%0 Journal Article
%T Exploring Urological Surgery Wait Times as a Quality Indicator of Care: A Case Study of Different Health Care Systems.
%A Walker A
%A Leslie R
%A Siemens DR
%A Feustel PJ
%A Kogan BA
%J Urol Pract
%V 2
%N 5
%D 2015 Sep
%M 37559324
暂无%R 10.1016/j.urpr.2014.11.006
%X 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.