Surgical volume increased by about 5 per cent between 2019-20 and 2023-24, but did not keep up with the 7-per-cent population growth and 10-per-cent rise in demand for people 65 and older, the CIHI analysis notes.Frank Gunn/The Canadian Press
Canadians are waiting longer for some surgeries, including for cancer and knee replacements, than they were before the pandemic, even as the number of procedures being performed has increased, according to a new report.
The Canadian Institute for Health Information (CIHI), in an analysis released on Thursday, said the country’s aging population, health work-force shortages and more medically complex patients are reasons for the delays. This is in addition to competition for limited hospital resources, such as operating rooms and beds.
Cheryl Chui, director of health system analytics at CIHI, said the findings show progress is being made in Canada’s surgical system after the COVID-19 pandemic delayed numerous surgeries. But there is still “room for improvement” in getting patients care in a timely manner, she said.
“Although the surgical backlog that was really caused at the height of the pandemic has been cleared, we’re still seeing ripple effects through health systems across Canada,” Ms. Chui said. “The capacity is not necessarily meeting the rising demand for these procedures.”
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Surgical volume in Canada increased by roughly 5 per cent to about 2.3 million in 2023-24 from 2.2 million in 2019-20. However, the CIHI analysis notes that the increase did not keep up with Canada’s 7-per-cent population growth and a 10-per-cent rise in surgical demand for people 65 and older.
Still, Ms. Chui said there is reason for “cautious optimism” as governments at all levels are trying to improve timely access to surgeries. The use of alternative care settings, such as private centres and short-stay units, and surgical wait-list monitoring and management to prioritize the most in-need patients, are some of the strategies being implemented, the report said.
Data in the report show that, in 2024, 68 per cent of patients across Canada who had hip surgery and 61 per cent who had knee surgery received replacements within the recommended six months. That is a decrease from 75 per cent and 70 per cent, respectively, in 2019.
Quebec, Newfoundland and Labrador and British Columbia recorded the biggest increases in median waiting times for both hip and knee replacements.
Median waiting times nationally for cancer surgeries also increased by between one and nine days in 2024 when compared with before the pandemic. Both colorectal and lung cancer surgeries had a national median waiting time increase of one day.
Prostate cancer surgery had the largest jump to 50 days in 2024 from 41 in 2019, followed by a five-day increase for breast cancer and four-day increase for bladder cancer surgeries nationally.
On a provincial level, Nova Scotia saw a substantial increase to 157 days in 2024 from 55 in 2019 for prostate cancer surgery. Alberta and New Brunswick both saw increases of 22 days, the data show.
Ms. Chui said different population sizes and needs, in addition to the number of specialists in a certain province, factor into varying waiting times across jurisdictions. Smaller regions, she added, are more sensitive to changes.
The CIHI report said factors associated with longer waiting times for cancer surgeries are similar to those affecting hip and knee replacements, such as shortages of specialists, but are also affected by other factors.
“Not all hospitals perform surgeries for all cancers; some cancer patients wait longer for repeat diagnostic imaging; and slower-growing cancers, such as prostate cancer, tend to have the longest surgical wait times,” it said.
Additionally, patients who received radiation therapy within 28 days and hip fracture repairs within 48 hours in 2024 were 94 per cent and 83 per cent, respectively. This is a three-percentage-point drop each compared to 2019.
Delays also increased for diagnostic imaging, magnetic resonance imaging (MRI) and computed tomography (CT) scans.
Waiting times for cataract surgeries, on the other hand, remained relatively stable with 69 per cent of patients being treated within the 16-week benchmark in 2024, compared with 70 per cent in 2019.
