KEY TAKEAWAYS
- The study aimed to measure variation in surgical wait times across hospitals and surgeons.
- Addressing wait time variability requires better provider coordination and potentially single-entry models.
Timely access to surgical care is crucial for patient outcomes and trust in the healthcare system. While wait time targets are now established in several regions, the variation in wait times between providers remains underexplored, leading to uncertainty about the primary issue—whether overall wait times are too long or excessively variable.
Pieter de Jager and the team aimed to measure the variation in surgical times for commonly performed elective procedures across hospitals and surgeons in Ontario, Canada.
Researchers conducted a cross-sectional analysis of surgical wait times for adults undergoing non-urgent procedures like cataract surgery, knee and hip arthroplasty, gallbladder surgery, and non-cancer uterine surgery in Ontario from 2013 to 2019. Data was sourced from the Wait Times Information System (WTIS) database.
Variations in wait times between hospitals and surgeons were visually represented with caterpillar plots. Using hierarchical random effects models, they estimated the proportion of wait time variance attributed to surgeons and hospitals.
The results indicated that the analysis covered 942,605 procedures across 107 healthcare facilities and 1,834 surgeons. Significant variations in wait times were found across all 5 procedures. For instance, median wait times varied 6-fold for gallbladder surgery and 15-fold for knee arthroplasty between facilities.
Surgeon-related wait time differences were even more significant, with a 17-fold difference for cataract surgery and up to 216-fold for non-cancer uterine surgery. Facility-related variation in wait times ranged from 6.2% for gallbladder surgery to 23.0% for cataract surgery, while surgeon-related variation ranged from 16.0% for non-cancer uterine surgery to 28.0% for cataract surgery.
The study concluded that wait times for common non-urgent surgeries vary significantly. Addressing this variability requires improved coordination between service providers, and approaches like single-entry models to enhance system performance may be beneficial.
The study was funded by the Canadian Institutes of Health Research.
Source: https://pubmed.ncbi.nlm.nih.gov/39116181/
de Jager P, Aleman D, Baxter N, et al. (2024). “Surgeon- and hospital-level variation in wait times for scheduled non-urgent surgery in Ontario, Canada: A cross-sectional population-based study.” PLoS One. 2024 Aug 8;19(8):e0307845. doi: 10.1371/journal.pone.0307845. PMID: 39116181.
