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At least 19 recordsLinked to original sources
PubMed2005

Waiting lists, waiting times and admissions: an empirical analysis at hospital and general practice level.

We report an empirical analysis of the responses of the supply and demand for secondary care to waiting list size and waiting times. Whereas previous empirical analyses have used data aggregated to area level, our analysis focuses on the supply responses of a single hospital and the demand responses of the GP practices it serves, and distinguishes between first outpatient visits, inpatient admissions, day-case treatment and emergency admissions. The results are plausible and in line with the theoretical model. For example: the demand from practices for first outpatient visits is negatively affected by waiting times and distance to the hospital. Increases in waiting times and waiting lists lead to increases in supply; the supply of elective inpatient admissions is affected negatively by current emergency admissions and positively by lagged waiting list and waiting time. We use the empirical results to investigate the dynamic responses to one off policy measures to reduce waiting times and lists by increasing supply.

Health Services Needs and Demand↗
PubMed2004

[The length of the patient list, waiting lists, workload and job satisfaction among general practitioners in Bergen].

BACKGROUND: A list patient system was established in Norway in June 2001. Among general practitioners (GPs) there were much concern about workload according to list length, and about uneven distribution of workload among GPs. MATERIAL AND METHODS: In February 2003 a questionnaire about working hours, waiting time for appointments and job satisfaction was sent to all GPs in Bergen. RESULTS: 160 out of 185 (85%) GPs replied. Working hours were closely related to list length, waiting time was not. 79% had a waiting time of less than eight "days in practice". 46% rated their job satisfaction within the list system as "good/very good", 37% were moderately satisfied. We found lower scores among GPs with long waiting time and a full list. No relevant differences between male and female GPs were found. INTERPRETATION: GPs adjust their working hours in order to cope with waiting time. Job satisfaction is lower when the GP has a waiting time of more than three weeks and a full list, factors that could indicate a heavy workload.

Adult↗
PubMed2005

Bilirubin appears to be the only independent variable affecting mortality on liver transplant waiting list if waiting time exceeds 1 year.

BACKGROUND: The Model for End-Stage Liver Disease (MELD) score has been shown to be the best predictor of short-term mortality on the liver transplant waiting list in the United States but waiting time often exceeds 1 year in many countries. We wanted to identify the factors affecting mortality on the liver transplant waiting list in Singapore where waiting time for liver transplant exceeds 1 year. PATIENTS AND METHODS: All patients who were listed on the liver transplant waiting list in Singapore from January 1997 to December 2003 excluding those who were transplanted were analyzed. MELD was calculated according to the United Network for Organ Sharing formula. Univariate analysis was performed to identify factors affecting mortality on the waiting list and multivariate analysis by logistic regression. Categorical and continuous variables were compared with the chi-square and Mann-Whitney U tests. RESULTS: There were 48 patients in the study. We found that on univariate analysis, bilirubin, INR, MELD score, and Child's score significantly influenced mortality on the waiting list but on multivariate analysis, bilirubin was the only independent prognostic indicator of mortality on the waiting list (LR = 1.97; 95% confidence interval = 1.08 to 3.61). INR was found to be significantly correlated to bilirubin with Pearson correlation (R = 0.63, P < .001). CONCLUSION: Bilirubin is the only independent factor affecting mortality on the liver transplant waiting list where waiting time exceeds 1 year.

Analysis of Variance↗
PubMed1987

Waiting list statistics. I: Relation between admissions from waiting list and length of waiting list.

The relation between changes in inpatient workload, measured as increases or decreases in the number of inpatients admitted from the waiting list, and the overall length of the waiting list was studied. Overall trends in admissions from the waiting list, the influence of seasonal patterns, and the impact of industrial action on admissions were also studied. The hypothesis was that when admissions from the waiting list increased the length of the waiting list would decrease and vice versa. No such simple relation was found. In fact, if anything, as the number of admissions from the waiting list increased so did the length of the waiting list. This result could be due to inconsistencies in compiling waiting list data or to the use of waiting lists to improve organisational efficiency. It is also possible, and perhaps likely, that the ability to meet need in admitting patients to hospital influences patients and their doctors to translate previously unmet need into demand for hospital services.

Appointments and Schedules↗
PubMed1991

[Grouping and calculated measurements of standardized waiting lists in Norway. Definitions and interpretations of waiting lists].

Waiting list parameters calculated for defined dates and time periods allow studies to determine balance between new and completed referrals. The authors discuss various sub-groupings of the waiting lists. The main waiting time parameter is mean waiting time for the various levels of care in the case of the different medical specialties and diagnostic groups. Waiting time is defined as the difference between date of first admission to hospital and the date when the patient was referred. It is possible to calculate total waiting time for patients undergoing out-patient evaluation before in-patient or day-care treatment. Aggregated waiting times should exclude control admissions and admissions postponed at the wish of the patient.

Diagnosis-Related Groups↗
PubMed1994

Impact of a waiting list initiative on a general surgical waiting list.

OBJECTIVES: To determine the effects of cuts in surgical beds and operating lists upon the waiting list. To evaluate the effects of the Waiting List Initiative upon the total number of patients on the waiting list, the number of patients waiting for more than one year, and the ratio of patients with low priority, non-life-threatening diagnoses to those with a higher priority, potentially more serious, diagnosis. DESIGN: The study of facilities available and waiting list figures between 1979-1991; a prospective study of a Waiting List Initiative. SETTING: The surgical departments of the Royal Berkshire and Battle Hospitals, Reading and Newbury District Hospital. PATIENTS: Those patients on general surgical waiting lists between 1979 and 1993; those patients who had operations under the Waiting List Initiative. RESULT: Between 1979 and 1989 the number of surgical beds fell from 225 to 153, a reduction of 38 per cent. The number of weekly operating lists fell from 40 to 30, a reduction of 25 per cent. The waiting list remained fairly constant, between 1979-1987, with a median of 420 patients (range 295-688) before 1987, against 983 (range 688-1,253) after 1987. After the Waiting List Initiative the total number of patients on the waiting list fell from 1,114 to 904, a fall of 19 per cent. Patients waiting for more than one year fell from 381 to 176 (54 per cent), whilst those waiting less than one year remained constant at 730. The proportion of patients with low priority varicose veins fell from 65 per cent to 40 per cent, whilst the proportion of patients with potentially more serious inguinal hernias rose from 10 per cent to 15 per cent. CONCLUSION: These results demonstrate the relationship between the increase in the size of the waiting list and the decrease in the facilities available in beds and operating sessions. While the Waiting List Initiative has resulted in a reduction in the number of patients waiting more than one year, there has been no reduction in numbers waiting less than one year. The reduction has been achieved at the expense of those patients with potentially more serious clinical conditions.

Beds↗
PubMed1991

[Reports of waiting list data from hospitals to the central registry--a database for reducing hospital waiting lists. Minimum dataset of waiting list parameters].

The governmental regulations concerning registration of waiting lists and priority of patients, laid down in July 1990, introduce a "waiting time guarantee" which ensures a waiting time not exceeding six months for patients suffering from diseases having severe impacts on health. Hospitals that are unable to treat these patients within six months are requested to refer them to other hospitals before the deadline. All hospitals have to make monthly reports of waiting list parameters to a Central Waiting List Register, enabling both a nationwide waiting list survey and comparisons between different hospitals and different counties. An online communication facility to the central register enables searches for and reporting of vacant treatment capacity.

Databases, Factual↗
PubMed1994

How long is your waiting list? Experience of a urological waiting list initiative.

Experience with a urological waiting list initiative is presented, wherein a list of 231 non-urgent cases was cleared over a 5 month period by a single operator. Some patients had waited 10 years for surgery. Following a postal request, the waiting list was validated; 31.2% of patients wished to be removed. The remaining 68.8% desired surgery and consisted of 51 requiring minor surgical procedures and 108 who needed more major surgery mostly for the relief of bladder outflow obstruction. Minor cases received dates for surgery; however, only 68.2% of this group attended despite being given more than one date for admission. Major cases were reviewed in a pre-admission clinic. General and urological condition was assessed, improved where necessary and surgery booked or delayed accordingly. A small number of patients did not attend or only attended to be reassured that surgery was not needed. Following clinical review, 18.5% of this group did not require operation. The long urological waiting list is a unique situation where patients listed may no longer require surgery. Reviewing these patients not only reduces numbers but also markedly increases percentage attendance for surgery.

Adult↗
PubMed2002

[Nurses on strike, waiting lists and waiting time at a regional hospital].

BACKGROUND: From 22 January to 6 March 2002, Norwegian hospitals were struck by the longest strike among nurses ever. The strike strategy was aimed at creating the least possible effect on patient treatment by mainly including nurses in administrative positions and in outpatient departments. However, several reports of increasing numbers of patients in line for treatment and of operations cancelled caused the minister of health to finally order the nurses back to work. MATERIAL AND METHODS: To get a more comprehensive view on the effect of the strike, patients in line for treatment at St. Olavs Hospital, a large regional university hospital, were analysed for the months January and February. RESULTS: Surprisingly, no major negative effects on the volume of treated patients and on the number of patients waiting for treatment were found. In fact, the total number of patients in line for treatment as well as the number of patients waiting more than 12 months were reduced during the strike. The mean waiting time for treatment was also reduced. INTERPRETATION: A limited strike may improve the selection of patients with high priority. Furthermore, the yearly summer vacation in hospitals, that also includes doctors, probably represents a larger health threat to patients than a limited and well planned strike among one single health profession.

Hospital Departments↗
PubMed2003

Effect of minimal listing criteria on waiting list registration for liver transplantation: a process-outcome analysis.

OBJECTIVE: To determine the level of association between minimal listing criteria (MLC) recognition and outcomes associated with waiting list registration for liver transplantation (LT). PATIENTS AND METHODS: A total of 147 patients and 201 patients were identified as first-time referrals for LT evaluation between January 1, 1997, and November 30, 1997 (cohort A), and December 1,1997, and December 31, 1998 (cohort B), respectively. Relevant demographic and clinical information was abstracted from medical records. Minimal listing criteria were defined as a Child-Turcotte-Pugh (CTP) score of 7 or higher. RESULTS: Patient age, sex, hepatic disease etiology, and mean CTP scores were similar between cohorts A and B. However, the proportion of registered patients in cohort B with CTP scores of 7 or higher increased significantly after formal MLC recognition (96% vs 82% for cohort A; P=.001). In cohort A, waiting list registration was based on patient age, male sex, nonalcohol-related hepatic disease, and a CTP score of 7 or higher in the absence of formal MLC. The rate of first-time patient referral was also increased in cohort B vs cohort A after formal MLC recognition (80% vs 69%, respectively; P=.002) despite similar clinical characteristics. Although the number of patients with a CTP score of 10 or higher was greater in cohort B vs cohort A, the proportion of patients with advanced end-stage liver disease was similar (29% vs 26%, respectively; P=.72). CONCLUSION: The explicit recognition of MLC was strongly associated with improvements in appropriate waiting list registration for LT.

Cohort Studies↗
PubMed2004

Towards a systemic understanding of a hospital waiting list.

Hospital waiting lists are a feature of publicly funded health services that result when demand appears to exceed supply. While much has been written about surgical waiting lists, little is known about the dynamics of radiology waiting lists, which is surprising given that rational treatment, and indeed the medical profession's claim to expertise, rests on establishing a diagnosis. This paper reports the findings of a case study of a problematic ultrasound waiting list. In particular, this paper highlights how the management of the ultrasound waiting list served to subordinate the needs of waiting patients and their general practitioners to the interests and values of radiologists. Radiologist concern to protect specialist expertise from encroachment by outpatient clinicians and sonographers is implicated in the growth of the ultrasound waiting list. It is argued that an adequate understanding of ultrasound waiting lists depends on grasping how radiologists are successful in structuring problems of access in ways that enhance radiologist control over ultrasound imaging. The case study reported helps to shed light on why increasing funding to clear waiting lists proves ineffective.

Health Services Needs and Demand↗