Wait times for health care in Canada have lengthened considerably over the past two decades. Across 12 major medical specialties, the estimated typical wait time has risen from 9.3 weeks in 1993 to 18.2 weeks in 2013. These inordinately long waits, among the longest in the developed world, have become a defining feature of the Canadian healthcare experience.

Waiting for medically necessary care is not a benign process and can have important consequences both for patients and for those who care for and rely upon them. Delayed access to medical care may subject patients to increased pain, suffering, and mental anguish. Waiting for health care can also have broader economic consequences such as increased absenteeism, reduced productivity, and reduced ability to work for the individual waiting as well as for family members and friends who are concerned for them or may be called to assist them with activities of daily living. Waiting may also lead to poorer outcomes from care, if not a requirement for more complex treatments, as a result of deterioration in the patients? condition while they wait for treatment. Such deterioration may also result in permanent disability.

Beyond these serious personal and economic consequences lies the risk of death resulting from delayed medical care. In the 2005 Chaoulli decision, Justices of the Supreme Court of Canada noted that patients in Canada die as a result of waiting lists for universally accessible health care. Numerous studies have demonstrated the negative impact of wait times on patient outcomes for a variety of specific diseases and medical conditions. Studies also point to the reality that wait times can have an impact on general health and well-being, which may also result in untimely demise. The unanswered question in the discussion so far has been how many died due to delays in receiving timely care?

It is the answer to this question?the relationship between delayed access to medical services and mortality rates at the population level?that is the focus of our study. Understanding the association between wait times for medical care and death at the population level is critical if we are to more fully understand the consequences of the lengthy delays Canadians endure when accessing medically necessary care.