International research sheds light on waiting times
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* Marcel Saulnier

*   © 2004 Canadian Medical Association or its licensors

About half of the countries in the Organization for Economic Cooperation and Development — including Canada — report having problems with waiting times for elective surgery, reports the OECD. A study by OECD staff members Jeremy Hurst and Luigi Siciliani examines the causes of variations in wait times across countries and determines which policies are most effective in addressing excessive waiting times.

Among the countries experiencing waiting time problems, the availability of doctors was the most significant factor. An increase of 0.1 practising physicians per 1000 population was linked to a reduction of median waiting times of 7.6 days across all procedures included in the study. Similarly, an increase of 0.1 specialists per 1000 population was associated with a reduction of 8.9 days in median waiting times.

The level of health expenditures was also found to be a significant explanatory factor, with each increase in total health expenditure per capita of $100 associated with a reduction of median waiting times of 6.1 days.

In the comparison between countries with and without waiting times, the authors found that low supply of acute care beds was a significant factor in explaining the presence of waiting times. They also found fee-for-service remuneration for specialists to be negatively associated with the presence of waiting times, and suggested that activity-based funding for hos pitals (payment on the basis of services provided and case mix, rather than global funding) may also help reduce waiting times. — *Marcel Saulnier*, Director, Policy Research, CMA 

View this table:
[Table1](http://www.cmaj.ca/content/170/10/1526.1/T1)

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