Ontario patients are waiting anywhere from 33 days to nearly two and a half months to see a specialist after their family physicians makes a referral, according to a study by researchers at the Institute for Clinical Evaluative Sciences (ICES).
The study, published today in the journal BMC Family Practice, set out to calculate the wait times from when a referral is made by a family physician to when a patient sees a medical or surgical consultant.
“Currently, surgical and medical care wait times don’t include the time from primary to specialty care but they should because from a patient’s perspective, wait times include the steps in care before they see a specialist physician or undergo an advanced diagnostic test,” said Dr. Liisa Jaakkimainen, a scientist at ICES and family physician.
Wait times in Canada have focused on the time from seeing a specialist physician to having either an investigation or procedure, with the goal of improving access for a select number of health services such as cataract surgeries, cancer surgeries, cardiac procedures, hip and knee replacements and CT and MRI testing.
“But patients may face the greatest wait-related risk at the earlier stages of care before the disease has been fully characterized. Our study shows wait times from primary care to specialty care are longer than those reported by physician surveys in Ontario,” added Jaakkimainen.
The study looked at wait times in days, from primary care to medical specialist and surgical specialist and found:
- Cardiology had the shortest median medical wait time at 39 days.
- General surgery had the shortest median surgical wait time of 33 days.
- Gastroenterology had the longest median medical wait time at 76 days.
- Orthopedics had the longest median surgical wait time at 66 days.
The researchers studied electronic medical record (EMR) data collected from 54 community based family physicians in Ontario from January 1, 2008 and December 31, 2008. The sample came from the Electronic Medical Record Administrative Data Linked Database (EMRALD) which was developed by Dr. Karen Tu, a senior scientist at ICES and links EMR data from several hundred Ontario family physicians to administrative databases housed at ICES.
“Prolonged wait times to see a specialist physician will potentially change the burden of care for some patients from specialty care to primary care,” adds Jaakkimainen.
The study authors add that practice location and size is the most consistent influence on wait times. In some cases, busier practices may have higher referral rates and therefore longer wait times.
The study “Waiting to see the specialist. Patient and provider characteristics of wait times from Primary to Specialty Care,” was published this week in BMC Family Practice.
Authors: L. Jaakkimainen, R. Glazier, J. Barnsley, E. Salkeld, H. Lu and K. Tu
ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care 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.
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