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Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991 – 2000

BACKGROUND: In British Columbia, Canada, all necessary medical services are funded publicly. Concerned with growing wait lists in the mid-1990s, the provincial government started providing extra funding for coronary artery bypass grafting (CABG) operations annually. Although aimed at improving acces...

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Autores principales: Levy, Adrian R, Sobolev, Boris G, Hayden, Robert, Kiely, Michael, FitzGerald, J Mark, Schechter, Martin T
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2005
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1079832/
https://www.ncbi.nlm.nih.gov/pubmed/15766381
http://dx.doi.org/10.1186/1472-6963-5-22
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author Levy, Adrian R
Sobolev, Boris G
Hayden, Robert
Kiely, Michael
FitzGerald, J Mark
Schechter, Martin T
author_facet Levy, Adrian R
Sobolev, Boris G
Hayden, Robert
Kiely, Michael
FitzGerald, J Mark
Schechter, Martin T
author_sort Levy, Adrian R
collection PubMed
description BACKGROUND: In British Columbia, Canada, all necessary medical services are funded publicly. Concerned with growing wait lists in the mid-1990s, the provincial government started providing extra funding for coronary artery bypass grafting (CABG) operations annually. Although aimed at improving access, it is not known whether supplementary funding changed the time that patients spent on wait lists for CABG. We sought to determine whether the period of registration on wait lists had an effect on time to isolated CABG and whether the period effect was similar across priority groups. METHODS: Using records from a population-based registry, we studied the wait-list time before and after supplementary funding became available. We compared the number of weeks from registration to surgery for equal proportions of patients in synthetic cohorts defined by five registration periods in the 1990s. RESULTS: Overall, 9,231 patients spent a total of 137,126 person-weeks on the wait lists. The time to surgery increased by the middle of the decade, and decreased toward the end of the decade. Relative to the 1991–92 registration period, the conditional weekly probabilities of undergoing surgery were 30% lower among patients registered on the wait lists in 1995–96, hazard ratio (HR) = 0.70 (0.65–0.76), and 23% lower in 1997–98 patients, HR = 0.77 (0.71–0.83), while there were no differences with 1999–2000 patients, HR = 0.94 (0.88–1.02), after adjusting for priority group at registration, comorbidity, age and sex. We found that the effect of registration period was different across priority groups. CONCLUSION: Our results provide evidence that time to CABG shortened after supplementary funding was provided on an annual basis to tertiary care hospitals within a single publicly funded health system. One plausible explanation is that these hospitals had capacity to increase the number of operations. At the same time, the effect was not uniform across priority groups indicating that changes in clinical practice should be considered when adding extra funding to reduce wait lists.
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spelling pubmed-10798322005-04-15 Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991 – 2000 Levy, Adrian R Sobolev, Boris G Hayden, Robert Kiely, Michael FitzGerald, J Mark Schechter, Martin T BMC Health Serv Res Research Article BACKGROUND: In British Columbia, Canada, all necessary medical services are funded publicly. Concerned with growing wait lists in the mid-1990s, the provincial government started providing extra funding for coronary artery bypass grafting (CABG) operations annually. Although aimed at improving access, it is not known whether supplementary funding changed the time that patients spent on wait lists for CABG. We sought to determine whether the period of registration on wait lists had an effect on time to isolated CABG and whether the period effect was similar across priority groups. METHODS: Using records from a population-based registry, we studied the wait-list time before and after supplementary funding became available. We compared the number of weeks from registration to surgery for equal proportions of patients in synthetic cohorts defined by five registration periods in the 1990s. RESULTS: Overall, 9,231 patients spent a total of 137,126 person-weeks on the wait lists. The time to surgery increased by the middle of the decade, and decreased toward the end of the decade. Relative to the 1991–92 registration period, the conditional weekly probabilities of undergoing surgery were 30% lower among patients registered on the wait lists in 1995–96, hazard ratio (HR) = 0.70 (0.65–0.76), and 23% lower in 1997–98 patients, HR = 0.77 (0.71–0.83), while there were no differences with 1999–2000 patients, HR = 0.94 (0.88–1.02), after adjusting for priority group at registration, comorbidity, age and sex. We found that the effect of registration period was different across priority groups. CONCLUSION: Our results provide evidence that time to CABG shortened after supplementary funding was provided on an annual basis to tertiary care hospitals within a single publicly funded health system. One plausible explanation is that these hospitals had capacity to increase the number of operations. At the same time, the effect was not uniform across priority groups indicating that changes in clinical practice should be considered when adding extra funding to reduce wait lists. BioMed Central 2005-03-14 /pmc/articles/PMC1079832/ /pubmed/15766381 http://dx.doi.org/10.1186/1472-6963-5-22 Text en Copyright © 2005 Levy et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Levy, Adrian R
Sobolev, Boris G
Hayden, Robert
Kiely, Michael
FitzGerald, J Mark
Schechter, Martin T
Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991 – 2000
title Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991 – 2000
title_full Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991 – 2000
title_fullStr Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991 – 2000
title_full_unstemmed Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991 – 2000
title_short Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991 – 2000
title_sort time on wait lists for coronary bypass surgery in british columbia, canada, 1991 – 2000
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1079832/
https://www.ncbi.nlm.nih.gov/pubmed/15766381
http://dx.doi.org/10.1186/1472-6963-5-22
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