Chapter 7 - Summary of Findings [564 KB]

Enhancing the effectiveness of health carefor Ontarians through research

7.1 Percentage change in the annual number of procedures in Ontario, 1994/95 vs. 2004/05






7.3 Percentage change in the rate of procedures per 100,000 population in Ontario, 2003/04 vs. 2004/05

7.3 Percentage change in the rate of procedures per 100,000 population in Ontario, 2003/04 vs. 2004/05

-2

-1 -1

2

5 5

7

8

11

12

14

22

-5

0

5

10

15

20

25

BypassSurgery

Mastectomy LargeBowel

Resection

Hysterectomy RadicalProstatectomy

CataractSurgery

CoronaryAngiography

TotalHip

Angioplasty CT TotalKnee

MRI

Pe

rce

nt


7.4 Variation in procedures across Local Health Integration Networks in Ontario, 2004/05

7.4 Variation in procedures across Local Health Integration Networks in Ontario, 2004/05

1.41.5

1.61.7

1.92.0 2.0

2.2 2.22.3

2.4

2.9

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

Large BowelResection

CT CataractSurgery

MRI BypassSurgery

CoronaryAngiography

Total Hip Angioplasty TotalKnee

RadicalProstatectomy

Hysterectomy Mastectomy

Extr

em

al

qu

oti

en

t


7.5a Percentage difference in rate of procedures between lowest and highest neighbourhood income quintiles in Ontario, 2004/05

7.5a Percentage difference in rate of procedures between lowest and highest neighbourhood income quintiles in Ontario, 2004/05

-10 -9-4

36

11

21

27 27

33

51

70

-20

-10

0

10

20

30

40

50

60

70

80

Angioplasty CoronaryAngiography

CT Large BowelResection

BypassSurgery

CataractSurgery

Hysterectomy TotalKnee

Mastectomy MRI TotalHip


Per

cen

t


7.5b Percentage difference in median wait times for selected procedures between lowest and highest neighbourhood income

quintiles in Ontario, 2004/05

7.5b Percentage difference in median wait times for selected procedures between lowest and highest neighbourhood income

quintiles in Ontario, 2004/05

-7

-4 -4 -4

0 0 0 0 0

12

-10

-5

0

5

10

15

Hysterectomy RadicalProstatectomy

Total Hip Large BowelResection

Angioplasty CataractSurgery

CoronaryAngiography

Mastectomy TotalKnee

BypassSurgery

Per

cen

t


7.6 Percentage difference in the age- and sex-adjusted rate of procedures between lowest and highest neighbourhood income quintiles in Ontario,

2003/04 vs. 2004/05

7.6 Percentage difference in the age- and sex-adjusted rate of procedures between lowest and highest neighbourhood income quintiles in Ontario,

2003/04 vs. 2004/05-1

0

-11 -9

4

-7

7

17

21

2

21

47

69

-10 -9

-4

3

6

11

21

27 27

33

51

70

-20

-10

0

10

20

30

40

50

60

70

80

Angioplasty CoronaryAngiography

CT Large BowelResection

BypassSurgery

CataractSurgery

Hysterectomy TotalKnee

Mastectomy MRI TotalHip


Per

cen

t

2003/04 2004/05


7.7a Comparison of median wait times (days) for cancer and cardiac procedures in Ontario, 2003/04 vs. 2004/05

7.7a Comparison of median wait times (days) for cancer and cardiac procedures in Ontario, 2003/04 vs. 2004/05


7.7b Comparison of median wait times (weeks) for cataract and joint replacement procedures in Ontario, 2003/04 vs. 2004/05

7.7b Comparison of median wait times (weeks) for cataract and joint replacement procedures in Ontario, 2003/04 vs. 2004/05

15

24

33

15

23

33

0

5

10

15

20

25

30

35

40

CataractSurgery

TotalHip

TotalKnee

Wai

t ti

me

(wee

ks)

2003/04 2004/05


7.8a Percentage of patients waiting longer than the Recommended Maximum Wait Time* for selected cancer surgeries,

2003/04 vs. 2005/05

7.8a Percentage of patients waiting longer than the Recommended Maximum Wait Time* for selected cancer surgeries,

2003/04 vs. 2005/05

2935

87

55

33 35

87

52

0

10

20

30

40

50

60

70

80

90

100

Large BowelResection

Mastectomy RadicalProstatectomy

Hysterectomy

Per

cen

t > 6

wee

ks

2003/04 2004/05

*It is recognized that Ontario has adopted a priority classification with four priority levels and associated wait time targets. However, the Recommended Maximum Wait Time of 6 weeks is being used to allow for comparison with the methods used in last year’s Atlas, which for cancer, define the wait time from the first surgical consultation to surgery. This translates into an additional two weeks being added to the Ontario wait time target of 4 weeks for priority level 3 patients. Therefore, this initial 2-week period is the time between initial consultation and decision to treat, while the 4 week period represents the time from decision to treat to surgery, for a total of 6 weeks.


7.8b Percentage of urgent patients waiting longer than the Recommended Maximum Wait Time for coronary angiography and longer than the

Ontario wait time target for bypass surgery, 2003/04 vs. 2005/05

7.8b Percentage of urgent patients waiting longer than the Recommended Maximum Wait Time for coronary angiography and longer than the

Ontario wait time target for bypass surgery, 2003/04 vs. 2005/05

35

3129 28

0

5

10

15

20

25

30

35

40

CoronaryAngiography

BypassSurgery

Pe

rce

nt

2003/04 2004/05


7.8c Percentage of urgent patients waiting longer than the Recommended Maximum Wait Time* for cataract surgery and longer than the Ontario

wait time target for joint replacement surgery, 2003/04 vs. 2004/05

7.8c Percentage of urgent patients waiting longer than the Recommended Maximum Wait Time* for cataract surgery and longer than the Ontario

wait time target for joint replacement surgery, 2003/04 vs. 2004/05

49 47

60

46 46

59

0

10

20

30

40

50

60

70

> 16 Week Wait for Cataract Surgery

> 26 Week Wait for Total Hip

> 26 Week Wait for Total Knee

Per

cen

t

2003/04 2004/05

*It is recognized that Ontario has adopted a priority classification with four priority levels and associated wait time targets. However, the Recommended Maximum Wait Time of 16 weeks is being used to allow for comparison with the methods used in last year’s Atlas and because existing administrative data do not distinguish patient priority levels.


7.9 Median wait times for selected procedures by age and gender in Ontario, 2004/05

7.9 Median wait times for selected procedures by age and gender in Ontario, 2004/05

Median Waits Among Men

Median WaitsAmong Women

Median Waits

Youngest Oldest Youngest OldestOverallWomen

OverallMen

Large bowel resection (days) 29 33 27 30 28 29

Mastectomy (days) n/a n/a 30 29 29 n/a

Radical prostatectomy (days) 93 n/a n/a n/a n/a 93

Hysterectomy (days) n/a n/a 43 44 43 n/a

Coronary angiography – Urgent (days) 1 2 1 2 2 1

Coronary angiography – Semi-urgent (days) 4 9 6 9 11 11

Coronary angiography – Elective (days) 15 19 20 19 20 21

Angioplasty – Referred from home (days) 13 16 18 17 18 16

Angioplasty – Referred from in-hospital (days) 0 1 1 1 1 1

Angioplasty – Overall (days) 1 3 1 3 3 3

Coronary bypass surgery – Urgent (days) 1 3 1 3 3 3

Coronary bypass surgery – Semi-urgent (days) 6 7 28 8 6 7

Coronary bypass surgery – Elective (days) 35 22 35 21 22 24

Cataract surgery (weeks) 12 15 13 16 15 14

Total hip replacement surgery (weeks) 29 19 26 16 22 25

Total knee replacement surgery (weeks) 37 32 37 28 32 33

Procedures


7.10 Summary of service rates per 100,000 population, by type of procedure and Local Health Integration Network, in Ontario, 2004/05

(Slide 1 of 2)


(Slide 1 of 2)

Local Health

Integration Network

Cancer Surgery Cardiac Procedures

Large

Bowel

Resection Mastectomy

Radical

Prostatectomy Hysterectomy

Coronary

Angiography Angioplasty

Coronary

Bypass

Surgery

1. Erie St. Clair 113 115 110 57 504 138 82

2. South West 114 125 148 69 412 124 77

3. Waterloo Wellington 100 85 131 69 411 139 75

4. Hamilton Niagara Haldimand Brant

120 89 92 77 593 198 96

5. Central West 91 89 92 77 593 198 96

6. Mississauga Oakville 115 68 92 63 547 172 74

7. Toronto Central 90 70 78 58 495 160 58

8. Central 104 73 94 59 530 174 74

9. Central East 102 89 129 55 584 174 83

10. South East 110 79 65 47 733 277 67

11. Champlain 106 109 70 68 478 221 67

12. North Simcoe Muskoka 114 92 119 67 754 276 82

13. North East 134 132 92 67 754 276 82

14. North West 108 80 92 33 803 162 103

All Ontario 109 90 102 63 556 185 83

LHIN highest rate/LHIN lowest rate

1.5 2.9 2.3 2.4 2.0 2.2 1.9



(Slide 2 of 2)


(Slide 2 of 2)

Local Health

Integration Network

Cataract

Treatment

Total Joint

Replacement

Diagnostic

Scans

Surgery Total Hip Total Knee CT MRI

1. Erie St. Clair 1,417 124 180 9,223 1,530

2. South West 1,271 154 193 8,376 1,670

3. Waterloo Wellington 1,020 110 151 8,251 1,586

4. Hamilton Niagara Haldimand Brant 1,152 126 181 8,100 2,461

5. Central West 919 77 167 8,662 1,766

6. Mississauga Oakville 1,121 111 154 9,154 2,288

7. Toronto Central 901 92 96 9,637 2,546

8. Central 1,133 103 135 9,945 2,142

9. Central East 1,264 106 175 10,102 2,063

10. South East 1,261 153 209 9,586 1,708

11. Champlain 1,368 108 152 10,293 1,770

12. North Simcoe Muskoka 1,276 129 179 12,156 1,826

13. North East 1,368 120 186 8,896 2,300

14. North West 1,193 123 203 8,662 2,481

All Ontario 1,185 115 162 9,354 2,047

LHIN highest rate/ LHIN lowest rate

1.6 2.0 2.2 1.5 1.7


7.11 Summary of median wait times for services, by type of procedure and Local Health Integration Network, in Ontario, 2004/05

(Slide 1 of 3)


(Slide 1 of 3)

Local Health

Integration Network

Cancer Surgery

Median Wait Time (Days)

Large Bowel

Resection Mastectomy

Radical

Prostatectomy Hysterectomy

1. Erie St. Clair 27 25 102 47

2. South West 31 23 98 49

3. Waterloo Wellington 36 38 90 47

4. Hamilton Niagara Haldimand Brant 28 29 88 42

5. Central West 31 39 99 62

6. Mississauga Oakville 30 30 95 36

7. Toronto Central 22 35 85 48

8. Central 26 37 95 48

9. Central East 29 27 89 48

10. South East 36 27 113 46

11. Champlain 23 27 114 35

12. North Simcoe Muskoka 32 29 76 46

13. North East 33 34 90 42

14. North West 37 41 93 29

All Ontario 29 29 93 43



(Slide 2 of 3)


(Slide 2 of 3)

Local Health

Integration Network

Cardiac ProceduresMedian Wait Time (Days)

Coronary Angiography Angioplasty Coronary Bypass Surgery

Urgent Semi-urgent Elective Overall Urgent Semi-urgent Elective

1. Erie St. Clair 3 15 27 7 4 8 23

2. South West 2 11 21 2 4 8 27

3. Waterloo Wellington 1 12 30 1 3 7 37

4. Hamilton Niagara Haldimand Brant 2 22 30 3 3 9 37

5. Central West 1 14 23 2 3 7 24

6. Mississauga Oakville 2 14 27 2 3 8 29

7. Toronto Central 1 4 10 2 2 6 20

8. Central 1 7 13 3 2 6 22

9. Central East 2 9 24 2 4 6 20

10. South East 2 9 24 2 4 6 15

11. Champlain 2 33 61 4 1 5 21

12. North Simcoe Muskoka 2 7 14 3 3 6 23

13. North East 1 14 22 3 2 4 22

14. North West 2 14 38 7 6 7 33

All Ontario 1 11 21 3 3 7 24



(Slide 3 of 3)


(Slide 3 of 3)

Local Health Integration Network

Cataract Surgery

Median Wait Time (Weeks)

Total Joint Replacement

Median Wait Time (Weeks)

Total Hip Total Knee

1. Erie St. Clair 9 16 27

2. South West 19 27 40

3. Waterloo Wellington 20 23 32

4. Hamilton Niagara Haldimand Brant 16 22 36

5. Central West 15 23 30

6. Mississauga Oakville 14 22 27

7. Toronto Central 16 22 31

8. Central 16 22 28

9. Central East 13 20 23

10. South East 13 26 34

11. Champlain 15 36 43

12. North Simcoe Muskoka 10 25 33

13. North East 15 27 45

14. North West 14 22 46

All Ontario 15 23 33


7.12 Summary of percentage of patients receiving procedures within the Ontario wait time targets, 2004/05

(Slide 1 of 3)


(Slide 1 of 3)


Cancer Surgery% Completed within Recommended Maximum Wait Time of Six Weeks*

Large Bowel Resection Mastectomy

Radical Prostatectomy Hysterectomy

1. Erie St. Clair 67 75 16 47

2. South West 63 75 10 43

3. Waterloo Wellington 63 54 11 45

4. Hamilton Niagara Haldimand Brant 66 65 17 49

5. Central West 61 51 11 27

6. Mississauga Oakville 66 60 13 56

7. Toronto Central 75 55 16 45

8. Central 74 55 15 41

9. Central East 69 67 10 41

10. South East 63 75 4 45

11. Champlain 74 70 2 64

12. North Simcoe Muskoka 64 61 23 48

13. North East 64 63 23 50

14. North West 53 53 5 86

All Ontario 67 65 13 48* Cancer surgery: It is recognized that Ontario has adopted a priority classification with four priority levels and associated wait time targets. Cancer Care Ontario’s Recommended Maximum Wait Time (RMWT) from consult to "decision to treat" is two weeks. The RMWT from “decision to treat” to surgery for Priority III patients is four weeks. Similar to last year's ICES Atlas, cancer surgery wait times in this report are defined as the wait time from surgical consultation to surgery. Therefore, the RMWT used here includes the initial two-week period between consultation and “decision to treat” plus the four-week period from “decision to treat” to surgery, for a total of six weeks.



(Slide 2 of 3)


(Slide 2 of 3)

Cardiac Procedures

Coronary Angiography* % completed within RMWT of:

Coronary Bypass Surgery % completed within Ontario wait time target of:


Urgent (0-7 days)

Semi-urgent(8-28 days)

Elective(≥29 days)

Urgent(2 weeks)

Semi-urgent(6 weeks)

Elective(26 weeks)

1. Erie St. Clair 61 41 59 67 81 79

2. South West 61 48 65 58 85 76

3. Waterloo Wellington 80 48 60 74 80 64

4. Hamilton Niagara Haldimand Brant 55 31 59 69 75 75

5. Central West 78 41 71 81 85 87

6. Mississauga Oakville 73 44 68 61 82 88

7. Toronto Central 87 67 87 80 83 91

8. Central 80 59 84 75 85 88

9. Central East 78 61 91 82 86 94

10. South East 69 51 61 73 92 99

11. Champlain 61 36 28 83 90 97

12. North Simcoe Muskoka 70 58 85 69 81 84

13. North East 78 42 65 69 81 90

14. North West 70 44 48 58 76 78

All Ontario 71 49 70 72 83 86

* Coronary angiography: As Ontario wait time targets have not been adopted for coronary angiography, the Cardiac Care Network of Ontario’s Urgency Rating System, which is well established in Ontario, has been used above. Recommended Maximum Wait Times are: Urgent = 0-7 days; Semi-Urgent = 8-28 days; Elective = ≥ 29 days.


7.12. Summary of percentage of patients receiving procedures within the Ontario wait time targets, 2004/05

(Slide 3 of 3)

7.12. Summary of percentage of patients receiving procedures within the Ontario wait time targets, 2004/05

(Slide 3 of 3)


Cataract Surgery * % Completed with RMWT of 16 weeks

Total Joint Replacement% Completed within Ontario wait time target of 26 weeks

Total Hip Total Knee

1. Erie St. Clair 74 70 49

2. South West 43 49 33

3. Waterloo Wellington 40 54 44

4. Hamilton Niagara Haldimand Brant 51 56 36

5. Central West 52 56 40

6. Mississauga Oakville 56 58 49

7. Toronto Central 50 55 44

8. Central 50 57 45

9. Central East 57 62 55

10. South East 57 51 38

11. Champlain 54 37 27

12. North Simcoe Muskoka 73 52 41

13. North East 53 48 29

14. North West 54 57 28

All Ontario 54 54 41

* Cataract surgery: It is recognized that Ontario has adopted a priority classification with four priority levels and associated wait time targets. However, the Recommended Maximum Wait Time of 16 weeks is being used to allow for comparison with findings in last year’s ICES Atlas and because existing administrative data do not distinguish patient priority levels.

Health & Medicine

Chapter 7 - Summary of Findings [564 KB]