(S.19) Wait Times: Case Study

Question 1

What constitutes a ‘wait time’?

Answer 1

Time between being referred - presumably from a primary care physician or a practitioner - to seeing a specialist

Question 2

When are wait times a problem

Answer 2

Jeopardizes health = some people may not be affected by waiting long, others will

Question 3

What causes wait times?

Answer 3

○ Lack of staff
○ Appropriate care - ER for something small
○ Disorganization, inefficiency

Question 4

Wait times

Answer 4

when the demand for treatment exceeds the supply, either due to lack of capacity or inefficient use of existing capacity

Question 5

Ontario Health tracks 2 waiting times

Answer 5

○ Time from referral to First Clinician Appointment

○ Time from Decision to Surgery

Question 6

Problem with wait times

Answer 6

• People may die from lack of urgent care
• Diseases may rapidly progress (waiting for surgeries, MRIs, diagnostics .etc)

Question 7

T or F: Canadians were more likely to receive care within 4 hours at the emergency department compared with CMWF average (11 other countries)

Answer 7

F: less likely

Question 8

Respondents in ______ communities were more likely to wait longer than _____

Answer 8

rural wait longer than urban

Question 9

More Canadians waited longer for ____ appointments and ____ surgeries compared with CMWF average

Answer 9

specialist appointments
elective surgeries

Question 10

___% of respondents who wanted mental health care in the past year received it

Answer 10

43%

Question 11

___/____ canadians reported they had wanted to talk to a doctor or other health professional about their mental health in the past year

Answer 11

1/5

Question 12

T or F: people in healthcare rank fixing wait times = one of the most important care issues

Answer 12

T

Question 13

Ministry of Health refers to who as “long-waiters”

Answer 13

Waiting longer than clinical guidelines for their health problem allows harm

Question 14

Massively increasing aging population requires increase in _____

Answer 14

beds

Question 15

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:

Answer 15

shortfall = Province has not allocated sufficient funds to the health sector to support existing programs and announced commitments

Question 16

Policy Solutions to wait times

Answer 16

*Ontario’s Wait Time Strategy (2004)
*Mandatory reporting of wait times
*Setting benchmarks

Question 17

Ontario’s Wait Time Strategy (2004)

Answer 17

• 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’

Question 18

‘Wait Times Information System’

Answer 18

○ 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

Question 19

Mandatory reporting of wait times does 4 things …

Answer 19

• MEASURES the problem
• TRACKS the problem over time
• Enhances ACCOUNTABILITY for addressing the problem
• REDIRECTS patients to shorter wait lists via patient choice

Question 20

Benchmarks

Answer 20

Targets representing the maximum amount of time a patient should wait, beyond which evidence shows adverse health effects will likely occur

Question 21

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

Answer 21

F: do not currently exist in Ontario

Question 22

Alternative policy solutions

Answer 22

• 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

Question 23

Proposal to extend family Dr. residency from 2 to 3 years training … concerns?

Answer 23

○ Already have a shortage of family doctors, may further disincentivize physicians
○ Change in training can increase wait times

Question 24

Your Health Act

Answer 24

• Law provides legislative framework to expand type of surgeries/procedures being done outside hospitals

**CHECK NOTES WTF IS THIS

Question 25

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

Answer 25

accessibility