Canadians still waiting longer for surgeries than before COVID

The massive surgical backlogs left after rolling pandemic lockdowns are clearing but Canadians are still waiting longer than they were pre-COVID for new hips and knees, cancer surgeries and other “priority” procedures, new data show. Even though 26 per cent more hip and knee replacements were done in 2024 than 2019, it still wasn’t enough to meet the need: just 68 per cent of Canadians received a hip replacement within the 26-week benchmark last year, compared to 75 per cent in 2019. For those needing a knee replacement, 61 per cent got a slot in the operating room within the 182-day threshold, compared with 70 per cent in 2019, even though 21 per cent more knee replacements were performed in 2024 than in 2019. Median wait times for breast, bladder, colorectal, lung and prostate cancer surgery also rose, with prostate cancer seeing the biggest bump in wait times, an extra nine days over 2019. Wait times for scans to diagnose diseases and injuries also increased, “with MRI scans requiring an additional 15 days and CTS scans three more days compared with 2019,” the Canadian Institute for Health Information (CIHI) reported in a background release. Canadians waited a median 57 days for an MRI scan in 2024. One in 10 waited 198 days. The longer people wait, the more they deteriorate. Delays getting to an operating room “can lead to disease progression, increased symptoms of anxiety and depression, risk of mental health flareups and worsening of surgical and nonsurgical patient outcomes,” Canadian researchers have warned. Hospitals across the country pushed back non-urgent surgeries during the early waves of COVID to free up beds. Almost 600,000 fewer operations were performed in the first 22 months of the pandemic alone compared to 2019, CIHI reported. The backlog has meant that by the time people see a surgeon, their problem is more complex than it would have been in the past, Dr. James Howard, chief of orthopedic surgery at University Hospital – London Health Sciences Centre said in the news release. Canada’s aging baby boomer generation, with arthritis and other joint conditions, is also putting pressure on the system. “So even with surgeons collectively working as much as they can and completing more surgeries than we have in the past, we are not seeing wait times come down due to the complexity and volume of patients presenting to orthopedic surgeons,” Howard said. While case numbers are bouncing back — five per cent more surgeries of all types were performed in 2023 than in 2019 — the volumes still haven’t kept up with population growth (seven per cent over the same period) or the 10 per cent rise in demand for surgery among those 65 and older, CIHI reported. “Although an increase in the volume of procedures performed across Canada means that the surgical backlog from the height of the pandemic period has effectively been cleared, ripple effects in the health systems — due in part to the pandemic — persist that impact wait times in Canada,” CIHI’s Cheryl Chui, director of health system analytics, said in a statement. Factors driving those longer wait times include a shortage of specialists and nurses, limited operating room time, space and staff, and emergency cases that take priority over scheduled ones. Ontario and other provinces are trying to push through more surgeries and procedures, partly by doing more on an outpatient basis, meaning no overnight hospital stay. Ontario has also announced plans to expand the number of private clinics providing publicly covered hip and knee replacements. Other provinces have done the same, though “the impact on surgical volumes and wait times is still being assessed,” CIHI said. According to the agency’s latest waitlist snapshot, while the number of hip replacements increased from 22,000 in 2019, to 28,000 in 2024, and the number of knee replacements from 35,000 to 42,000 over the same period, a smaller proportion of people received joint replacement surgery within the recommended six months. Nationally, in 2024, only 68 per cent of people needing a new hip were treated within the 26-week benchmark, compared to 75 per cent in 2019. Ontario fared better than all other provinces: 82 per cent of hip replacement patients were treated within that timeframe. Newfoundland and Labrador (41 per cent) and Prince Edward Island (45 per cent) performed the worst. British Columbia (63 per cent), Saskatchewan (50 per cent), Manitoba (54 per cent) and Quebec (49 per cent) also scored below the proportion nationally. In Alberta, 73 per cent of hip replacements were performed within the benchmark in 2024. Overall, patients waited a median 125 days for hip surgery in 2024 (half waited less, half waited more). One in 10 waited 340 days. For knee replacements, 79 per cent of patients in Ontario received surgery within the 26-week benchmark in 2024, compared to 38 per cent in Quebec, 47 per cent in Saskatchewan, 55 per cent in B.C. and 62 per cent in Alberta. While efforts are being made to better manage and monitor surgical waitlists, researchers have warned that people with severe pain or worsening symptoms aren’t being prioritized. Wait times for cataract surgery were close to pre-pandemic levels — 69 per cent of people were treated within a 16-week benchmark in 2024 versus 70 per cent in 2019. The percentage of people who received radiation therapy within 28 days and surgery to repair a fractured hip within 48 hours dropped slightly, by three percentage points from 2019 to 2024, falling to 94 per cent and 83 per cent, respectively. The volume of prostate cancer surgeries performed dropped by three per cent, from 3,500 in 2019, to 3,400 in 2024. And men waited longer for the procedure — from a median 41 days in 2019, to 50 days in 2024. Slower-growing cancers like prostate cancer tend to have the longest surgical wait times, CIHI reported. Median wait times for breast cancer surgery increased from 18 days in 2019 to 23 days in 2024, and wait times for bladder cancer increased from 24 days to 28 days. National Post

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