Waiting to see the specialist: patient and provider characteristics of wait times from primary to specialty care

Liisa Jaakkimainen,Jan Barnsley,Hong Lu,Erin Salkeld,Karen Tu,Richard Glazier

doi:10.1186/1471-2296-15-16

Abstract

BackgroundWait times are an important measure of access to various health care sectors and from a patient’s perspective include several stages in their care. While mechanisms to improve wait times from specialty care have been developed across Canada, little is known about wait times from primary to specialty care. Our objectives were to calculate the wait times from when a referral is made by a family physician (FP) to when a patient sees a specialist physician and examine patient and provider factors related to these wait times.MethodsOur study used the Electronic Medical Record Administrative data Linked Database (EMRALD) which is a linkage of FP electronic medical record (EMR) data to the Ontario, Canada administrative data. The EMR referral date was linked to the administrative physician claims date to calculate the wait times. Patient age, sex, socioeconomic status, comorbidity and FP continuity of care and physician age, sex, practice location, practice size and participation in a primary care delivery model were examined with respect to wait times.ResultsThe median waits from medical specialists ranged from 39 to 76 days and for surgical specialists from 33 days to 66 days. With a few exceptions, patient factors were not associated with wait times from primary care to specialty care. Similarly physician factors were not consistently associated with wait times, except for FP practice location and size.ConclusionsActual wait times for a referral from a FP to seeing a specialist physician are longer than those reported by physician surveys. Wait times from primary to specialty care need to be included in the calculation of surgical and diagnostic wait time benchmarks in Canada.

Highlights

Wait times are an important measure of access to various health care sectors and from a patient’s perspective include several stages in their care
There were 54 family physicians who participated in Electronic Medical Record Administrative data Linked Database (EMRALD) as of 2008
EMRALD family physician (FP) compared to all FPs in Ontario were younger, more likely to be female, a Canadian medical graduate and more likely to participate in a patient enrolment model

Summary

Introduction

Wait times are an important measure of access to various health care sectors and from a patient’s perspective include several stages in their care. Wait times in Canada have focused on the time from seeing a specialist physician to having either an investigation or procedure, with the goal of improving access for a select number of health services such as cataract surgeries, cancer surgeries, cardiac procedures, hip and knee replacements and CT and MRI testing [1,2,3,4]. A patient’s pathway of care includes access to primary care, the wait. There is little information about what patient or provider factors are associated with primary care wait times

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Conclusion