A new study has shown that the wait times across Ontario hospitals can be up to 15 times longer, depending on the facility a patient is referred to.
The study, published in the scientific journal PLoS ONE and led by Dr. David Urbach, who is head of the department of surgery at Women’s College Hospital in Toronto, tracked wait times, from when a doctor prescribed an operation until the date of surgery.
“The problem isn’t that everybody’s waiting too long overall, but that some people, for whatever reason, are just waiting too long…. Those people are suffering more than they have to, and we have to figure out a way to be able to get care to those people more quickly,” Urbach said in an interview on CBC Radio’s Metro Morning.
What was found was a staggering amount of variance in wait times for non-emergency surgeries. The wait time for cataract surgery ranged from 15 days to 249 days, a 1,560 per cent increase, Urbach told CBC.
Similarly, the hospital with the shortest waiting time for hip replacement surgery saw patients wait 16 days while the hospital with the longest wait time kept patients waiting for 382 days, an increase of 2,287 per cent.
Urbach and his team catalogued the wait times of 942,605 surgeries performed across 107 hospitals by over 1,834 surgeons. The data was collected between 2013 and 2019, before the COVID-19 pandemic, and all patients were categorized as “priority level 4” for hip and knee replacements, cataract surgery, gallbladder removal, or uterine surgery.
While one would think simply opening more hospitals and training more surgeons would be the solution to this problem, Urbach and his team suggest otherwise, stating that the issue is more bureaucratic than material. They cited poor allocation of resources and inefficient coordination between medical professionals.
Urbach told CBC that in other studies, he has found that while socioeconomic factors do play a small role in wait-time length, there is not a strong correlation and the bulk of this variance was caused by happenstance, such as to which hospital and to which surgeon you happened to be recommended.
Regarding what can be done to mitigate this problem, the study said, “Strategies to address surgical wait times must address the variation between service providers through better coordination of supply and demand. Approaches such as single-entry models could improve surgical system performance.”
One of the main reasons for the discrepancy was that most referrals to hospitals, and especially surgeons, come through family doctors referring their patients. The study recommends what is known as a centralized referral system, which involves a unified central waitlist that would assign patients to the next available hospital or specialist in their area.
Urbach also told CBC that a centralized waitlist would give a clear indication of whether more capacity is needed in the health-care system and, if so, where and of what type.
While there have been only limited tests of a centralized referral system in Canada, according to the Ontario Medical Association, centralized referrals could reduce wait times by around 20 to 30 per cent.
In one instance, Saskatchewan’s health ministry reported that using a central referral registry reduced the number of patients who had to wait more than three months for surgical specialities by 89 per cent.
According to Urbach, some surgeons remain skeptical, fearing a loss of their professional independence and generally being resistant to change.
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