Hip, knee backlog pressure settles in on wait times
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Manitoba hospitals are boosting hip and knee surgeries to near-record levels, yet wait times for the procedures continue to climb.
It seems counterintuitive, but there is a reason for it: the backlog of surgeries and other medical procedures that piled up during the COVID-19 pandemic are so high, hospitals are struggling to clear them, even as volumes return to or exceed pre-pandemic levels.
Manitoba surgeons performed 495 hip and knee operations in May, the third-highest monthly volume over the past five years, according to data released this week by Manitoba Health. That’s up from 396 the previous month.
Prior to the pandemic, Manitoba increased the number of monthly hip and knee surgeries to more than 400 per month. That fell well below 300 some months during the pandemic, after hundreds of surgical and other staff were redeployed to medical wards to treat COVID-19 patients.
Operating room capacity was so low during much of the pandemic, many surgeons stopped taking new patients or significantly reduced the number of new bookings. Meanwhile, demand for hip and knee surgery didn’t slow. It continued to rise by an estimated five per cent a year.
It created a backlog, estimated by Doctors Manitoba advocacy group to be as high as 3,131 cases.
Now that operating rooms have returned to pre-pandemic capacity at most hospitals, surgeons are booking patients again. They’re doing so at, or above, pre-pandemic levels. With no additional capacity in the system, that’s causing wait times to rise.
Some patients may be given the option of travelling out-of-province for hip and knee surgery later this year (paid for by Manitoba Health) but no details have yet been released.
Even with the higher number of surgeries performed in recent months, data released this week show the median wait time for hips and knees jumped in May to 43 weeks, by far the longest over the past five years. That’s up from 35 weeks the month before, and 28 weeks in January and February.
Even with the higher number of surgeries performed in recent months, data released this week show the median wait time for hips and knees jumped in May to 43 weeks.
Prior to the pandemic, the median wait time for hip and knee surgery was between 20 and 30 weeks.
The longest waits are for knee replacement: 52 weeks at Winnipeg hospitals. The wait time was half that prior to the pandemic. It’s not as long for hip replacement (31 weeks), but that’s still well above wait times of 12 to 21 weeks prior to the pandemic.
The results are similar in other areas, including cataract surgery.
The data show 1,395 cataract procedures were performed in May, slightly above pre-pandemic levels. Yet, wait times for cataracts remained stubbornly high at 20 weeks at Misericordia Health Centre, where the bulk of Manitoba’s eye surgeries are performed. It was 10 to 16 weeks prior to the pandemic.
(The real wait times for cataract surgery are much longer. Manitoba Health blends wait times for first and second eye procedures, giving the impression wait times are shorter than they really are.)
Wait times for diagnostic testing will be more difficult to assess going forward; the province is changing the methodology used to measure them to comply with Canadian Institute for Health Information standards.
Already this week, Manitoba Health stopped publishing provincial averages for diagnostic tests such as MRIs, CT scans and ultrasounds, providing wait time data by hospital only (it used to publish both). Wait times for MRIs at St. Boniface Hospital and Health Sciences Centre in Winnipeg were 13 weeks in May, slightly lower than prior to the pandemic.
Wait times for MRIs at St. Boniface Hospital and Health Sciences Centre in Winnipeg were 13 weeks in May, slightly lower than prior to the pandemic.
The challenge for hospitals now will be keeping up with growing demand for surgeries and other medical procedures while trying to clear the backlog created during the pandemic. So far, neither the province nor the Stefanson government’s diagnostic and surgical recovery task force have provided estimates on volumes or wait times for 2022 or 2023.
The task force is expected to publish a new online dashboard this summer to provide more information on wait times and procedures completed, but no targets on future wait times or backlog estimates.
With a planned expansion for hip and knee surgeries at Concordia Hospital delayed until the 2023-24 fiscal year, Manitobans may have to get used to longer wait times, even while hospitals return to pre-pandemic levels of operation.
Tom has been covering Manitoba politics since the early 1990s and joined the Winnipeg Free Press news team in 2019.