Shortt Samuel E D, Shaw Ralph A
Centre for Health Services and Policy Research, Faculty of Health Sciences, Queen's University, Kingston, ON.
CMAJ. 2003 Feb 18;168(4):413-6.
Waiting times for surgical and other procedures are an important measure of how well the health care system responds to patient needs. In a universal health care system such as Canada's, it is important to determine if waiting times vary by socioeconomic status (SES). We compared waiting times for elective surgery of patients living in low and high socioeconomic areas.
We reviewed the medical charts of all patients who underwent elective surgery at a Canadian academic health centre between 1992 and 1999. Using patient postal codes we assigned SES on the basis of 5 characteristics in the 1996 census data. We compared waiting times for surgery for people from regions in the lowest third (low SES group) with that for patients from regions in the upper third (high SES group).
On average, patients in the high SES group waited 31.1 days and those in the low SES group waited 29.3 days. When differences in waiting times for 22 common procedures were examined between the groups, only the difference for prostatectomy was statistically significant: patients in the high SES group waited 4.4 fewer days than those in the low SES group.
We found little evidence that residing in a region in which SES was in the lowest third was associated with longer waiting times for elective surgery.
手术及其他医疗程序的等待时间是衡量医疗保健系统满足患者需求程度的一项重要指标。在加拿大这样的全民医疗保健系统中,确定等待时间是否因社会经济地位(SES)而异很重要。我们比较了生活在社会经济地位低和高地区的患者进行择期手术的等待时间。
我们查阅了1992年至1999年间在加拿大一家学术医疗中心接受择期手术的所有患者的病历。利用患者邮政编码,我们根据1996年人口普查数据中的5个特征来确定社会经济地位。我们比较了来自最低三分之一地区(低社会经济地位组)的人与来自最高三分之一地区(高社会经济地位组)的患者的手术等待时间。
高社会经济地位组患者平均等待31.1天,低社会经济地位组患者平均等待29.3天。当检查两组之间22种常见手术的等待时间差异时,只有前列腺切除术的差异具有统计学意义:高社会经济地位组患者比低社会经济地位组患者少等待4.4天。
我们几乎没有发现证据表明居住在社会经济地位处于最低三分之一的地区与择期手术等待时间较长有关。