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Doctors say lengthy surgical wait times driven by lack of operating room time and changes in patient case load

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Release Date: October 17, 2011
VANCOUVER, BC—A lack of operating room time and changes in patient case loads are two of the most commonly reported factors behind increased wait times for medical care and surgical procedures, concludes a new report released today by the Fraser Institute, Canada’s leading public policy think-tank.

The report, Why We Wait: Physician Opinions on Factors Affecting Health Care Wait Times, analyzes physicians’ responses to the Institute’s annual Waiting Your Turn survey on health care wait times and the reasons they gave for changes in their waiting lists.

Among the physicians who reported increased wait times in 2010, the lack of available operating room time was cited by 67.9 per cent as the reason why their wait lists had increased. The next most cited reasons were changes in patient case load (38.8 per cent) and lack of available hospital beds (29.5 per cent).

“Governments and the medical establishment now agree that Canadians are waiting too long for many medical procedures. The next logical step to improving access to health care is determining what is preventing physicians from providing medical services in a more timely manner,” said Nadeem Esmail, Fraser Institute senior fellow.

Highlighting the important relationship between operating room availability and waiting lists, 37.5 per cent of physicians who reported that their wait times had decreased also attributed the change to availability of operating room time.

When the responses to the survey questions are broken down by province or medical specialty, the majority of respondents say either the availability of operating room time or change in patient case load is the primary reason for increases in wait times. The one exception is radiation oncologists, who said the availability of technical staff was the primary reason for both increased or decreased waiting times.

The study also expands the data to include physician responses dating back to 2001, and finds that a lack of operating room time has consistently been the most cited factor by physicians for increases in wait times.

“Physicians have been telling us for a decade that a lack of available operating room time is one of the major determinants forcing Canadians to endure lengthy waits for surgical procedures,” Esmail said.

“Our health care system rations physicians’ access to operating room time, and in doing so, rations patient access to medical care.”

The 2010 edition of Waiting Your Turn: Wait Times for Health Care in Canada found that the total waiting time between referral from a general practitioner and delivery of elective treatment by a specialist, averaged across 10 provinces, rose to 18.2 weeks in 2010 from 16.1 weeks in 2009. It also found that Canadians are waiting 12 per cent longer for medical treatment in 2010 than they were in 2001.

Research studies have pointed to several factors contributing to the long waits Canadians have grown accustomed to, including underuse of operating rooms, limited physician supply, inefficient use of hospital beds, a relative lack of hospital beds, and the employment of funding models that do not encourage efficient, patient-focused care.

“Canada spent approximately 10.3 per cent of its GDP on its health care system in 2008, making it the fifth most expensive among 32 OECD countries that maintain universal approaches to health care insurance. This level of funding shows that the long wait times Canadians endure are hardly the result of an underfunded system, but rather due to inefficiencies within the system itself,” Esmail said.

“If physicians are pointing to a shortage of available time in operating rooms as a main reason for lengthy waits, then policy makers should consider making greater use of private surgical clinics which have fully functioning operating rooms and available surgical nurses as a way of reducing wait times.”