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.

“There is no doubt that the impact of the pandemic will be felt for years to come. But for many Canadians, it could become a serious quality of life issue as they wait for their procedures,” CMA President Dr. Ann Collins said in a press release.

Collins warned that the second wave of the pandemic may add to the backlog.

“Clearing this growing backlog must be addressed promptly, recognizing that the resurgence of the pandemic may exacerbate the issue with other potential delays,” she said.

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. These estimates do not include the impact on primary care services, according to the report.

The report suggests that clearing the current backlog would require an additional 307,498 procedures to be performed over the next 12. 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 study reports that wait times have increased by up to 75 days for cataract surgeries and 33 days for a CT scan since the start of the pandemic. Wait times for hip replacements and knee replacements have gone up 55 and 65 days, respectively.

“Our analysis of the data shows that there was a considerable decline in volumes across all studied procedures, with cataract and knee replacement procedures dropping the most. A gradual restoration of capacity is underway, but considerable differences remain across procedure types,” the study said.

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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