Comparative Wait Times

Topic Box from the 2006 Sixth Annual Benchmark Report

"Wait Times" have become a focal point in the ongoing debate over the relative success of our health care systems in meeting and treating the health needs of Canadians. Statistics Canada surveys indicate that roughly 20 percent of patients waiting for care reported that they were adversely affected by the wait, indicating factors such as pain, anxiety, deterioration in their health, impairment in daily activities, and family stress.

There are challenges in the use of this measure for interprovincial comparisons. Wait times can be – and are regularly both within BC and across Canada – defined in different terms. Typically they are defined as the length of time between any two points in the continuum of care, but there is little agreement or continuity beyond this about when the waiting time for care begins and when it ends. Within a patient's care progression there are three distinct waiting periods that have all received some degree of attention: wait time to see a specialist, wait time to receive surgery or other hospital based care, and total wait time from first visit to a primary care provider until required treatment is finally provided. Even within these three broad definitions, variations between jurisdictions and over time exist, making meaningful comparison of wait times difficult. The table below provides an overview of what Statistics Canada (SC) and the Canadian Institute for Health Information (CIHI) have been able to assemble to date.

The federal and provincial governments continue to work on quantifying wait lists. On December 12th, 2005, Health Ministers announced benchmarks for five types of non-emergency surgery, radiation therapy and cancer screening. All provinces have web sites that list wait times in at least one of the five priority areas (cancer, heart, diagnostic imaging, joint replacement and sight restoration). British Columbia's site includes data for ninety-five percent of all scheduled surgery in BC grouped into nineteen categories.

As BC's population has aged in recent decades, many surgeries have also become less traumatic and more accessible, meaning that the number of surgeries done in BC has increased at a rate far faster than population growth, putting pressure on the health care system and on wait times. Reducing wait times in such an environment, with health care costs already escalating, will not be simple. A recent OECD study across member states on reducing wait times for elective surgeries found that low availability of acute care beds and salaried remuneration of specialists were associated with higher wait times, while fee-for-service systems and increased health care spending were systematically associated with lower wait times, other things being equal. Among the countries studied, the availability of doctors was found to have the highest negative correlation with wait times.

Sources: Statistics Canada, Access to Health Care Services in Canada, cat. #82-575; British Columbia Medical Association (2003), Patient Care Guarantees: A Discussion Paper by BC's Physicians; Claudia A. Sanmartin and the Steering Committee of the Western Canada Waiting List Project (2003), Toward Standard Defifinitions For Waiting Times, Healthcare Management Forum, Canadian College of Health Service Executives; BC Ministry of Health, Pressures on the System; Organisation for Economic Cooperation and Development (2003), Explaining Waiting Times Variations for Elective Surgery across OECD Countries, OECD Health Working Papers 7; Canadian Institute for Health Information, Waiting for Health Care in Canada: What We Know and What We Don't Know.