Abstract：
BACKGROUND: We determined and compared wait times for urological procedures at 2 centers in different health care systems to more fully understand the usefulness of wait times as a quality indicator.
METHODS: A retrospective review of patient wait times for transurethral bladder tumor resection was performed at Albany Medical Center, Albany, New York and Kingston General Hospital, Kingston, Ontario, Canada. The time from the decision for surgery until the completion of surgery (Wait 2) was determined for 495 consecutive patients during calendar years 2011 and 2012. Patient, surgeon and tumor factors that could potentially affect wait times were collected, as were wait times from referral to initial consultation (Wait 1) for new patients. These findings were contrasted with the wait times for 375 patients who underwent transurethral prostate resection.
RESULTS: Median Wait 2 time for transurethral bladder tumor resection was statistically but not clinically different at 24 days at Albany Medical Center and at 35 days at Kingston General Hospital. High grade and stage were associated with shorter wait times at Albany Medical Center but not at Kingston General Hospital. Median Wait 1 time was different at Albany Medical Center (13 days) vs Kingston General Hospital (25 days), significantly adding to the total wait. For transurethral prostate resection the Wait 2 times were more disparate at 29 and 58 days at Albany Medical Center and Kingston General Hospital, respectively.
CONCLUSIONS: The use of wait time as a measure of surgical quality of care is complex. These results suggest that measuring a summary wait time (Wait 2) may not identify the structural and process issues that affect care delivery.
METHODS: A retrospective review of patient wait times for transurethral bladder tumor resection was performed at Albany Medical Center, Albany, New York and Kingston General Hospital, Kingston, Ontario, Canada. The time from the decision for surgery until the completion of surgery (Wait 2) was determined for 495 consecutive patients during calendar years 2011 and 2012. Patient, surgeon and tumor factors that could potentially affect wait times were collected, as were wait times from referral to initial consultation (Wait 1) for new patients. These findings were contrasted with the wait times for 375 patients who underwent transurethral prostate resection.
RESULTS: Median Wait 2 time for transurethral bladder tumor resection was statistically but not clinically different at 24 days at Albany Medical Center and at 35 days at Kingston General Hospital. High grade and stage were associated with shorter wait times at Albany Medical Center but not at Kingston General Hospital. Median Wait 1 time was different at Albany Medical Center (13 days) vs Kingston General Hospital (25 days), significantly adding to the total wait. For transurethral prostate resection the Wait 2 times were more disparate at 29 and 58 days at Albany Medical Center and Kingston General Hospital, respectively.
CONCLUSIONS: The use of wait time as a measure of surgical quality of care is complex. These results suggest that measuring a summary wait time (Wait 2) may not identify the structural and process issues that affect care delivery.
摘要：
背景：我们确定并比较了不同医疗保健系统中2个中心泌尿外科手术的等待时间，以更全面地了解等待时间作为质量指标的有用性。
方法：在奥尔巴尼医疗中心对患者经尿道膀胱肿瘤切除术的等待时间进行了回顾性分析，奥尔巴尼,纽约和金斯敦综合医院，金斯顿,安大略省,加拿大。在2011年和2012年期间，确定了495名连续患者从决定手术到完成手术的时间（等待2）。病人,收集了可能影响等待时间的外科医生和肿瘤因素，以及新患者从转诊到初次咨询的等待时间（等待1）。这些发现与375例接受经尿道前列腺电切术的患者的等待时间形成对比。
结果：经尿道膀胱肿瘤切除术的平均等待2时间在24天在奥尔巴尼医疗中心和35天在金斯敦总医院有统计学差异，但没有临床差异。在奥尔巴尼医疗中心，高年级和阶段与较短的等待时间有关，但在金斯敦总医院则没有。奥尔巴尼医疗中心（13天）与金斯敦总医院（25天）的平均等待时间不同，大大增加了总的等待。对于经尿道前列腺切除术，在奥尔巴尼医疗中心和金斯敦总医院的等待2次在29天和58天更加不同。分别。
结论：使用等待时间作为衡量手术护理质量的指标是复杂的。这些结果表明，测量汇总等待时间（等待2）可能无法识别影响护理交付的结构和过程问题。
方法：在奥尔巴尼医疗中心对患者经尿道膀胱肿瘤切除术的等待时间进行了回顾性分析，奥尔巴尼,纽约和金斯敦综合医院，金斯顿,安大略省,加拿大。在2011年和2012年期间，确定了495名连续患者从决定手术到完成手术的时间（等待2）。病人,收集了可能影响等待时间的外科医生和肿瘤因素，以及新患者从转诊到初次咨询的等待时间（等待1）。这些发现与375例接受经尿道前列腺电切术的患者的等待时间形成对比。
结果：经尿道膀胱肿瘤切除术的平均等待2时间在24天在奥尔巴尼医疗中心和35天在金斯敦总医院有统计学差异，但没有临床差异。在奥尔巴尼医疗中心，高年级和阶段与较短的等待时间有关，但在金斯敦总医院则没有。奥尔巴尼医疗中心（13天）与金斯敦总医院（25天）的平均等待时间不同，大大增加了总的等待。对于经尿道前列腺切除术，在奥尔巴尼医疗中心和金斯敦总医院的等待2次在29天和58天更加不同。分别。
结论：使用等待时间作为衡量手术护理质量的指标是复杂的。这些结果表明，测量汇总等待时间（等待2）可能无法识别影响护理交付的结构和过程问题。
