Inconsistencies in cardiac surgery wait time benchmarks, according to new study



    QUEBEC CITY, Oct. 24 /CNW Telbec/ - Health care wait time benchmarks in
Canada and around the world are not based on systematic reviews of clinical
evidence or patient outcome data, but rather on health care policies and
professional consensus, according to research presented today at the Canadian
Cardiovascular Congress 2007, co-hosted by the Heart and Stroke Foundation and
the Canadian Cardiovascular Society.
    Dr. Robert Gow, presenting on behalf of the research team, told heart
health professionals that despite reviewing the information available from
countries around the world, including Canada, the study was not able to find a
single example of a benchmark set by systematic review or conclusive clinical
evidence.
    "Most of the benchmarks seem to be set through the consensus of
professionals, which is a form of scientific approach," noted Dr. Tanya
Horsley, lead author of the Canadian Institutes of Health Research-funded
study. "Others mention the use of 'best evidence' but don't define what that
is."
    "The bottom line is that we don't have direct evidence on who to operate
on when," said Dr. Horsley.
    "Obviously part of the problem is that such evidence is difficult to
establish, given the ethical considerations of deliberately delaying treatment
for some individuals," noted Dr. Gow.
    "The CIHR Institute for Health Services and Policy Research is committed
to supporting research in the critical area of wait times," noted scientific
director Colleen M. Flood. "This study is part of a suite of research studies
designed to achieve evidence-informed wait time benchmarks in Canada."
    The study examined current cardiac wait time benchmarks for coronary
revascularization procedures (catheterization, percutaneous coronary
intervention (PCI) and coronary artery bypass graft surgery (CABG)).
    Demand for these and other cardiac services are expected to increase over
the next two decades. The Canadian Institute for Health Information (CIHI)
reported in 2006 that the number of angioplasty and bypass surgeries had a
combined increase of 51 per cent over five years between 1997-1998 and
2002-2003, amounting to almost 22,000 more surgeries over this period.
    "The good news is, internationally, Canada has had the best criteria for
wait times for cardiac surgery," said Dr. Blair O'Neil, chair of Canadian
Cardiovascular Society's Access to Care working group. "Generally, they have
been classified according to risk based upon review of the literature, but not
nearly as systematic as the review done by Dr. Horsley and her colleagues. The
Canadian Cardiovascular Society is trying to establish consistent pan-Canadian
wait times for surgery, as well as for all the other services and procedures a
patient may need for optimal health."
    Dr. Horsley and her colleagues were surprised at how difficult it was to
access information on how wait times are set, considering the health care
dollars and political capital at stake in setting, meeting and monitoring
benchmarks.
    "We scoured the published and unpublished literature from around the
world, and the only consistency was the inconsistency of information," said
Dr. Gow.

    Statements and conclusions of study authors are solely those of the study
authors and do not necessarily reflect Foundation policy or position. The
Heart and Stroke Foundation of Canada makes no representation or warranty as
to their accuracy or reliability.

    The Heart and Stroke Foundation (www.heartandstroke.ca), a
volunteer-based health charity, leads in eliminating heart disease and stroke
and reducing their impact through the advancement of research and its
application, the promotion of healthy living, and advocacy.




For further information:

For further information: or interviews: CCC 2007 MEDIA OFFICE, (418)
649-5215 (Oct 21-24); Marie-Christine Garon, Massy-Forget Public Relations,
(514) 842-2455 ext. 23, mcgaron@mfrp.com; Congress information and media
registration at www.cardiocongress.org; After October 24, 2007: Jane-Diane
Fraser, Heart and Stroke Foundation of Canada, (613) 569-4361 ext 273,
jfraser@hsf.ca


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