Wait Times

Question 1

What are wait times?

Answer 1

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

Question 2

When are wait times a problem?

Answer 2

• In a life of death situation
• Might jeopardize health

Question 3

What causes wait times?

Answer 3

• Too many people trying to access the same service at the same time
• Demand for care exceeds the supply we have
  (Ie. Limited specialists in a certian field)
• Inappropriate care (ie. Going to the ER instead of family doctor)
• Disorganization

Question 4

2 Forms of Waiting

Answer 4

1) Referral from doctor to specialist

2) Time from decision to surgery

Question 5

Ontario’s Wait Time Strategy

Answer 5

• 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 (if they do not report it, they do not receive money/ funding)

Question 6

Why should wait times be reported?

Answer 6

• Measures the problem
• Tracks the problem over time
• Enhances accountability for addressing the problem
• Redirects patients to shorter wait lists via patient choice

Question 7

What are benchmarks?

Answer 7

• Targets representing the maximum amount of time a patient should wait, beyond which evidence shows adverse health effects will likely occur
  
  • The Ontario wait time
    strategy provides
    benchmarks

Question 8

Priority level for patient conditions

Answer 8

1) Immediate - emergency surgery required
- patients is seen within 24 hours of referral

2) Patients diagnosed with highly aggressive malignancies
- patients is seen within 10 days of referral

3) Patients with know or suspected invasive cancer that do not meet the criteria of priority 2 or 4
- patients is seen within 21 days of referral

4) Patients diagnosed with malignancies
- patients is seen within 35 days of referral

Question 9

What are alternative policy solutions?

Answer 9

• Eliminate inappropriate tests and treatments
  (not giving antibiotics for viral infections)
• Recruit/increase pay for key human resources
• Increase after-hours care
• Pay-for-performance (encourage employees to hit performance goals by offering monetary incentives)
• Activity-based funding
  (instead of giving a lot of money to hospitals, provincials could say that 70% of the money must be used toward something specific)
• Integrated funding models
• Establish centralized intake of patients (root referrals to a central intake (hospital) , not to a specific physician)
• Incentivize (ie. Pay healthcare workers more money to attract more people into the profession)
• Fund more training
  (Increase spots in curriculum [Nursing program])
• Rank urgency of patient situations (send patients to other regions where they can be treated faster)

Question 10

What is the “Your Health Act”?

Answer 10

• Ontario passed the law: Your health act
• This tried to address wait times
• We do not know the impact yet bc it is a new policy
• Provides a framework to expand the types of surgeries and procedures being done
• Shift surgeries outside of the hospitals and into the community (ie. private clinics)
• Can be covered by OHIP

Question 11

Why would it be a problem if people could go to Quebec for $750 to get an MRI, instead of waiting 6 weeks to get an MRI in Ottawa?

Answer 11

• By allowing something like thus, you undermine accessibility - key to the Canada health act

Question 12

What common wealth country has longest wait times?

Answer 12

Canada

Question 13

Doug fords plan to cut wait times

Answer 13

• move towards private sector - move low risk surgeries and procedures to private clinics, that will still be paid by Ontario Health Insurance plan

Question 14

Controversy with moving toward private clinics

Answer 14

• health care unions have warned government not too
• people are worried it will not actually be covered by insurance
• clinics may use more expensive equipment than hospitals, or offer special perks that end up being paid out of pocket
  ex; patient putting in an eye lense - private clinic may offer a more advanced one, but would have to be paid out of pocket
• Pushing/encouraging people to spend money? Deception by clinic practitioners?
• Might make patient do more diagnostic tests/measurements that are unnecessary
• Ohip can pay private clinics differently - slightly more than hospitals ? Inequity
• Surgeries do not run overnight/ evening - critics say give them more money to run overnight, no need for private clinics