Quebec is the worst province for emergency room wait times: study

Quebec has the longest emergency room wait times, confirms a new MEI study that has compared emergency room wait times across Canadian provinces since 2020.

“The overall trend is that wait times are increasing across the country, and our healthcare systems are disintegrating,” said Emmanuelle B. Faubert, an economist at the Montreal Economic Institute (MEI) and author of the report.

She isn’t surprised by the study’s findings, since the data collected confirms the stories of patients who report waiting long hours in emergency rooms. “We hear about it. People wait a long time, people have difficulty accessing services. So, we knew it somewhat anecdotally, but these figures really prove that our perception is true,” she says.

Working with colleagues, Faubert assessed the total length of stay in the emergency department, which corresponds to the time a patient spends from arrival and registration to departure, whether they are discharged from the hospital or hospitalized.

Quebec ranks last, far behind the other provinces with a median wait time of 5 hours and 23 minutes. Ahead of La Belle Province are Prince Edward Island with a median wait time of 4 hours 36 minutes, New Brunswick with 4 hours 28 minutes, and British Columbia with 4 hours 13 minutes.

Montrealer Maria Mermolia knows all too well the meaning of the MEI’s stats, after dealing with issues more than once when consulting urgent care.

“I know that in the last maybe three years my daughter took me three times,” she said. “It wasn’t nothing major but still I went to the emergency only to get turned away. So yeah, it’s bad.”

In 2015, she wound up in an ER and waited there for 12 hours.

“I felt really really sick,” she said. “Even after 12 hours, they told me they still don’t know how much more I have to wait, so I actually walked out. Thank God nothing serious happened.”

Montrealer Danièle Mpinwa lived a similar experience.

“One time at the emergency, my partner was sick and we stayed there from 10 p.m. to 6 a.m. and we were not getting care,” she said. “And when he started to feel better, we just went home. So the government really has to find solutions to avoid this.”

Mermolia described a recent visit to a Toronto ER as “beautiful service, very fast” — after waiting about three hours.

First place goes to Newfoundland and Labrador, with a median stay of 2 hours 45 minutes. Alberta follows with 3 hours 48 minutes, and Ontario and Manitoba share third place with a median wait time of 4 hours. Data for Saskatchewan and Nova Scotia were not available for this indicator.

“We have to be careful with comparisons simply because the methods, measurements, and also the way data is recorded by different provinces can vary and be slightly different. That’s why the comparison must be taken with a grain of salt, but the fact remains that, data quality or not, Quebec remains fairly low in the rankings,” explains Faubert.

Wait times increasing yearly

Since 2020, data shows that Canadians are spending more and more time in emergency rooms.

In Quebec, this represents an increase of about one hour in five years. “It may not seem like a lot, but hundreds of thousands of people are going to the emergency room. So one hour out of hundreds of thousands of people is a lot of extra time spent in the emergency room,” comments Faubert.

She adds that urban centers, which have a high population density, are generally the places where wait times are the longest.

The study’s authors also analyzed the time taken to see a doctor initially, that is, the time elapsed between patient registration or triage and the initial assessment by a physician or nurse practitioner.

In Quebec, the median wait time to see a doctor in the emergency room is 1 hour and 51 minutes, which is similar to most provinces that provided this data. Prince Edward Island stands out with a median wait time of 2 hours and 58 minutes.

The median is the midpoint, meaning that 50 per cent of patients will wait less time and 50 per cent will wait longer. The median is therefore more representative of the typical case, and therefore, of the experience a patient will have when presenting to the emergency room, explains Faubert. The average could be influenced by extreme cases.

Montreal’s Royal Victoria Hospital with longest wait time

The Pavillon Albert-Prévost’s mental health emergency room in Montreal’s St-Laurent has the longest visits in Quebec, with a median length of stay of 13 hours and 5 minutes last year.

In the number two and number three spots, respectively, are the Royal Victoria Hospital (10 hours and 33 minutes) and the Centre hospitalier Anna-Laberge (10 hours and 26 minutes).

According to data from Index Santé, the average length of stay of people in the waiting room at the Royal Vic on Monday was 7 hours and 54 minutes.

“The Royal Vic, for instance, in terms of traditional ERs, so not mental health hospitals, has the worst performance in the province,” says Renaud Brossard, the VP of communications for the MEI.

The McGill University Health Centre (MUHC) overseeing the Royal Victoria Hospital tells CityNews in a statement that wait times there involve a number of factors including receiving ambulances from other parts of the island and even off-island, an increase in ER visits in the last year — without funding for inpatient beds, and the occupation of beds by those awaiting home care.

“We recognize the ongoing challenges affecting emergency departments across Quebec, including at the MUHC, and we are aware that this has an impact on our patients and their families, as well as our staff and physicians, who are working tirelessly to provide the best care in this difficult context,” said a spokesperson.

The MUHC says they have put in place a number of initiatives to improve coordination mechanisms and the trajectory of patients in our emergency departments, to reduce the average length of stay, and to offer other options than the emergency department, “such as the development of new outpatient services enabling rapid referral of patients to the emergency department, but these are limited in impact given the beds occupied by patients awaiting discharge to long-term care and rehabilitation centres.”

Centres for minor emergencies

Faubert tries to remain optimistic about the future. “Let’s hope that through reforms, we’ll find ways to change things,” she says. The economist is encouraged by the bills that granted more powers to certain health professionals, such as nurses and pharmacists.

“It’s an excellent idea because many people are showing up at the emergency room due to a lack of access to primary care. People who need prescription renewals, people who have something minor, but because they can’t get an appointment with a family doctor, [they’re] forced to go to the emergency room,” says Faubert.

To continue improving the situation in Quebec, she believes the province should draw inspiration from immediate care medical centers, a recent model created by doctors in France. The idea would be for a patient with a minor condition to be able to go to these centers for faster treatment, thus relieving the pressure on emergency rooms for lower-priority cases.

Faubert gives the example of a person with a broken arm. “You can’t go to a doctor “I have family to help you, but if you go to the emergency room, you’ll wait all day, maybe all night. It’s a very long wait because it’s an emergency, but a relatively minor one. So these immediate care medical centers specialize in these minor emergencies, which means these patients, who are classified as P4 and P5 in Quebec, don’t need to go to the emergency room,” she explains.

If they are established in Quebec, she believes these centers should be private, independent of the public network, for greater flexibility in their management. Care should be reimbursed by the public insurance plan.

The Quebec government has a goal of reducing ER wait times to 90 minutes by improving access to clinics and family doctors.

“They should try to resolve the problem because there are people that go a lot more than I would go,” said Mermolia. “And they should really change something about the system because it’s terrible. There’s nowhere to turn to.”

-With files from The Canadian Press