WaitingYourTurnWaitTimesforHealthCareinCanada,2022ReportMackenzieMoirandBacchusBarua20222022???FraserInstituteWaitingYourTurnWaitTimesforHealthCareinCanada,2022ReportbyMackenzieMoirandBacchusBContentsExecutivesummary?/?iFindings?/?1Method?/?11ComparisonsofDatafromOtherSources?/?15Conclusion?/?18Selectedgraphs?/?19Selectedtables?/?33AppendixA:LinkstoWaitTimesDataPublished,byProvincialGovernmentAgencies?/?59AppendixB:PsychiatryWaitingListSurvey,2021Report?/?60AppendixC:TheFraserInstituteNationalWaitingListSurveyquestionnaire(2014)/?68AppendixD:TheFraserInstituteAnnualStudyofWaitTimesforHealthCareinCanada(2022)/?70References?/?71AbouttheAuthors? /? 73Acknowledgments? /? 74PublishingInformation? /? 75SupportingtheFraserInstitute? /? 76Purpose,Funding,andIndependence? /? 76AbouttheFraserInstitute? /? 77EditorialAdvisoryBoard? /? 78MoirandBarua???WaitingYourTurn:2022Report???iExecutivesummaryWaitingfortreatmenthasbecomeadefiningcharacteristicofCanadianhealthcare.Inordertodocumentthequeuesforvisitstospecialistsandfordiagnosticandsurgicalpro-ceduresinthecountry,theFraserInstitutehas—foralmostthreedecades—surveyedspe-cialistphysiciansacross12specialtiesand10provinces.ThiseditionofWaitingYourTurnindicatesthat,overall,waitingtimesformedicallynecessarytreatmenthaveincreasedsincelastyear.Specialistphysicianssurveyedreportamedianwaitingtimeof27.4weeksbetweenreferralfromageneralpractitionerandreceiptoftreatment—longerthanthewaitof25.6weeksreportedin2021.Thisyear’swaittimeisthelongestwaittimerecordedinthissurvey’shistoryandis195%longerthanin1993,whenitwasjust9.3weeks.Thereisagreatdealofvariationinthetotalwaitingtimefacedbypatientsacrosstheprov-inces.Ontarioreportstheshortesttotalwait—20.3weeks—whilePrinceEdwardIslandreportsthelongest—64.7weeks.Thereisalsoagreatdealofvariationamongspecialties.PatientswaitlongestbetweenaGPreferralandneurosurgicalprocedures(58.9weeks),whilethosewaitingforradiationtreatmentsbegintreatmentin3.9weeks.Thetotalwaittimethatpatientsfacecanbeexaminedintwoconsecutivesegments.1Fromreferralbyageneralpractitionertoconsultationwithaspecialist.Thewaitingtimeinthissegmentincreasedfrom11.1weeksin2021to12.6weeksin2022.Thiswaittimeis242%longerthanin1993,whenitwas3.7weeks.TheshortestwaitsforspecialistconsultationsareinOntario(10.1weeks)whilethelongestoccurinPrinceEdwardIsland(41.7weeks).2Fromtheconsultationwithaspecialisttothepointatwhichthepatientreceivestreatment.Thewaitingtimeinthissegmentincreasedfrom14.5weeksin2021to14.8weeksthisyear.Thiswaittimeis164%longerthanin1993whenitwas5.6weeks,and6.7weekslongerthanwhatphysiciansconsidertobeclinically“reasonable”(8.1weeks).Theshortestspecialist-to-treatmentwaitsarefoundinOntario(10.2weeks),whilethelongestareinManitoba(25.4weeks).ii???WaitingYourTurn:2022Report???MoirandBaruaItisestimatedthat,acrossthe10provinces,thetotalnumberofproceduresforwhichpeoplearewaitingin2022is1,228,047.Thismeansthat,assumingthateachpersonwaitsforonlyoneprocedure,3.2%ofCanadiansarewaitingfortreatmentin2022.Thepropor-tionofthepopulationwaitingfortreatmentvariesfromalowof2.44%inOntariotoahighof6.05%inNewfoundland&Labrador.Itisimportanttonotethatphysiciansreportthatonlyabout11.03%oftheirpatientsareonawaitinglistbecausetheyrequestedadelayorpostponement.Patientsalsoexperiencesignificantwaitingtimesforvariousdiagnostictechnologiesacrosstheprovinces.Thisyear,Canadianscouldexpecttowait5.4weeksforacomputedtomography(CT)scan,10.6weeksforamagneticresonanceimaging(MRI)scan,and4.9weeksforanultrasound.DatawerecollectedfromtheweekofJanuary10toSeptember15,2022,longerthantheperiodofcollectioninyearsprecedingtheCOVID-19pandemic.Despitetheextendedperiod,thisyear’sresponseratewas7.1%(alowerresponseratethaninpreviousyears).Asaresult,thefindingsinthisreportshouldbeinterpretedwithcaution.Researchhasrepeatedlyindicatedthatwaittimesformedicallynecessarytreatmentarenotbenigninconveniences.Waittimescan,anddo,haveseriousconsequencessuchasincreasedpain,suffering,andmentalanguish.Incertaininstances,theycanalsoresultinpoorermedicaloutcomes—transformingpotentiallyreversibleillnessesorinjuriesintochronic,irreversibleconditions,orevenpermanentdisabilities.Inmanyinstances,patientsmayalsohavetoforgotheirwageswhiletheywaitfortreatment,resultinginaneconomiccosttotheindividualsthemselvesandtheeconomyingeneral.Theresultsofthisyear’ssurveyindicatethatdespiteprovincialstrategiestoreducewaittimesandhighlevelsofhealthexpenditure,itisclearthatpatientsinCanadacontinuetowaittoolongtoreceivemedicallynecessaryBritishColumbiaMoirandBarua???WaitingYourTurn:2022Report???iiiMedianwaitfromreferralbyGPtotreatment,byprovince,1993and2022. . .....Alberta.Saskatchewan.......Manitoba......Ontario......Quebec......NewBrunswick..NovaScotia......PrinceEdwardIsland......Newfoundland&Labrador.....Canada......WeekswaitedGPtospecialistspecialisttotreatmentGPtospecialistspecialisttotreatmentSources:TheFraserInstitute’snationalwaitinglistsurvey,2022;WaitingYourTurn,1997.iv???WaitingYourTurn:2022Report???MoirandBaruaThispublicationhasfiveseriesofillustrationsandtabularmaterial.Charts,whichmaybegraphsortables,willbefoundinthemaintext,pp.1–18.Graphswillbefoundin“Selectedgraphs”,pp.19–32.Tableswillbefoundin“Selectedtables”,pp.33–57.AppendixB:PsychiatryWaitingListSurvey,2020Report,pp.60–67,hastablesandagraphlabeled“B1”andsoMoirandBarua???WaitingYourTurn:2022Report???1FindingsTotalwaittimesTheFraserInstitute’sthirty-firstannualwaitinglistsurveyfindsthatwaittimes[1]forsur-gicalandothertherapeutictreatmentsincreasedin2022(chart1;table2).Thetotalwait-ingtimebetweenreferralfromageneralpractitioneranddeliveryofmedicallyneces-saryelectivetreatmentbyaspecialist,averagedacrossall12specialtiesand10provincessurveyed,hasrisenfrom25.6weeksin2021to27.4in2022.Thisyear’swaittimeis195%longerthanin1993,whenitwasjust9.3weeks.Chart1:Medianwaitbyprovincein2022—weekswaitedfromreferralbyGPtotreatmentBritishColumbia...Alberta...Saskatchewan...Manitoba...Ontario...Quebec...NewBrunswick...NovaScotia...PrinceEdwardIsland...Newfoundland&Labrador...Canada...WeekswaitedWaitfromGPtospecialistWaitfromspecialisttotreatmentNote:Totalsmaynotequalthesumofsubtotalsasaresultofrounding.Source:TheFraserInstitute’snationalwaitinglistsurvey,2022.ForanexplanationofhowWaitingYourTurnmeasureswaittimes,seethe“Method”2???WaitingYourTurn:2022Report???MoirandBaruaOntarioreportstheshortesttotalwaitin2022(20.3weeks),followedbyBritishColumbia(25.8weeks)andQuebec(29.4weeks).PrinceEdwardIslandhasthelong-esttotalwaitat64.7weeks,followedbyNovaScotia(58.2weeks)andNewBrunswick(43.3weeks).WaittimebysegmentTotalwaittimecanbeexaminedintwoconsecutivesegments:fromreferralbyageneralpractitionertoconsultationwithaspecialist;fromtheconsultationwithaspecialisttopointatwhichpatientreceivestreatment.Theincreaseintotalwaitingtimefrom2021to2022istheresultofanincreaseinbothsegments.Thewaitingtimeinthefirstsegment—fromreferralbyageneralpractitionertoconsultationwithaspecialist—hasrisenfrom11.1weeksin2021to12.6weeksin2022.Thiswaittimeis242%longerthanin1993,whenitwas3.7weeks(graph1;graph2).Thewaitingtimetoseeaspecialistincreasedinsevenprovincessince2021,butdecreasedinAlberta,Saskatchewan,andQuebec(chart2).Theshortestwaitsforspecialistconsulta-tionsareinOntario(10.1weeks),Quebec(10.9weeks),andSaskatchewan(11.9weeks).ThelongestwaitsforspecialistconsultationsarefoundinPrinceEdwardIsland(41.7weeks),NovaScotia(37.3),andNewBrunswick(19.4weeks)(table3).Thewaitingtimeinthesecondsegment—fromconsultationwithaspecialisttothepointatwhichthepatientreceivestreatment—hasincreasedfrom14.5weeksin2021to14.8weeksin2022(chart3).Thisportionofwaitingis164%longerthanin1993whenitwas5.6weeks(graph3;graph4).WaitingtimesfromspecialistconsultationtotreatmenthaveincreasedinsevenprovincesbuthavedecreasedinBritishColumbia,andNovaScotia,whilestayingrelativelyunchangedinOntario(withadifferenceoflessthan0.1weeks).Theshortestspecialist-to-treatmentwaitsarefoundinOntario(10.2weeks),BritishColumbia(13.4weeks),andNewfoundland&Labrador(16.6weeks),whilethelongestareinManitoba(25.4weeks),NewBrunswick(23.9weeks),andPrinceEdwardIsland(23.0weeks)(table4).MoirandBarua???WaitingYourTurn:2022Report???3Chart2:Waitbyprovincein2021and2022—weekswaitedfromreferralbyGPtoappointmentwithspecialistBritishColumbia ..Alberta..Saskatchewan ..Manitoba..Ontario ..Quebec..NewBrunswick..NovaScotia..PrinceEdwardIsland..Newfoundland&Labrador..Canada..Weekswaited20212022Source:TheFraserInstitute’snationalwaitinglistsurvey,2021,2022.4???WaitingYourTurn:2022Report???MoirandBaruaChart3:Waitbyprovincein2021and2022—weekswaitedfromappointmentwithspecialisttotreatmentBritishColumbia ..Alberta..Saskatchewan ..Manitoba..Ontario..Quebec..NewBrunswick..NovaScotia..PrinceEdwardIsland..Newfoundland&Labrador..Canada..Weekswaited20212022Source:TheFraserInstitute’snationalwaitinglistsurvey,2021,2022.MoirandBarua???WaitingYourTurn:2022Report???5WaitingbyspecialtyAmongthevariousspecialties,theshortesttotalwaitsexistforradiationoncology(3.9weeks),medicaloncology(4.4weeks),andelectivecardiovascularsurgery(16.4weeks).Conversely,patientswaitlongestbetweenareferralbyaGPandneurosurgery(58.9weeks),plasticsurgery(58.1weeks),andorthopaedicsurgery(48.4weeks)(table2;chart4).Thelargestincreasesinwaitsbetween2021and2022havebeenforneurosur-gery(+25.8weeks),plasticsurgery(+24.1weeks),orthopaedicsurgery(+14.3weeks),andgynaecology(+8.1weeks).Suchincreasesarepartiallyoffsetbydecreasesinwaittimesforpatientsreceivingtreatmentinfieldslikeradiationoncology(?0.7weeks),andotolaryngology(?0.3weeks).Chart4:Medianwaitbyspecialtyin2022—weekswaitedfromreferralbyGPtotreatmentPlasticSurgery...Gynaecology...Ophthalmology...Otolaryngology...GeneralSurgery...Neurosurgery...OrthopaedicSurgery...Cardiovascular(Elec.)...Urology....InternalMedicine...RadiationOncology...MedicalOncology...WeightedMedian...WeekswaitedWaitfromGPtospecialistWaitfromspecialisttotreatmentNote:Totalsmaynotequalthesumofsubtotalsbecauseofrounding.Source:TheFraserInstitute’snationalwaitinglistsurvey,2022.6???WaitingYourTurn:2022Report???MoirandBaruaWhenwaitingtimeisbrokendownintoitstwocomponents,thereisalsovariationamongspecialties.Theshortestwaitsfromreferralbyageneralpractitionertoconsultationwithaspecialistareinradiationoncology(1.5weeks),medicaloncology(2.1weeks),andcardiovascularsurgery(6.0weeks).Thelongestwaitsareforneurosurgery(45.7weeks),plasticsurgery(23.8weeks),andophthalmology(16.3weeks)(table3).Forthesecondsegment—fromconsultationwithaspecialisttothepointatwhichthepatientreceivestreatment—patientswaittheshortestintervalsforurgentcardiovascularsurgery(2.0weeks),medicaloncology(2.3weeks),andradiationoncology(2.4weeks).Theywaitlongestforplasticsurgery(34.3weeks),orthopaedicsurgery(32.4weeks)andophthalmology(18.7weeks)(table4;chart5).Medianwaittimesforspecificprocedureswithinaspecialty,byprovince,areshownintables5A–5L.Comparisonbetweenclinically“reasonable”andactualwaitingtimesSpecialistsarealsosurveyedastowhattheyregardasclinically“reasonable”waitingtimesinthesecondsegmentcoveringthetimespentfromspecialistconsultationtodeliv-eryoftreatment.Outofthe109categories(somecomparisonswereprecludedbymis-singdata),actualwaitingtime(table4)exceedsreasonablewaitingtime(table8)in83%ofthecomparisons.Averagedacrossallspecialties,BritishColumbiaandPrinceEdwardIslandhavecomeclosesttomeetingthestandardof“reasonable”waittimes.However,theiractualsecond-segmentwaitsexceedthecorresponding“reasonable”valuesbysub-stantialpercentages,47%and60%,respectively(table10).Moreover,thesetwoprov-incesachievetheirperformancebydifferentmeans:the“reasonable”waittimeinPrinceEdwardIslandisthelongestinCanadaat14.3weeks,whilethe“reasonable”waittimeinBritishColumbia(9.1weeks)isclosertotheCanadianaverage(8.1).Thegreatestabso-lutedifferencebetweenthesetwovaluesacrossallprovincesforaspecialtyisinplasticsurgery,wheretheactualwaitingtimeis20.7weekslongerthanwhatisconsideredtobe“reasonable”byspecialists(chart6).[2]Medianreasonablewaittimesforspecificproced-ureswithinaspecialty,byprovince,areshownintables9A–9L.Thegreatestproportionaldifferenceforaspecialtyisalsoinplasticsurgery,wheretheactualwaitingtimeexceedsthecorrespondingreasonablevalueby151%.MoirandBarua???WaitingYourTurn:2022Report???7Chart5:Waitbyspecialtyin2021and2022—weekswaitedfromappointmentwithspecialisttotreatmentPlasticSurgery..Gynaecology..Ophthalmology..Otolaryngology..GeneralSurgery..Neurosurgery..OrthopaedicSurgery..CardiovascularSurg.(Urg.)..CardiovascularSurg.(Elect.)..Urology..InternalMedicine..RadiationOncology..MedicalOncology..WeightedMedian..Weekswaited20212022Source:TheFraserInstitute’snationalwaitinglistsurvey,2021,2022.8???WaitingYourTurn:2022Report???MoirandBaruaChart6:Medianactualwaitcomparedtomedianclinicallyreasonablewait,byspecialty,inCanadain2022—weekswaitedfromappointmentwithspecialisttotreatmentPlasticSurgery..Gynaecology..Ophthalmology..Otolaryngology..GeneralSurgery..Neurosurgery..OrthopaedicSurgery..CardiovascularSurg.(Urg.)..CardiovascularSurg.(Elect.)..Urology..InternalMedicine..RadiationOncology..MedicalOncology..WeightedMedian..WeekswaitedMedianactualwaitMedianclinicallyreasonablewaitSource:TheFraserInstitute’snationalwaitinglistsurvey,2022.MoirandBarua???WaitingYourTurn:2022Report???9WaitingfordiagnosticandtherapeutictechnologyPatientsalsoexperiencesignificantwaitingtimesforvariousdiagnostictechnologiesacrosstheprovinces.Thewaitforacomputedtomography(CT)scanhasincreasedto5.4weeksin2022from5.2weeksin2021.Saskatchewan,Ontario,andNewfoundland&LabradorhadtheshortestwaitforaCTscan(4.0weeks),whilethelongestwaitsoccurinNewBrunswick(8.0weeks).Thewaitforamagneticresonanceimaging(MRI)scanhasincreasedto10.6weeksin2022from10.2weeksin2021.PatientsinManitoba,Ontario,andNewfoundland&LabradorfacedtheshortestwaitforanMRI(8.0weeks),whileresidentsofPrinceEdwardIslandwaitlongest(20.0weeks).Finally,thewaitforanultrasoundincreasedin2022to4.9weeksfrom3.6weeksin2021.Saskatchewanhadtheshortestwaitforanultrasound(2.0weeks),whilePrinceEdwardIslandhadthelongest:24.0weeks(chart7).Chart7:Waitingfortechnology—weekswaitedtoreceiveselecteddiagnostictestsin2022,2021,and2020CT-ScanMRIUltrasound202220212020202220212020202220212020BritishColumbia6.86.06.012.012.012.08.05.06.0Alberta7.010.014.012.024.026.03.02.02.8Saskatchewan4.04.04.016.012.08.52.02.02.0Manitoba7.06.04.08.08.08.05.56.06.3Ontario4.04.04.08.06.08.03.02.02.0Quebec5.54.04.012.08.09.56.05.04.0NewBrunswick8.08.04.512.016.012.08.012.08.0NovaScotia7.05.54.018.017.512.08.06.04.0PrinceEdwardIsland6.08.04.020.021.314.024.016.017.0Newfoundland&Labrador4.04.03.08.08.04.54.06.04.5CanadaSource:TheFraserInstitute’snationalwaitinglistsurvey,2020,2021,2022.Note:LinkstowaittimesdatapublishedbyprovincialgovernmentagenciescanbefoundinAppendixA.10???WaitingYourTurn:2022Report???MoirandBaruaNumbersofproceduresforwhichpeoplearewaitingThisstudyestimatesthat,acrossthe10provinces,thetotalnumberofproceduresforwhichpeoplearewaitingin2022is1,228,047(table12;table14presentsthenumbersfortheprovincesonapopulation-adjustedbasis),adecreaseof14%fromtheestimated1,425,517proceduresin2021.Theestimatednumberofproceduresforwhichpeoplearewaitingdecreasedinsevenprovinces,BritishColumbia,Alberta,Saskatchewan,Ontario,Quebec,NewBrunswick,andNovaScotia.Thedecreaseinthenumberofpatientswait-ingfortreatmentshouldbeinterpretedwithcautionasitisbasedonboththeexpectedwaittimein2022aswellastherelavantnumberofproceduresperformedin2020/21(seeMethodformoredetails).Notably,thetotalnumberofproceduresperformedin2020/21includedinthisyear’sreportissignificantlylowerthanin2019/2020(usedinthepreviousyear’sreport).Assumingthateachpersonwaitsforonlyoneprocedure,3.2%ofCanadiansarewaitingfortreatmentin2022,whichvariesfromalowof2.44%ofthepopulationinOntariotoahighof6.05%inNewfoundland&Labrador.[3]Tables13A–13L(pp.49–52)showthenumberofproceduresforwhichpeoplearewaitingwithinaspe-cialty,byprovince.Thesenumbersshouldbeinterpretedwithcaution,especiallyforSaskatchewan.Asaresultofdiscus-sionswithprovincialauthoritiesin2002,countsof“thenumberofpatientswaitingforsurgery”havebeenreplacedwiththe“numberofproceduresforwhichpatientsarewaiting”.Theredonot,however,appeartobesignificantsystematicdifferencesbetweenthenumbersof“proceduresforwhichpeoplearewaiting”estimatedinthiseditionofWaitingYourTurnandcountsof“patientswaiting”reportedbyprovincialMoirandBarua???WaitingYourTurn:2022Report???11MethodThedataforthisissueofWaitingYourTurnwerecollectedbetweentheweekofJanuary10andSeptember15,2022.Surveyquestionnaires[4]weresenttopractitionersin12med-icalspecialties:plasticsurgery,gynaecology,ophthalmology,otolaryngology,generalsur-gery,neurosurgery,orthopaedicsurgery,cardiovascularsurgery,urology,internalmedi-cine,radiationoncology,andmedicaloncology.Thisyear,855responseswerereceived,foranoverallresponserateof7.1%(table1).Themajorfindingsfromthesurveyresponsesaresummarizedintable2totable15.Thisstudyreplicatesmethodsusedinpreviouseditionsbut,likethesurveysof2015to2021,thisyear’ssurveycontainsfewerquestionsthaninpreviousyears(2014andearlier).Bothversionsofthesurveyareincludedforcomparison(AppendixesC,D).Becausedatafromtheeliminatedquestionsweretreatedindependentlyofcalculatedmedians,thereisnoreasontobelievethattheirremovalwillhaveamaterialimpactontheresultscon-tainedinthiseditionofthereport.Aswithpreviouseditions,thisstudyisdesignedtoestimatethewaitformedicallynecessaryelectivetreatment.[5]Waitingtimeiscalculatedasthemedianofphysicianresponses.Themedianiscalculatedbyrankingspecialists’responsesineitherascendingordescendingorder,anddeterminingthemiddlevalue.[6]DeloitteToucheTohmatsuLimitedprovidedmailinglists,drawnfromtheCanadianMedicalAssociation’smembershiprolls.Unlikelistsofpastyears,thisyear’slistincludeddoctorswithmultiplespecialties,manyofwhichareoutsidethepurviewofthe12specialtiestheWaitingYourTurnques-tionnaireisdesignedfor.Inordertostayconsistentwithearliersurveys,weincludeonlydoctorsasso-ciatedexclusivelywiththe12specialtiesforwhichtheWaitingYourTurnquestionnaireisdesigned.Forinstanceswheredoctorsinthisyear’slistwereassociatedwithmorethanoneofthe12specialtiesincludedinoursurveydesign,theuniquespecialtytheywereassociatedwithpreviouslywasused.Specialistswereofferedachancetogaina$2,000cashprize(toberandomlyawarded)asaninduce-menttorespond.Physicianswerecontactedvialetter-mail,facsimile,andtelephone.Emergent,urgent,andelectivewaittimesaremeasuredforcardiovascularsurgery.Thespecialtiesofinternalmedicine,medicaloncology,neurosurgery,andradiationoncologyalsoincludenon-electivewaittimes.Foraneven-numberedgroupofrespondents,themedianistheaverageofthetwomiddle12???WaitingYourTurn:2022Report???MoirandBaruaTheprovincialweightedmedians,foreachspecialty,reportedinthelastlineoftables5A–5L,arecalculatedbymultiplyingthemedianwaitforeachprocedure(forexample,mammoplastyorneurolysisforplasticsurgery)byaweight—thefractionofallsurgerieswithinthatspecialtyconstitutedbythatprocedure.Thesumofthesemultipliedtermsformstheweightedmedianforthatprovinceandspecialty(ananalogousmethodisusedfortables9A–9L).Toobtaintheprovincialmedians(displayedinthelastrowoftables2,3,4,and8),the12specialtymediansareeachweightedbyaratio—thenumberofproceduresdoneinthatspecialtyintheprovince,dividedbythetotalnumberofproceduresdonebyspecialistsofalltypesintheprovince.Toobtainthenationalmedians(displayedinthelastcolumnoftables2,3,4,and8)weuseasimilarratio—thenumberofproceduresdoneinthatspe-cialtyintheprovince,dividedbythetotalnumberofproceduresdonebyspecialistsinthatspecialtyacrossallprovinces.Toestimatethenumberofproceduresforwhichpeoplearewaiting,thetotalannualnumberofproceduresisdividedby52(weeksperyear)andthenmultipliedbytheFraserInstitute’sestimateoftheactualprovincialaveragenumberofweekswaited.Thismeansthatawaitingperiodofonemonthimpliesthat,onaverage,patientsarewaitingone-twelfthofayearforsurgery.Therefore,thenextpersonaddedtothelistwouldfindone-twelfthofayear’spatientsaheadofhimorherinthequeue.Themainassumptionunder-lyingthisestimateisthatthenumberofsurgeriesperformedwillneitherincreasenordecreasewithintheyearinresponsetowaitinglists.Thenumberofnon-emergencyproceduresforwhichpeoplearewaitingthatwerenotincludedinthesurveyisalsocalculated,andislistedintable12asthe“residual”numberofproceduresforwhichpeoplearewaiting.Toestimatethisresidualnumber,thenumberofnon-emergencyoperationsnotcontainedinthesurveythataredoneineachprovinceannuallymustbeused.Thisresidualnumberofoperations(compiledfromtheCanadianInstituteforHealthInformation’sdata)isthendividedby52(weeks)andmultipliedbyeachprovince’sweightedmedianwaitingtimeforallspecialties.Thisstudy’sweightingofmediansandtheestimationofthenumberofproceduresforwhichpatientsarewaitingarebasedondatafromtheCanadianCancerSociety’sAdvisoryCommitteeonCancerStatistics(2022)aswellas,for2020/21,fromtheDischargeAbstractDatabase(DAD)(CIHI,2022a),theNationalAmbulatoryCareReportingSystem(NACRS)(CIHI,2022b),andtheHospitalMorbidityDatabase(HMDB)(CIHI,2022c)publishedbytheCanadianInstituteforHealthInformation(CIHI).ThereareaMoirandBarua???WaitingYourTurn:2022Report???13ofminorproblemsinmatchingtheCIHI’scategoriesofoperationstothosereportedintheFraserInstitute’ssurvey.Inafewinstances,anoperationsuchasrhinoplastyislistedundermorethanonespecialtyinWaitingYourTurn.Inthesecases,wedividethenumberofpatientsannuallyundergoingthistypeofoperationamongspecialtiesaccordingtotheproportionofspecialistsineachoftheoverlappingspecialties:forexample,ifplasticsur-geonsconstitute75%ofthegroupofspecialistsperformingrhinoplasties,thenthenum-berofrhinoplastiescountedunderplasticsurgeryisthetotalmultipliedby0.75.Asecondproblemisthat,insomecases,anoperationlistedintheWaitingYourTurnquestionnairehasnodirectmatchintheCIHItabulation.Anexampleisophthalmologicalsurgeryforglaucoma,whichisnotcategorizedseparatelyintheCIHIdischargeabstractdata.Inthesecases,wemakenoestimateofthenumberofpatientswaitingfortheseoperations.TheFraserInstitute’scardiovascularsurgeryquestionnaire,followingthetraditionalclas-sificationbywhichpatientsareprioritized,hasdistinguishedamongemergent,urgent,andelectivepatients.However,indiscussingthesituationwithphysiciansandhospitaladministrators,itbecameclearthattheseclassificationsarenotstandardizedacrossprov-inces.Decisionsastohowtogrouppatientswerethuslefttorespondingphysiciansandheartcentres.Directcomparisonsamongprovincesusingthesecategoriesshould,there-fore,bemadetentatively.Finally,thereareanumberofreasonsforreaderstoexercisecautionwhileinterpretingtheresultsofthis—andtheprevious—years’surveys.TheCOVID-19crisisledmanyprov-incestotakedrasticmeasuresbothtolimitthespreadofthevirusandtoensurescarcemedicalresourceswereavailableintheeventofasurgeincases.Oneofthesemeasureswasthecancellation—orpostponement—ofthousandsofelectivesurgeriesacrossanum-berofprovincesoverthepasttwoyear