraser Institute report doesn’t elaborate on how these numbers affect wait times.

What about the in between steps?

The report didn’t just measure the wait time between the referral from the GP to treatment: it also included that in between step of a consultation with a specialist. Not surprisingly, it takes longer to get in to see a specialist than it has in the past, and there’s also a bigger delay between seeing the specialist and receiving the surgery.

According to the report, the wait time to see a specialist increased from 8.9 weeks in 2010 to 9.5 weeks in 2011. Since 1993, the wait time has increased by 156 per cent.

What about after you see the specialist? In 2011, in took 9.5 weeks to receive treatment, up from 9.3 in 2010. Since 1993, it takes 70 per cent longer to receive treatment after seeing a specialist.

What about diagnostic tests? There’s good news here: according to the report, many Canadians don’t have to wait as long for tests like CT-scan, MRI or ultrasound — again, it depends on where you live. Overall, Canada is on a par with last year thanks to decreases in some areas offset by increases in others.  For instance, Newfoundland and Labrador residents now wait half as long for a CT-scan then in 2010 (now three weeks), but a week longer for an MRI and up to three times as long for an ultrasound.

The take-away message?

In case you missed it, the Frasier Institute warns that Canadians are waiting too long to receive treatment — and that’s going to cost us in the long run. It’s expensive to treat people waiting for surgery, not to mention lost productivity in terms of the economy. Unfortunately, there isn’t much individuals can do about these numbers except put pressure on politicians and policy makers.

“It’s time for policy makers to embrace sensible reforms that have worked in other industrialized countries with universal-access health care systems.” Rovere concluded in the press release.

For more information on the report, read the press release and download the report.

For more details on wait times in your area, start with your province’s Ministry of Health website.

Photo © Hüseyin Tuncer