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France - Emergency departments: 7 in 10 patients wait less than an hour for treatment

The report produced by the DREES presents data on wait times for medical care in emergency departments (ED) in France. ED registration and triage occurs within a half hour of arrival for 9 in 10 patients, and care actually begins within an hour for 7 in 10 patients. Data are also analyzed by time the day and patient age. Finding a bed for in-patient treatment takes more than 4 hours for 10% of patients; however, this wait is only 10 minutes for 45% of patients.

UK - Waiting time prioritisation: evidence from England

Numerous countries have introduced wait time policies prioritizing severely ill patients. This study investigates how patients in England are prioritized using a national dataset of 200,000 people waiting for hip and knee replacement between 2009 and 2012. It finds that patients with the worst pain and immobility have the shortest waits, particularly in hospitals with longer average waiting times.

USA - Transforming Health Care Scheduling and Access: Getting to Now

According to this report, long waits for treatment typify the way most health systems have evolved to accommodate doctors and administrators. The report says that utilizing systems engineering, new management approaches and patient engagement can enable health systems to reduce wait times without additional personnel or investment. Ways to promote efficient physician scheduling are emphasized.

Canada - Canadians lagging well behind similar countries on access to new medicines: report

This report prepared by IMS Brogan for Rx&D says Canadians’ access to new medicines ranks 17th among 18 OECD countries. Canadians face wait times of over 460 days to gain access to new medicines, and only 23% of Health Canada-approved new medicines in 2014 are included within public drug plans.

UK - The NHS under the coalition government. Part two: NHS performance

Ruling together since 2010, Britain’s coalition government of Conservatives and Liberal Democrats faces an election in May 2015. This paper, the second in a series, looks at the National Health Service’s (NHS) performance under the coalition government. It concludes that NHS performance has slipped since 2008, with sizeable increases in waiting times and an unprecedented number of hospitals reporting deficits.

Canada - Wait times remain stable, while number of procedures grows

While the number of priority procedures performed in Canada has increased, wait times for these procedures—radiation therapy, joint replacement, hip fracture repair and cataract surgery—have remained stable. In fact, about 8 out of 10 patients have consistently had their priority surgery performed within the approved benchmark time frame every year since 2010. This information is included in Wait Times for Priority Procedures in Canada, 2015, released by the Canadian Institute for Health Information (CIHI).

UK - NHS maximum waiting times and patient choice policies

Developed by British parliamentary researchers, this briefing describes National Health Service (NHS) waiting time standards and patient choice policies in England. As set out in the NHS Constitution, patients have a right to a maximum 18 week waiting time from referral to consultant-led treatment, and to be seen by a cancer specialist within a maximum of two weeks from GP referral for urgent referrals where cancer is suspected.

Australia - Elective surgery waiting times 2014–15: Australian hospital statistics

Australia has released hospital statistics on wait times for elective surgery during 2014-15. Of the 700,000 patients admitted to public hospitals from elective surgery waiting lists, 50% were admitted within 35 days; fewer than 2% waited over 12 months for surgery.

Canada - Wait Times for Priority Procedures in Canada, 2016

Variations still exist in the percentage of patients receiving treatment within wait time benchmarks, depending on the province and the priority procedure. Priority procedures reported on include hip replacement, knee replacement, hip fracture repair, cataract surgery and radiation therapy. The overall number of priority procedures done continued to increase between 2011 and 2015, and about 8 out of 10 Canadians continued to receive their procedure within benchmarks. Wait Times for Priority Procedures in Canada, 2016, released by the Canadian Institute for Health Information (CIHI), provides a snapshot of wait times in Canada. Data on trends from 2008 to 2015 is available in CIHI’s online Wait Times tool, organized by province, health region and procedure.

Canada - The Private Cost of Public Queues for Medically Necessary Care, 2016 edition

This Fraser Institute briefing calculates the private costs of waiting times for treatment in Canada (i.e. the value of time lost while waiting). Valuing only hours lost during the work week, the estimated cost of waiting for medically necessary care in 2015 was $1.2 billion. This works out to an average of about $1,304 for each of the 894,449 Canadians waiting for treatment that year.

International - Public reporting on quality, waiting times and patient experience in 11 high-income countries

This article published in Health Policy maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, the authors found that the data most commonly made available to the public are on waiting times for hospital treatment, with Information on patient experience at hospital level also made available in many countries.

Sweden - Measures for shorter waiting times in cancer care

The Swedish government is carrying out a number of measures to ensure improvements in the country’s cancer care system. Between now and 2018, it will set aside 500 million krona per year ($82 million Cdn) to ensure more equitable and accessible cancer care that shortens waiting times and reduces regional differences.

Canada - New Wait Time Alliance Report Card reveals important lessons for next Health Accord

The Wait Time Alliance's (WTA) tenth national report card shows that, despite encouraging signs that wait times for the initial five areas identified in the 2004 Health Accord are being reduced, progress to reduce waits for care other medical procedures and treatments is spotty across the country.

Canada - Waiting Your Turn: Wait Times for Health Care in Canada, 2015 Report

Produced annually by the Fraser Institute, this report indicates that Canadian wait times for medically necessary treatment did not improve in 2015. Provincially, Saskatchewan reported the shortest total waits (13.6 weeks), while Prince Edward Island reported the longest (43.1 weeks). In 2015, roughly 2.5% of Canadians were waiting for treatment; the longest waits are for orthopedic surgery (35.7 weeks).

UK - Are people waiting longer for health care?

Produced by a British charity, this report considers the performance of the UK National Health Service (NHS) in providing timely access to health care over the past five years. After analyzing data across key services (emergency, cancer, and secondary and primary care), the report finds that wait times for cancer treatments have increased. Overall, waits remain shorter than they were 10 years ago.

Canada - Analysis of a centralized registry to improve access to family doctors

This project report published by CIRANO analyses results of Quebec's GACOs (guichets d’accès pour la clientèle orpheline), seeking in particular to evaluate whether these registries designed to help orphan patients find a GP actually improved access to GPs for people living with chronic diseases. The authors find that wait times to access a GP actually increased since the GACO registry was created in 2008. The percentage of patients registered with the GACOs to be referred to a GP ranges between 65% and 80% according to region.

The Netherlands - Health Care Lessons from the Netherlands

This instalment in the Fraser Institute series "Lessons from Abroad" looks at what Canada can learn from the Dutch system of funding and providing health care. The author highlights features he feels contribute to lower wait times in The Netherlands, such as cost-sharing for non-primary medical services, private provision of acute care hospital and surgical services, activity-based funding for hospitals, direct purchasing and independent insurers. He recommends adopting these measures in Canada, acknowledging that some would contravene the Canada Health Act.

Australia - Appointment Zen—Shaping demand and matching capacity

This article, published in Australian Family Physician, describes how general practitioners can, by actively managing the appointment systems, reduce waiting times and delays, improve patient care, improve physician quality of life and improve practice financial viability. It presents a proactive, smarter way to plan and manage a primary care practice.

Norway - Impact of changed management policies on operating room efficiency

This study, published in Biomed Central, investigates the impact on operating room (OR) efficiency in Norway of new policies for resource allocation and patient urgency classification and a new system for OR booking. The authors found that each intervention facilitated the implementation of others, leading to a 48% increase in daytime surgery, a 26% drop in use of overtime, and shorter median wait times even for the lowest urgency patients.

Germany - Health Care Lessons from Germany

Published by Canada’s Fraser Institute, this study compares the German and Canadian healthcare systems. The study concludes that the German system performs at a level similar to Canada, with a stronger performance in patient safety. Germany’s health expenditures, as an age-adjusted share of GDP, were 22% lower than Canada’s. Germany also has higher ratios of physicians and hospital beds per population and shorter wait times for all types of care.

Canada - Release of 2014 Report Card on Wait Times in Canada - Time to Close the Gap

The Wait Time Alliance (WTA) released its 2014 Report Card on June 3. It finds that medical wait times have improved since the signing of the 2004 Health Accord, but progress has been uneven. While Newfoundland and Labrador, Ontario and Saskatchewan have made or are beginning to make substantive and sustained progress, other provinces continue to struggle and there remain significant variations within provinces and communities.

Canada - Timely access to care for all Canadians: The role of the federal government

The Wait Time Alliance’s (WTA) 2014 annual report card identifies progress on reducing wait times in several provinces. However, Canadians still wait longer for primary, specialist, and emergency department care than citizens in other developed countries. The report card highlights differences in wait times across the country, reviews successful federal initiatives in reducing wait times, and calls for increased involvement of the federal government in setting and revising wait time benchmarks.

Poland - The first attempt to create a national strategy for reducing waiting times in Poland: Will it succeed?

Poland recently created its first national strategy to reduce waiting times for specialist care. This overview article describes the new strategy, provides background on the Polish health system, and explores the agendas of important stakeholders. The article says the country’s primary care doctors may yet block reform if the goal is to shift patients to the lowest level of care.

International - Measuring and comparing health care waiting times in OECD countries

Waiting times for elective treatments are an international concern. This study describes common measures of wait times from 12 OECD countries. It focuses on procedures, such as hip replacements, where lengthy waits are the norm, and analyzes different country policies to reduce waiting times. Solutions include increased spending and the introduction of targets and incentives.

International - The Changing Role of Government in Financing Health Care: An International Perspective

This paper explores the changing role of governments in health care financing internationally. It reviews the economic literature to analyze policy decisions and performance results in financing incentives, risk pooling, hospital competition, performance-related pay, and wait times. The paper says there is little international evidence that revenue collection mechanisms alone can manage care costs.

Canada - Learning from the Saskatchewan Surgical Initiative to Improve Wait Times in Canada

In 2010, the Saskatchewan government announced an initiative to tackle wait times for surgery. Today, the province’s wait times for elective surgery are among the shortest in Canada. This Fraser Institute study looks at Saskatchewan’s approach and lessons for other provinces. It credits the controversial use of private for-profit clinics to deliver day-surgery procedures as an important ingredient in Saskatchewan’s success.

Canada - Reducing Surgical Wait Times. The Case for Public Innovation and Provincial Leadership

British Columbia’s provincial government recently released a policy paper recommending the use of private for-profit facilities to reduce elective surgery wait times. This study provides a review of research on for-profit surgical delivery within public healthcare systems. It presents recommendations that build on best practices from the province of Saskatchewan, along with Scotland, which is recognized as a global leader in public sector wait-time solutions.

Canada - Measuring Up 2017. A yearly report on how Ontario’s health system is performing

Using 50 indicators to assess the annual performance of Ontario’s health system, this year’s report by Health Quality Ontario (HQO) finds improvements in premature mortality, care continuity, screening, surgical wait times and long-term care. It gives black marks to access, equity, caregiver support and transitional and palliative care.

Sweden - Saint Göran: A Competitive Hospital in a Universal System

Publically funded but run by a private company, Saint Göran is a Stockholm hospital that regularly stands out in Sweden and internationally on important performance indicators such as emergency room wait times, cost effective management, and patient and staff satisfaction. This article by Quebec researchers analyzes Saint Göran in depth to see what lessons can be drawn for Canadian hospitals.

Canada - Canada should not allow two-tiered practicing for medically-necessary services

Comparing Canada with European nations that operate two-tiered health systems with both public and private care, this paper argues that Canada should not allow a two-tiered approach to medically necessary services. It says doing so will weaken healthcare outcomes in the public system as practitioners migrate to the private sector, leaving publicly-funded services with longer wait times and reduced quality.

Canada - New Wait Times Data Now Available for Surgeries and Procedures Across Ontario

Ontario has launched an online tool to help people find wait times information for surgeries and procedures at the province’s hospitals. Available at, the easy-to-use tool includes the length of time between referrals and specialist appointments, as well as providing the date a procedure is due to be performed.

Canada - Major $1.3 Billion Investment for Quicker Access to Specialized Care and Services in Ontario

Ontario is improving access to health care by investing $1.3 billion over three years to reduce wait times, with more than $285 million designated for the year 2017-2018. Patients will see improved local access through the introduction of innovative interprofessional models of care, including new ways to assess patients with lower back, hip, and knee pain.

Canada - The Private Cost of Public Queues for Medically Necessary Care, 2017

This study by the Fraser Institute calculates the privately borne costs of waiting times for medically necessary treatments, defined as the value of time lost while waiting for treatment. Valuing hours lost during the workweek, the estimated cost of waiting for care in Canada in 2016 was more than $1.7 billion — an average $1,759 for each of the 973,505 Canadians waiting for treatment that year.

Finland - Rehabilitation reform committee published its report

A parliamentary committee in Finland has submitted its final report on reforming the country’s rehabilitation services, which has been criticized for long wait times. The report contains a total of 55 proposals concerning training, planning, and the reorganization of rehabilitation services into a more decentralized model relying on a mix of public and private regional providers.

Canada - Is the Canada Health Act a Barrier to Reform?

The Canada Health Act (CHA) prevents provinces from implementing proven health-care reforms that would improve the system and shorten wait times, finds a new study released recently by the Fraser Institute.

Germany - Waiting times in primary care depending on insurance scheme in Germany

The aim of this study was to uncover possible differences in waiting times dependent on health insurance scheme (public or private), and to identify predictors for excessive waiting times in primary care. After analyzing data from 5,618 respondents, the study found that barriers to access most often depend on insurance status, age, and region of residence. Privately insured respondents reported shorter waiting times for appointments.

UK - Sharp drop in public satisfaction with the NHS, new analysis shows

This survey by the Nuffield Trust and The King’s Fund shows that public satisfaction with the National Health Service (NHS) dropped from 63% in 2016 to 57% in 2017, its lowest level since 2011. The four main reasons for dissatisfaction with health services were: staff shortages, long waiting times, lack of funding and government reforms.

Canada – New Brunswick: Premier unveils multi-year plan to reduce wait times in health care

The government of New Brunswick has committed $25 million to fund a multi-year plan to reduce wait times in the province’s healthcare system. Intended to improve accessibility and quality, the plan calls for hiring more family physicians and nurse practitioners in primary care, and accelerating the use of electronic medical records.

UK - Understanding NHS financial pressures: how are they affecting patient care?

This report examines what current National Health Service (NHS) financial constraints mean for patient care in four areas: genito-urinary medicine (GUM), district nursing, elective hip replacement, and neonatal services. Strong evidence was found that quality of care has suffered in GUM and district nursing services. Waiting times for hip replacements are also rising, although neonatal services appear to have maintained quality.

Canada - Ontario: Wait times down in emergency, but still long for some patients

A new report by Health Quality Ontario (HQO), the provincial advisor on health care quality, shows a 10% drop in the maximum amount of time patients spent waiting in Ontario’s emergency departments (EDs). Urban residents wait longest, especially ED patients requiring hospital admission.

Canada - Leaving Canada for Medical Care, 2016

Published by the Fraser Institute, this briefing estimates that 45,619 Canadians left the country to receive medical treatment in 2015. The largest number was from Ontario (22,352 patients). Almost 4,980 Canadians travelled abroad for urology procedures alone. One explanation for travelling abroad is long wait times in Canada’s healthcare system.

International - Waiting time policies in the health sector

Examining wait time policies in the 34 OECD countries, this study compares policies in the UK with those in Scandinavia, Portugal, the Netherlands and New Zealand. It discusses the prioritization policies of the UK National Health Service (NHS) and assesses inequalities in waiting times by socioeconomic status across the OECD.

Ireland - Minister Harris announces action plan on waiting lists

The Irish Minister of Health has announced a plan to reduce the number of patients currently on waiting lists. By the end of 2016, the new plan is expected to cut the number of patients waiting over 18 months by 50%. Waiting list improvement programs will be started in all of the country's hospitals, and will be monitored monthly.

Australia - Elective surgery waiting times 2015–16: Australian hospital statistics

Recently released statistics show that wait times for elective surgery in Australia’s public hospitals are improving. In 2015-16, 50% of patients were admitted within 37 days, and 90% within 260 days. About 2% of patients waited more than a year for their surgery, compared with 2.7% in 2013-14.

Canada - New data shows continued improvements in Canada’s health system performance

Canada’s health system performance is showing continued improvements according to new data from the Canadian Institute for Health Information (CIHI). The CIHI reports improvements in long-term care (lower usage of restraints and inappropriate antipsychotics); hospital deaths (a 3% improvement in 2015-2016); and wait times in emergency departments (down slightly from 2013-2014).

Canada - Most Canadians receive priority procedures within medically acceptable wait times

The Canadian Institute for Health Information’s new report, Wait Times for Priority Procedures in Canada, 2017, shows that 3 out of 4 Canadians received their procedure within the medically recommended wait time. This edition includes regional-level data for hip and knee replacements, as well as provincial data in 5 priority areas: cancer treatment, cardiac care, diagnostic imaging, joint replacement and sight restoration. It also features updated interactive graphics on wait times across the country.

Canada - Canadians continue to report longer wait times for care

A new international survey shows that Canadians continue to report some of the longest wait times for doctors, specialists and emergency department visits compared with citizens in peer countries. However, once they do get medical care, Canadians generally report experiences with their regular providers that are better than the international average. These and more insights come from How Canada Compares: Results From The Commonwealth Fund’s 2016 International Health Policy Survey of Adults in 11 Countries, released by the Canadian Institute for Health Information (CIHI) in partnership with the Canadian Institutes of Health Research.

UK - Northern Ireland Department of Health publishes plan to address waiting lists

Northern Ireland’s Health Department has published an Elective Care Plan (ECP) to address waiting times for treatments, care and diagnostics. The ECP contains a number of actions designed to reform elective care to meet demand, including the establishment of new models of provision, such as regional elective care centres.

Ireland - Minister Harris announces major focus on patients waiting longest in 2017

Ireland’s Minister of Health has announced that reducing waiting times is a priority for 2017. An action plan to standardize the scheduling of patients on waiting lists has been developed, and capacity in Ireland’s private hospital sector will be utilized to provide publicly funded treatment to patients who have been waiting the longest.

Canada - Québec's health care commissioner releases its 2014 report on the performance of the health and social services system

Published on May 13, this report is based on analysis of a wide range of data from multiple sources at provincial, national, and international levels. Quebec performs very well with regard to wait times to see a specialist, obtain specialized testing, as well as for hospital readmissions, but performs less well on continuity and coordination between specialists and family physicians. Quebec comes dead last in the use of information technology by physicians, access to a regular doctor, and follow-up care.

China - A web-based appointment system to reduce waiting for outpatients: A retrospective study

Long waiting times for registration to see a doctor are problematic in China, especially in tertiary hospitals. To address this issue, a web-based appointment system was developed for the Xijing hospital. The aim of this study, published in BMC Health Services Research, was to investigate the efficacy of the web-based appointment system in the registration service for outpatients.

Sweden - How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's Hospital, Stockholm, Sweden

This study published in BMC Health Services investigates how a package of “lean-like” changes translated into better care process management in a health care setting. The authors studied an intervention in a children’s hospital’s emergency department in Stockholm. Improvements in wait and lead times were sustained following changes to employee staffing, scheduling, and problem solving.

Australia - Discrimination in a universal health system: Explaining socioeconomic waiting time gaps

One of the goals of any universal health care system is to eliminate discriminatory access on socioeconomic grounds. Waiting times for treatment should reflect patients’ needs, with priority given to urgent cases. This paper from the University of Technology in Sydney finds evidence that wealthier patients get priority in the Australian system, especially among least urgent cases.

Canada - More surgeries, more beds improve access to health care in Alberta. First 5-Year Health Action Plan update shows steady progress

A progress update on Alberta’s 5-Year Health Action Plan was released. The update reports the successful completion of 18 actions by June 2011 and outlines strategies to further improve the province’s health system. Achievements include cutting wait times, increasing numbers of surgeries and hospital beds, establishing coordinated cancer care, and expanding the eHealth platform

Canada - Doctors say lengthy surgical wait times driven by lack of operating room time and changes in patient case load

A lack of operating room time and changes in patient case loads are two of the most commonly reported factors behind increased wait times for medical care and surgical procedures, concludes a new report released recently by the Fraser Institute. The report, Why We Wait: Physician Opinions on Factors Affecting Health Care Wait Times, analyzes physicians’ responses to the Institute’s annual Waiting Your Turn survey on health care wait times and the reasons they gave for changes in their waiting lists.

Canada - Moving To Patient-Based Funding Will Improve Care in Ontario

On March 19, 2012, the Ontario government announced a new funding model that will see hospitals funded based on how many patients they see, the services they deliver and the quality of those services. Anticipated results include shorter wait times and better access, more services and better quality care with less variation between hospitals.

Canada - Report Card on Wait Times in Canada

The absence of a concerted national effort to reduce wait times is undermining progress on addressing the time lags endured by Canadians needing medical care, warns the Wait Time Alliance (WTA). The 2012 WTA report card gives Canadians a picture of how long they have to wait to access a broad range of medical procedures and services. In a reversal from past years, the 2012 Report Card shows a decline in performance for patients receiving care in the five areas identified as priorities by federal, provincial and territorial governments under the 2004 Health Accord.

Finland - Health-care tourism booming

Finland’s health-care services are particularly popular among Russians due to short waiting times and high quality. Demand has grown immensely in the past few years, and markets are expected to triple in size by the year 2020. Doing its part to boost the business is the portal, which is helping more and more Russians to find Finnish speciality health-care services.

Time for Transformative Change: A review of 2004 Health Accord

Brief analytical summaries or syntheses #40 Time for Transformative Change A review of 2004 Health Accord Summary Canada is no longer seen as a model of innovation in health care delivery and financing, says this report from the Standing Senate Committee on Social Affairs, Science and Technology. The committee’s review revealed that real systematic transformation of health care systems across the country had not yet occurred, despite more than a decade of government commitments and increasing investments. The committee made 46 recommendations it believes will truly transform the way health care professionals do business and will achieve lasting reform. Background On January 31, 2011, the Minister of Health requested that the Standing Senate Committee on Social Affairs, Science and Technology initiate the second parliamentary review of the 10-Year Plan to Strengthen Health Care (10-Year Plan), an agreement reached by First Ministers on September 16, 2004 that focuses on federal/provincial/territorial (F/P/T)…

Canada - Little change in wait times for Canadians

A new analysis from the Canadian Institute for Health Information (CIHI) reveals that about 8 out of 10 Canadians receive priority-area procedures within the medically recommended time frames. Nationally, 97% of patients receive radiation therapy within the recommended four weeks, 82% of patients receive hip replacement surgery within recommended time frames, as do 75% of patients receiving knee replacement surgery. The wait times are generally similar to last year’s, though some provinces are seeing longer waits for certain procedures.

How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children’s Hospital, Stockholm, Sweden

Brief analytical summaries or syntheses #36 How does lean work in emergency care ? A case study of a lean-inspired intervention at the Astrid Lindgren Children’s Hospital, Stockholm, Sweden Summary This study published in BMC Health Services investigates how a package of “lean-like” changes translated into better care process management in a health care setting. The authors studied an intervention in a children’s hospital’s emergency department in Stockholm. Improvements in wait and lead times were sustained following changes to employee staffing, scheduling, and problem solving. Background There is growing interest in applying lean thinking in health care, yet there is still limited knowledge of how and why lean interventions succeed (or fail). Emergency departments (EDs) all over the world are challenged with problems of overcrowding and excessive waiting times. Overcrowding and delays correlate with increased patient mortality, decreased patient and staff satisfaction, and inefficient use of resources. Moreover, as EDs…

Canada — Progress Report 2011: Health care renewal in Canada

This report on Canada's health care performance is a pan-Canadian look at five key commitments of the 2003 First Ministers' Accord on Health Care Renewal and the 2004 10- Year Plan to Strengthen Health Care, and it highlights the progress being achieved to date on wait times, pharmaceuticals management, electronic health records, teletriage, and health care innovation since 2003.

Canada – Alberta: 5-year Health Action Plan sets clear course for health system

Reduced wait times for surgeries, quicker access to cancer treatment and more continuing care options are some of the improvements Albertans can expect as part of a new health action plan released by the Government of Alberta and Alberta Health Services (AHS).

Canada - Waiting Your Turn: Wait Times for Health Care in Canada 2010 Report

The Fraser Institute’s twentieth annual waiting list survey finds that province-wide wait times for surgical and other therapeutic treatments have increased in 2010. The total waiting time between referral from a general practitioner and delivery of elective treatment by a specialist, averaged across all 12 specialties and 10 provinces surveyed, has risen from 16.1 weeks in 2009 to 18.2 weeks in 2010.

Canada - New health information technology strategy: put money where the patient is

The Canadian Medical Association (CMA) has released a new health information technology (HIT) investment strategy that aims to reboot Canada’s HIT agenda to better focus on supporting front line patient care. Transforming the health care system hinges on building better tools and supports to help health care professionals interact and provide care for patients. To that end, the HIT strategy prioritizes the key clinical and system priorities for investment over the next 3-5 years as follows: chronic disease management; prevention and health promotion; medication management; continuity of care (information flow, access and wait times); patient involvement; and public health reporting.

Canada - Wait Time Hot Spots Highlight Work to be Done

A Wait Time Alliance (WTA) report card released recently reveals troubling wait time hot spots in the five clinical areas deemed priorities by governments and more problems across a broader range of medical care. The WTA’s fifth annual report card — entitled No Time for Complacency highlights the fact that much more work remains to be done to cut down waiting times — grades provinces on wait times in the initial five priority areas set by governments in 2004 and across additional areas of specialty care.

Opportunities and challenges in measuring the quality of care in England

Brief analytical summaries or syntheses #5 Opportunities and challenges in measuring the quality of care in England Summary Greater use of quality measurement in the National Health Service (NHS) has real potential for improving quality of care, efficiency and productivity. Changes in the economic climate in England since the publication of the NHS Next Stage Review in 2008 are challenging healthcare authorities to achieve demonstrable improvements in outcomes for patients but also greater productivity and efficiency. This paper sets out the issues that need to be considered in developing and using indicators to measure quality. It attempts to define what is meant by ‘quality’ in health care, examine initiatives likely to improve quality and identify not only the potential benefits of quality indicators, but also the complexities and challenges involved in their implementation. Background The transition from an NHS focused on targets, activity volumes and waiting times to one focused…

Nurses in advanced roles: a description and evaluation of experiences in 12 developed countries

Brief analytical summaries or syntheses #1 Nurses in advanced roles a description and evaluation of experiences in 12 developed countries Summary This health working paper from the OECD Directorate for Employment, Labour and Social Affairs looks at the development of advanced practice nurses in 12 countries Australia, Belgium, Canada, Cyprus, Czech Republic, Finland, France, Ireland, Japan, Poland, United Kingdom and United States. Many countries are seeking to improve healthcare delivery by reviewing the roles of health professionals, including nurses. Developing new and more advanced roles for nurses could improve access to care in situations of limited or diminishing supply of doctors. The redefinition of roles might also contain costs by delegating some of the tasks currently accomplished by expensive doctors to nurses, especially in primary care. The paper also assesses how the reorganization of work impacts the quality of patient care. Background Advanced nursing roles vary significantly between countries. The…

UK — How is the NHS performing? Quarterly monitoring report

This monitoring report is the first of a regular quarterly review, which will combine publicly available data on selected NHS performance measures with views from a panel of finance directors on the key issues their organisations are facing. It complements the monthly waiting times tracker and is a continuation of work that has been done historically to assess, analyse and report on the performance of the NHS.

Canada — Eight out of 10 Canadians receive priority area procedures within recommended wait times

At least 8 out of 10 Canadian patients are receiving priority area procedures, such as hip replacements, cataract surgery and cancer radiation treatment, within medically recommended wait times, according to a new study from the Canadian Institute for Health Information (CIHI). The study provides the first comprehensive national picture of how long Canadians wait for care in priority areas as compared with evidence-based benchmarks of acceptable waits. In 2010, more than 80% of Canadian patients received hip replacements (84%) and cataract surgery (83%) within wait time benchmarks, while the proportion of patients receiving knee replacements and hip fracture repairs within recommended waits was slightly lower, at 79% and 78%, respectively. Almost all (98%) Canadians who needed radiation treatment received it within the clinically recommended time frame.

How health systems make available information on service providers: experience in seven countries

Brief analytical summaries or syntheses #16 How health systems make available information on service providers experience in seven countries Summary This technical report examines seven countries' experience with systems that release information on the performance of healthcare providers. It is meant to guide the further development of quality information systems in Britain's NHS. Systems in Denmark, England, Germany, Italy, the Netherlands, Sweden and the United States are reviewed. Background There is growing interest in the public release of information on the performance of healthcare providers as a means to improve the quality of care and promote transparency and accountability. Countries have made considerable investments in creating systems to make available such information. However, there is lack of systematic comparative assessment of such systems. The report aims to help fill the gap by reviewing the information systems reporting on the quality of healthcare provision in seven countries. Analysis and results The…

United Kingdom: Management of NHS hospital productivity

Brief analytical summaries or syntheses #13 United Kingdom Management of NHS hospital productivity Summary Hospital productivity has fallen over the last ten years. There have been significant increases in funding and hospitals have used this to deliver against national priorities. But, according to this report from the National Audit Office, hospitals need to provide more leadership, management and clinical engagement to optimise the use of additional resources. Background In 2000, the Department of Health published the NHS Plan, a ten-year vision for reforming the NHS. The Plan argued that the NHS was failing to deliver because it had been under-funded, and set out to substantially increase funding in order to meet public expectations for more and better paid staff using new ways of working; reduced waiting times; high quality patient-centred care; and improvements in local healthcare buildings. The Plan set out the systemic problems of the NHS, such as a…

USA - Wait Time for Treatment in Hospital Emergency Departments: 2009

This Data Brief from the U.S. Department of Health and Human Services reveals that from 2003 through 2009, the mean wait time in U.S. emergency departments (EDs) increased 25%, from 46.5 minutes to 58.1 minutes.

Norway - Hospital Capacity, Waiting Times and Sick Leave Duration - An Empirical Analysis of a Norwegian Health Policy Reform

This paper from the University of Bergen evaluates Norway’s Faster Return to Work (FRW) scheme to reduce hospital wait times and sickness absences. Sixty FRW facilities were established as part of health reforms in 2007-2009. The study finds that wait times for FRW patients are 12 to15 days shorter than those of other patients.

International - Improving detection and treatment would cut cancer death rates significantly, says OECD

The report by the OECD was prepared with the support of the European Commission and builds on earlier WHO research. It finds that earlier detection and better treatment for cancer would cut death rates from the disease by around a third, saving the lives of nearly a million people in the developed world every year. Improving care standards, cutting waiting times and spending resources more effectively are key steps to save many lives.

New Zealand - Targeting Waiting Times

This report published by New Zealand’s Health Ministry examines how that country’s district health boards are achieving three patient access targets — briefer emergency department stays, improved access to elective surgery, and shorter wait times for cancer treatment. Nine case studies describe initiatives, innovations and organizations that contribute to improvements.

Canada - Reducing Wait Times for Health Care: What Canada Can Learn from Theory and International Experience

From the Fraser Institute, this new book on Canadian healthcare wait times assesses wait list policy issues such as health effects, costs and labour market consequences. The authors argue that Canada’s current policies will not improve timely healthcare provision.

Canada - Wait times for public sector health services in Québec : mesures, consequences and ways to reduce them

This report from CIRANO proposes a precise definition of waiting times and uses it to compare wait times in Quebec to those in other provinces. It then examines the impact of wait times on society and on individual earnings before presenting possible means of reducing wait times.

International - Measuring and Comparing Health Care Waiting Times in OECD Countries

Waiting times for elective non-emergency treatments are a key health policy concern. This study provides comparative data on waiting times from twelve OECD countries. It presents trends in waiting times over the past decade, focusing on such common elective procedures as cataract surgery and hip and knee replacement.

UK - The four health systems of the United Kingdom: how do they compare?

This report is the fourth in a series looking at how the publicly financed healthcare systems in the four countries of the UK (England, Wales, Scotland and Northern Ireland) compare in terms of quality and productivity. The report finds that mortality rates are considerably lower in England, as are median wait times for medical procedures.

UK - NHS waiting times for elective care in England

The UK Parliamentary Public Accounts Committee has published its 54th annual report into waiting times for elective care within Britain’s National Health Service (NHS). The report says waiting times are increasing for many procedures and that penalties for providers who flout waiting time standards are not succeeding in driving improved performance.

Canada - Wait Times Holding Steady Across Canada. Demand for priority procedures continues to rise

Last year, 8 out of 10 patients received priority surgical procedures within medically acceptable wait times, a figure that has not improved over the past three years, according to the Canadian Institute for Health Information (CIHI). CIHI’s new report, Wait Times for Priority Procedures, 2014, focuses on wait times for five key priority procedures: knee and hip replacement, hip fracture repair, cataract surgery and radiation therapy. The report focuses on the degree to which patients received these procedures within benchmarks established by the federal government and provinces in 2005.

Lunch hour conferences 2014

By Jean-Pierre Ménard, lawyer Christine Lavoie Patricia Lavoie, Direction des affaires juridiques Ministère de la Santé et des Services sociaux Monique St-Pierre, Direction des services hospitaliers et des affaires universitaires Ministère de la Santé et des Services sociaux The Act respecting end-of-life care, adopted on June 10th 2014, is in line with the unanimous recommendations of the Select Committee on Dying with Dignity and is based on the values of solidarity, compassion and respect for individual wishes. This Act follows three objectives to frame palliative care, to allow medical aid in dying in certain special and exceptional situations, and to establish an advance medical directives regime. This conference will explain why this Act was created. Indeed, the Act respecting end-of-life care is part of a social and legal context. This environment is characterized by the medicine progress, but also by the state of practices (advance wishes, rights and obligations of…

Canada - Where you live matters: Canadian views on health care quality Results from the 2013 Commonwealth Fund International Health Policy Survey of the General Public

This final bulletin in the Health Council of Canada's Canadian Health Care Matters series presents Canadians’ views on and experiences with health care, based on the 2013 Commonwealth Fund Survey. It focuses on differences between provinces, comparisons among the 11 OECD countries participating in the survey, and changes in Canada’s performance over the past decade. Large variations between provinces in patient experiences, not only around wait times and coordination of care, but also in other areas including out-of-pocket expenses, patient safety, and preventive care, were identified.

Switzerland - Health Care Lessons from Switzerland

The focus of this paper in the Fraser Institute series on how health services are funded and delivered in other nations is Switzerland. The Swiss healthcare system is highly responsive and provides some of the best outcomes among countries with universal coverage. As well, waiting times are not considered to be a problem.

International - Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times

This systematic review, published in Implementation Science, examines factors influencing the implementation and sustainability of wait time management strategies at the organizational level. Specific factors for successful implementation were consultation with front-line actors and common standards and guidelines, and at the organizational level, financial incentives and dedicated staffing. The authors consider that more research is needed to understand the sustainability of wait time management strategies.

UK – The NHS reforms and efficiency savings: an early assessment of the impact on cancer services in England

Produced by Cancer Research UK, this report assesses the impact on cancer services of current British health reforms and efficiency gains. The report analyses trends in cancer care wait times, diagnostic wait times and expenditures from 2010 onwards, and conducts interviews with key stakeholders to explore experiences in eight cancer networks.

International - Waiting Time Policies in the Health Sector. What Works?

This book describes healthcare system wait-list policies in 14 OECD countries. It looks at discrepancies between countries in wait times for medical specialties, reviews best practices and different policy approaches, and discusses government use of sanctions against providers with long wait times.

Canada - Canadians continue to wait for care

While progress has been made in some areas - most notably priority surgeries - people continue to wait at nearly all points of their journey through the health care system, concludes two new reports from the Canadian Institute for Health Information (CIHI). Health Care in Canada, 2012: A Focus on Wait Times looks at people’s experiences in accessing care across the health system. Seniors and Alternate Level of Care provides further insight into hospitalized patients waiting for long-term care or home care services.

Sweden – Health System Review

Brief analytical summaries or syntheses #43 Sweden – Health System Review Summary Published by the European Observatory on Health Systems and Policies, this report regards Sweden’s health system in detail. It describes the institutional framework, process, content, and implementation of Swedish health policies, highlighting challenges and areas that require further analysis. Background Sweden is a monarchy with a parliamentary form of government. The size of the population is about 9.4 million inhabitants and more than 80% of the population lives in urban areas. The GDP per capita, measured as purchasing power parity (PPP, current international US$), amounted to Swedish krona (SEK) 37 775 (€4200) in 2010. Life expectancy in Sweden is among the highest in the world. Diseases of the circulatory system are the leading cause of mortality, accounting for about 40% of all deaths in 2009. The second largest cause of death is cancer. There are three independent government…

Health policy responses to the financial crisis in Europe

Brief analytical summaries or syntheses #47 Health policy responses to the financial crisis in Europe Summary This August 2012 report by the Health Evidence Network (HEN) identifies key challenges for European health policy makers in the wake of the ongoing financial crisis. The report focuses on responses to essential service cuts and interruptions in revenue streams, as well as on inefficiencies and exacerbations of adverse effects evident in national health systems. Background The global financial crisis that began in 2007 can be classified as a health system shock – that is, an unexpected occurrence originating outside the health system that has a large negative effect on the availability of health system resources or a large positive effect on the demand for health services. Economic shocks present policy-makers with three main challenges Health systems require predictable sources of revenue with which to plan investment, determine budgets and purchase goods and services.…

Sweden - Waiting management at the emergency department - a grounded theory study

Emergency departments (EDs) should always offer timely care. This study from BMC Medicine collected two years of data at a Swedish ED to explore waiting times and management procedures. The authors find that managing unacceptable waits is a driving force behind ED staff behaviour.

Canada - Health care reforms not keeping pace with needs of Canadians, says report

The Health Council of Canada progress report highlights five key areas: wait times, primary health care and electronic health records, pharmaceuticals management, disease prevention/health promotion and Aboriginal health. It finds significant variability across Canada and shortcomings in many areas. To achieve better health care for all Canadians, the report calls for governments to set clear policy goals with clear lines of responsibility, to continue the spread of innovative practices, and to support collaborative efforts across all jurisdictions, including the federal government.

Canada - Report Card on Wait Times in Canada : Progress Has Stalled

Canadians are waiting as long, if not longer, than previous years for medical care, the eighth report card issued by the Wait Time Alliance has concluded. The 2013 WTA report card, entitled "Time for transformation: Canadians still waiting too long for health care," gives Canadians a picture of how long they have to wait to access a broad range of medical procedures and services.

Canada - Ontario Proposes Investments in Home and Community Care

On April 23, 2013, the Ontario government stated it wants more people to receive timely access to home and community care. The proposed additional investment in the community care sector of $260 million in 2013-2014 would aim to reduce wait times for patients who require nursing services and permit those with complex needs to receive home care within five days of their Community Care Access Centre assessment.

Canada – Quality Monitor. Ontario Health Quality Council. 2010 report on Ontario’s health System

The report shows that although there have been some modest improvements in quality across Ontario’s health system, there is room for more improvement. There are examples of higher performance that could be applied more broadly. The top-line findings underscore areas of concern that are of critical importance: wait times; the accuracy and completeness of medical information; chronic disease management; access to primary care; and patient safety.