Clearing health care backlog caused by COVID-19 will require $1.3B in additional funding: CMA

TORONTO — Clearing the health care backlog of surgeries and scans delayed by the first wave of the COVID-19 pandemic will require more than a billion dollars in government funding, according to a new study.

The study, commissioned by the Canadian Medical Association (CMA), suggests that at least $1.3 billion in additional funding is needed to return wait times for six procedures to pre-pandemic levels.

The six procedures include coronary artery bypass grafting (CABG), cataract surgeries, hip replacements, knee replacements, MRI scans and CT scans.

As hospitals’ resources shifted in March towards preparing for COVID-19, many of these procedures were deemed non-essential and were cancelled to free up hospital capacity.

The report released on Monday quantifies the backlog resulting from the first wave of COVID-19 for these six procedures, which the CMA said together accounts for nearly 80 per cent of the diagnostic and surgical care provided in Canadian hospitals.

“My heart does ache for those patients. They’re in pain. The uncertainty of when this is going to happen has a great impact on them. Some of these patients are still in the workforce. It affects their productivity. It affects their families, their caregivers,” CMA President Dr. Ann Collins told CTV National News on Monday.

“This is a real patient-centred problem, and it needs to be addressed.”

Collins warned that the second wave of the pandemic may add to the backlog and noted that the $1.3 billion figure doesn’t take that into account. Nor does it factor in delays around primary care.

“Our point in releasing [the report] now is to start having this conversation,” she told CTV News Channel on Monday night.

The report considers the volume and cost of the backlog caused by COVID-19, and the financial investment needed to return to pre-pandemic wait times within one year. 

The report suggests that clearing the current backlog would require an additional 307,498 procedures to be performed over the next 12 months. This is a six per cent increase compared to what would have expected to be performed over the course of a year, according to the CMA.

The report suggests that clearing the current backlog would require an additional 307,498 procedures to be performed over the next 12 months. This is a six per cent increase compared to what would have expected to be performed over the course of a year, according to the CMA. Addressing the backlog will require additional staffing and time in operating rooms, Collins told CTV National News.

“You can’t clear a backlog up just using the resources that you have now,” Collins said. “We know that our health human resources are taxed to the max. This is a marathon that they’ve been undertaking now for many months.”

The study reports that wait times have increased by up to 33 days for a CT scan, 55 days for a hip replacement, and 65 days for a knee replacement, since the start of the pandemic.

People awaiting cataract surgeries may be another 75 days in limbo because of the backlog.

One of those people was Hennie Ross Palmer, who had been waiting for cataract surgery in her right eye since February of last year. The operation was originally scheduled for March in Ottawa, but was put on hold when the COVID-19 pandemic worsened that month. She’s also been told that she must wait a year and a half for an injection to stop her searing back pain. She has spinal stenosis and severe arthritis.

On a scale of one to 10, her back pain is an 11 or 12, she told CTV National News.

“It is a very faulty system. People talk about ‘Oh Canada, with its medical health system… it’s wonderful’ — it isn’t wonderful If you are sitting and waiting,” she said.

The waiting has been painful for patients of family physician Kamila Premji. The Ottawa doctor told CTV National News that she thinks even more than the $1.3 billion cited in the report will be required to address the backlog. One of her patients awaiting cataract surgery may be waiting two years. She has another patient who needs knee surgery but doesn’t even know when it will be.

“She’s in a terrible amount of pain and quite disabled as a result of this,” Premji said. “It was supposed to happen earlier this year. It got cancelled. Nothing has been rescheduled yet. Who knows how long a wait that could be. Before the pandemic it was already, usually, at least a year wait.” 

While many hoped hospitals would be able to quickly return to normal rates of performing procedures, the CMA says the recent uptick in COVID-19 cases and the continued implementation of virus restrictions will further limit hospitals’ capacity.

The CMA said enhanced cleaning measures, additional time for each procedure, and restrictions to the number of patients allowed in rooms further delay treatment and increase wait times for patients.

“If less procedures are able to be performed per day with the current resourcing, it will require additional funding to return the wait times back to normal levels,” the CMA said.

To address the backlog, the CMA recommends that the federal government create a one-time Health Care and Innovation Fund to help resume health care services, bolster public health capacity and expand primary care teams.

The study suggests that all provinces will require at least 15 per cent more funding over baseline costs to return the wait times for all six of these procedures to pre-pandemic levels.

While the amount of additional funding needed varies by province due to factors such as accumulated backlog, capacity and population size, the report found that the highest funding needed in dollar terms is in Ontario and Quebec because they have the largest populations.

However, the CMA noted that P.E.I. requires the largest percentage increase in funding while Manitoba and New Brunswick require the smallest relative increase in funding, given their capacity capabilities.

For each procedure, the additional funding required is estimated as follows:

  • CABG: $103.3M
  • Cataract: $357.4M
  • Hip replacement: $77.4M
  • Knee replacement: $101.2M
  • MRI scan: $377.0M
  • CT scan: $377.0M

The study says the cost estimates are based on an aggregation of the provincial estimates for each procedure.

The report noted that the estimates do not take into account the costs associated with acquiring additional PPE, additional cleaning measures, or any new virus-related guidelines that may further reduce capacity. Because these factors were not included in the report, the CMA acknowledges that the cost estimates may be even higher.

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