Health-care wait time numbers not very helpful, but they’re likely accurate

Opinion

Virtually every time I write about health-care wait times, I’m told my numbers are wrong. Last week when I editorialized about the need to resume out-of-province surgeries, it was no different.

People wrote in to say the wait-time figures I’m reporting can’t be right because it took far longer for them (or someone they know) to get hip or knee surgery than what I was reporting. Others got their procedures done sooner. So surely the numbers I’m using can’t be right. Actually they are.

The disconnect between reported wait times and individual experiences can be easily explained.

The wait time numbers I or anyone else in the media use come from the provincial government, or one of their health-care agencies, such as Shared Health or a regional health authority. Their data comes from hospitals, surgeons and clinics. In my 30-years experience writing about health care, I have never found any evidence that those agencies are deliberately reporting inaccurate numbers. If they were, it would eventually be exposed by insiders.

The data collection methods used to determine wait times may not be perfect, or even very good at times. But I have no reason to believe government is fabricating the numbers.

One the most glaring differences between what is reported and what people are experiencing is that government doesn’t include the time it takes for patients to see a specialist. Most people with ailments see their family doctor first and are referred to a specialist, sometimes a surgeon, if they need one.

The time it takes to do so is not included in the wait-time data. That’s mostly because government doesn’t have the data collection technology to do so. Information technology in Canada’s publicly run health-care system is notoriously poor.

Another reason reported wait times and real-life experience don’t always match up is because government agencies typically use what is called median wait times. That’s the point at which half of patients wait longer and half wait less.

Naturally, many will wait longer than the reported median wait time and some will get quicker service. The median wait time is not indicative of how long most people wait, but it gets interpreted as such.

Government agencies sometimes use what is called the 90th-percentile wait time, which shows the longest wait time for nine out of 10 patients. That methodology gives a more accurate picture of the longest wait times. But it’s not any more indicative of how long most people are waiting, because that varies considerably by individual.

The best thing to do would be to report both, as the Winnipeg Regional Health Authority does with emergency-room wait times. By contrast, the province reports median wait times only for surgeries and diagnostic testing (MRIs, CT scans, ultrasounds, etc.).

Wait-time numbers vary further by surgeon or facility. For example, the median wait time for knee surgery at Concordia Hospital in March was 22 weeks. At Grace Hospital it was 27 weeks. It was even longer in rural areas, including 38 weeks at Boundary Trails Health Centre, located between Winkler and Morden.

There are other factors that contribute to the discrepancy between what is reported and what is happening on the ground. But those are the main ones.

So when it’s reported that the median wait time for knee surgery in Manitoba in March was 36 weeks, it’s easy to see why my email inbox gets flooded with people who say the numbers must be wrong. When you include the time it takes to see a specialist, and if a surgeon or a health facility has a longer wait time than the median, the time it takes from family doctor to operating room could easily be two years or more.

So why report median wait times at all? Because it’s a consistent and relatively accurate way of assessing whether people overall are waiting longer for medical procedures or getting in sooner. If the median wait time for hip and knee surgeries is getting longer over time (as it is in Manitoba) it’s trending in the wrong direction.

The province says it’s working on a more comprehensive data collection system to report health-care wait times, one that will hopefully include more procedures. Right now, the monthly reports (which are typically two or three months behind) include only nine procedures, including a few surgeries and several diagnostic tests. In addition, the WRHA reports ER wait times.

Provinces such as Manitoba need to do a better job of reporting wait times. In the meantime, I will continue to report what is available.

tom.brodbeck@freepress.mb.ca