How long are Canadians waiting to access specialty care? Retrospective study from a primary care perspective.

OBJECTIVE:To calculate patient wait times for specialist care using data from primary care clinics across Canada. DESIGN:Retrospective chart audit. SETTING:Primary care clinics. PARTICIPANTS:A total of 22 primary care clinics across 7 provinces and 1 territory. MAIN OUTCOME MEASURES:Wait time 1, defined as the period between a patient's referral by a family physician to a specialist and the visit with said specialist. RESULTS:Overall, 2060 referrals initiated between January 2014 and December 2016 were included in the analysis. The median national wait time 1 was 78 days (interquartile range [IQR] of 34 to 175 days). The shortest waits were observed in Saskatchewan (51 days; IQR = 23 to 101 days) and British Columbia (59 days; IQR = 29 to 131 days), whereas the longest were in New Brunswick (105 days; IQR = 43 to 242 days) and Quebec (104 days; IQR = 36 to 239 days). Median wait time 1 varied substantially among different specialty groups, with the longest wait time for plastic surgery (159 days; IQR = 59 to 365 days) and the shortest for infectious diseases (14 days; IQR = 6 to 271 days). CONCLUSION:This is the first national examination of wait time 1 from the primary care perspective. It provides a picture of patient access to specialists across provinces and specialty groups. This research provides decision makers with important context for developing programs and policies aimed at addressing the largely ignored stage of the wait time continuum from the time of referral to eventual appointment time with the specialist.