Canada - World Health Organization Regional Office for Europe

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