Cardiovascular Care in Ontario

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USE OF ADMINISTRATIVE DATA FOR MEASURING ACCESS
TO CAREJack V. Tu MD MSc PhD FRCPC FACP
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Background

• Ontario Wait Times Strategy
• Needed baseline information against
• which to measure improvements
• Why ICES?
• Independent / 3rd party
• Objective and credible
• Fact-based evidence to support decisions

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Areas of Focus

• CT/MRI scans
• Cataract surgery
• Cardiac Angiography
• Angioplasty
• Bypass surgery
• Hip and knee replacements
• Cancer Bowel resection
• Mastectomy
• Prostatectomy
• Hysterectomy

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Framework for AssessingAccess to Care
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Time Periods Examined

• Changes over a decade
• 1993/94 2003/04
• Changes in the past 3 years
• 2001/02 2003/04
• No real time data !

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Level of Reporting

• Rates
• By hospital corporation for cancer, cardiac and
  joints not cataract or CT/MRI
• By Local Health Integration Network (LHIN)
• Provincially
• Waits
• By LHIN
• Provincially

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Summary of Findings
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MRI SCANS
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CATARACT
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CANCER
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S E S
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Comparison of median wait time for selected
procedures,in Ontario, 2001/02 vs. 2003/04
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Comparison of median wait time for selected
procedures,in Ontario, 2001/02 vs. 2003/04
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Comparison of median wait time for selected
procedures,in Ontario, 2001/02 vs. 2003/04
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Comparison of median wait time for selected
procedures,in Ontario, 2001/02 vs. 2003/04
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Conclusions

• Administrative data can be used to measure many
  aspects of medical care (rates, waiting,
  small-area variations, outcomes)
• Less useful for appropriateness and clinical
  urgency
• Will provide a critical source of info for
  policymakers interested in evaluating the
  performance of their health care system