Timely Access to Care Canada continues to perform below the international average for timely access to patient care. Most Canadians (93%) have a regular doctor or place of care, but they generally report longer wait times for medical care than adults in comparable countries. One possible reason for longer waits here is that Canadians consult with physicians more often than people in other countries. • Only 43% of Canadians report that they were able to get a same- or next-day appointment at their regular place of care the last time they needed medical attention — the lowest percentage of all countries. • Only 34% of Canadians report that they could get care on evenings or weekends without going to an emergency department. However, after-hours access is closer to the international average (43%) in some provinces (Ontario and Alberta). • Canadian patients are generally not seeing improvements in timely access to primary care over time. This is contrary to what primary care physicians reported in The Commonwealth Fund’s 2015 survey. • Canadians visit emergency departments more often than people in other countries and wait longer for emergency care; Canada has the highest proportion of patients waiting 4 or more hours during a visit. • Reported wait times for specialists and non-emergency surgeries in Canada are also the highest among the 11 countries, with all provinces showing significantly longer waits for specialists.
Person-Centred Care Once they do get in for a visit, Canadians are generally happy with the medical care they receive from their regular doctor or place of care. However, their overall views about their health care system are less positive. • Nearly 3 in 4 Canadians rate the quality of care they receive from their regular doctor as very good or excellent; however, 55% also believe the health care system overall requires fundamental changes. • Canadians report better experiences than the international average when it comes to their regular doctor knowing their medical history, involving them in medical decisions and explaining things in a way that is easy to understand. • When it comes to health promotion and disease prevention, Canadians have more discussions with their primary care providers about healthy lifestyle choices than patients in most other countries, with Alberta, Manitoba and Ontario leading the way. • With regard to hospital stays, patients report results that are similar to the international average overall. Most Canadians also report good hospital discharge planning, with staff arranging follow-up care and providing written instructions for symptoms to watch for at home. • Results suggest that coordination of patient care between regular providers and specialists could be improved in all countries. Similar to the international average, 1 in 5 Canadians report that their regular doctor did not seem up to date about the care they received from a specialist.
These issues do not appear to be a function of Single Payer:
Timely Access to Care Most Canadians (93%) have a regular doctor or place of care, but they have trouble accessing their health care system in a timely manner. Same- or next-day appointments are difficult to get in Canada?i Last time you were sick or needed medical attention, how quickly could you get a same- or next-day appointment to see a doctor or a nurse? Country results from lowest to highest Canada, 43% (below average); Norway, 43%; Sweden, 49%; United States, 51%; Germany, 53%; France, 56%; Switzerland, 57%; United Kingdom, 57%; Commonwealth Fund average, 57%; Australia, 67%; New Zealand, 76%; Netherlands, 77%
Access to after-hours care continues to be below average in Canada?ii Is it very/somewhat easy to get medical care in the evenings, on weekends or on holidays without going to the hospital emergency department? Country results from lowest to highest Sweden, 24%; Canada, 34% (below average); France, 35%; Germany, 36%; Switzerland, 41%; United States, 42%; United Kingdom, 43%; Commonwealth Fund average, 43%; Norway, 49%; Australia, 49%; New Zealand, 53%; Netherlands, 72%
Some of the issues faced in Canada are related to population density. In the U.S. rural hospitals and healthcare must be subsidized and it is in crisis mode because of the current healthcare for profit system.
Timely access to primary care varies across the country While results are below the international average in most parts of the country, some provinces report timelier access to regular care. Able to get same- or next-day appointment to see a doctor or a nurse: Province results from east to west Newfoundland and Labrador, 34% (below average); Prince Edward Island, 30% (below average); Nova Scotia, 34% (below average); New Brunswick, 33% (below average); Quebec, 39% (below average); Ontario, 44% (below average); Manitoba, 47% (below average); Saskatchewan, 49% (same as average); Alberta, 48% (below average); British Columbia, 44% (below average); Canada, 43% (below average); Commonwealth Fund average, 57%
Very/somewhat easy to get medical care in the evenings, on weekends or on holidays without going to the hospital emergency department: Province results from east to west Newfoundland and Labrador, 16% (below average); Prince Edward Island, 25% (below average); Nova Scotia, 26% (below average); New Brunswick, 35% (below average); Quebec, 27% (below average); Ontario, 40% (same as average); Manitoba, 34% (below average); Saskatchewan, 32% (below average); Alberta, 42% (same as average); British Columbia, 27% (below average); Canada, 34% (below average); Commonwealth Fund average, 43% Always/often receive an answer the same day when they contact their regular doctor’s office with a medical concern: Province results from east to west Newfoundland and Labrador, 61% (below average); Prince Edward Island, 70% (same as average); Nova Scotia, 64% (same as average); New Brunswick, 50% (below average); Quebec, 54% (below average); Ontario, 62% (below average); Manitoba, 57% (below average); Saskatchewan, 51% (below average); Alberta, 58% (below average); British Columbia, 64% (same as average); Canada, 59% (below average); Commonwealth Fund average, 72%
Good report on mental health care:
Canadians report more timely access to mental health care than those in other countries 1 in 4 surveyed Canadians say they experienced emotional distress, such as anxiety or great sadness, in the past 2 years, which they found difficult to cope with by themselves (below average). More Canadians — 59% — who experienced emotional distress were able to get professional help when they needed it (above average compared with the international average of 54%).
Again, Single Payer does not seem to be the determining variable here:
Canadians are high users of emergency departments Adults who used an emergency department in the past 2 years: Country results from highest to lowest Canada, 41% (below average); Sweden, 37%; United States, 35%; France, 33%; Switzerland, 30%; Commonwealth Fund average, 27%; Norway, 26%; United Kingdom, 24%; New Zealand, 23%; Australia, 22%; Netherlands, 20%; Germany, 11%
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Emergency department wait times are longest in Canada 29% of Canadians report waiting 4 or more hours the last time they went to the hospital emergency department. Patients who reported waiting 4 or more hours: Country results from highest to lowest Canada, 29% (below average); Sweden, 20%; Norway, 13%; United States, 11%; Commonwealth Fund average, 11%; Australia, 10%; New Zealand, 10%; United Kingdom, 8%; Switzerland, 7%; Netherlands, 4%; Germany, 3%; France, 1%
Yes, wait times for specialists and elective surgeries are longer:
Wait times for specialists are longest in Canada and not improving Patients who waited 4 weeks or longer to see a specialist, after they were advised or decided to see one in the last 2 years: Country results from highest to lowest Canada, 56% (below average); Norway, 52%; New Zealand, 44%; Sweden, 42%; United Kingdom, 37%; Commonwealth Fund average, 36%; France, 36%; Australia, 35%; Germany, 25%; United States, 24%; Netherlands, 23%; Switzerland, 22%
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Wait times are longer than average in Canada for all elective surgeries Patients who waited 4 months or longer for elective surgery in last 2 years: Country results from highest to lowest Canada, 18% (below average); New Zealand, 15%; Norway, 15%; United Kingdom, 12%; Sweden, 12%; Commonwealth Fund average, 9%; Australia, 8%; Switzerland, 6%; Netherlands, 4%; United States, 3%; France, 2%; Germany, 0% Median wait times in days for priority procedures in 2014 Cataract surgery: Canada, 48 days; Commonwealth Fund average, 73 days Hip replacement: Canada, 87 days; Commonwealth Fund average, 100 days Knee replacement: Canada, 98 days; Commonwealth Fund average, 126 days Note: The Commonwealth Fund average median wait time is calculated using the following countries: Australia, Canada, New Zealand, Norway and the United Kingdom. While Canada performs better when it comes to wait times for priority procedures (cataract, hip and knee), these procedures account for less than half of elective surgeries in Canada9 (unpublished data, National Ambulatory Care Reporting System and Hospital Morbidity Database, CIHI).
Note that these "elective surgeries" are often just skipped by U.S. citizens with high deductible insurance plans.
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