[Impact of an intervention on the waiting-list for medical specialists in a health area].

OBJECTIVE

To evaluate the impact on waiting-lists and waiting time of an intervention that modified the appointment system in specialist out-patients.

DESIGN

Intervention study. Intervention group, medical specialists (MS); and control group, surgical specialists (SS). Comparison of variables. Analysis at one year (1997) and at two years (1998) of the intervention in the two groups.Setting. Area 20 of the health board for the Community of Valencia, a Southern county in the province of Alicante, which had 12 health districts and included specialist care.

PARTICIPANTS

The first-visit diary for medical and surgical specialist clinics.Interventions. Redistribution of MS first visits in proportion with the population over 14 by areas. Health centre self-management of specialist appointments. Introduction of visits of choice and second-visit re-scheduling from specialist care. Introduction of clinical protocols for action and referral.

MEASUREMENTS

Referral percentage. Patients seen in primary care and at medical and surgical specialist clinics. Days waiting to be seen by a specialist. Patients on waiting list. Index of waiting for consultations.

RESULTS

Referral ranged between 5.1% and 5.8%. There was a significant drop (P<.05) in the mean number of days an MS patient had to wait vs the SS (37 vs 48 in 1997 and 34 vs 50 in 1998), and in the number of MS consultations being waited for. There was a significant difference in the index of waiting for a consultation (P<.05) in favour of MS (17.74 vs 25.45 in 1997, and 16.77 vs 34.92).

CONCLUSIONS

The intervention optimised specialist medical health care in terms of the number of consultations and reduction of waiting time, with an improvement of these variables against SS.