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Many Islanders' hip, knee, cataract surgeries don't meet national wait time targets

CHARLOTTETOWN — Prince Edward Island's auditor general says many Islanders aren't receiving knee and cataract surgeries within wait times that meet national targets.
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Prince Edward Island's auditor general says many Islanders aren't receiving knee and cataract surgeries within wait times that meet national benchmarks. A sign for a hospital is shown in Montreal on Feb. 6, 2022. THE CANADIAN PRESS/Graham Hughes

CHARLOTTETOWN — Prince Edward Island's auditor general says many Islanders aren't receiving knee and cataract surgeries within wait times that meet national targets.

Darren Noonan's audit also says the province's health authority isn't using national methods of measuring wait times for hip, knee and cataract surgeries.

One key standard for measuring wait times is to calculate the median — the number of days in which half the patients have received surgery and half are still waiting. 

Noonan says P.E.I.'s median wait times rose about 35 per cent between 2013 and 2022 for hip, knee and cataract surgeries. 

However, the province doesn't publish these median figures, preferring instead to use averaging and other methods that don't conform with national standards.

Half the patients booked for cataract surgery from April 1, 2022, to Sept. 30, 2022, received one within 127 days — higher than the national target of 112 days, and the longest wait time for all jurisdictions except Newfoundland and Labrador.

The median wait time in P.E.I. for knee replacement surgery was 210 days, higher than the national median of 182 days, and the median wait time for knee surgeries was 164 days, lower than the national median of 182 days. 

"Patients waiting for these surgeries may experience vision impairment, pain disability and stiffness," the audit says. "This negatively impacts the patient's quality of life as they can be unable to conduct their normal day-to-day activities."

The Canadian Institute of Health Information calculates the national wait time targets for surgeries.

Noonan's audit says wait times for 60 per cent of cataract surgeries, representing 337 patients, were greater than the Canadian target of 112 days; meanwhile, 111 knee replacement patients, or 64 per cent of the total, missed the benchmark of 182 days. There were 39 hip replacement patients, or 47 per cent of the total, who waited longer for surgery than the 182-day benchmark.

The report criticized Health P.E.I. for calculating wait times by using the average instead of the median, which is preferred by the Canadian Institute of Health Information because it reduces the distorting impact of extreme cases of delay.

It also notes that the health authority calculates the start to wait times from the date a surgery is formally booked by the hospital, rather than the date a surgeon and patient decide surgery is the best option, which is the national norm. P.E.I.'s method, the report says, cut an average of seven days out of the province's wait time figures.

Noonan's report also finds no evidence that senior health executives during quarterly meetings discussed how to improve the wait times in the audit period from April 1, 2021, to June 30, 2022.

"There were no documented discussions on surgical wait times compared to targets, factors causing wait times to be higher than the targets, or proposing solutions to address wait time issues. We also found that no other group was assigned this responsibility during our audit scope period," the audit says.

It recommends that the health authority adopt national standards of measuring wait times and regularly discuss how to meet national targets.

This report by The Canadian Press was first published Dec. 12, 2023.

—By Michael Tutton in Halifax.

The Canadian Press

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