OTTAWA — Canada’s hospital system is increasingly gummed up by chronic-care patients who are in the wrong place, taking up beds that others need, a coalition of specialists and national medical organizations says.
The Wait Time Alliance has issued its annual report card, and gives Canada’s health-care system a ’B’ for reducing wait times in specific targeted areas.
But the system is a dismal mess when it comes to psychiatric, emergency, gastroenterology and other services, the report says.
“Nearly 10 years and billions of dollars later, Canadians still experience lengthy delays in accessing a wide range of necessary care,” said alliance chairman Lorne Bellan.
“The data show that the system is barely functioning as a system at all, as too often patients are languishing in hospitals instead of receiving the appropriate level of care they need.”
The report card says most provinces have made modest progress in reducing wait times in five areas set out in 2004 — cancer care, heart procedures, diagnostic imaging, joint replacement and sight restoration.
But the alliance says that because so many chronic-care patients wind up in hospital beds meant for other purposes, emergency rooms are overcrowded and seriously ill patients aren’t getting timely care.
Health Minister Leona Aglukkaq noted that the report saw some progress in wait times, and she pledged to take the matter up with the provinces as they negotiate the next health accord that will take effect after 2014.
The pressure on governments to deal adequately with emergency-room waits and long-term care is mounting, especially as the 10-year federal-provincial agreement on health-care funding draws to a close and talks begin on a new deal.
“In our discussions to renew the accord we will stress the importance of accountability and results, to ensure that the needs of Canadians come first, and that wait times for medically necessary procedures continue to get shorter,” Aglukkaq said in an e-mailed statement.
For now, the report says one in six beds is filled by a patient who should be cared for elsewhere.
These patients are mainly older — the median age is 80. They often have dementia or other chronic conditions. They stay in the hospital for about 26 days, and usually enter the hospital system through the emergency department.
The problem is, one of these misplaced patients taking up an acute-care bed denies access to about four patients per hour to the emergency department, the report calculates.
They also divert the attention of paramedics, and lead to last-minute cancellations of scheduled surgeries because they take up needed recovery beds.
And, their care is far more expensive than it would be in an appropriate setting, the report says.
They suggest governments invest in home care and in providing more support for family caregivers, especially as the population ages and chronic conditions become more prevalent.
“This issue has the potential to dramatically worsen as Canada’s population ages.”
The report card echoes observations made by several other health care analyses.
The Canadian Institute for Health Information complains there is only spotty progress among provinces in dealing with the five targeted wait times. The Health Council of Canada is also concerned about long emergency department waits and misplaced patients.