Open Collections

Description

Wait times for many types of planned surgeries have increased beyond clinical recommendations in Canadian provinces in recent years. The causes of lengthening wait times are complex and there are no easy fixes, but provinces have increasingly turned to contracts with private surgical facilities. This commentary reviews key policy issues associated with provincial governments contracting for-profit surgical centres through the lens of the Quadruple Aim quality improvement framework, focused on population health outcomes (volume-quality relationship, corner-cutting); cost and value (marginal cost of increasing surgeries in public hospitals, risk selection or ‘cherry-picking’, ‘upselling’ of services); provider satisfaction (competition for skilled staff); and patient experience; and offers recommendations for policy makers.