Wait time report shows Manitobans better off breaking a hip than wearing it out

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This article was published 28/03/2017 (3143 days ago), so information in it may no longer be current.

If you need cataract surgery in Manitoba, you’re going to wait longer than anywhere else in Canada.

Manitoba has the longest waiting list for cataract surgery in the country; only 34 per cent of patients diagnosed with the age-related deterioration to eyesight can expect to have surgery within 16 weeks, the national benchmark for the procedure.

Manitobans are also better off breaking a hip than wearing it out when it comes to the length of time they wait for surgery, just like last year.

Break a hip and a patient will typically roll into surgery within 48 hours. Wear it out and six out of every 10 Manitobans who need it will get hip replacement within six months.

By another measure, if you need radiation to treat a cancer diagnosis, you can’t beat this province. No one waits longer than four weeks for treatment.

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If that sounds like a mixed result, a new report card on the state of Canada’s health care system says the way provinces prioritize selected surgeries determines whether wait times are long or short. Called Wait Times for Priority Procedures in Canada, 2017, the national report card was issued Tuesday by the Canadian Institutes on Health Information.

"Manitoba’s always been always been a leader in the country for prompt access to care for broken hips (and) access to radiation for cancer patients," Kathleen Morris, vice-president of research and analysis for CIHI, said in a statement to compare this province against the national average.

And gradually, this province is whittling back the waits for those hip and knee replacements, Morris added.

"A growing number of patients are getting hip and knee replacements within the recommended six months," she said. The report notes 66 per cent of patients waiting for hip replacements get them on time. That’s at least five per cent better than 2012. Waits for knees, not so much. Only 58 per cent get done in time, a drop of five per cent over the last four years.

"Waits are still longer than the national average (86 per cent of Canadians) with less than 2/3 of patients in Manitoba having surgery in the targeted time frame," Morris said.

The report is issued annually and it measures provinces against specific time frames called benchmarks that are set nationally for cataract surgery, hip fractures, hip and knee replacement, radiation therapy for cancer and diagnostic imaging.

This year’s report draws on adult patients aged 18 and older in hospitals across the country that was collected between 2012 and 2016.

The doctor who supervises surgery slates in Winnipeg said he saw no surprises in CIHI’s latest report but he eyed how Manitoba measured up this year on cataracts and dug up his own statistics to show the province’s progression downward.

"This is confirmation we’re not keeping up with the demand for cataracts. We certainly seem to falling behind the demand for cataract surgery relative to our aging population," said Dr. Jack McPherson, the medical director for surgical programming with the Winnipeg Regional Health Authority and head of surgery for the University of Manitoba’s medical faculty.

The length of time to get a cataract done in this province is measured with the first and the second eye — 79 per cent of patients have their second eye done within 16 weeks, said McPherson.

But only 34 per cent get the first eye done in that time frame, according to CIHI data, which is the lowest number in four years, McPherson said.

Prior to 2015, Manitoba averaged out the waits of both the first and second eye. After that, the numbers dropped sharply when the province started reporting the wait for the first eye instead of the two together, consistent with CIHI standards.

The change had the effect of highlighting the long waits in Manitoba. From 2012 to 2014, 60 per cent of Manitobans could expect to get both eyes done within 16 weeks of each other.

By changing it to the first eye, the numbers showed just how long it took to get into the system, a wait that’s reflected in the nose-dive the numbers took, from 63 per cent in 2014 to 41 per cent in 2015.

Then the numbers dropped again last year to 34 per cent, underscoring the problem McPherson drew attention to.

CIHI figures released Tuesday show 50 per cent of cataract patients wait 148 days to get in for the first eye, and nearly twice as long for the rest of patients. Ninety per cent of patients wait 289 days for the first eye.

Once a person is in, though, the process speeds up: nearly 80 per cent of patients only wait 16 weeks for the second surgery.

In December, the Pallister government appointed four doctors, including McPherson, to lead a task force targeting worsening wait times for diagnostic imaging, hip, knee and cataract surgery and emergency room care.

"The provincial government has created a wait times reduction task force which is going to be reporting over the next several months on recommendations to improve wait times for Manitoba in areas where we’re below the Canadian average which would obviously include cataracts," McPherson said.

CIHI sources its data directly from hospitals across the country, based on adult patients 18 and older. This report draws on data collected April to September 2016.

alexandra.paul@freepress.mb.ca