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System Performance

These data show how Ontario’s kidney care system is progressing towards achieving the performance goals set in the Ontario Renal Plan 2015–2019. For more information, see the Methodology.

The figures here report on the following indicators.

Vascular Access Wait Times

We track vascular access wait times as a key performance indicator for Regional Renal Programs. People having dialysis need to receive timely vascular access surgeries as part of high-quality care. We report on the proportion of patients who have their surgery within the recommended timeframes for priority 2 and priority 3 patients. For definitions of the priority levels, view Vascular Access Wait Times.

Proportion of Patients on Home Dialysis

Increasing home dialysis helps improve the quality of life for individuals, as well as being more cost-effective for the healthcare system. That is why it is one of our major strategic priorities.

Proportion of Patients with Deferred Start

The evidence does not support a planned early dialysis start strategy. There is no association with better outcomes or health-related quality of life. When caring for people with end-stage kidney disease, a better strategy would be intent to defer the start of dialysis.

Figure 1

Data Source:
Wait Time Information System

Figure 2

Data Source:
Wait Time Information System

Figure 3

Data Source:
Ontario Renal Reporting System

Glossary:
HD - Hemodialysis
PD - Peritoneal dialysis

Figure 4

Data Source:
Ontario Renal Reporting System

Data Table for Figure 1

Proportion of Vascular Access Surgery for Dialysis Cases Completed within Target Wait Time - Priority 2 Cases, By Fiscal Year and Quarter, 2014/15 Q4 to 2017/18 Q3
Fiscal Period Target % Actual % Denominator (Number of Cases, Last 4 Quarters) Numerator (Number of Cases, Last 4 Quarters)
2014/15 Q4 n/a 48.6% 286 139
2015/16 Q1 n/a 51.6% 256 132
2015/16 Q2 n/a 54.8% 228 125
2015/16 Q3 n/a 55.4% 175 97
2015/16 Q4 n/a 66.0% 141 93
2016/17 Q1 75% 75.0% 108 81
2016/17 Q2 75% 74.7% 99 74
2016/17 Q3 75% 76.1% 92 70
2016/17 Q4 75% 73.5% 83 61
2017/18 Q1 75% 70.4% 98 69
2017/18 Q2 75% 74.4% 90 67
2017/18 Q3 75% 76.3% 93 71

Data Source:
Wait Time Information System

Data Table for Figure 2

Proportion of Vascular Access Surgery Cases Completed within Target Wait Time - Priority 3 Cases, By Fiscal Year and Quarter, 2014/15 Q4 to 2017/18 Q3
Fiscal Period Target % Actual % Denominator (Number of Cases, Last 4 Quarters) Numerator (Number of Cases, Last 4 Quarters)
2014/15 Q4 n/a 62.3% 1116 695
2015/16 Q1 n/a 62.5% 1153 721
2015/16 Q2 n/a 65.0% 1152 749
2015/16 Q3 n/a 69.4% 1136 788
2015/16 Q4 n/a 74.1% 1165 863
2016/17 Q1 80% 74.8% 1212 906
2016/17 Q2 80% 75.7% 1194 904
2016/17 Q3 80% 76.7% 1214 931
2016/17 Q4 80% 77.2% 1165 899
2017/18 Q1 80% 77.4% 1103 854
2017/18 Q2 80% 76.9% 1155 888
2017/18 Q3 80% 75.9% 1127 855

Data Source:
Wait Time Information System

Data Table for Figure 3

Proportion of Prevalent Chronic Dialysis Patients on A Home Dialysis Modality, By Fiscal Year and Quarter, 2014/15 Q4 to 2017/18 Q3
Fiscal Period Target % Actual % Denominator (Prevalent Chronic Dialysis Patients) Numerator Prevalent Chronic Dialysis Patients on PD Numerator Prevalent Chronic Dialysis Patients on Home HD
2014/15 Q4 n/a 24.1% 10836 2017 594
2015/16 Q1 28% 24.2% 10999 2053 604
2015/16 Q2 28% 24.4% 11006 2098 586
2015/16 Q3 28% 24.8% 11100 2153 602
2015/16 Q4 28% 25.5% 11179 2221 625
2016/17 Q1 28% 26.0% 11189 2263 641
2016/17 Q2 28% 25.8% 11284 2287 622
2016/17 Q3 28% 26.1% 11268 2305 636
2016/17 Q4 28% 26.1% 11316 2330 620
2017/18 Q1 28% 25.7% 11468 2339 613
2017/18 Q2 28% 25.9% 11563 2365 629
2017/18 Q3 28% 26.2% 11570 2412 622

Data Source:
Ontario Renal Reporting System

Glossary:
HD - Hemodialysis
PD - Peritoneal dialysis

Data Table for Figure 4

Proportion of Incident Chronic Dialysis Patients with Deferred Elective Dialysis Start, By Fiscal Year and Quarter, 2014/15 Q4 to 2017/18 Q2
Fiscal Period Target % Actual % Denominator (Number of Incident Chronic Dialysis Patients) Numerator
2014/15 Q4 n/a 68.4% 553 378
2015/16 Q1 n/a 66.9% 598 400
2015/16 Q2 n/a 69.9% 515 360
2015/16 Q3 n/a 70.4% 567 399
2015/16 Q4 n/a 67.0% 591 396
2016/17 Q1 n/a 69.4% 568 394
2016/17 Q2 75% 71.7% 540 387
2016/17 Q3 75% 70.2% 531 373
2016/17 Q4 75% 72.7% 598 435
2017/18 Q1 75% 71.1% 588 418
2017/18 Q2 75% 72.7% 557 405

Data Source:
Ontario Renal Reporting System

Figure 1: Proportion of Vascular Access Surgery for Dialysis Cases Completed within Target Wait Time - Priority 2 Cases, By Fiscal Year and Quarter, 2014/15 Q4 to 2017/18 Q3

Target for priority 2 cases: 14 days

Goal: 75% of priority 2 surgeries completed within target by the end of March 2019

The line graph shows the target and actual proportion of priority 2 vascular access surgery for dialysis cases completed within the recommended timeframe. The area graph shows the case volume. Both represent data in Ontario over time.

Overall, the proportion increased from 48.6% in Q4 of fiscal year 2014/15 to 76.3% in Q3 of fiscal year 2017/18. The number of cases has dropped from 286 in the first quarter reported to 93 in the most recent quarter. See data table for details.

Figure 2: Proportion of Vascular Access Surgery for Dialysis Cases Completed within Target Wait Time - Priority 3 Cases, By Fiscal Year and Quarter, 2014/15 Q4 to 2017/18 Q3

Target for priority 3 cases: 28 days

Goal: 80% of priority 3 cases completed within the recommended timeframe by the end of March 2019

The line graph shows the target and actual proportion of priority 3 vascular access surgery for dialysis cases completed within the recommended timeframe. The area graph shows the case volume. Both represent data in Ontario over time.

Overall, the proportion increased steadily over the period, from 62.3% in Q4 of fiscal year 2014/15 to 75.9% in Q3 of fiscal year 2017/18. The number of cases fluctuated from quarter to quarter, with a low of 1,103 in Q1 of fiscal year 2017/18 and a high of 1,214 in Q3 of fiscal year 2016/17. See data table for details.

Figure 3: Proportion of Prevalent Chronic Dialysis Patients on A Home Dialysis Modality, By Fiscal Year and Quarter, 2014/15 Q4 to 2017/18 Q3

Target: 28%

Goal: 28% home prevalence rate by the end of March 2019.

The line graph shows the target and actual proportion of patients receiving home dialysis. The area graph shows the denominator, which is patients on chronic dialysis. Both represent data in Ontario over time.

Overall, the proportion increased over the period, from 24.1% in Q4 of fiscal year 2014/15 to 26.2% in Q3 of fiscal year 2017/18. The number of patients also rose over that time, from 10,836 in the first quarter reported to 11,570 in the last quarter reported. See data table for details.

Figure 4: Proportion of Incident Chronic Dialysis Patients with Deferred Elective Dialysis Start, By Fiscal Year and Quarter, 2014/15 Q4 to 2017/18 Q2

Target: 75%

Goal: 75% deferred dialysis start rate by the end of March 2019

The line graph shows the target and actual proportion of patients with a deferred dialysis start. The area graph shows the denominator, which is patients starting chronic dialysis. Both represent data in Ontario over time.

The proportion fluctuated during the period reported, with an overall increase over time, starting at 68.4% in Q4 of fiscal year 2014/15 and ending at 72.7% in Q2 of fiscal year 2017/18. The number of patients also fluctuated over the period, starting at 553 in the first quarter reported, and ending at 557 in the last. See data table for details.