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Research ArticleResearch

How long are Canadians waiting to access specialty care?

Retrospective study from a primary care perspective

Clare Liddy, Isabella Moroz, Ewan Affleck, Emma Boulay, Sarah Cook, Lois Crowe, Neil Drimer, Laurie Ireland, Pamela Jarrett, Susan MacDonald, Derek McLellan, Ariana Mihan, Nico Miraftab, Véronique Nabelsi, Christopher Russell, Alex Singer and Erin Keely
Canadian Family Physician June 2020, 66 (6) 434-444;
Clare Liddy
Clinician Investigator at the C.T. Lamont Primary Health Care Research Centre of the Bruyère Research Institute and Associate Professor in the Department of Family Medicine at the University of Ottawa in Ontario.
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  • For correspondence: cliddy@uottawa.ca
Isabella Moroz
Research associate at the C.T. Lamont Primary Health Care Research Centre of the Bruyère Research Institute at the time of the study.
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Ewan Affleck
Medical Director for Northwest Territories Health and Social Services in Yellowknife.
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Emma Boulay
Project Support and Coordination Expert at the New Brunswick Department of Health in Fredericton.
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Sarah Cook
Territorial Medical Director with Northwest Territories Health and Social Services.
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Lois Crowe
Research Manager at the C.T. Lamont Primary Health Care Research Centre of the Bruyère Research Institute.
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Neil Drimer
Director of Programs with the Canadian Foundation for Healthcare Improvement in Ottawa.
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Laurie Ireland
Family physician with the Nine Circles Community Health Centre in Winnipeg, MB.
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Pamela Jarrett
Physician Lead in the Department of Geriatric Medicine for the Horizon Health Network in Fredericton, NB.
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Susan MacDonald
Associate Professor in the Department of Family Medicine at Memorial University of Newfoundland in St John’s.
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Derek McLellan
Family physician at the Riverside Medical Centre in Ottawa.
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Ariana Mihan
Summer student at the C.T. Lamont Primary Health Care Research Centre of the Bruyère Research Institute.
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Nico Miraftab
Project Lead for Fraser Health in British Columbia.
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Véronique Nabelsi
Professor in the Département des Sciences Administratives at the Université du Québec en Outaouais.
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Christopher Russell
Family medicine resident at McMaster University in Hamilton, Ont.
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Alex Singer
Assistant Professor in the Department of Family Medicine at the University of Manitoba in Winnipeg.
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Erin Keely
Professor in the Department of Medicine and the Department of Obstetrics and Gynecology at the University of Ottawa.
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Abstract

Objective To calculate patient wait times for specialist care using data from primary care clinics across Canada.

Design Retrospective chart audit.

Setting Primary care clinics.

Participants A total of 22 primary care clinics across 7 provinces and 1 territory.

Main outcome measures Wait time 1, defined as the period between a patient’s referral by a family physician to a specialist and the visit with said specialist.

Results Overall, 2060 referrals initiated between January 2014 and December 2016 were included in the analysis. The median national wait time 1 was 78 days (interquartile range [IQR] of 34 to 175 days). The shortest waits were observed in Saskatchewan (51 days; IQR = 23 to 101 days) and British Columbia (59 days; IQR = 29 to 131 days), whereas the longest were in New Brunswick (105 days; IQR = 43 to 242 days) and Quebec (104 days; IQR = 36 to 239 days). Median wait time 1 varied substantially among different specialty groups, with the longest wait time for plastic surgery (159 days; IQR = 59 to 365 days) and the shortest for infectious diseases (14 days; IQR = 6 to 271 days).

Conclusion This is the first national examination of wait time 1 from the primary care perspective. It provides a picture of patient access to specialists across provinces and specialty groups. This research provides decision makers with important context for developing programs and policies aimed at addressing the largely ignored stage of the wait time continuum from the time of referral to eventual appointment time with the specialist.

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Canadian Family Physician: 66 (6)
Canadian Family Physician
Vol. 66, Issue 6
1 Jun 2020
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How long are Canadians waiting to access specialty care?
Clare Liddy, Isabella Moroz, Ewan Affleck, Emma Boulay, Sarah Cook, Lois Crowe, Neil Drimer, Laurie Ireland, Pamela Jarrett, Susan MacDonald, Derek McLellan, Ariana Mihan, Nico Miraftab, Véronique Nabelsi, Christopher Russell, Alex Singer, Erin Keely
Canadian Family Physician Jun 2020, 66 (6) 434-444;

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How long are Canadians waiting to access specialty care?
Clare Liddy, Isabella Moroz, Ewan Affleck, Emma Boulay, Sarah Cook, Lois Crowe, Neil Drimer, Laurie Ireland, Pamela Jarrett, Susan MacDonald, Derek McLellan, Ariana Mihan, Nico Miraftab, Véronique Nabelsi, Christopher Russell, Alex Singer, Erin Keely
Canadian Family Physician Jun 2020, 66 (6) 434-444;
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