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Waiting time for medical specialist consultations in Canada, 2007

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by Gisèle Carrière and Claudia Sanmartin

Abstract
Keywords
Findings
Authors
What is already known on this subject?
What does this study add?

Abstract

Background

Waiting for specialist consultations can represent a substantial component of overall waiting time in the continuum of care. However, relatively little is known about the factors associated with how long patients wait for an initial specialist consultation.

Data and methods

The analysis is based on a subsample of 5,515 respondents aged 15 or older to the 2007 Canadian Community Health Survey who had consulted a specialist about a new condition in the previous 12 months and reported a waiting time. Multivariate logistic regression models were used to identify patient- and provider-related factors associated with waiting time.

Results

Female patients were less likely than male patients to see a specialist within a month. The nature of the new condition and the source of referral were significantly associated with waiting time. Compared with those referred by a family physician, patients referred by another specialist or a health care provider other than a physician, or who did not require a referral, were more likely to have a shorter waiting time. For men, but not women, household income and immigrant status were associated with waiting time.

Interpretation

This analysis suggests that factors beyond medical need are associated with how long patients wait to see a specialist.  More research could usefully explore decision-making and communication processes between primary care physicians and specialists to better understand how urgency is assessed, how patients are triaged for specialist consultations, and how these patterns differ among various groups of patients.

Keywords

access to care, specialists, immigrant, socio-economic

Findings

Accessibility is fundamental to the quality of health care. In Canada, waiting time has been identifi ed as a key measure of access and the major barrier among those who experienced diffi culties obtaining care. In 2005, approximately 20% of Canadians reported adverse effects as a result of waiting for health care, including worry and stress and pain.[Full text]

Authors

Gisèle Carrière (1-604-666-5907; Gisele.Carriere@statcan.gc.ca) is with the Health Analysis Division at Statistics Canada; she is based in Vancouver, British Columbia. Claudia Sanmartin (1-613-951-6059; Claudia.Sanmartin@statcan.gc.ca) is with the Health Analysis Division at Statistics Canada, Ottawa, Ontario, K1A 0T6.

What is already known on this subject?

  • Waiting time for an initial consultation with a specialist can constitute a substantial part of the continuum of care.
  • Little known about factors associated with waiting time for specialist consultations.

What does this study add?

  • This study identifies factors associated with shorter versus longer waiting times for specialist consultations.
  • As might be expected, the nature of the health condition prompting the consultation was significantly associated with how long patients waited.
  • Women tended to wait longer than men.
  • For both sexes, waiting time varied significantly depending on the source of referral.
  • For men only, household income and immigrant status were significant factors in waiting time.