Improving access to health services

Albertans have said that wait times for services is their number one concern for the health care system. 

Many people experience long waiting periods to be assessed by a specialist, followed by another wait to receive a surgery or procedure. This problem is not unique to Alberta, it is happening in most other Canadian provinces.

How long do Albertans wait for selected health services?

Wait lists and wait times

Health facilities and physicians maintain wait lists for patients requiring non-emergency surgery or diagnostic tests. The wait time is measured from when a procedure is determined to be necessary until when it is actually performed.

The growing number of Albertans over the age of 65 has a major impact on wait lists. As our population ages, the incidence of chronic diseases such as cardiovascular disorders, joint disorders, diabetes, arthritis, and mental health problems increases. This leads to a greater demand for diagnostic imaging, specialist assessments, and treatments for both acute and chronic conditions.

By 2010, it is estimated there will be more than 398,000 Albertans over the age of 65, an increase of 28 per cent compared to 2004. Based on these figures, it is expected that the demand for services will increase and wait lists will continue to be a concern.

Open-heart surgery

Alberta has been successful in reducing wait times for heart surgeries provided in Calgary and Edmonton. The number of people waiting for open-heart surgery has decreased by 55 per cent over the past two years. As well, over the past year, the median wait time for urgent outpatient and planned outpatient surgeries has decreased by 64 and 66 per cent respectively.

The Ministry has identified provincial targets of a one-week wait for inpatients urgently needing heart surgery and a six-week wait for outpatients with a less urgent need for planned surgery. Calgary and Edmonton are at, or close to, the one-week target and are approaching the six-week target.

Changes in management of care for heart disease, including new methods of treatment, have been implemented to reduce wait times for heart surgery. These changes mean that some patients who would have received heart surgery in the past are now being successfully treated by other means. The result is that patients in need of heart surgery now face shorter wait times.

Open Heart Surgery
by Quarter
Jan-Mar 2002 to Jan-Mar 2004

Source: Alberta Health and Wellness

Median Wait Times in Weeks for Open Heart Surgery
by Urgency, by Quarter
Jan-Mar 2002 to Jan-Mar 2004

Source: Alberta Health and Wellness

Diagnostic Imaging (CT and MRI) scans

The average provincial wait time for a CT scan is approximately nine weeks and an MRI is approximately 18 weeks. Specific wait times vary for each procedure depending on urgency and location. Any patient requiring an emergency CT scan or MRI will receive one without delay.

According to Statistics Canada, in 2003, 55 per cent of Albertans waiting for diagnostic tests (including MRIs and CT scans) reported waiting less than one month and 90 per cent reported waiting less than three months.

The number of persons waiting for CT scans has increased slightly during 2003/04. The overall number of scans performed has also increased in that time.

CT Scans
by Quarter
Jan-Mar 2002 to Jan-Mar 2004

Source: Alberta Health and Wellness

The number of persons waiting for MRI scans in Alberta increased in 2003-04, though the rate of this increase appears to be slowing.

As of January 2003, Alberta had the highest availability of MRI scanners in Canada with 7.3 machines per million people. However, MRI scans are now more frequently used for a greater variety of diagnostic procedures. increasing demand combined with the aging population has led to an increase in the number of people waiting for an MRI scan.

MRI Scans
by Quarter
Jan-Mar 2002 to Jan-Mar 2004

Source: Alberta Health and Wellness

Major joint replacements

Alberta has identified a provincial target of a four-month wait for major joint replacement surgery. All of the health regions that perform these surgeries are close to meeting this target. As of March 2004, the average wait in Alberta was five months. Specific wait times will vary depending on urgency and location.

While the number of persons waiting for hip or knee replacement surgery has increased over the past two years, the average waiting time has not changed considerably. The current capacity is keeping up with the increased demand and there has been little impact on the length of the wait time for these surgeries. Over the past two years the waiting time has varied between 4.5 to 5 months.

Major Joint Replacement Surgery
by Quarter
Jan-Mar 2002 to Jan-Mar 2004

Source: Alberta Health and Wellness

Specialized services - reported wait times

A survey conducted by Statistics Canada found waiting times in Alberta for specialized services are very similar to the Canadian average. About 50 per cent of Albertans surveyed reported waiting less than one month for elective surgery, diagnostic tests, or a visit to a specialist. Approximately 90 per cent of Albertans reported receiving service within three months for non-emergency surgery, a specialist physician visit, or diagnostic tests.

People Waiting For Health Services Household Population ages 15 and Over Alberta and Canada, 2003
	Canada 2003	Alberta 2003
Selected Diagnostic Tests
Waiting time less than 1 month	57.5%	55.0%
Waiting time 1 to 3 months	31.1%	34.5%
Waiting time longer than 3 months	11.5%	10.5%E
Median wait time (weeks)	3.0E	3.0E
Specialist Visit
Waiting time less than 1 month	47.9	51.1
Waiting time 1 to 3 months	40.7	37.3
Waiting time longer than 3 months	11.4	11.6
Median wait time (weeks)	4.0E	3.0E
Non-Emergency Surgery
Waiting time less than 1 month	40.5	49.2
Waiting time 1 to 3 months	42.1	37.8
Waiting time longer than 3 months	17.4	13.0E
Median wait time (weeks)	4.3	4.0E

E - estimate has high variability - use with caution
Source: Statistics Canada

What affects wait lists?

Wait lists can occur when the demand for a specialty service is greater than the ability of the health system to provide the service.

Demand for service increases when new and improved treatments or diagnostic tools are approved for common diseases or conditions. It takes time for professionals to receive training on the new technologies, additional time and resources must be allocated and new equipment purchases must be financed.

The number of health care professionals, specialists, and technicians that are trained also affects how quickly the health system can meet the demand for a new service. Many of Alberta’s health care professionals are nearing retirement. If these professionals are not replaced as they retire it will lead to a shortfall of trained staff and result in longer waiting times.

How is Alberta addressing wait lists now?

Alberta is working to improve access to health care services. Improving access to MRI and CT scans, major joint replacement surgery, open heart surgery and angioplasty, breast and prostate cancer treatment, and children’s mental health services are initial priorities. The government is working together with health professionals and health authority staff to evaluate how each service is currently provided to find ways to redesign service delivery for greater efficiency, and develop specific guidelines for access.

Since October 2003, Albertans have had online access to wait times for a variety of procedures through the Alberta Waitlist Registry. The registry shows patients and physicians wait time information for selected surgeries and procedures available across the province.

Over the past four years, Alberta has added more than 2,100 additional post-secondary education seats in the health professions. This is expected to translate into an increased number of health care professionals entering the workforce at a time when the number of retirements is expected to rise.

The Alberta Electronic Health Record is a clinical health information system that links physicians, pharmacists, hospitals, home care and other health care providers across the province. The Electronic Health Record stores pertinent patient information online to allow health care providers to access a patient's prescription history, allergies and laboratory test results immediately by computer. The result is more accurate diagnosis and treatment for better, safer patient care, and improved access through efficient service delivery.

Since its launch in October 2003, more than 5,000 health care providers have signed-up to use the Electronic Health Record system.

Rural Albertans have greater access to specialist services through Telehealth. With videoconferencing and specialized medical instruments, patients at remote locations can be examined or monitored as if they were in the same urban facility as their specialist.

Telemental Health uses videoconferencing to provide access to mental health services for Albertans in rural areas, and Telehealth provides speech therapy to patients outside major centres. Other services include a tele-homecare program for Calgary health region patients with defibrillators and a program to screen for strokes with a virtual clinic that allows neurologists in Edmonton to make decisions with local physicians in rural and remote communities.

The videoconferencing service links 230 sites throughout Alberta, as well as 25 tele-radiology locations.

Looking forward

On June 30, 2004 the Alberta government announced a health renewal strategy to improve health service access and quality. The investment will improve access to health services by:

• Increasing orthopedic surgeries by 1,200

• Reducing wait times for certain heart surgeries to two weeks

• Funding health facilities in rural Alberta, including community support for seniors

• Fast-tracking additional hospital beds in the Calgary and Capital regions

• Accelerating the planning and design of the South Calgary Hospital

• Eliminating health authority deficits to help regions to better meet patient needs.

Work continues to establish reasonable and achievable access standards for the following priority health services:

• Diagnostic imaging (MRIs and CT scans)

• Major joint replacements

• Adult open-heart surgery and angioplasty

• Breast and prostate cancer treatment

• Children’s mental health services

The job of providing the most efficient delivery of essential health services is ongoing. Alberta will continue to look for ways to improve the delivery of vital health care services to keep wait times to a minimum.

For more information:

Alberta Health and Wellness
Phone: (780) 427-7164
E-mail: ahinform@gov.ab.ca
Dial 310-000 for toll free access outside Edmonton

When you see a key it means that the information is a featured indicator based on a plan for reporting comparable health indicators developed by the Federal, Provincial and Territorial Ministers of Health. The Report of the Auditor General of Alberta on the featured indicators, and an appendix including methodology and technical information is available in the Province of Alberta’s 2004 Report on Comparable Health Indicators How Healthy Are We?

Complete results and technical information for all provinces and territories will be available after December 1, 2004 on the Canadian Institute for Health Information website at: http://www.cihi.com/

• Also available in PDF

• Technical Notes