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Ontario Wait Times

About Wait Times Data

The province’s Wait Times Strategy has provided funding to individual hospitals to provide additional wait list surgeries, MRIs and CTs. A funding condition is that the hospitals must supply and verify their wait times information.

Hospitals submit their information electronically directly to either the Access to Care Portfolio, Cancer Care Ontario or the Cardiac Care Network. Cancer Care Ontario compiles the information for reporting on this website.

The information is the most current and accurate Ontario wait time information that is available. However, there are significant challenges in compiling and ensuring data accuracy and the Ministry of Health and Long-Term Care is working to resolve these.

Index



Definitions

What is being measured?

We measure the time from “decision to treat” to “treatment” :

What is being reported?

There are situations where there may be no available information for a given period of time (e.g., August-September). The wait time data tables identify these situations using the following abbreviations :

NA = Not Available: Note: Wait times for prostate and thyroid and endocrine cancers are not available prior to April 2006.

NC = Non-compliant:  A hospital that is required to report wait times data for this service but did not report by the deadline for publication on this website. Note:   Hospitals that did not submit any cancer data as required are listed as non-compliant only in the Cancer Surgery summary table.

NV = No, or low, volume:  A hospital that is required to report, either reported that they did not perform this service during the reporting period, or the reported number of cases did not meet the indicator threshold (the number of reported cases was less than 10 for quarterly data and less than 6 for monthly data).

NR = Not required to report:  The hospital provides this service but is not one of the hospitals that received funding to provide additional treatments this year. Therefore, it is not currently required to submit wait times information. Some hospitals that are not required to report their information do so anyway.

NS = No service information available:  No hospitals in a particular LHIN offered this service during the period.



Calculations

What is included?

Calculations include all the cases where the hospital completed the treatment (surgery or exam) during the reporting period.

How are wait times calculated?

Wait times are measured in days.

Wait time = "treatment" date minus "decision to treat" date.

The wait time is calculated for each patient who received treatment within the most current time period, for a particular service area and hospital. Using these individual wait times, there are three other calculations:  median wait time, average wait time and 90 per cent completed within.

Median wait time:   This is the point at which half the patients have had their treatment and the other half are still waiting. For example, if a median wait time is 26 days, this means that half of the patients waited less than 26 days and half waited more than 26 days.

The median is another way to show what a "typical" patient might have experienced in that time period. Unlike the average wait time, the median wait time is not affected by one or two very unusual cases (long or short). Therefore, it is more stable over time.

Average wait time:  This is the average (or mean) length of time a patient waited to have the treatment. A few very short or very long wait times may skew this wait time. The average wait time is calculated by dividing the total number of waiting days that a hospital reported, by the total number of treatments reported during the time period.


Average Wait Time =

total number of days waited

 

number of treatments

90 per cent completed within:  This is the point at which 90 per cent of the patients received their treatment and the other 10 per cent waited longer. For example, if a 90 per cent wait time is 58 days, this means that 90 per cent or 9 out of 10 of the patients waited less than 58 days, and the other 10 per cent waited more than 58 days.

Why There May Be a Significant Difference Between the Average Wait Time and the Median Wait Time

In some circumstances, there may be a significant difference between the median and average wait time for a specific treatment. This is because a few cases that are very long can dramatically skew the average wait time. This "skewing" effect gets bigger if the total number of cases being measured is relatively small. Using the median to measure wait times gets rid of this skewing and gives a better reflection of how long the "typical" patient will wait.



Data Sources

Hospitals and / or clinician offices electronically send their data for all service areas directly to the Wait Time Information System (WTIS), with the exception of cardiac procedures.

Adult Health Care Service Areas

Data Source

 

 

Cancer procedures

WTIS

Cardiac (heart) surgery

Cardiac Care Network

General surgery

WTIS

Gynaecologic (female reproductive system) surgery

WTIS

Neurosurgery (nervous system)

WTIS

Opthalmic (eye) surgery

WTIS

Oral (mouth) and maxillofacial (upper jaw and face) surgery and dentistry

WTIS

Orthopaedic (e.g., muscles, joints, ligaments, etc.) surgery

WTIS

Otolaryngic (ears, nose and throat) surgery

WTIS

Plastic and reconstructive surgery

WTIS

Thoracic (chest) surgery

WTIS

Urological (male and female urinary tract; male reproductive system) surgery

WTIS

Vascular (blood vessel) surgery

WTIS

MRI / CT exams

WTIS

 

Paediatric (Age 18 or Less) Health Care Service Areas

Data Source

Paediatric heart surgery

WTIS

Paediatric dental / oral maxillofacial surgery

WTIS

Paediatric general surgery

WTIS

Paediatric gynaecologic (female reproductive system)surgery

WTIS

Paediatric neurosurgery (nervous system)

WTIS

Paediatric ophthalmic (eye) surgery

WTIS

Paediatric orthopaedic (e.g., muscles, joints, ligaments, etc.) surgery

WTIS

Paediatric otolarynic (ear, nose, throat) surgery

WTIS

Paediatric plastic and reconstructive surgery

WTIS

Paediatric urologic (male and female urinary tract, male reproductive system) surgery

WTIS



Comprehensiveness

Contributing Facilities

The Ministry of Health and Long-Term Care's Wait Times Strategy has provided funding to hospitals to perform additional surgeries and exams. The hospitals that received this funding were selected based on a variety of factors. These included :

To receive this funding, the hospitals agreed to report their wait times for these services. There are other hospitals that provide these services. Currently, they are not required to report their wait times.

The Ontario hospitals that are reporting on this website provide most of the services for which there are wait times. The services with higher numbers are usually centralized at a few specialty centres (e.g., eye surgery). This makes it easier to collect wait time information for the procedures.

For other services, like diagnostic scans, almost all Ontario hospitals perform some. This makes it more difficult to collect comprehensive information.

Cancer Surgery Reporting

Since April 1, 2006, reports on :

Many cancer surgery procedures are the same as the procedures for benign (non-cancerous) conditions, and the same doctors perform both cancer surgery and non-cancer surgery. As a result, almost every hospital in Ontario performs at least a few cancer surgeries every year. However, the hospitals with smaller numbers of cancer procedures may not have a formal cancer program or specialize in cancer surgery. This makes it difficult to collect comprehensive information.

What Cases Are Excluded?

The wait time information does not include emergency cases (a situation where a patient arrives through a hospital’s ER and / or needs immediate treatment due to an imminently life-threatening condition), except for emergency cancer surgery.



Limitations

Small Volumes

The wait times show :

Note:  The smaller the number of cases reported, the more difficult it is to draw conclusions about what should be expected. For example :

Interpretation of Definitions

It is easy for hospitals to identify the date of treatment. However, it is often not as easy to identify the date of the decision to treat. This has a less standardized definition that is open to some interpretation. As the Wait Time Improvement Strategy continues, the Ministry of Health and Long-Term Care will continue to work with hospitals, Cancer Care Ontario and the Cardiac Care Network to refine these definitions to help hospitals and clinicians apply the definitions more precisely.

The following table summarizes the definitions used in each of the service areas for which wait times are reported :


Service Area

“Decision to Treat” Definition

Surgery

The date the surgeon decides that a surgical procedure is required and the patient agrees to undergo the procedure and to be placed on a waiting list

Cardiac

The date a cardiologist or cardiac surgeon accepts a patient for angiography, angioplasty or bypass surgery.

Waiting periods do not include time spent investigating heart disease before a patient is accepted for a procedure (e.g., the time it takes for a patient to have a heart catheterization procedure before being referred to a heart surgeon is not part of the waiting time shown for heart surgery).

MRI and CT Diagnostic Scans

The date the DI facility receives the request to book an MRI and/or CT scan for the patient, i.e. Order Received Date.

Multi-site Facilities

Many Ontario hospitals reporting information on this website have more than one physical location and they may perform procedures at one or more of their sites. The wait times may vary at different sites. This could be due to the populations they serve and the services they provide. These hospitals collect data for all of their sites. Currently, they report it at the overall hospital facility level.

Differences within Facilities

The information on this website shows the wait times for individual hospitals. However, there may be a variety of wait times within each hospital, depending on the individual surgeons.

Other Factors Affecting Wait Times

There are factors that affect wait times for a surgical procedure or diagnostic exam that do not relate to a hospital’s efficiency, to a particular doctor or the availability of resources. They include :

Right now, there is no way to capture all of these possible factors in the information that hospitals are reporting. However, the provincial Wait Time Information System will collect information about when patients are not available for treatment. Although these factors may have a significant effect on the wait time for an individual patient, overall wait times are still a good reflection of the current situation for a typical patient at that hospital.

Cancer Surgery

The intent of the data collection is to have the wait time for a patient undergoing an operation where cancer is a real possibility. In some cases, it is only after surgery that a negative result is known. Some reported wait time data for cancer surgery includes data for surgeries where there are benign or non-cancerous tumours.

The Ministry of Health and Long-Term Care is working with the surgical community to have more accurate reporting of surgical treatment data involving “intentional” and “patient unavailable” wait times either by :

MRI / CT Diagnostic Scans

A patient who has an existing condition may be pre-booked for a follow-up exam or a series of follow-up exams at a later date, resulting in apparently long wait times for those particular exams. Please note, as of January 1st, 2008 these cases are excluded from MRI and CT wait time data. For historical comparability, see MRI and CT wait times with these cases.

Cardiac Wait Times

The Cardiac Care Network collects cardiac wait time information. More information about the data collection methods and the data’s limitations is at http://www.ccn.on.ca.



Comparisons

Please note that the collection and analysis of wait time information on this site uses different methods than the information reported in the ICES (Institute for Clinical Evaluative Sciences) Access to Care report and in the Cancer Care Ontario Cancer System Quality Index. These sources of information cannot be directly compared because they include :

There is work underway to develop standard definitions for wait times across the country but care should be taken when comparing data between provinces.



Data Quality

Several activities ensure data accuracy and its compliance with established reporting guidelines for Wait Time Information System (WTIS) data :

The Ministry of Health and Long-Term Care provided a Data Quality Framework to Cancer Care Ontario’s Corporate Data Quality Improvement Team. This team uses the framework in its role as the lead for these activities. It also chairs the Access to Care Data Quality Working Group. For more information related to data quality and the working group, please contact the team via e-mail at CCODataQuality@cancercare.on.ca.

WTIS Data Quality Annual Report Highlights (Fiscal 2011-12) [PDF]

Hospital Specific Data Quality Notes [PDF]



Privacy of Information

 

For More Information

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