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Wait times for “non-priority” surgeries
Topic Started: Dec 10 2013, 09:26 AM (1,566 Views)
Berton
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Connecting supply with demand

While efficiency gains can improve wait times somewhat, a more fundamental issue in non-priority areas is that their funding is not determined by population need. In other words, there is limited connection between supply and demand.

Historically, most Canadian hospitals have been funded through global budgets; stable funding arrangements determined by historical spending patterns, inflation and one-off negotiations between hospital executives and government. Under the global budget system, hospital managers have been largely free to allocate those funds according to their own priorities. This can lead to service gaps, both from lack of coordination between hospitals, as well as a tendency in some institutions to prioritize surgeries that cost less, says Jim Waddell, an orthopedic surgeon at St. Michaels Hospital.

This began to change when the Wait Times Strategy introduced targeted payments for hip and knee replacements. Where non-priority surgeries still had to be paid for out of a hospitals’ global budget, some hip and knee replacements were paid for individually with separate funds. This encouraged hospitals to devote more operating room time to hip and knees.

Daniels believes the strength of targeted funding was that it tied supply (surgical time) to demand (the large unmet need for hip and knee replacement surgery). He thinks a similar mechanism could be put in place for more surgical services, so that hospitals have a financial incentive – or at least no disincentive – to provide the services their communities need (services with very long wait lists).

Daniels is aware that in the current fiscal climate, there is unlikely to be new money available for targeted funding, but he is hopeful that Ontario’s ongoing restructuring of hospital financing – especially the move towards Quality Based Procedures – will provide a cost-neutral mechanism for better connecting supply with demand.

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I still wonder why bureaucrats are making health care decisions?

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ImaHeadaU
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According to the B.C. Ministry of Health web site an elective foot/ankle surgery wait time can be from 1.4 weeks to as much as 93.7 weeks depending on the complaint, the facility and the surgeon. Some facilities don't do much surgery. Some do. Generally, a patient can be referred to the surgeon and or facility with the shortest wait times unless he or she wants a particular surgeon or facility.

B.C. Ministry of Health Surgical Wait Times Website

If you care to look for it, you can probably find this information for most provinces.

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Berton
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I still don't have the answer to my question. But thanks for inserting additional information about how long wait times are for people who are in serious pain.

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ImaHeadaU
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The information I provided was regarding elective non-urgent surgeries.
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Berton
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I understand that non-urgent surgeries have long wait times even if the patient is in serious pain. That agrees with the article. But why are bureaucrats making health care decisions?

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Mike
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Berton
Dec 11 2013, 10:53 AM
I understand that non-urgent surgeries have long wait times even if the patient is in serious pain. That agrees with the article. But why are bureaucrats making health care decisions?

Berton,

The simple answer to your question is this...because they were elected to the decision making office charged with deciding how best to cover the healthcare needs of all citizens and to do so within the budget.

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Brewster
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The better answer is that Berton is dead wrong.

And Mike, if Berton is claiming that politicians are making decisions about who gets what, I know of no province in Canada where ANY elected representative has ANY say in the day to day operation of the system.

As you say, the only decision they get to make is the total budget.

And the fact that some bureaucrat is setting the overall budget is true in every country in the world, including the US.

And even then, in Alberta at least, there is always a discretionary budget to draw on in extreme cases.

And in every country in the world, if you're prepared to kick in your own dollars, you can have anything you want done, at any time.
Edited by Brewster, Dec 11 2013, 01:54 PM.
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wanderingjays
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I gotta call BS on the extended wait times in Canada. I have family in Vancouver , Kelowna , Penticton and Toronto. If you have an emergency requiring surgery you don't wait , if it's elective you wait. Just like in the good old US of A
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Neutral
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Right, except you nor any of the canooks can explain the horror stories of the waits in Canada. I have relatives too that have not waited because they haven't been in the situation that would cause a wait. Duh
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campingken
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Sorry Neutral but your "I have Canadian relatives" story lost all credibility when you ended the sentence with "duh."

If you want to experience wait time take a trip to the ER in a large city hospital on a Friday or Saturday night.
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