According to the 2016 Commonwealth Fund Survey, Canadians have the longest wait times among 11 countries in the emergency department and to see a family doctor or a specialist (1). There are a number of complex factors influencing this, both systemic and institutional in nature, and its consequences can be devastating to health outcomes of Canadians. Fortunately, there are number of things that can be done to mitigate the growing problem of wait times at the physician and healthcare system levels. A number of problems contributing to long wait times in emergency rooms have been identified. One of the largest problems is the lack of availability of acute-care beds. According to the Canadian Institute for Health Information (CIHI), there were …show more content…
Overall, delayed access to medical care in any setting (emergency departments, family doctors, and specialists) can increase mortality, prolong pain and suffering, strain personal relationships, decrease productivity at work, and cause mental anguish in patients and their families (9). A large study conducted by the Fraser Institute examining the effect of wait times on all-cause mortality in Canada found that a one week increase in wait time from referral by a general practitioner to receiving medically necessary elective treatment meant an increase of three female deaths per 100,000 people (9). When looking at specific conditions, waiting longer to receive medical care for conditions such as cancer or heart disease puts patients at risk of disease progression, which can prove fatal or lead to longer and more intensive treatments than when the problem was first identified. Delays in elective treatments such as knee replacements can mean decreased quality of life due to prolonged periods of pain and functional limitation (10), while delays in cataracts surgery means patients are at greater risk of falls, accidents, and further vision loss, and likely higher mortality (11). It is clear that high wait times can mean reduced quality of life and poorer outcomes for a variety of patients, and an emphasis on tackling this issue is of utmost …show more content…
Currently, Canada’s hospital funding model allocates funds based on past expenditures, but a budget model based on the volume of medical procedures could optimize limiting steps in workflow and thus be an effective way to reduce emergency room wait times (12). In relation to this, using analytical techniques from other fields such as industrial engineering could allow hospitals to analyse patient flow and identify specific inefficiencies in the system. Resources and staffing could then be optimized based on this to improve wait times. Increased government funding towards expanding long-term care centers, nursing homes, and home visits should be considered to offload patients from hospitals and thus free up beds. In order to prevent unnecessary visits to the emergency department, methods of electronic communication such as email should be established between patients and their physicians to allow patients to contact their physician and help differentiate between urgent and non-urgent problems before visiting the emergency department. Physicians should also be open to referring to non-physician services such as occupational therapists and nurse practitioners where appropriate to offload some work from physicians. In fact, the CIHI report notes that Canadians underuse these services and rely on physicians to provide care more than any other country (1). To reduce specialist wait times,
Monitoring staff levels is an important factor. Also leveling the flow of patients in and out institutions could help to reduce wide fluctuations in occupancy rates and prevent surges in patient visits that lead to overcrowding, poor handoffs, and delays in care. Studies show that overcrowding in areas such as the emergency rooms lead to adverse outcomes, because physicians and nurses having less time to focus on individual patients. One study found that for each additional patient with heart failure, pneumonia, or myocardial infarction assigned to a nurse, the odds of readmission increased between 6 percent and 9 percent (Hostetter and Klein, 2013). All of which costs the hospital money.
The challenges that all acute care hospitals and facilities faces are the demand for highly specialized services has increased. The US population is constantly aging and the elderly tend to need more acute care services. Because many people lack health insurance, they tend to use emergency rooms in the hospitals as their source of care. The increase demand in acute care prompted hospitals to expand their facility
In the 1990s the government made the decision to cut back on physician production because it though that it had enough physicians (Dauphinee, 2005). This lead to the greatest net loss of Canadian physicians to other countries, primarily the united states (Dauphinee, 2005). It was approximated that 508 physicians left in 1996 (Dauphinee, 2005).
In the U.S and other nations of the world, the health expenditure and number of physicians increase as the economy expands. However, physician shortage is of a great concern globally, which the U.S and the Military Healthcare System (MHS) are no exceptions. According to Garber (2004) “a shortage exit when there is unsatisfied demand, which occurs when the quantity of a good or service is less than what people will be willing to buy at the current price”. For example a long wait time to get an elective surgery done, or a long wait for a patient to get an appointment to see the doctor are evidence of physician shortage. Another definition of shortage is “having a projected supply of physicians that meet less than 80% of the forecasted demand or need, calculated at the estimated means (Scheffler, Liu, Kinfu, & Dal Poz, 2007). The World Health Organization report (2006) estimated that, 57 countries had absolute shortage of 2.3 million physicians. This shortage according to prior studies implied the lack of a sufficient number of health care professionals to deliver skilled health interventions such as child-birth.
There has been a shortage of physicians, lack of inpatient beds, problems with ambulatory services, as well as not having proper methods of dealing with patient overflow, all in the past 10 years (Cummings & francescutti, 2006, p.101). The area of concern that have been worse...
The major concern of clients that have made an Emergency Department visit is due to pain. In fact, according to Tanabe and Buschmann 70 percent of patients who go to the Emergency Departments are going due to pain. (Duignan & Dunn, 2008, p. 30). Olioganalgesia is a prevalent issue in emergency health care. In a study by Wilson and Pendleton in 1989 on 198 patients, 56% patients received no pain medicine while waiting in the emergency room; 69% had to wait more than one hour to receive pain medication, and 42 had to wait more than two hours. These patients that received analgesics, 32% received too little to meet their needs. Many factors seem to lead to this problem by it seems that the most widespread reason in the emergency department is the lack of time. There is much bias that contributes to inadequate treatment of pain. An evaluation of 321 clients showed 80% of the young clients received pain medicine received pain medicine while only 66% of the elderly patients received the same treatment. A study conducted by P...
In the past, Canada’s government-funded, universally accessible, health care system has been praised and admired both at home and abroad as one of the finest in the world. A great source of pride and comfort for many Canadians is that it is based on five fundamental principles. Principles that are a reflection of the values held by Canadian citizens since the formation of Medicare in 1966. These principles were reinforced in the Canada Health Act, (CHA), of 1984 and state that the Canadian system is universal, accessible, portable, comprehensive and non-profit.
The number of doctors that present in the United States of America directly affects the communities that these doctors serve and plays a large role in how the country and its citizens approach health care. The United States experienced a physician surplus in the 1980s, and was affected in several ways after this. However, many experts today have said that there is currently a shortage of physicians in the United States, or, at the very least, that there will be a shortage in the near future. The nation-wide statuses of a physician surplus or shortage have many implications, some of which are quite detrimental to society. However, there are certain remedies that can be implemented in order to attempt to rectify the problems, or alleviate some of their symptoms.
Health care has become an issue because of the shortage of doctors in Canada. Many of them are either going to the U.S.A. or going to other countries to practice in hospitals and clinics. The earning cap imposed by the government has forced doctors to work fewer hours than are necessary to serve the public. Many Canadians are without a doctor to help them with their needs, and emergency rooms are filled to capacity with no available beds for those who have to be admitted to the hospital. Waiting time for specialist and specialty tests has become so long that someone diagnosed with a major illness may die before they can be properly treated.
reimbursement determinations. As a result, the camaraderie among physicians has developed into a more aggressive approach to impede competition (Shi & Singh, 2012). Little information is shared with patients in regards to procedures or disease control. The subjects are forced to rely on the internet for enlightenment on the scope of their illnesses (Shi & Singh, 2012). Furthermore, the U.S. health care system fails to provide adequate knowledge on billing strategies for operations and other medical practices. The cost in a free system is based on supply and demand and is known in advance of hospital admission (Shi & Singh, 2012). The need for new technology is another characteristic that is of interest when considering the health care system. Technology is often v...
According to Mexican citizens, the health care system needs further reform to improve the efficiency, availability, and quality of medical services provided to the uninsured. A major source of inconvenience in medical provision is the long wait for treatment. Patients with scheduled appointments, as well as those in emergency situations often have to wait hours for care, and it is an accepted fact for those with Popular Health Insurance that a medical consultation in a hospital would likely engage the entire day.Additionally, both Ordoñez Ramírez and Mercadao Juárez agree that subsequent reforms must be made to change the focus of medical treatment towards serious diseases such as cancer and diabetes, as they are prevalent in Mexican society and especially in women and children, and IRC (chronic renal failure), which cause high hospitalization and mortality rates throughout Mexico.
In health delivery system, one common goal for all providers, doctors and administrators is to provide high quality health care services at low costs. But in the United States, health care spending has increased drastically, but outcomes are not efficient. In the recent study conducted by common wealth fund shows that United States health care spending is 50 percent more when compared to 13 top nations in the world. [1] This report also shows that despite of having high health care expenditure in the United States, the health care outcomes are worse when compared to other countries whose health expenditure is low. To address these problems and improve outcomes, patient safety and satisfaction, in the field of surgery the American
The healthcare system in Canada is funded largely by the federal government as determined by the constitution. However, the actual healthcare delivery and social services is left up to each province and territory. Each province has the power to pass legislation that governs the financing and delivery of healthcare services to Canadians residing in that province. This fact encourages all healthcare professionals who have a strong provincial association and want to advocate their position on healthcare to speak up, if they want something different. If a physician wants to start delivery of telemedicine to rural areas of the province, he or she can advocate their position and
Surgical procedure wait times in Canada are so long that Canadians are now resorting to travelling to India to receive hip replacements and cardiac surgeries (Eggerston, 2006) Historically wait times have burdened the healthcare system however, they are 95% longer now than in 1993 across Canada (Barua & Esmail, 2013). Ontario is adding to wait times by adding non-residents unjustly and making taxpayers wait or leave the country. MedSolution.com has provided 2500 Canadians information pertaining to medical services abroad (Eggerston, 2006). The RNAO has also requested information from the provincial government asking for data regarding medical tourism in Ontario (CBC News, 2014).
Commonly throughout most countries of the world, citizens of the society at large establish the system for Emergency Medical Services. In the case that the public is not willing or capable of summoning such a service, the country often finds other emergency services, businesses, or the government and authorities who act to employ a system. In other parts of the world, the emergency medical service additionally takes on the role of transporting patients from one medical facility to an alternative one. This occurs with some frequency because once a patient is analyzed and provided care at the immediate hospital; it may be more appropriate for a variety of reasons the patient needs to move to another facility. As one can see, the relat...