Access to health care services

January to June 2005

Waiting times remain the number one barrier for Canadians who had difficulties in accessing specialized health care services in 2005, according to preliminary results from the report Access to Health Care Services in Canada.

The data also show that between 2003 and 2005, median waiting times for all specialized services under study remained relatively stable at between three and four weeks. (The median is the point where exactly one half of waiting times are higher and one half lower.) Most individuals reported they received care within three months, which was also relatively unchanged.

The median waiting time was about four weeks for visits to specialists, four weeks for non-emergency surgery and three weeks for diagnostic tests.

However, there were some differences noted at the provincial level for selected specialized services. Median waiting times for non-emergency surgery were reduced by half in Quebec from almost nine weeks in 2003 to four weeks in 2005.

For diagnostic tests, median waiting times in New Brunswick rose from two weeks in 2003 to four weeks in 2005.

Similarly, patients' views about waiting for care remained fairly stable during the two-year period.

Waiting for care still number one barrier to access

While most individuals who accessed a specialized service did not experience any difficulties, some did. An estimated 2.8 million aged 15 or older visited a medical specialist in 2005. Of these, 18% reported that they faced difficulties accessing care.

Of the 1.5 million people who reported that they had non-emergency surgery, 11% reported that they had difficulty accessing care. Similarly, 15% of the 2.1 million people who accessed a diagnostic test also reported difficulties.

As in previous surveys, those who experienced difficulties cited waiting too long for care as the number one barrier.

Among people who experienced difficulties getting a consultation with a specialist, 65% indicated that waiting was a barrier. Over one-third (37%) indicated that they had difficulties getting an appointment, up from 25% in 2003.

Among those who had difficulties accessing non-emergency surgery, 79% indicated that it was because they had to wait too long. This was higher than the 62% who identified waiting as a barrier in 2003. One in five individuals reporting difficulties indicated that they experienced difficulties getting an appointment, a rate similar to 2003 results.

Similarly, among the 15% who had difficulties accessing diagnostic tests such as a magnetic resonance imaging (MRI) or computed tomogram (CT) scan, 58% reported that they waited too long to get an appointment, while 38% reported that they waited too long to get the test. The results are similar to those reported in 2003.

Waiting times varied with the type of non-emergency surgery

Waiting times varied by type of non-emergency surgery. For example, 42% of individuals receiving cardiac and cancer related surgery received care within one month. This was more than twice the proportion of 19% who waited a month or less for joint replacements or cataract surgery.

In contrast, 39% of those who had joint replacement or cataract surgery waited more than three months. This was nearly five times the proportion of 8% among those who waited over three months for cardiac and cancer related surgery.

There were some changes in the distribution of waiting times for two of the three types of non-emergency surgery. The proportion of cardiac and cancer related surgeries performed within one to three months nearly doubled from 27% in 2003 to 50% in 2005.

The proportion of patients who waited longer than three months for joint replacement and cataract surgeries increased from 26% to 39% during the two-year period.

Waits unacceptably long for some

Waiting for care is not inherently problematic, but may be considered so when patients experience adverse effects and/or feel they have simply waited too long for care.

The proportion of patients who felt their waiting time was unacceptable was highest among those who waited for specialist visits (29%) and diagnostic tests (24%).

It was lowest among those who waited for non-emergency surgery (17%), even though individuals are more likely to wait longer, that is, more than three months, for non-emergency surgical care compared with other specialized services.

This finding points to potential differences regarding thresholds for unacceptable waits across different specialized services. That is, Canadians may be more willing to wait longer for surgery than for a visit to the specialist.

Others experienced adverse effects

About one in five (19%) individuals who had a consultation with a specialist indicated that waiting for the visit affected their life, compared with about 13% among those who waited for non-emergency surgery or diagnostic tests.

Most individuals who were affected reported that they experienced worry, stress and anxiety during the waiting period. These feelings were reported by 52% of those whose lives were affected by waiting for non-emergency, and 70% of those affected by waiting for a consultation with a specialist.

About one-half of all individuals affected indicated that they experienced pain. Nearly 35% of those who were affected by waiting for a consultation with a specialist or non-emergency surgery indicated that they experienced difficulties with activities of daily living.

About 35% of those who were affected by waiting for a diagnostic test indicated that it resulted in worry, stress and anxiety for their friends and family members, which was double the proportion of 18% in 2003.

Definitions, data sources and methods: survey number 3226.

The report Access to Health Care Services in Canada, 2005 (82-575-XIE, free) is now available on our Web site. From the Our products and services page, under Browse our Internet publications, choose Free, then Health.

To enquire about the concepts, methods or data quality of this release, contact Claudia Sanmartin (613-951-6059; fax: 613-951-3959; claudia.sanmartin@statcan.gc.ca) or Jean-Marie Berthelot (613-951-3760; fax: 613-951-3959; berthel@statcan.gc.ca), Health Analysis and Measurement Group.

For more information regarding access to the 2005 Canadian Community Health Survey data, contact Mario Bédard (613-951-8933; fax: 613-951-4198; mario.bedard@statcan.gc.ca), Health Statistics Division.