What are wait times to see a specialist? An EMR based analysis of 16115 referrals in South-western Ontario to ascertain equity

Objective: Reducing wait times has become a key goal of Canadian health planners and policymakers. Using clinical data from the electronic medical records (EMRs) of 25 family physicians across South-western Ontario, we present data on wait times to see a specialist. This is the first study in Canada that presents such extensive data on specialist wait times, and to assess equity in these waits.

Study design: Cross-sectional analysis of EMR derived database containing de-identified data for 33,544 patients, and 305,824 encounters from the period October 2005 to March 2008; data were linked by postal code to census data to obtain socio-demographic characteristics. Wait time was calculated as the difference between the specialist appointment date and the date of family physician referral.

Results: The mean wait was 74 days, with female patients having a slightly longer mean wait than males (76 vs. 73 days), and younger patients having the shortest mean wait. Differences were noted among practices, with a range of 56 days (Practice 9) to 93 days (Practice 7). By specialty, the longest waits were for gastroenterology (129 days) and orthopaedics (125 days), with the shortest being for referrals to paediatricians (39 days). The waits were equitable with respect to socio-economic status.

Conclusion: This is the first study to present data on actual specialist wait times. Although waits were equitable, there exist significant variations between specialities and by practice. Future work should model the patient, physician and contextual level factors that determine specialist wait times.