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Alberta

Wait times down. Better EMS response times. Province releases results of 90 day Health Care Action Plan

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90-day HCAP update: Health care wait times dropping

Albertans are spending less time waiting for the medical care they need since the Health Care Action Plan (HCAP) was launched.

Alberta has the best front-line health care workers in the world, and Alberta’s government will work to have the right supports in place to ensure Albertans get the care they need when and where they need it. When Alberta’s HCAP was launched on Nov. 17, Alberta’s government identified four different areas on which it would work with Alberta Health Services to improve. After 90 days, Albertans are seeing improvements in all four areas.

“We are delivering on our promise to reduce wait times, add more front-line staff and keep Albertans updated on the progress we’re making. There is no one silver bullet to fixing our health care system, and change will take time. But positive change is happening, and Albertans are receiving better access to the level of care they need when and where they need it. We appointed Dr. John Cowell as official administrator to speed up improvements and make sure Albertans are getting high quality of care sooner and we are seeing some good, early results.”

Danielle Smith, Premier

Improving EMS response time

In an emergency, every minute counts and over the past three months, ambulances have been responding faster to emergency calls. Improved ambulance times means that Albertans are receiving the urgent care they need from highly skilled paramedics more quickly.

From November to the end of January, EMS response times for most urgent calls improved across the province in metro, urban, rural and remote areas. The decrease in EMS wait times across the province can be broken down to:

  • 17 minutes in metro and urban areas, down from 21.8 minutes
  • 19.2 minutes in communities with more than 3,000 residents, down from 21.5 minutes
  • 34.9 minutes in rural communities with fewer than 3,000 residents, down from 36 minutes
  • 57.5 minutes in remote communities, down from 63.9 minutes

In addition to improved EMS wait times, more ambulances have been available, meaning that red alerts, which indicate a lack of ambulance availability at a point in time, were substantially reduced in Edmonton and Calgary:

  • Edmonton has seen a 92 per cent reduction in the number of alerts issued in January 2023 compared with January 2022.
  • Calgary has seen a 60 per cent reduction over the same period.

The initiative to triage 911 calls to the most appropriate level of care has also played a role in ensuring paramedics are able to answer the most urgent calls. Since the program was launched in January, 1,600 callers with non-urgent conditions were transferred from 911 to Health Link registered nurses. Alberta’s government is pleased to see progress on its aim to reduce EMS wait times and will continue working to further decrease the amount of time an Albertan waits for an ambulance to arrive.

“The good news is wait times are trending in the right direction and Albertans are getting the care they need more quickly. More doctors, nurses and paramedics are available to help Albertans, and more help is on the way as Alberta continues to add front-line workers for ambulances, ERs and across the system.”

Jason Copping, Minister of Health

Reducing surgery wait times

Alberta’s government continues its work to reduce surgical wait times for Albertans. Part of a strong health care system is ensuring that Alberta patients are receiving their surgeries within clinically recommended times. Since November 2022, the number of patients waiting longer than the clinically recommended time has decreased by 9.4 per cent.

Alberta’s chartered surgical facilities are helping to reduce wait times and ensure Albertans are receiving the surgeries they need to improve their health and their quality of life. Nearly 7,000 more publicly funded surgeries were completed at chartered surgical facilities in January compared with November, a number that includes orthopedic and eye surgeries. As this work continues, AHS is focused on ensuring that those patients who have waited the longest for surgery are prioritized.

“I would like to thank our incredible front-line workers as well as our AHS leaders, who have worked extremely hard to identify and implement improvements to our health care system, with focus on our priority areas. We have emerged from an extremely challenging time, and I am optimistic that we will continue to see improvements that will benefit all Albertans whenever they need our care and support.”

Dr. John Cowell, official administrator, Alberta Health Services

Decreasing emergency room wait times and improving access to care

Alberta’s government is also encouraged to see that in January, more Albertans received care sooner when they visited emergency departments. Progress in lowering emergency department wait times has been seen in the two measures:

  • Wait time to see a doctor in an emergency department decreased by almost 10 per cent provincially since November.
  • Time spent in an emergency department for admitted patients has been reduced by about five per cent.

There is still work to be done to ensure Albertans have lower wait times in emergency rooms across the province, and Alberta’s government will continue to make policy and funding decisions to see those improvements. In January, the number of assessed patients waiting in the province’s top 14 hospitals for a continuing care space was 179, lower than the 218 patients in the 2018-2019 fiscal year, and also lower than the 253 patients waiting in November 2022. A number of changes have helped to spur progress on emergency department wait times from November to the end of January:

  • AHS opened 255 new acute care beds (non-intensive care unit) across the province.
  • More beds in continuing care facilities have been opened – freeing more hospital beds for urgent care: 55 new long-term care beds, 292 new designated supportive living beds and 38 new community addiction and mental health beds.
  • Additionally, 36 new transition beds for people discharged from ERs in Edmonton who are experiencing homelessness will be opened this year.

Empowering health care workers to deliver health care

Alberta continues to hire more health care workers to support key areas. AHS is adding 420 more positions in emergency rooms, acute care, EMS and community care, on top of the nearly 400 front-line and support staff hired since November. If passed, Budget 2023 would provide $158 million for a new Health Workforce Strategy to make sure the province has the medical professionals needed and to improve the work environment.

Alberta is making good progress on increasing the number of highly skilled doctors, nurses, paramedics, nurse practitioners and other health allied professionals in the province:

  • AHS added 800 registered nurses, licensed practical nurses and health care aides in 2022.
  • Since 2019, AHS has added 5,800 front-line staff, including 1,800 registered nurses and 300 paramedics.
  • AHS recruited 28 physicians to rural Alberta and added 278 more registered nurses, licensed practical nurses and health care aides since November.
  • EMS added 39 front-line staff, including paramedics and emergency communications officers, over the last three months.
  • 80 additional full-time paramedic positions are being recruited, and AHS is transitioning 70 current temporary full-time EMS positions to regular full-time.
  • AHS is currently hiring 114 full-time nursing staff for emergency department teams to speed up EMS transfers and free up paramedics to respond to more calls.

Alberta

Alberta takes big step towards shorter wait times and higher quality health care

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From the Fraser Institute

By Nadeem Esmail

On Monday, the Smith government announced that beginning next year it will change the way it funds surgeries in Alberta. This is a big step towards unlocking the ability of Alberta’s health-care system to provide more, better and faster services for the same or possibly fewer dollars.

To understand the significance of this change, you must understand the consequences of the current (and outdated) approach.

Currently, the Alberta government pays a lump sum of money to hospitals each year. Consequently, hospitals perceive patients as a drain on their budgets. From the hospital’s perspective, there’s little financial incentive to serve more patients, operate more efficiently and provide superior quality services.

Consider what would happen if your local grocery store received a giant bag of money each year to feed people. The number of items would quickly decline to whatever was most convenient for the store to provide. (Have a favourite cereal? Too bad.) Store hours would become less convenient for customers, alongside a general decline in overall service. This type of grocery store, like an Alberta hospital, is actually financially better off (that is, it saves money) if you go elsewhere.

The Smith government plans to flip this entire system on its head, to the benefit of patients and taxpayers. Instead of handing out bags of money each year to providers, the new system—known as “activity-based funding”—will pay health-care providers for each patient they treat, based on the patient’s particular condition and important factors that may add complexity or cost to their care.

This turns patients from a drain on budgets into a source of additional revenue. The result, as has been demonstrated in other universal health-care systems worldwide, is more services delivered using existing health-care infrastructure, lower wait times, improved quality of care, improved access to medical technologies, and less waste.

In other words, Albertans will receive far better value from their health-care system, which is currently among the most expensive in the world. And relief can’t come soon enough—for example, last year in Alberta the median wait time for orthopedic surgeries including hip and knee replacements was 66.8 weeks.

The naysayers argue this approach will undermine the province’s universal system and hurt patients. But by allowing a spectrum of providers to compete for the delivery of quality care, Alberta will follow the lead of other more successful universal health-care systems in countries such as Australia, Germany, the Netherlands and Switzerland and create greater accountability for hospitals and other health-care providers. Taxpayers will get a much better picture of what they’re paying for and how much they pay.

Again, Alberta is not exploring an untested policy. Almost every other developed country with universal health care uses some form of “activity-based funding” for hospital and surgical care. And remember, we already spend more on health care than our counterparts in nearly all of these countries yet endure longer wait times and poorer access to services generally, in part because of how we pay for surgical care.

While the devil is always in the details, and while it’s still possible for the Alberta government to get this wrong, Monday’s announcement is a big step in the right direction. A funding model that puts patients first will get Albertans more of the high-quality health care they already pay for in a timelier fashion. And provide to other provinces an example of bold health-care reform.

Nadeem Esmail

Senior Fellow, Fraser Institute
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Alberta

Alberta’s embrace of activity-based funding is great news for patients

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From the Montreal Economic Institute

Alberta’s move to fund acute care services through activity-based funding follows best practices internationally, points out an MEI researcher following an announcement made by Premier Danielle Smith earlier today.

“For too long, the way hospitals were funded in Alberta incentivized treating fewer patients, contributing to our long wait times,” explains Krystle Wittevrongel, director of research at the MEI. “International experience has shown that, with the proper funding models in place, health systems become more efficient to the benefit of patients.”

Currently, Alberta’s hospitals are financed under a system called “global budgeting.” This involves allocating a pre-set amount of funding to pay for a specific number of services based on previous years’ budgets.

Under the government’s newly proposed funding system, hospitals receive a fixed payment for each treatment delivered.

An Economic Note published by the MEI last year showed that Quebec’s gradual adoption of activity-based funding led to higher productivity and lower costs in the province’s health system.

Notably, the province observed that the per-procedure cost of MRIs fell by four per cent as the number of procedures performed increased by 22 per cent.

In the radiology and oncology sector, it observed productivity increases of 26 per cent while procedure costs decreased by seven per cent.

“Being able to perform more surgeries, at lower costs, and within shorter timelines is exactly what Alberta’s patients need, and Premier Smith understands that,” continued Mrs. Wittevrongel. “Today’s announcement is a good first step, and we look forward to seeing a successful roll-out once appropriate funding levels per procedure are set.”

The governments expects to roll-out this new funding model for select procedures starting in 2026.

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The MEI is an independent public policy think tank with offices in Montreal, Ottawa, and Calgary. Through its publications, media appearances, and advisory services to policymakers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship.

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