BC Medical Association

VANCOUVER, BRITISH COLUMBIA--(CCNMatthews - June 28, 2006) - Two new reports released today provide evidence that waiting for health care has a quantifiable price tag and that wait time benchmarks must be set for all major diagnostic, therapeutic and surgical procedures.

The BCMA today released a policy paper "Waiting Too Long: Reducing and Better Managing Wait Times in BC" in which it calls for governments to establish wait time benchmarks for all major medical procedures and as an interim measure where no benchmark exists to ensure no one waits more than six months for care.

"There is collective agreement that wait time reduction is a priority. We believe there needs to be an immediate commitment to set and monitor a maximum wait time of six months for all medically required services," Dr. Margaret MacDiarmid, President of the BC Medical Association said.

The Association's report also calls for a 25 percent increase in operating room capacity in BC within two years and a further 25 percent increase in capacity by the close of the 2009/10 government fiscal year.

The BCMA recommends that routine hospital occupancy not exceed 85 percent to allow for patient flow fluctuations and the accommodation of patients coming into hospital through the emergency room.

The report also calls for the establishment of a BC Wait Times Commission to make recommendations regarding how to target health care funding to deal with wait time priorities. This new commission would be a collaborative effort between physicians, nurses, government, the health authorities and members of the public. They would oversee the spending of the $715 million that the Federal government has earmarked for wait list reduction in BC over the next 10 years.

The urgency to take these actions was reinforced with the simultaneous release of a report "The Economic Cost of Wait Times in Canada", commissioned by the BCMA and Canadian Medical Association. The study, completed by The Centre for Spatial Economics assesses the overall cost to the community of lengthy wait times. It provides data on the impact of wait times for BC, Alberta, Saskatchewan and Ontario for four medically required procedures.

"When looking at the real impacts of what increased wait times in our health care system are we need to look at everything from lost wages to increased physician costs associated with extra office visits," said Ernie Stokes, Managing Director for The Centre for Spatial Economics.

The BCMA is hoping that the release of both papers today will provide information that creates a greater sense of urgency for governments to address the wait time issue.

The BCMA represents the interests of all physicians across the province and is an advocate for excellence in patient care with the provincial and federal governments. The Association supports initiatives related to health promotion, physician relations with the community, developing health care policy, and negotiating compensation for physicians with the provincial government. More information on the BCMA can be found at bcma.org.

Media Backgrounder - Waiting Too Long

Wait lists continue to be one of the most significant problems facing patients in BC's health care system. Governments have only recently begun addressing the issue. As part of the 2004 First Ministers Ten Year Health Plan, BC will receive approximately $715M in wait reduction funding. Some of this funding has already been provided to health authorities across the province to increase the number of surgeries, especially joint replacement, and to UBC for the creation of its Centre for Surgical Innovation which supports dedicated operating rooms to help clear patient backlogs for hip and knee surgeries.

In August 2005, the Wait Time Alliance, an association of the Canadian Medical Association and six national medical specialty societies, released wait-time benchmarks across six specialties. They include:

- Hip and knee replacement within 6 months of consultation with a specialist for scheduled cases, and within 30 or 90 days for urgent cases, depending on severity;

- CT and MRI scans within 30 days for scheduled cases, and within 7 days for urgent cases;

- Cataract surgery within 4 months of consultation with a specialist;

- Cardiac bypass surgery within 6 weeks for scheduled cases, and within 7 days for urgent cases

The BCMA recommends that, no later than December 2007, there should be specific benchmarks for all major diagnostic, therapeutic, and surgical services, and patients should wait a maximum of 6 months from the time of GP referral to the provision of any medically required service.

The management and reduction of wait lists must not be focused on just the five priority areas. Waits for all procedures are equally important - especially to the patients who are waiting.

Although new funding and the introduction of benchmarks are welcome, changes in the ways wait lists are managed must also take place. The release of the BCMA's report, Waiting Too Long: Reducing and Better Managing Wait times in BC, addresses this issue and outlines specific recommendations to improve upon current practices.

- Establishing routine hospital occupancy that does not exceed 85 percent to allow for patient flow fluctuations and the accommodation of patients admitted through the emergency room

- Operating room capacity should increase by 25% by 2008;

- Additional expansion of OR capacity of 25% by 2009/2010;

- The physician and nursing shortage needs to be aggressively addressed;

- Prioritize Emergency Room waits through the Provincial Emergency Room Task Force to deal with short-term issues as well as look at long term issues;

- Create an accountable BC Wait Times Commission including government, physicians, nurses, and health authorities to make decisions on how targeted wait time funding will be allocated.

Not only are too many patients still waiting for their procedures, but a new report called, The Economic Cost of Wait Times in Canada, shows that patients who wait too long for care cost society upwards of $10,000 per patient in terms of lost wages and reduced government tax revenue, as well as increased physician and pharmaceutical costs. (See accompanying backgrounder)

The Economic Costs of Waiting for Health Care

The wait times experienced by patients having to wait longer than medically reasonable for treatment impose costs not only on the patients themselves, but also on the economy as a whole. To accompany the BCMA's policy document released today, which provides recommendations to alleviate the long wait times in British Columbia, a study of the economic cost of waiting for care has also been released. Entitled The Economic Cost of Wait Times in Canada, the report was commissioned by the BC Medical Association and the Canadian Medical Association and examines the cost of waiting longer than medically recommended for treatment. While physicians have drawn attention to the health impact of excessive waits for care, this study is the first to attempt to determine the economic impact of these waits.

In 2005, the Wait Times Alliance (WTA) -- a group comprised of the CMA and six medical specialty organizations -- identified several wait time benchmarks. The Economic Cost of Wait Times report focuses on the costs associated with a patient's excess wait time after the WTA benchmark wait time has been reached in four key areas: joint replacement, cataract surgery, coronary bypass, and MRI scans; and in four provinces: BC, Alberta, Saskatchewan, and Ontario.

Three types of costs are taken into consideration:

- Patient Costs - This includes the reduced economic activity due to patients being unable to work, for example, reduced production of goods and services, lower income with lower income tax revenue, and less purchasing of consumer goods.

- Caregiver Costs - Some caregivers may have to give up their employment to take care of family members waiting for medical care. So as with patients, these caregivers' reduced income means additional reduced taxes and reduced spending in the marketplace.

- Healthcare System Costs - These include the additional costs to the health care system for extra medical appointments, tests, and procedures, and for additional medication that patients would not normally need had they been treated within the medically recommended time.

Measurement of these costs is based on historical wait times data provided by governments and other organizations in each province, and begins after the WTA benchmark has been reached until, on average, the patient has received his/her procedure.

The study found that although the costs vary among the four provinces, in British Columbia the cost of each patient who waits excessively for care are:

- Joint replacement - $10,864

- Cataract surgery - $1,017

- Cardiac bypass surgery - $10,238

- MRI scans - $5,065

Per-patient costs increase the longer the patient waits. Reducing the wait times of those patients waiting the longest for treatment will, therefore, result in the greatest savings. The cost of providing treatment earlier should rise on a per patient basis and with the number of patients treated.