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Monday, July 15, 2002

Health Services Access Survey

2001

Almost one in five Canadians who accessed health care for themselves or a family member in 2001 encountered some form of difficulty, ranging from problems getting an appointment to lengthy waiting times, according to a new survey.

Access to two kinds of health care services were explored: first contact services included routine care, health information and immediate care for a minor health problem; specialized services included specialist visits, non-emergency surgery and diagnostic tests.

According to the Health Services Access Survey (HSAS), an estimated 23.2 million Canadians, or about 94% of the total population aged 15 and over, accessed first contact health care services in 2001.

Of these, about 18%, or just under 4.3 million people, encountered a difficulty of some kind. This proportion varied by time of day and type of service. The type of difficulty varied by type of service but long waits and problems contacting a health care provider topped the list.

An estimated 6.1 million individuals accessed specialized services. Among them, 23%, or about 1.4 million people, encountered some kind of difficulty. Again, long waits topped the list.

The proportion of individuals reporting that they waited less than one month for specialized services ranged from 40% for non-emergency surgery to 55% for diagnostic tests. Just over 5% waited 26 weeks (six months) or more for specialist visits and diagnostic tests. For non-emergency surgery, close to 10% reported waiting for 26 weeks and about 5% for 35 weeks or more.

For non-emergency surgery, the waiting time varied by type of surgery. Individuals who waited for cardiac- or cancer-related surgery were more likely to receive services within one month (54%), compared with those who waited for a joint replacement or cataract surgery (20%).

More than 20% of those who waited for specialized services felt that the time they waited was unacceptable. Those who said their waiting times were unacceptable had waited significantly longer, in some cases up to six times as long as those who said their waits were acceptable. They were also more likely to report that waiting for care affected their lives (over 50%), compared with those who felt that their waits were acceptable (5%).


Note to readers

This release presents the first results from the Health Services Access Survey, developed by Statistics Canada and partly funded by Health Canada and three provincial governments - Prince Edward Island, Alberta and British Columbia.

It gathered comprehensive and comparable information at the national level on the patterns of use of health care services and self-reported difficulties faced by Canadians aged 15 and over in accessing health care when they needed it.

The survey was conducted as a supplement to the Canadian Community Health Survey. Interviews were conducted in all 10 provinces in November and December 2001. The total sample size for the survey was 14,210.


The survey also indicates that most Canadians (88%) had a regular family physician. Among them, most considered the quality of care received to be excellent (53%) or good (39%). Among the 12% who do not have a regular family physician, most (63%) indicated that it was because they had not tried to contact one.

Access to first contact services: Difficulties vary by time of day

The survey examined three types of first contact services: routine care, health information or advice and immediate care for a minor health problem.

During regular office hours, individuals who required such services were most likely to contact their physician's office. During evenings and weekends, walk-in clinics and emergency rooms were the first point of contact. During the middle of the night, people went mainly to emergency rooms.

Overall, 11% (2.5 million) of those who accessed routine care reported they had difficulties, as did 13% (1.5 million) of those who accessed health information or advice, and 19% (1.6 million) of those who needed immediate care for a minor health problem. Difficulties were reported during all three time periods and reflected reasons associated with the health care system as well as personal reasons.

During regular office hours, 42% of individuals who reported difficulties accessing routine care did so because of problems getting an appointment, while during evenings and weekends - a time when most accessed walk-in clinics - 47% cited lengthy in-office waiting times.

Close to 40% of those who had difficulties getting health information during regular office hours or during evenings and weekends indicated that it was because they did not get adequate information. In the middle of the night, a time when most accessed or called emergency rooms, close to 60% cited that they had to wait too long to speak to someone.

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About 38% of individuals who had difficulties getting immediate health care for a minor health problem during regular office hours cited in-office waiting times as the cause. This proportion increased to 57% during evening and weekends, and 59% during the middle of the night, times when most accessed walk-in clinics and emergency rooms.

Specialized services: Difficulties vary by type of service

The HSAS examined three types of specialized services: specialist visits for a new illness or condition, non-emergency surgery and diagnostic tests. Over the past 12 months, almost one quarter of Canadians sought specialist care.

An estimated 5.1 million individuals aged 15 or over visited a specialist for a new illness or condition. About 1.2 million had non-emergency surgery and almost 1.7 million had certain non-emergency diagnostic tests - MRIs, CT scans or angiographies over a 12-month period.

About 22% of those who visited a specialist reported difficulties obtaining the service, as did 21% of those who had a non-emergency surgery and 18% of those who had a diagnostic test.

The majority of those who indicated that they had problems accessing specialized services said it was because of long waits. This was the primary reason given by 55% of those who had difficulties accessing non-emergency surgery, 66% of those who had difficulties seeing a specialist, and 72% of those who had difficulties accessing diagnostic tests. Other reasons cited included problems getting an appointment and lengthy in-office waits.

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Waiting times: Most access specialized services within a month

More than half (55%) of individuals who had a diagnostic test received it within a month. About 45% of individuals who had a specialist visit and about 40% of people who had a non-emergency surgery waited less than a month.

The picture changes when surgical procedures that are known, or suspected, to have shorter waits are examined separately. For example, 54% of individuals needing surgery related to cardiac or cancer problems got it within one month. By contrast only 20% of joint-replacement or cataract surgery was provided within a month.

However, 35% of people having a joint-replacement or cataract surgery problems waited more than three months, compared with less than 20% of those having other types of non-emergency surgery.

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Waiting for care: Many feel stress, anxiety and pain

Of the estimated 5 million people who visited a specialist, roughly 18%, or 900,000 people, reported that waiting for care affected their lives. The majority of these people (59%) reported worry, anxiety or stress. About 37% said they experienced pain.

The situation was similar among individuals who said their lives were affected by waiting for diagnostic tests, with 68% reporting increased levels of worry, anxiety and stress. This may be because people waiting for specialist visits and diagnostic tests often do not know the details of their health problems and are waiting for a diagnosis.

Over 20% of those who waited for specialized services felt the amount of time was unacceptable. This ranged from 22% of people who waited for non-emergency surgery to 27% of those who waited for specialist visits. At first glance, these results may appear surprising, given that most individuals received care within a month.

However, the survey data shows that people who reported unacceptable waiting times had waited up to six times longer than those who considered their wait acceptable.

For example, among people who visited a specialist, those who said their waiting times were unacceptable had waited 13 weeks (median value), compared with only two weeks among those who reported acceptable waiting times. For non-emergency surgery, those who said their waits were unacceptable had also waited 13 weeks, three times longer than those who reported acceptable waiting times.

More than 50% of those who reported that their waiting times were unacceptable stated that waiting for care affected their lives. This compares with only 5% among those who reported that their waits were acceptable.

The report Access to health care services in Canada, 2001 (82-575-XIE, free) is now available on Statistics Canada's Web site (). From the Our products and services page, choose Free publications, then Health.

For information regarding access to the HSAS data, contact Mario Bédard (613-951-8933; fax: 613-951-4198; mario.bedard@statcan.gc.ca).

For more information, or to enquire about the concepts, methods or data quality of this release, contact Jean-Marie Berthelot (613-951-3760; fax: 613-951-3959; berthel@statcan.gc.ca) or Christian Houle (613-951-3767; fax: 613-951-3959; houlchr@statcan.gc.ca), Health Analysis and Measurement Group.



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Date Modified: 2002-07-15 Important Notices