TORONTO — Eight out of 10 patients waiting for procedures in priority areas — including cataracts and hip and knee surgeries — are getting needed care within time frames that were agreed upon by Canada’s first ministers.
For the first time since the accord was reached in 2004, the Canadian Institute for Health Information says it can provide this overall score for Canada that tallies accomplishments in whittling down wait times in five areas.
“In the past we could actually look at improvements over a time for each different province, but this time we can really compare,” says Jeremy Veillard, vice-president of research and analysis at the institute.
“We can give an aggregate score for how Canada is doing with regard to wait times for the five priority areas — and what we can say this year is that eight Canadians out of 10 actually have access to procedures for those priority areas within the agreed benchmark.”
The accord’s 10-year term will end in 2014, and Veillard says “the jury’s still out in terms of overall achievement.”
Most jurisdictions seem to be aiming for nine out of 10 patients getting access to care within the defined benchmarks, he says.
And why not 10 out of 10?
Veillard says information systems aren’t sensitive to deal with changes in people’s expectations, for instance, or the fact that some people might be going into palliative care and won’t require one of the procedures.
“So the 90th percentile seems to be a more sensitive approach than saying that we want 100 per cent of patients within the benchmark.”
He notes that most provinces are either at, or close to, the timelines for access to cancer radiation treatment and the most urgent surgeries — heart bypasses or hip fractures.
But the annual report released Monday shows more variation across the country for knee replacements and cataract surgeries.
Veillard says performance is not improving for cataract surgery in Alberta or for hip and knee replacements in Manitoba, but these are relatively isolated cases.
“The largest jurisdictions are doing better, the smaller ones are still struggling for a number of priorities,” he says.
“However, it’s interesting to see that for any province in this country, they have made significant progress in at least one of the priority areas over the last three years.”
Eighty-four per cent of patients received hip replacements within the recommended 26 weeks, while 79 per cent got knee replacements within 26 weeks and 78 per cent got hip fracture repairs within 48 hours.
Ninety-eight per cent of patients had radiation treatment within the clinically recommended time frame of 28 days of being ready to receive care.
For bypass surgery, 99 per cent of patients received the operation within the benchmark of two to 26 weeks, depending on how urgently care was required.
Prince Edward Island, New Brunswick and Saskatchewan had notable improvements in the number of patients receiving cataract surgery within the recommended time frame of 16 weeks, while other provinces had waits that remained the same or increased in the past three years.
Pamela Fralick of the Canadian Healthcare Association in Ottawa, a national body that includes provincial hospital and health-care associations, says there are some promising outcomes.
“Finally we are getting some data which is a major step, because for the first few years of monitoring the wait-time situation, the data itself was unreliable, uncomparable — it just was quite meaningless,” she says.
But there are still black holes of data in terms of waits for other procedures, she notes.
“What have we learned over these last few painful and vaguely productive years? That first of all, the areas we targeted were the ones that were deemed most necessary, most needy of attention, but they are still only a fraction of what is going on out there,” she says.
“Yes, let’s welcome the good news that we have made some progress, but let’s recognize that we’ve only touched the tip of the iceberg.”
Veillard notes that a Senate committee is reviewing the accord — public hearings began recently — and a report to the federal minister of health is planned for October.
“All that will prepare for negotiations for the renewal of the accord,” he says, adding that debate is heating up.
“At this point, anything is on the table,” he says, noting that professional organizations such as the Canadian Medical Association and the Canadian Nurses Association have made a number of proposals.
A Nanos Research poll released Friday by the two associations showed that 86 per cent of respondents thought it was important to have programs that promote good health and wellness, as well as home care that allows patients to return home with the assistance of family and friends, and support from a health-care professional.
The original accord included a $5.5-billion Wait Times Reduction Fund meant to build on provincial and territorial investments and to help jurisdictions reduce wait times.