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Access to Cardiac Specialists in a Socialized Medicine System.

The Canada Health Act stipulates that covered health services be available to all insured persons on uniform terms and conditions. Because of concern that access to cardiovascular services in Canada may not be based solely on medical factors, University of Toronto investigators sent out anonymous questionnaires to Ontario cardiologists, cardiac surgeons, hospital executives, family practitioners, and internists to determine their views on and experience with preferential access to care.

Over 90 percent of the cardiologists and cardiac surgeons and over 80 percent of the internists reported that they had personally been involved in the care of at least one patient who received preferential access to cardiac services based on nonmedical criteria. Common nonmedical reasons why patients received such access included personal connection to the treating physician, community standing of the patient (e.g., celebrities, politicians), patients' awareness of potential risks of delay, and practitioner's fear of potential litigation.

Comment: These results suggest that even within a system of universal socialized medicine, access to cardiac specialists is at least partly based on nonmedical criteria.

— MS Lauer

Published in Journal Watch Cardiology November 6, 1998

Citation(s):

Alter DA et al. A survey of provider experiences and perceptions of preferential access to cardiovascular care in Ontario, Canada. Ann Intern Med 1998 Oct 1 129 567-572.

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