Variation in time spent on the waiting list for elective vascular surgery: a case study

Sobolev, Boris; Brown, Peter; Zelt, David
August 2000
Clinical & Investigative Medicine;Aug2000, Vol. 23 Issue 4, p227
Academic Journal
Case Study
Objective: To review the variation in time spent on the waiting list for elective vascular surgery provided by a single team of specialists. Design: A prospective cohort study. Setting: An acute care hospital in Ontario. Population: One thousand and eighty-four consecutive patients with vascular problems accepted for elective surgery between 1994 and 1998. Interventions: Abdominal aortic aneurysm (AAA) repair; carotid endarterectomy (CAD); surgery for peripheral vascular disease (PVD); and arteriovenous fistula (AVF) for long-term access in patients with renal failure. Outcome measures: Time-to-treatment curves, admission rates. Results: The weekly admission rate was 9.8% on average. The proportion of patients who underwent operation was 50% at 7 weeks, 75% at 14 weeks and 90% at 26 weeks. The weekly admission rate varied according to clinical priority, from 42% in priority class 1 to 6% in class 5. In any priority class, the admission rate was not constant over time. Although the proportion of patients operated on within the maximum recommended time in classes 1, 2, 3 and 4 was 52%, 50%, 35% and 20% respectively, the last 10% of patients waited 5 to 16 weeks, 10 to 16 weeks, 16 to 37 weeks, and 25 to 39 weeks respectively. There were statistically significant differences in waiting time by surgical procedure among the least urgent cases, with median times of 7, 10 and 19 weeks for AVF, PVD and CAD procedures, respectively. Conclusions: When queuing procedures are uniform, the waiting times for access to elective vascular surgery provided by the same team of specialists differ considerably for patients with equal surgical needs and urgency. It remains to be examined whether delays in scheduling operations and cancellations affect the waiting time after adjustment for urgency and comorbidity.


Related Articles

  • ASSESSMENT OF PATIENT WAITING TIMES FOR VASCULAR SURGERY. Turnbull, Robert G.; Taylor, David C.; Hsiang, York N.; Salvian, Anthony J.; Nanji, Suliman; O'Hanley, Gerry; Doyle, D. Lynn; Fry, Peter D. // Canadian Journal of Surgery;Apr2000, Vol. 43 Issue 2, p105 

    Explores the waiting times of vascular surgery patients. Analysis on the implications of waiting times for vascular surgery complications; Influence of patient hospital admission for operation within the benchmark time on patient recovery and outcome; List of acceptable waiting times for...

  • Nurses not to blame.  // Australian Nursing Journal;Jul2003, Vol. 11 Issue 1, p7 

    States that nurses should not be blamed for the elective surgery waiting list in the Australian Capital Territory. Number of people scheduled for elective surgery in April 2003; Reason for the closure of hospitals during Christmas and Easter; Role of nursing staff in the ability of hospital...

  • Govt pays public to go private.  // Australian Nursing Journal;Jul2005, Vol. 13 Issue 1, p7 

    Reports on the initiative of the New South Wales government to pay private hospitals to operate public patients in a bid to help reduce waiting lists. Number of patients who have waited for several months for elective surgery; Minor procedures included in the surgery; Statement issued by New...

  • Minister promises more ops, less waiting; DHBs promise frugality. Wilson, Peter // New Zealand Doctor;3/4/2015, p16 

    The article reflects on the statement of New Zealand Prime Minister John Key who vowed to continue to increase the volumes of elective surgery and reduce waiting times, expressed in his opening remarks to the Parliament that set out the government's agenda for 2015.

  • Socioeconomic differences in waiting times for elective surgery: a population-based retrospective study. Petrelli, Alessio; De Luca, Giuliana; Landriscina, Tania; Costa, Giuseppe // BMC Health Services Research;2012, Vol. 12 Issue 1, p268 

    Background: Widespread 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...

  • A model to prioritize access to elective surgery on the basis of clinical urgency and waiting time. Valente, Roberto; Testi, Angela; Tanfani, Elena; Fato, Marco; Porro, Ivan; Santo, Maurizio; Santori, Gregorio; Torre, Giancarlo; Ansaldo, Gianluca // BMC Health Services Research;2009, Vol. 9, p1 

    Background: Prioritization of waiting lists for elective surgery represents a major issue in public systems in view of the fact that patients often suffer from consequences of long waiting times. In addition, administrative and standardized data on waiting lists are generally lacking in Italy,...

  • Factors influencing waiting times for elective laparoscopic cholecystectomy. Lau, Richard; Vair, Brock A.; Porter, Geoffrey A. // Canadian Journal of Surgery;Feb2007, Vol. 50 Issue 1, p34 

    Introduction: Health Canada states that waiting list information and management systems in Canada are woefully inadequate, especially for elective surgical procedures. Understanding the reasons for waiting is paramount to achieving fairness and equity. The objective of this study was to examine...

  • Managing a patient waiting list with time-dependent priority and adverse events. Min, Daiki; Yih, Yuehwern // RAIRO -- Operations Research;Jan2014, Vol. 48 Issue 1, p53 

    This paper addresses the problem of managing a waiting list for elective surgery to decide the number of patients selected from the waiting list and to schedule them in accordance with the operating room capacity in the next period. The waiting list prioritizes patients not only by their initial...

  • Waiting lists. Butler, Debra // British Journal of Perioperative Nursing;Dec2005, Vol. 15 Issue 12, p537 

    The article presents information about the problem of waiting lists in the hospitals. It is commonly seen that the patients who have to undergo elective surgery have to wait for their turn to get an admission into the hospital due to the shortage of beds in the hospital. Many changes regarding...

  • Surgery waits continue despite cash boost.  // Australian Nursing Journal;Mar2008, Vol. 15 Issue 8, p11 

    The article focuses on the results of the December Quarter 2007 Public Hospitals Performance Report in Queensland. Patients are waiting longer than recommended times for elective surgery in the state despite the 2007-2008 cash injection for public patients in the private sector. State Health...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics