Access to care Timely access to care Cost as a barrier to health care 1

Most older Canadians have a regular doctor of Canadians age 55 and older had 1 or more doctors they usually went to for their medical care. How does Canada compare (2014)? Older Canadians were more likely to have a regular doctor than younger Canadians. 85% of Canadians older than 12 had a regular doctor. Source Statistics Canada. Table —Health indicator profile, annual estimates, by age group and sex, Canada, provinces, territories, health regions (2013 boundaries) and peer groups, occasional. 96% 2

Older Canadians wait longest for primary care No improvement since 2007 Source The Commonwealth Fund, 2007 International Health Policy Survey in Seven Countries. waited for at least 2 days to see a doctor or a nurse the last time they were sick or needed medical attention. 53% How does Canada compare (2014)? 2007 of older Canadians waited at least 6 days or gave up (2014). 30% 53% 3

Canadians are least likely to get timely responses Proportion of older Canadians who wished to or were able to their doctors with a medical question, 2014 Proportion of older Canadians who always or often got an answer the same day when they called their regular doctor with a medical concern In 2012, 11% of family physicians offered patients the option to them about a medical question or concern. Source The Commonwealth Fund, 2012 Commonwealth Fund International Survey of Primary Care Doctors. 4

Canadians have fewer after-hours options for primary care Source The Commonwealth Fund, 2012 Commonwealth Fund International Survey of Primary Care Doctors. thought it was very or somewhat difficult to get medical care in the evenings and on weekends or holidays without going to the emergency department (ED). 51% Proportion of family physicians whose practice had an arrangement for after-hours care How does Canada compare (2014)? % 5

Lack of access to timely care has an impact on ED use How does Canada compare (2014)? In 2013–2014, 1 in 5 emergency visits in Canada was for a condition that could have been treated elsewhere, such as a doctor’s office. The most common conditions were upper respiratory infections (13%) and antibiotic therapy (13%). Source Canadian Institute for Health Information. Sources of Potentially Avoidable Emergency Department Visits. Ottawa, ON: CIHI; of older Canadians went to an ED for a condition that could have been treated by their regular doctor. 37% 6

Canadians wait longest for specialist care How does Canada compare (2014)?Specialist wait times, by year Sources The Commonwealth Fund, 2010 and 2013 Commonwealth Fund International Health Policy Survey. of older Canadians waited for at least 2 months to see a specialist; these waits had not improved over time. 25% 7

How do the provinces compare? Older Canadians (55+) whoB.C.Alta.Sask.Man.Ont.Que.N.B.N.S.P.E.I.N.L.Can.CMWF Avg. Waited for at least 2 days to see a doctor 50%55%57%54%50%58%54%55%53% 32% Said it was very or somewhat difficult to get medical care after hours 47%45%49%55%47%60%53%59%57%65%51%29% Went to the ED for a condition that could have been treated by their regular doctor 30%39%33%34%39%38%42%37%40%50%37%28% Waited for at least 2 months to see their specialist 24%28%32% 24%25%29%27%28%34%25%15% The timeliness of primary and specialist care was significantly below the international average for all Canadian provinces. Compared with the CMWF average Above averageSame as averageBelow average 8

In the past yearCanadaCMWF averageUnited States Did not see a doctor for a medical problem because of the cost Skipped a medical test, treatment or follow-up recommended by a doctor because of the cost Did not fill a prescription for medicine or skipped doses of medications because of the cost Did not see a dentist when needed to because of the cost Is cost a barrier to accessing care? 4% In Canada’s publicly funded health care system, most older Canadians accessed the medical care they needed without having to worry about costs. 5%15%5% 15%7%4%15% N/A Compared with the CMWF average Above averageSame as averageBelow averageNot applicable 9

Cost can be a barrier for prescription drugs How does Canada compare (2014)?Public share of total prescribed drug spending, 2012 or nearest year Notes * 2008 data. † 2011 data. Source OECD Health Statistics Did not fill a prescription for medicine or skipped doses because of the cost Canada was second to only the United States in the proportion of older people who did not fill a prescription because of costs. † † † 10

Drug costs affect a higher proportion of people age 55 to 65 Proportion by age Canadians age 55 to 64 did not fill their prescriptions or skipped their medications because of the cost. 1 in 10 10% 55– % Most Canadian provinces have public drug coverage programs for seniors age

Cost can be a barrier for dental care Only 4 jurisdictions (Alberta, Yukon, the Northwest Territories and Nunavut) have public oral health care services for seniors. Proportion who did not receive dental care by age, 2014 Source Canadian Academy of Health Sciences. Improving Access to Oral Health Care for Vulnerable People Living in Canada. Ottawa, ON: CAHS; of older Canadians did not receive the dental care they needed because of the cost. 15% 19% 55–64 12%

Public coverage of dental care is lower in Canada Share of public spending on outpatient dental care, 2012 or nearest year Source Organisation for Economic Co ‑ operation and Development. Health at a Glance 2013: OECD Indicators Probability of a dental visit, by income, 2009 Low incomeHigh income Notes † 2011 data. Source OECD Health Statistics % 79% † † † 13

How do the provinces compare? B.C.Alta.Sask.Man.Ont.Que.N.B.N.S.P.E.I.N.L.Can.CMWF Avg. Did not see a doctor for a medical problem because of doctor visit costs 4% 3% 4%3%5%3%5%4% 5% Skipped a medical test, treatment or follow-up recommended by a doctor because of diagnostic/ treatment costs 3%4%2%4%7%4%5% 4%6%5% Did not fill a prescription for medicine or skipped doses of medications because of prescription costs 8%6%2%7%8%7%12%7%8%7% 4% Compared with the CMWF average Above averageSame as averageBelow average 14 Results were generally comparable to the international average. Differences in public coverage and program design for drug plans may partly explain variation in results between provinces.