What are wait times to see a specialist? an analysis of 26,942 referrals in southwestern Ontario.

BACKGROUND

Reducing wait times is a key goal of Canadian health planners and policy makers. Using data from the EMRs of 23 family physicians across southwestern Ontario, we present data on wait times to see a specialist, and evaluate these data for equity.

METHODS

Cross-sectional analysis of EMR database of 29,303 patients and 544,398 encounters from October 2005 to July 2010. Wait time was calculated as the difference between the specialist appointment date and the family physician's referral date. Multilevel regression analysis was used to assess equity in waiting times.

RESULTS

The median wait was 53 days, with female patients having a slightly longer wait than males (55 vs. 51 days), and younger patients (median = 45 days) having the shortest wait. Differences were noted among practices, with a range of 42-63 days. The longest waits were for neurosurgery (median = 103 days) and the shortest for paediatricians (median = 28 days). There was no correlation between wait times and income, but significant associations were noted for patient age, sex and referral urgency.

INTERPRETATION

This is the first study to present data on actual wait times for a broad array of specialists over a five-year period. There is variation among specialties and by practice, and further research is needed to understand reasons for these. From a policy perspective, there is equity in wait times in southwestern Ontario, as waits are not correlated with SES. Future work should model the patient-, physician- and contextual-level factors that determine specialist wait times.