Canadians wait longer to see doctor than international average

Canadians wait longer for health care than people in many other countries, but are generally more satisfied with their experience once they are seen, according to a new report.

The Canadian Institute for Health Information's report released Thursday is titled "How Canada Compares," and based on results from the Commonwealth Fund's 2016 survey of adults in 11 countries.

Canadians continue to report longer wait times for doctors, specialists and emergency department visits than their peers in other countries, the authors said. Once they do go get medical care, Canadians are often pleased with its quality.

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The other countries in the report are the United States, Germany, Norway, the Netherlands, Sweden, New Zealand, Switzerland, United Kingdom, Australia and France.

Less than half (43 per cent) of Canadians could get a same- or next-day appointment with their family doctors or at their regular place of care the last time they needed medical attention, researchers found. The highest were in New Zealand (76 per cent) and the Netherlands (77 per cent). The international average was 57 per cent. 

The trend for same- or next-day appointments in Canada dropped from 42 per cent in 2010 to 38 per cent in 2013. 

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Canadians are also more frequent users of services such as emergency departments, drugs and doctors than in most other countries included.

Part of the issue may be because of a gap in access to electronic records in Canada compared with other Commonwealth Fund countries, said Tracy Johnson, director, health system analysis and emerging issues with CIHI in Toronto.

For instance, it might help if more patients were able to email their doctors a question and get an answer back about whether it can wait a couple of days or needs to be addressed immediately.

"If patients could access their lab results in an electronic format or they could access through email questions to their family doc, then it may help solve some of the flow-through problems we have to ED or the perception that they're not getting access quickly enough," Johnson said. 

Hard to wait

Dr. Joshua Tepper, a Toronto family physician who wasn't involved in the report, would also like to see more e-referrals and e-consultations that link back into a patient's electronic health record.

The, president and CEO of Health Quality Ontario also sees ways to improve how care is organized, such as through centralized intake and assessments to streamline appointments with care teams for areas such as hip and knee replacements or back pain.

"Waiting can feel long for very good reason," said Tepper. "It is hard to wait, especially around your health, especially if you're worried about certain diagnosis, if you're in pain."

In the report, low-income Canadians said they had greater cost barriers to accessing care in general, an inequity Tepper called striking.

For instance, one in 10 Canadians didn't fill a prescription or skipped a dose because of cost, according to the report. About 58 per cent of Canadians reported using one or more prescription drugs, compared with the international average of 52 per cent.

About one in four people 18 and older in this country reported skipping a dental visit because of the cost compared with one in five elsewhere.

Just over a third, 34 per cent, of Canadians said they could get care on evenings or weekend without going to an emergency department. But after-hours was closer to the international average of 43 per cent in Ontario and Alberta.

Tepper noted the report is based on averages from self-reported data. There are areas of the country that offer models of excellence, but they aren't the norm.

Canadians also reported the longest wait times for specialists, with 56 per cent waiting longer than four weeks to see a specialist, compared with the international average of 36 per cent.

Excellent quality of care 

Canada's health-care system scored better on meeting the needs of individual patients. This included saying their regular doctor knew their medical history, involved them in decisions and explained things in a way that's easy to understand.

What's more, 74 per cent of respondents in Canada rated the quality of care from their regular provider as excellent or very good, compared with the 11-country average of 65 per cent.

The Commonwealth Fund describes itself as a private U.S. foundation that aims to promote a high-functioning health-care system. The CIHI is an independent, non-profit organization that provides information on Canadians' health systems and the health of Canadians.