----- exerpt from Monday, July 15th, StatCan Daily:
Internet site: http://www.statcan.ca/Daily/English/020715/td020715.htm

    Health Services Access Survey, 2001
        Almost one in five Canadians who accessed health care for
        themselves or a family member in 2001 encountered some form
        of difficulty, ranging from problems getting an appointment
        to lengthy waiting times, according to a new survey.
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Health Services Access Survey  2001

   Almost one in five Canadians who accessed health care for themselves or a
family member in 2001 encountered some form of difficulty, ranging from problems
getting an appointment to lengthy waiting times, according to a new survey.

   Access to two kinds of health care services were explored: first contact
services included routine care, health information and immediate care for a
minor health problem; specialized services included specialist visits,
non-emergency surgery and diagnostic tests.

   According to the Health Services Access Survey (HSAS), an
estimated 23.2 million Canadians, or about 94% of the total population
aged 15 and over, accessed first contact health care services in 2001.

   Of these, about 18%, or just under 4.3 million people, encountered a
difficulty of some kind. This proportion varied by time of day and type of
service. The type of difficulty varied by type of service but long waits and
problems contacting a health care provider topped the list.

   An estimated 6.1 million individuals accessed specialized services. Among
them, 23%, or about 1.4 million people, encountered some kind of difficulty.
Again, long waits topped the list.

   The proportion of individuals reporting that they waited less than one month
for specialized services ranged from 40% for non-emergency surgery to 55% for
diagnostic tests. Just over 5% waited 26 weeks (six months) or more for
specialist visits and diagnostic tests. For non-emergency surgery, close to 10%
reported waiting for 26 weeks and about 5% for 35 weeks or more.

   For non-emergency surgery, the waiting time varied by type of surgery.
Individuals who waited for cardiac- or cancer-related surgery were more likely
to receive services within one month (54%), compared with those who waited for a
joint replacement or cataract surgery (20%).

   More than 20% of those who waited for specialized services felt that the time
they waited was unacceptable. Those who said their waiting times were
unacceptable had waited significantly longer, in some cases up to six times as
long as those who said their waits were acceptable. They were also more likely
to report that waiting for care affected their lives (over 50%), compared with
those who felt that their waits were acceptable (5%).
______________________________________________________________________

Note to readers

   This release presents the first results from the Health Services Access
Survey, developed by Statistics Canada and partly funded by Health Canada and
three provincial governments - Prince Edward Island, Alberta and British Columbia.

   It gathered comprehensive and comparable information at the national level on
the patterns of use of health care services and self-reported difficulties faced
by Canadians aged 15 and over in accessing health care when they needed it.

   The survey was conducted as a supplement to the Canadian Community Health
Survey. Interviews were conducted in all 10 provinces in November and
December 2001. The total sample size for the survey was 14,210.
______________________________________________________________________

   The survey also indicates that most Canadians (88%) had a regular family
physician. Among them, most considered the quality of care received to be
excellent (53%) or good (39%). Among the 12% who do not have a regular family
physician, most (63%) indicated that it was because they had not tried to
contact one.

Access to first contact services: Difficulties vary by time of day

   The survey examined three types of first contact services: routine care,
health information or advice and immediate care for a minor health problem.

   During regular office hours, individuals who required such services were most
likely to contact their physician's office. During evenings and weekends,
walk-in clinics and emergency rooms were the first point of contact. During the
middle of the night, people went mainly to emergency rooms.

   Overall, 11% (2.5 million) of those who accessed routine care reported they
had difficulties, as did 13% (1.5 million) of those who accessed health
information or advice, and 19% (1.6 million) of those who needed immediate care
for a minor health problem. Difficulties were reported during all three time
periods and reflected reasons associated with the health care system as well as
personal reasons.

   During regular office hours, 42% of individuals who reported difficulties
accessing routine care did so because of problems getting an appointment, while
during evenings and weekends - a time when most accessed walk-in clinics - 47%
cited lengthy in-office waiting times.

   Close to 40% of those who had difficulties getting health information during
regular office hours or during evenings and weekends indicated that it was
because they did not get adequate information. In the middle of the night, a
time when most accessed or called emergency rooms, close to 60% cited that they
had to wait too long to speak to someone.

   About 38% of individuals who had difficulties getting immediate health care
for a minor health problem during regular office hours cited in-office waiting
times as the cause. This proportion increased to 57% during evening and
weekends, and 59% during the middle of the night, times when most accessed
walk-in clinics and emergency rooms.

Specialized services: Difficulties vary by type of service

   The HSAS examined three types of specialized services: specialist visits for
a new illness or condition, non-emergency surgery and diagnostic tests. Over the
past 12 months, almost one quarter of Canadians sought specialist care.

   An estimated 5.1 million individuals aged 15 or over visited a specialist for
a new illness or condition. About 1.2 million had non-emergency surgery and
almost 1.7 million had certain non-emergency diagnostic tests - MRIs, CT scans
or angiographies over a 12-month period.

   About 22% of those who visited a specialist reported difficulties obtaining
the service, as did 21% of those who had a non-emergency surgery and 18% of
those who had a diagnostic test.

   The majority of those who indicated that they had problems accessing
specialized services said it was because of long waits. This was the primary
reason given by 55% of those who had difficulties accessing non-emergency
surgery, 66% of those who had difficulties seeing a specialist, and 72% of those
who had difficulties accessing diagnostic tests. Other reasons cited included
problems getting an appointment and lengthy in-office waits.

Waiting times: Most access specialized services within a month

   More than half (55%) of individuals who had a diagnostic test received it
within a month. About 45% of individuals who had a specialist visit and
about 40% of people who had a non-emergency surgery waited less than a month.

   The picture changes when surgical procedures that are known, or suspected, to
have shorter waits are examined separately. For example, 54% of individuals
needing surgery related to cardiac or cancer problems got it within one month.
By contrast only 20% of joint-replacement or cataract surgery was provided
within a month.

   However, 35% of people having a joint-replacement or cataract surgery
problems waited more than three months, compared with less than 20% of those
having other types of non-emergency surgery.

Waiting for care: Many feel stress, anxiety and pain

   Of the estimated 5 million people who visited a specialist, roughly 18%,
or 900,000 people, reported that waiting for care affected their lives. The
majority of these people (59%) reported worry, anxiety or stress. About 37% said
they experienced pain.

   The situation was similar among individuals who said their lives were
affected by waiting for diagnostic tests, with 68% reporting increased levels of
worry, anxiety and stress. This may be because people waiting for specialist
visits and diagnostic tests often do not know the details of their health
problems and are waiting for a diagnosis.

   Over 20% of those who waited for specialized services felt the amount of time
was unacceptable. This ranged from 22% of people who waited for non-emergency
surgery to 27% of those who waited for specialist visits. At first glance, these
results may appear surprising, given that most individuals received care within
a month.

   However, the survey data shows that people who reported unacceptable waiting
times had waited up to six times longer than those who considered their wait
acceptable.

   For example, among people who visited a specialist, those who said their
waiting times were unacceptable had waited 13 weeks (median value), compared
with only two weeks among those who reported acceptable waiting times. For
non-emergency surgery, those who said their waits were unacceptable had also
waited 13 weeks, three times longer than those who reported acceptable waiting
times.

   More than 50% of those who reported that their waiting times were
unacceptable stated that waiting for care affected their lives. This compares
with only 5% among those who reported that their waits were acceptable.

   The report Access to health care services in Canada, 2001 (82-575-XIE, free)
is now available on Statistics Canada's  Web site (www.statcan.ca). From the Our
products and services page, choose Free publications, then Health.

   For information regarding access to the HSAS data, contact Mario Bédard
(613-951-8933; fax: 613-951-4198; [log in to unmask]).

   For more information, or to enquire about the concepts, methods or data
quality of this release, contact Jean-Marie Berthelot (613-951-3760; fax:
613-951-3959; [log in to unmask]) or Christian Houle (613-951-3767; fax:
613-951-3959; [log in to unmask]), Health Analysis and Measurement Group.

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