Background: Long wait times for elective surgery represent a persistent challenge in healthcare systems and for waiting patients, particularly in Canada. Delays to elective surgery impact patient well-being but may also disproportionately affect vulnerable populations. Despite high levels of immigration to Canada, research regarding immigrants' access to elective surgical care remains scarce. This population-based study measures and compares wait times for common elective general surgeries for immigrants with non-immigrants in British Columbia (BC), Canada.

Methods: All elective general surgery procedures performed in BC, Canada, between 2013 and 2021, were identified using hospital discharge summaries' procedure codes. A longitudinal cohort was created by linking cohort members with immigration and physician billing data. Patients' wait time was defined as the duration between the last general surgery visit and the surgery date. Wait times were compared between immigrants and non-immigrants, adjusting for patient- and system-level factors using multivariable regression.

Results: Among 159,151 elective general surgeries, 14.3% were performed on immigrants. Immigrants experienced longer wait times on average compared with non-immigrants (83.7 vs 76.3 days), a difference that remained significant after adjustment (rate ratio [RR]: 1.03, 95% confidence interval [CI]: 1.01, 1.05). Differences were most pronounced for cholecystectomies; immigrants waited 15.4 days longer on average (unadjusted) than non-immigrants. Among immigrants, “visible minorities” waited longer compared with immigrants from European/English-speaking countries (RR: 1.06, 95% CI: 1.03, 1.10).

Conclusion: This study highlighted that immigrants tended to wait longer for elective surgery in this study's setting. Visible minorities experienced the longest waits. Despite sharing the same structures and processes of care in the setting's publicly funded health system, barriers in healthcare delivery delayed access to elective surgical care for immigrants.

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