At the same time that wait times at VA hospitals have been in the news here in the U.S., a recent report has put healthcare queues in the news in Canada. Specifically, a recent report from the Fraser Institute (a research institute that I’ve seen described as “conservative” and “pro-free market“) concluded that 44,723 women in Canada died between 1993 and 2009 due to increased wait times–or 2.5% of all female deaths during that period. One week of delay was equated with 3 extra deaths per 100,000. That surprising result led to a good bit of coverage, which is how it came across my desk (thanks to a google news search). (See here, here, and here.) But I have to admit I am a little bit skeptical.
First, as I noted above, this report comes not from a peer-reviewed journal but from a private think tank. That doesn’t mean they don’t do good work, but without a respected journal giving the report its seal of approval, it is hard for me to know it is right. The report indicates that the Fraser Institute seeks its own peer review on all reports, which is certainly a good step, but somehow doesn’t give me the comfort that journal publication does. (And even then I wouldn’t necessarily be comfortable).
Second, the report shows zero increase in mortality for men. It’s odd to think the report could as easily be in the news for the fact that “wait times do not increase mortality (for men)” rather than for the fact that “wait times increase mortality (for women).” The study attempts to explain this result (at pages 34-35), but it is additional reason for skepticism.
A final note: While I am skeptical of the study, I cannot say I have reviewed it closely enough, or have the expertise, to assess its validity one way or the other. That’s why the lack of publication in a peer reviewed journal is so tough. Also, on a positive note, the study includes a nice summary of prior empirical research on the effect of wait times on mortality. If you’re curious to see what’s out there in light of recent events, it might be a good place to start.