Some Canadians are waiting longer for medical treatments that federal and provincial governments agreed to provide more quickly, according to a new report.
The Wait Times Alliance, which includes doctors from specialties such as emergency medicine, radiology and cardiology, released its annual report card on wait times Tuesday.
In a reversal from previous report cards, there was a decline in performance in patients receiving care in the five areas identified as priorities by federal, provincial and territorial governments under the 2004 Health Accord:
- Diagnostic imaging such as MRI and CT scans.
- Hip and knee replacements.
- Radiation oncology.
- Cataract surgery.
- Bypass surgery.
"Although some provinces have shown improvement, the overall results point toward lengthier waits for Canadians," the report card said.
"Unlike the past several years, the 2012 results show a worsening of performance with regard to patients receiving care within the pan-Canadian benchmarks set by government. Although some provinces have shown improvement, the overall results point toward lengthier waits for Canadians."
Even where provinces are earning high grades, some regions within the province may not be doing as well, a reflection of "slippage," said Dr. Chris Simpson, a cardiologist in Kingston, Ont., and chairman of the group.
Simpson said the alliance sees a strong role for the federal government to play in setting national strategies and facilitating their implementation, as was done in the past for heart disease.
"We need to look at what some of the lessons learned are from jurisdictions and continue to work with them," Health Minister Leona Aglukkaq replied.
Prince Edward Island earned an "F" for knee replacements, meaning less than 50 per cent of the population was treated within the benchmark, and a "D" for hip replacements — 50 to 59 per cent. Wait times for both procedures increased from last spring, the group said.
Manitoba earned "D" for hip and knee replacements and cataract surgery. Those three areas as well as radiation therapy had longer wait times than a year ago.
Ontario scored the best with "A" across the board and no significant changes in wait times.
The national averages were "A" for heart bypass and radiation therapy, "B" for cataract surgery and hip replacements, and "C" for knee replacements.
In the report, an "A" grade means that 80 per cent of all people are being treated within the time set in the benchmark. This falls to 70 per cent to 79 per cent for "B," and 60 per cent to 69 per cent for "C."
The association of pediatric surgeons collected its own data last year, which suggested that 31 per cent of children waited too long for surgery, a three per cent increase from the year before.
Some provinces are slipping backwards, the alliance said, because so many hospital beds are filled with elderly patients with dementia.
The group called for a national strategy to deal with illnesses such as Alzheimer's disease and to factor dementia into the management of other chronic diseases such as heart disease and diabetes. Doing so could help prevent those patients from ending up in hospitals in the first place, they said.
When seniors do go to hospital, they should be screened for delirium and dementia as early as possible to trigger services such as geriatric medicine and psychiatry while they're still waiting for a hospital bed, the report's authors suggested.
Dr. Frank Molnar of the Canadian Geriatrics Society said patients with dementia often go to hospital because of conditions like pneumonia or heart failure but destabilize in hospitals and can't be discharged home.
One solution is building up frontline community care, the group said.
At the Ottawa Hospital, Dr. Jeffrey Turnbull said 126 patients who would be better served with rehabilitation, enhanced home-based services or long-term care are in the hospital waiting to be discharged today while 14 other patients are waiting for a bed.
"Right across the country, this is a systemic problem that all facilities, all institutions have," Turnbull said. "It's a problem that's not getting better."
Provinces and territories know what areas are priorities for them, Aglukkaq said, noting that the problems of an aging society don't necessarily apply in the North where the average population is younger.
The findings are consistent with a report in March from the Canadian Institute for Health Information that said wait times are about the same as in 2009 with some provinces struggling more than others.
The Wait Time Alliance was created in 2004 to provide governments with advice from the physicians' perspective on medically acceptable wait-time benchmarks.
It includes the Canadian Medical Association, and other national organizations representing experts such as radiation oncologists and cardiovascular specialists.