(S.19) Wait Times: Case Study Flashcards
What constitutes a ‘wait time’?
Time between being referred - presumably from a primary care physician or a practitioner - to seeing a specialist
When are wait times a problem
Jeopardizes health = some people may not be affected by waiting long, others will
What causes wait times?
○ Lack of staff
○ Appropriate care - ER for something small
○ Disorganization, inefficiency
Wait times
when the demand for treatment exceeds the supply, either due to lack of capacity or inefficient use of existing capacity
Ontario Health tracks 2 waiting times
○ Time from referral to First Clinician Appointment
○ Time from Decision to Surgery
Problem with wait times
- People may die from lack of urgent care
- Diseases may rapidly progress (waiting for surgeries, MRIs, diagnostics .etc)
T or F: Canadians were more likely to receive care within 4 hours at the emergency department compared with CMWF average (11 other countries)
F: less likely
Respondents in ______ communities were more likely to wait longer than _____
rural wait longer than urban
More Canadians waited longer for ____ appointments and ____ surgeries compared with CMWF average
specialist appointments
elective surgeries
___% of respondents who wanted mental health care in the past year received it
43%
___/____ canadians reported they had wanted to talk to a doctor or other health professional about their mental health in the past year
1/5
T or F: people in healthcare rank fixing wait times = one of the most important care issues
T
Ministry of Health refers to who as “long-waiters”
Waiting longer than clinical guidelines for their health problem allows harm
Massively increasing aging population requires increase in _____
beds
the FAO projects that the Province’s health sector spending plan has a net funding shortfall over the six-year period from 2022-23 to 2027-28 of $21.3 billion, meaning:
shortfall = Province has not allocated sufficient funds to the health sector to support existing programs and announced commitments
Policy Solutions to wait times
*Ontario’s Wait Time Strategy (2004)
*Mandatory reporting of wait times
*Setting benchmarks
Ontario’s Wait Time Strategy (2004)
- Strategy created by provincial government (2004 to tackle wait times)
- Provides funding to hospitals to provide additional wait list surgeries, MRIs, and CTs
- As a condition of funding, hospitals must supply and verify their wait times information to the ‘Wait Times Information System’
‘Wait Times Information System’
○ Policy that required hospitals to disclose their wait times (surgical specialists, surgeries, diagnostic imaging, emergency departments
*condition of funding for Ontario’s Wait Time Strategy
Mandatory reporting of wait times does 4 things …
- MEASURES the problem
- TRACKS the problem over time
- Enhances ACCOUNTABILITY for addressing the problem
- REDIRECTS patients to shorter wait lists via patient choice
Benchmarks
Targets representing the maximum amount of time a patient should wait, beyond which evidence shows adverse health effects will likely occur
T or F: Government mandated legislation for the creation of benchmark targets, mandatory tracking, and reporting of wait times in psychiatry were passed in Ontario in 2001
F: do not currently exist in Ontario
Alternative policy solutions
- Eliminate inappropriate tests and treatments
- Not giving antibiotics for viral infections
- Recruit/increase pay for key human resources
- Don’t have enough PSW’s/nurses
- Incentivise with higher pay, train more people .etc
*Increase after-hours care
- Open ER/walk-ins after hours so people get treated then
*Pay-for-performance
- More $$ if they’re doing well, incentivizes other hospitals to find inefficiencies they may not have cared to find before
*Activity-based funding
- Provincial decision: instead of getting 100% of global funding, 70% can be used wherever but 30% must be spent on particular things
*Integrated funding models
- Set amount of $$$, work with resources they have
- Makes all care/professionals work together, ensuring resources aren’t being wasted
*Establish centralized intake of patients
- Establish resources of province and rank urgency
- Some regions have many resources but no referrals: may be able to send patients out of town
Proposal to extend family Dr. residency from 2 to 3 years training … concerns?
○ Already have a shortage of family doctors, may further disincentivize physicians
○ Change in training can increase wait times
Your Health Act
- Law provides legislative framework to expand type of surgeries/procedures being done outside hospitals
**CHECK NOTES WTF IS THIS
Quebec Supreme Court decided that MRIs and other procedures can be offered by private clinics, setting legal precedent to allow people paying out of pocket to get procedures quicker
Some would argue by allowing this, you undermine the key principle of ______ in the Canada Health Act
accessibility
