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An Analytical Perspective into the State of Surgery in Canada

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COVID has exposed many chronic challenges in healthcare over the last 24 months. In Canada, surgery is in a critical state with a growing backlog. While increased funding is promised, we believe good money should follow clear and actionable analytics on surgery. This article depicts the situation of the Canadian healthcare systems regarding medical and surgical procedures such as hip and knee replacement, hip fracture repair, radiation therapy, and cataract surgery.

The Fraser Institute has been following the state of healthcare in Canada since 1993. Their recent study shows that Canada’s median wait time for medical treatment increased by 22.5% between 2019 and 2021. The growing wait times significantly impact the surgical backlog across Canada. While COVID has exasperated the wait times issue, it is not the cause of the surgical backlog.

Wait times are comprised of two segments: first, a referral from GP to a specialist, and second, an initial consultation with a specialist for treatment. Both of these lead to a backlog in treatments.

According to the Fraser Institute, national wait times among the various specialties were the longest between a GP referral and neurosurgical procedures (49.2 weeks) and the shortest for radiation treatments (3.7 weeks). ​

CIHI data for benchmarked surgical procedures show a nuanced view of the state of the national surgical procedures, especially the ones with established benchmarks (hip and knee replacement, hip fracture repair, radiation therapy, and cataract surgery). More than 40% of patients do not receive treatments on time for these benchmarked procedures. Hip fracture repair is the only benchmarked procedure in Canada, where over 80% of patients receive treatment on time.

The interval from consultation with a specialist to the point at which the patient receives treatment is the shortest for urgent cardiovascular surgery (1.4 weeks), radiation oncology (2.5 weeks), and medical oncology (2.6 weeks). The longest wait time is for orthopedic surgery (30.2 weeks), neurosurgery (23.2 weeks), and otolaryngology (21.1 weeks).

The Ontario Medical Association (OMA) states that there is a backlog of 16 million medical procedures in Ontario alone, including one million surgical procedures. According to the OMA, reducing the surgical backlog is the biggest challenge facing the provincial health system. If all the facilities in Ontario were to operate at 120 percent capacity, it would take between one to two years to shrink the backlog; see below OMA’s estimated time to catch up to the respective surgical specialty backlog.

  • Cataract surgeries: 21 months
  • Knee replacements: 22 months
  • Hip replacements: 14 months
  • Cardiac surgery: 10 months

It is encouraging to see the political commentary and funding this chronic and systemic healthcare challenge has received. It is important to note that there is no silver bullet here. What is required is a clearer view of the state of surgery at individual hospital systems, regional, provincial, and national levels. Based on our customers' experience, we strongly believe developing this clear and usable view on the state of surgery is the most efficient path to improving access and efficiency of surgery in Canadian health systems.

 

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