Health Analysis Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
Health Rep. 2010 Jun;21(2):7-14.
Waiting for specialist consultations can represent a substantial component of overall waiting time in the continuum of care. However, relatively little is known about the factors associated with how long patients wait for an initial specialist consultation.
The analysis is based on a subsample of 5,515 respondents aged 15 or older to the 2007 Canadian Community Health Survey who had consulted a specialist about a new condition in the previous 12 months and reported a waiting time. Multivariate logistic regression models were used to identify patient- and provider-related factors associated with waiting time.
Female patients were less likely than male patients to see a specialist within a month. The nature of the new condition and the source of referral were significantly associated with waiting time. Compared with those referred by a family physician, patients referred by another specialist or a health care provider other than a physician, or who did not require a referral, were more likely to have a shorter waiting time. For men, but not women, household income and immigrant status were associated with waiting time.
This analysis suggests that factors beyond medical need are associated with how long patients wait to see a specialist. More research could usefully explore decision-making and communication processes between primary care physicians and specialists to better understand how urgency is assessed, how patients are triaged for specialist consultations, and how these patterns differ among various groups of patients.
在医疗保健连续体中,等待专家会诊可能占总等待时间的很大一部分。然而,人们对患者等待首次专家会诊的时间长短相关因素的了解相对较少。
该分析基于对 2007 年加拿大社区健康调查中年龄在 15 岁及以上的 5515 名受访者的一个子样本,这些受访者在过去 12 个月内因新病症咨询过专家,并报告了等待时间。使用多变量逻辑回归模型来确定与等待时间相关的患者和提供者相关因素。
女性患者比男性患者在一个月内看专家的可能性更小。新病症的性质和转诊来源与等待时间显著相关。与由家庭医生转诊的患者相比,由其他专家或医生以外的医疗保健提供者转诊的患者,或无需转诊的患者,更有可能等待时间较短。对于男性,但不是女性,家庭收入和移民身份与等待时间相关。
这项分析表明,除医疗需求以外的因素与患者等待看专家的时间长短有关。进一步的研究可以深入探讨初级保健医生和专家之间的决策和沟通过程,以更好地了解紧急情况是如何评估的,患者如何分诊接受专家会诊,以及这些模式在不同患者群体中如何不同。