There are more total hip and knee replacement surgeries being performed on Ontarians each year than ever before. The Ministry of Health and Long-Term Care (MOHLTC) has made it a priority program and has increased funding to meet growing demand. But despite the increase in the number of surgeries performed, waiting lists keep getting longer. These procedures are the definitive treatments for reducing pain and disability, and with an aging population, the number of people requiring surgery is expected to rise even higher. Our research has shown that over a six-year period, total hip replacements increased by 22% while the total number of knee procedures skyrocketed by 52%. Waiting lists, however, did not keep pace. In 1993, the median waiting time for total hip replacements was 16 weeks; in 1998 it had increased to 20 weeks. The median waiting times for total knee replacement increased from 20 weeks in 1993 to 26 weeks in 1998.
In an effort to address this growing issue, the MOHLTC asked ICES to lead a Consensus Group to make recommendations on an information system for managing waiting lists for total joint replacements. The panel comprised a broad range of clinical experts including orthopedic surgeons, rheumatologists and family physicians, as well as stakeholder organizations and the Canadian Joint Registry Initiative. The final results of this group were published in the ICES Technical Report, Urgency Rating, Waiting List Management and Patient Outcomes Monitoring for Primary Hip/Knee Joint Replacement.
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