Nova Scotia continues to limp in last in hip, knee replacement wait times

Nova Scotia continues to limp in last in hip, knee replacement wait times

Nova Scotians needing hip or knee replacements still have the longest average wait of any patients in Canada's 10 provinces, despite millions of dollars in spending and an auditor general's report that made recommendations on how to monitor the backlog.

The Canadian Institute for Health Information released its annual wait-times report on Tuesday. It showed that Nova Scotia has improved over the last five years on wait times for five priority procedures — hip replacement, knee replacement, hip fracture repair, cataract surgery, and radiation therapy.

But in all five cases, the percentage of people receiving the procedure within what is considered the appropriate wait time was lower than the pan-Canadian average. In the case of hip and knee replacements, it was much lower.

Less than half of Nova Scotia patients received their knee replacement surgery within the benchmark.

Nova Scotia ranked dead last for hip and knee replacement, ninth for cataracts and radiation therapy and sixth for hip fracture repair. 

Bringing up the rear

"Across all of the priority procedures the waits are shorter than they were five years ago," said Kathleen Morris, a vice-president at the institute. "Despite that improvement, though, the waits are longer for hip and knee replacements than in other parts of the country."

The wait times for joint replacements were also broken down by region in the province — and it made a big difference where patients lived.

Rates were better in Nova Scotia Health Authority's Zone 3, which includes Guysborough, Antigonish, Richmond, Inverness, Victoria and Cape Breton counties. Eighty-three per cent of hip-replacement patients had their surgery within the benchmark, as did 74 per cent of knee-replacement patients.

Results were poorer in the northern Zone 2 (hip 51 per cent, knee 37 per cent) and the central Zone 4 (hip 53 per cent, knee 28 per cent).

The worst results were in the western Zone 1, which includes Yarmouth, Shelburne, Digby, Queens, Annapolis, Lunenburg and Kings counties. In that region, only 40 per cent of hip-replacement patients and 26 per cent of knee-replacement patients were treated within the benchmark.

AG has been critical

In February, Nova Scotia Auditor General Michael Pickup said the health authority had only completed two of the seven recommendations he made in 2014 to improve wait-time reporting for knee and hip surgeries. He criticized the health authority for failing to give citizens a clear target of how long they must await for the operations as well as a monitoring system to indicate how hospitals are performing.

About 90 per cent of Nova Scotia patients receive their hip replacement within 750 days and knee replacements within 800 days.

"Important recommendations, such as setting specific targets for short-term surgery wait times and publicly reporting against those targets, are not complete," he said in his report.

Nova Scotia invested $8.1 million in orthopedic surgeries in 2016.