加拿大专科服务等待时间不可接受的决定因素。
Determinants of unacceptable waiting times for specialized services in Canada.
作者信息
Sanmartin Claudia, Berthelot Jean-Marie, McIntosh Cameron N
机构信息
Health Analysis and Measurement Group, Statistics Canada, Ottawa, ON.
出版信息
Healthc Policy. 2007 Feb;2(3):e140-54.
BACKGROUND
Much of the current evidence regarding timely access to healthcare services focuses on the duration of the waiting time as the principal determinant of wait time acceptability. We conducted the first national-level analysis of wait time acceptability in Canada to identify the determinants of unacceptable waits for specialized healthcare services, including selected demographic and socio-economic variables.
METHODS
We analyzed data reported by respondents to a national survey on access to healthcare services who accessed specialized services (i.e., specialist visits, non-emergency surgery and selected diagnostic tests) during a 12-month period. We used univariate analyses and weighted logistic regression to examine the relation between wait time acceptability and selected demographic, socio-economic and health status factors for each specialized service.
RESULTS
Between 17% and 29% of patients who waited for a specialized service declared that their waiting time was unacceptable. Most individuals reported waiting less than 3 months for their services. Between 10% and 19% of those who waited indicated that waiting for care affected their lives. Results of the logistic regression analyses showed that longer waits and adverse experiences during the waiting period were significantly associated with higher odds of reporting an unacceptable waiting time for all three types of specialized services. The role of socio-economic and demographic factors on wait time acceptability was varied. Individuals with lower education were consistently less likely to consider their waiting times unacceptable. Patients less than 65 years of age were more likely to consider their waiting times unacceptable for specialist visits and diagnostic tests.
INTERPRETATION
Our study shows that the primary determinants of waiting time acceptability are the length of the waiting time and the effects of waiting on the patient's life. In addition, some patient characteristics, such as age and education, may play a role, pointing to the potential role of patient expectations in determining the acceptability of waits for specialized services.
背景
目前关于及时获得医疗服务的许多证据都将等待时间的长短作为等待时间可接受性的主要决定因素。我们对加拿大等待时间的可接受性进行了首次国家级分析，以确定专科医疗服务不可接受等待时间的决定因素，包括选定的人口统计学和社会经济变量。
方法
我们分析了全国医疗服务可及性调查中受访者报告的数据，这些受访者在12个月内接受了专科服务（即专科门诊、非急诊手术和选定的诊断检查）。我们使用单变量分析和加权逻辑回归来检验每种专科服务的等待时间可接受性与选定的人口统计学、社会经济和健康状况因素之间的关系。
结果
在等待专科服务的患者中，17%至29%的人表示他们的等待时间不可接受。大多数人报告等待服务的时间不到3个月。在等待的人中，10%至19%的人表示等待治疗影响了他们的生活。逻辑回归分析结果表明，等待时间越长以及等待期间的不良经历与报告这三种专科服务的不可接受等待时间的较高几率显著相关。社会经济和人口统计学因素对等待时间可接受性的作用各不相同。受教育程度较低的人一直不太可能认为他们的等待时间不可接受。65岁以下的患者更有可能认为他们的专科门诊和诊断检查等待时间不可接受。
解读
我们的研究表明，等待时间可接受性的主要决定因素是等待时间的长短以及等待对患者生活的影响。此外，一些患者特征，如年龄和教育程度，可能会起到一定作用，这表明患者期望在确定专科服务等待的可接受性方面可能具有潜在作用。
Zotero 插件