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Ontario’s Wait Time Strategy has not impacted rates of other surgical procedures


A new Institute for Clinical Evaluative Sciences (ICES) study shows that the Ontario government’s Wait Time Strategy (WTS) to improve access in five key areas (cancer, cataract and cardiac surgeries; hip and knee replacements; and, CT/MRI scans) has not had an adverse impact on the rates of other surgical procedures in Ontario.

“As of May 2006, which closely coincides with the time period examined in our report, the Ontario government had invested $410 million in additional procedures,” said Dr. Andreas Laupacis, ICES adjunct scientist.

“As a result, there has been a clear increase in the rate of most WTS procedures. However, at the same time, there have been reports of decreased numbers of, and increased waits for, non-priority services.”

In this study, ICES investigators analyzed physician service claims paid by the Ontario Health Insurance Plan (OHIP) between January 1992 and June 2006 for 27 surgical procedures that were not part of the WTS. To assess the impact of the WTS upon procedure volumes, they divided each year before and after the 2004 WTS announcement into quarters, and compared forecasted and actual procedure rates after 2004.

None of the non-priority surgery areas saw significant rate decreases after the introduction of the WTS, when compared with pre-policy trends. In fact, the rate of a small number of non-WTS orthopedic procedures may have increased since the start of the WTS.

“Although we found no adverse impact upon quarterly rates of surgery on a provincial basis, it is possible that rates may have decreased in some regions. Also, we were not able to examine wait times for non-WTS procedures,” said Dr. Laupacis.

“Future research should assess effects of the WTS on surgical waits, particularly for urgent procedures where evidence suggests that delay may compromise outcomes. As well, since this study only evaluated a short period of time after the introduction of the WTS, ongoing monitoring is warranted.”

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. This study was supported by the Green Shield Canada Foundation. 


  • Julie Dowdie
  • Media Relations Officer, ICES
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