Frequently Asked Questions
*Ombudspersons in Alberta and Ontario do not currently have legislative authority to investigate health care complaints. However, as of March 6, 2014, Ontario has introduced legislation to establish a Patient Ombudsman.
**Prince Edward Island, Northwest Territories, and Nunavut do not have provincial/territorial ombudspersons.
General Information on Wait Times
Supply issues that can contribute to wait times include: a lack of doctors, nurses and technicians; a lack of operating room time; a lack of non-medical services to support patients following surgical care (e.g., support for the patient to be cared for in their home); and a lack of alternative services that would be more appropriate for the patient (e.g., housing and social supports or providing care closer to patients to prevent inappropriate emergency department visits).
Most of the wait times measured in Canada and elsewhere have focused on the wait for surgery; that is, the wait from when a patient and their physician decide treatment is necessary to the start of treatment. However, there can also be waits to see a family physician, waits for diagnostic testing, as well as a wait for a specialist consultation once referred. Adding up all of these points of waiting can lead to a long wait for the patient and that is why wait-time strategies are required across the patient’s journey.
Part of this is due to the fact that there is no standard way of managing wait times across the country. Canada is made up of 13 separate health care systems, each with their own funding and operational models. And even within these systems each health region, hospital and physician’s office faces a different reality (funding, demand for services, etc.) and employs different approaches to managing wait times. In areas where wait times are lower, there could be a number of factors at play, including: use of wait time management tools (e.g., pooling referrals where patients are put on a general waiting list and sent to the next available physician); effective use of operating room time and hospital beds; or, the availability of community supports like adequate home care services and residential care facilities which reduce the number of ALC patients and free up hospital beds. However, this list is not exhaustive and there could be many other regionally-specific factors at play.
It is also important to note that not all provinces report on wait times in the same way. A key step in addressing wait time variation is to have comparable data available on wait times by community level.
How does Canada compare to other Organisation for Economic Co-operation and Development (OECD) member countries?
In order to improve the health of the population, improve the patient’s health care experience and to increase the value for money spent on our health care system, we believe that the system needs to be transformed.
Patients, physicians and all health care providers need to work together in the decision-making process. This would lead to better health public policy decisions.
ALC patients have an impact on access to acute care beds, which are in short supply and are required for patients admitted through the emergency department or operating room. On average, one ALC patient in the emergency department denies access to four non-ALC patients per hour. Scheduled surgeries are also affected by high rates of alternate-levels-of-care stays—a lack of available beds for postoperative patients may result in many last-minute cancellations of scheduled surgeries, adding to even longer wait times for patients.
In 2008-2009, ALC patients accounted for more than 92,000 hospitalizations (approximately 5% of all hospitalizations) and over 2.4 million hospital days in Canada in 2008-2009. The cost of caring for these patients in a hospital is much more expensive than in a more appropriate setting (e.g., in the home with proper supports, or in a residential facility).
Wait Time Benchmarks
Wait Time Alliance Report Cards
While recognizing that all procedures and treatments are important, Wait Time Alliance members are asked each year to select treatments to be highlighted in the Wait Time Alliance report card based on the following criteria:
- A treatment that has the highest volume and or greatest return on investment.
- A treatment whose wait time could be significantly reduced with a simple and direct capacity increase of some piece of technology or personnel.
- All benchmarks developed by the Wait Time Alliance can be viewed here.
A+: 90-100% of population treated within benchmark
A: 80-89% of population treated within benchmark
B: 70-79% of population treated within benchmark
C:60-69% of population treated within benchmark
D: 50-59% of population treated within benchmark
F: Less than 50% of population treated within benchmark