Equity in Canadian health care: does socioeconomic status affect waiting times for elective surgery?

• Published in: Canadian Medical Association journal (CMAJ) Vol. 168; no. 4; pp. 413 - 416
• Main Authors: Shortt, Samuel E D, Shaw, Ralph A
• Format: Journal Article
• Language: English
• Published: Canada CMA Impact, Inc 18.02.2003
• Subjects: Bioethics; Canada; Data Collection; Delivery of Health Care - economics; Delivery of Health Care - statistics & numerical data; Elective Surgical Procedures - economics; Elective Surgical Procedures - statistics & numerical data; Evaluation; Gynecologic Surgical Procedures - economics; Gynecologic Surgical Procedures - statistics & numerical data; Humans; Income - statistics & numerical data; Medical waiting lists; Social Class; Socioeconomic factors; Time Factors; Waiting Lists; Canada; Empirical Approach; Health Care and Public Health
• ISSN: 0820-3946; 1488-2329

Waiting times for surgical and other procedures are an important measure of how well the health care system responds to patient needs. In a universal health care system such as Canada's, it is important to determine if waiting times vary by socioeconomic status (SES). We compared waiting times for elective surgery of patients living in low and high socioeconomic areas. We reviewed the medical charts of all patients who underwent elective surgery at a Canadian academic health centre between 1992 and 1999. Using patient postal codes we assigned SES on the basis of 5 characteristics in the 1996 census data. We compared waiting times for surgery for people from regions in the lowest third (low SES group) with that for patients from regions in the upper third (high SES group). On average, patients in the high SES group waited 31.1 days and those in the low SES group waited 29.3 days. When differences in waiting times for 22 common procedures were examined between the groups, only the difference for prostatectomy was statistically significant: patients in the high SES group waited 4.4 fewer days than those in the low SES group. We found little evidence that residing in a region in which SES was in the lowest third was associated with longer waiting times for elective surgery.