TORONTO – It’s a common complaint — Canadians needing medical attention having to cool their heels in a hospital emergency room for hours on end before being seen by a doctor or another health-care practitioner.
Well, it turns out that compared to other industrialized countries, Canada has the highest proportion of patients reporting excessively long waits in an emergency department, a report released Thursday by the Canadian Institute for Health Information (CIHI) shows.
The report, part of a survey of residents in 11 countries sponsored by the U.S.-based Commonwealth Fund, shows 29 per cent of Canadians had to wait four hours or longer before being seen by a practitioner during their most recent emergency department visit.
That’s almost three times the international average of 11 per cent of patients who had to wait that long. Patients in France, Germany and the Netherlands fared the best, with one to four per cent reporting a four-hour-plus wait time.
Canada also topped the list for having the highest proportion of patients with long delays to see specialists, with 56 per cent waiting longer than four weeks, compared with the international average of 36 per cent, CIHI said.
In Switzerland, the proportion of patients who waited that long was 22 per cent; in the U.S., it was 24 per cent.
“In seven out of eight measures of timely access to care, Canada was significantly below the international average,” Christina Lawand, a senior researcher at CIHI, said from Ottawa.
“I think timely access to care has been a challenge for a while that we’ve noted from these surveys and from patient experience more generally in Canada,” she said.
“We’re not really seeing improvements over the last 10 years in timely access to care from a patient’s perspective, particularly when we look at timely access to family doctors or primary-care doctors or to specialists and for emergency department wait times.”
The results were based on interviews with 4,200 Canadian adults aged 18 and older, conducted between March and May last year. Surveys that posed the same questions were undertaken in 10 other developed countries, including the United States, Britain, Australia and Sweden.
Digging further into the data, Lawand said the surveys show that Canadians tend to go to the emergency department more than their peers in other counties, “and often they tell us it’s for a problem that could have been treated by their regular doctor.”
“So all of these data help to shed light on the bigger picture, which is what is it in our system that may not be working so well and where could we concentrate or focus improvements?”
For example, re-organizing access to primary-care doctors by expanding hours on evenings and weekends might have an impact on emergency room overcrowding, she said.
It might also come down to boosting the amount of electronic communication between doctors and other parts of the health-care system, as well as between doctors and patients.
While progress has been made in increasing physician access to electronic medical records, Canada still lags behind other countries on the use of digital health applications, Lawand said.
For instance, only six per cent of Canadian respondents said they had online access to personal health information like lab test results in the previous two years. That compares to 27 per cent of patients in France and an 11 per cent international average overall.
“These findings remind us that Canada can learn from other nations and explore how digital health solutions can be used to address wait times and access barriers,” said Michael Green, president and CEO of Canada Health Infoway, a federally funded organization working to accelerate the adoption of electronic health applications across the country.
Green said electronic communication platforms — such as patient portals, tele-home care and virtual visits — can improve access and cut wait times by reducing some in-person appointments with physicians.
Still, Canada was far from a complete bust in its rankings compared to the other countries.
In 21 of 28 areas that measured patient satisfaction, Canada’s results were similar to or exceeded the international average.
“When we looked at measures of what we call patient-centred care, where patients have a good experience once they do get their foot in the door with their regular doctor, where care is well-co-ordinated for them, we see that’s really an area where Canada shines,” said Lawand.
Almost three-quarters of Canadians rated their quality of care as very good or excellent, well above the international average of 65 per cent, she said.
“I think that what is useful about a report like this is it really provides that international perspective,” she said. “You might think you’re doing really well here at home in one thing, but when you compare yourself, especially beyond our borders, you can see maybe we can do a lot better.
“The report doesn’t provide all of the answers, but it does point to where we should be looking.”
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