Most patients get priority surgeries within target wait times: report

Three out of four Canadians received a hip or knee replacement, cataract surgery, hip fracture repair or cancer radiation therapy within the recommended wait times for those priority procedures, although there was often wide variation from one province to another, researchers say.

A report by the Canadian Institute for Health Information (CIHI), released Tuesday, provides a snapshot of patient wait times for five priority medical procedures in 2016 and compares them to data for the previous four years.

Overall, wait times for hip fracture repair across the country continued to improve, with the percentage of patients receiving surgery within the 48-hour benchmark increasing to 86 per cent in 2016 from 81 per cent in 2012.

Nationally, wait times for joint replacement remained relatively unchanged last year, with 75 per cent of patients receiving hip or knee replacement surgery within the 182-day benchmark. Since 2012, the number of hip replacements rose 22 per cent, while knee replacements went up 18 per cent.

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"Essentially, when we look at hips and knees, they haven't changed too much over the five years," said Tracy Johnson, CIHI's director of health systems analysis and emerging issues.

"In the last year or so, there looks like there's a bit of a downward trend, but what we don't know is whether that will continue or it's just a little bit of the fluctuation you see year over year," she said Monday.

However, there was a significant drop in the proportion of Canadians who were able to get cataract surgery within the targeted wait time of 112 days: in 2016, 73 per cent of patients had the sight-restoring operation within that period, down from 83 per cent 2012.

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Median wait times increased over the five-year period: in 2012, half of patients got cataract surgery within 47 days; four years later, that median wait time had expanded to 67 days.

"What we can see with cataracts was that the volumes of cataract surgeries done has not increased as much as it has for hips and knees," said Johnson.

"So one of the reasons could be that we're not keeping up with the demand for cataracts," she said, acknowledging that the country's aging population could be a contributing factor.

Some difference among provinces

When it came to cancer patients, CIHI found that about 97 per cent received radiation therapy within the 28-day benchmark in 2016. While there was some variation in wait times across provinces, overall 90 per cent of patients were able to access the treatment within 15 to 27 days.

Still, there were some marked differences among provinces for the four other priority procedures.

In British Columbia, for instance, 61 per cent of hip-replacement and 47 per cent of knee-replacement patients were able to get their surgery within the target time frame of 182 days. Across the country in Nova Scotia, the figures were 56 per cent and 38 per cent, respectively.

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Meanwhile, 85 per cent of patients in Ontario and Quebec got hip replacements within the benchmark wait time, while about 80 per cent in both provinces received new knee joints within the period.

Johnson said Ontario, for instance, has a "fair number of resources it can focus on. You go to a smaller province like Nova Scotia and just a change in the number of surgeons available can have a big impact on the wait list and the number of people that they can do."

"No one province or area looks really bad in everything. They have strengths and weaknesses based on where they started," she said, noting that the federal and provincial governments agreed to set wait-time benchmarks for the priority procedures in 2004.

"How a province is doing in a particular area goes back to whatever their population needs are and what their emphasis has been."

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The report can help patients who find themselves on hold for a particular procedure by giving them information to discuss with their doctors, Johnson said.

For instance, a patient might say: "I can see that the benchmark is 182 days. How much longer or shorter am I going to have to wait? And is there another way that I might not have to wait?"