Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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<strong>Health</strong> systems in transition <strong>Canada</strong> 139<br />
For the general public and health system decision-makers, waiting times have<br />
emerged as a major indicator of quality in <strong>Canada</strong>. As discussed in Chapter 6,<br />
first ministers identified five waiting time priority areas in the 10-Year Plan<br />
of 2004: cancer, heart, joint replacement, sight restoration and diagnostic<br />
imaging. They then asked their respective health ministers to produce a set<br />
of pan-Canadian benchmarks against which per<strong>for</strong>mance could be measured<br />
over time.<br />
In 2005, health ministers produced six waiting time benchmarks <strong>for</strong> specific<br />
procedures in four of the five priority areas: (1) radiation therapy to treat cancer<br />
within four weeks; (2) cardiac bypass surgery within 2–26 weeks depending on<br />
the urgency of care; (3) surgery to remove cataracts within 16 weeks; (4) hip<br />
replacements within 26 weeks; (5) knee replacements within 26 weeks; and (6)<br />
surgical repair of hip fractures within 48 hours. While health ministers were<br />
unable to reach a consensus on pan-Canadian benchmarks <strong>for</strong> MRI and CT<br />
scans, some ministries of health have set their own waiting time thresholds <strong>for</strong><br />
advanced diagnostics. Table 7.4 indicates that while most provinces have met or<br />
come close to meeting the benchmarks <strong>for</strong> cancer radiation therapy and cardiac<br />
bypass surgery, they still have some distance to go be<strong>for</strong>e they meet the waiting<br />
time benchmarks <strong>for</strong> joint replacement and sight restoration.<br />
7.4.3 Equity of outcomes<br />
As in other OECD countries, there is a robust relationship between<br />
socioeconomic status and health outcomes – the lower status the poorer are<br />
health outcomes. In <strong>Canada</strong>, there is also considerable evidence of a strong<br />
relationship between socioeconomic status and health care utilization – the<br />
lower education and income level of individuals, <strong>for</strong> example, the more likely<br />
they are to use more health care services (Mustard et al., 1997; Roos & Mustard,<br />
1997; Curtis & MacMinn, 2008). The hard policy question is the extent to which<br />
existing and proposed health system interventions and services will improve<br />
health outcomes.