Factors associated with waiting time for surgery

Clover, Kerrie; Dobbins, Timothy; Smyth, Tim; Sanson‐Fisher, Rob

doi:10.5694/j.1326-5377.1999.tb127867.x

Cited by 12 publications

(6 citation statements)

References 5 publications

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“…At an individual level, employment, relative affluence, and higher urgency rating 4 28 are associated with less waiting. We have shown that prolonged waiting is not simply related to capacity, implying that many other factors are involved and raising questions about the appropriate policy interventions.…”

Section: Discussionmentioning

confidence: 99%

NHS waiting lists and evidence of national or local failure: analysis of health service data

Martin¹,

Sterne²,

Gunnell³

et al. 2003

BMJ

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Objectives To investigate the national distribution of prolonged waiting for elective day case and inpatient surgery, and to examine associations of prolonged waiting with markers of NHS capacity, activity in the independent sector, and need. Setting NHS hospital trusts in England. Population People waiting for elective treatment in the specialties of general surgery; ear, nose and throat surgery; ophthalmic surgery; and trauma and orthopaedic surgery. Main outcome measure Numbers of people waiting six months or longer (prolonged waiting). Characteristics of trusts with large numbers waiting six months or longer were examined by using logistic regression. Results The distribution of numbers of people waiting for day case or elective surgery in all the specialties examined was highly positively skewed. Between 52% and 83% of patients waiting longer than six months in the specialties studied were found in one quarter of trusts, which in turn contributed 23-45% of the national throughput specific to the specialty. In general, there was little evidence to show that capacity (measured by numbers of operating theatres, dedicated day case theatres, available beds, and bed occupancy rate) or independent sector activity were associated with prolonged waiting, although exceptions were noted for individual specialties. There was consistent evidence showing an increase in prolonged waiting, with increased numbers of anaesthetists across all specialties and with increased bed occupancy rates for ear, nose and throat surgery. Markers of greater need for health care, such as deprivation score and rate of limiting long term illness, were inversely associated with prolonged waiting. Conclusion In most instances, substantial numbers of patients waiting unacceptably long periods for elective surgery were limited to a small number of hospitals. Little and inconsistent support was found for associations of prolonged waiting with markers of capacity, independent sector activity, or need in the surgical specialties examined.

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Section: Discussionmentioning

confidence: 99%

NHS waiting lists and evidence of national or local failure: analysis of health service data

Martin¹,

Sterne²,

Gunnell³

et al. 2003

BMJ

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“…Some studies conducted in Northern Europe and North America during the previous decade have shown an inverse socioeconomic trend, as in Scotland for cardiac surgery [13] and in England for ophthalmologic surgery and hip replacement [14,15], whilst others have found no or a weak association, as in Canada [16], Australia [17] and Norway [18]. A large retrospective English study shows decreasing inequalities in waiting times during the last decade for elective hip replacement and cataract repair [19].…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic differences in waiting times for elective surgery: a population-based retrospective study

Petrelli¹,

Luca

Landriscina³

et al. 2012

BMC Health Serv Res

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BackgroundWidespread literature on inequity in healthcare access and utilization has been published, but research on socioeconomic differences in waiting times is sparse and the evidence is fragmentary and controversial. The objective of the present study is the analysis of the relationship between individual socioeconomic level and waiting times for in-hospital elective surgery.MethodsWe retrospectively studied the waiting times experienced by patients registered on hospital waiting lists for 6 important surgical procedures by using the Hospital Discharge Database (HDD) of the Piedmont Region (4,000,000 inhabitants in the North West of Italy) from 2006 to 2008. The surgical procedures analyzed were: coronary artery by-pass (CABG), angioplasty, coronarography, endarterectomy, hip replacement and cholecystectomy. Cox regression models were estimated to study the relationship between waiting times and educational level taking into account the confounding effect of the following factors: sex, age, comorbidity, registration period, and Local Health Authorities (LHA) as a proxy of supply.ResultsMedian waiting times for low educational level were higher than for high educational level for all the selected procedures. Differences were particularly high for endarterectomy and hip replacement. For all considered procedures, except CABG, an inverse gradient between waiting times and educational level was observed: the conditional probabilities of undergoing surgery were lower among individuals with a low to middle level education than for individuals with a higher level of education after adjustment for sex, age, comorbidities, registration period, and LHAs. For most procedures the effect decreases over the follow up period.ConclusionsThe results of the study show evidence of inequalities in access to elective surgery in Italy. Implementation of policies aimed to promote national information initiatives that guarantee wider access to those with low socio-economic status is strongly recommended.

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“…Evidence based and uniform priority criteria are still being developed 60,61 , which involves complex processes as the underlying ethical basis is being debated and as knowledge on which generic aspects to include is lacking 62 . For instance, an Australian study showed that waiting times in public hospitals were significantly associated with urgency ratings but not with the extent of disability as experienced by patients 63 . In New Zealand, priority criteria were found to correlate only weakly with general health and the extent of benefit from surgery 64 .…”

Section: Discussionmentioning

confidence: 99%

Waiting for elective general surgery: physical, psychological and social consequences

Oudhoff

Timmermans

Bijnen

et al. 2004

ANZ Journal of Surgery

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Factors associated with waiting time for surgery

Cited by 12 publications

References 5 publications

NHS waiting lists and evidence of national or local failure: analysis of health service data

NHS waiting lists and evidence of national or local failure: analysis of health service data

Socioeconomic differences in waiting times for elective surgery: a population-based retrospective study

Waiting for elective general surgery: physical, psychological and social consequences

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