Health Technology Assessment Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel; Dept. of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Biostatistics & Biomathematics Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel.
Health Policy. 2020 Aug;124(8):805-811. doi: 10.1016/j.healthpol.2020.06.006. Epub 2020 Jun 11.
Monitoring waiting time (WT) in healthcare systems is essential, since long WT are associated with adverse health outcomes, reduced patient satisfaction and increased private financing.
To describe a methodology developed for routine national monitoring of WT for community-based non-urgent specialist appointments, in a public healthcare system.
The methodology is based on data from computerized appointment scheduling systems of all Health Maintenance Organizations (HMOs) in Israel. Data included first 50 available appointments for community-based specialists and actual number of visits. Five most frequent specialties: orthopedics, ophthalmology, gynecology, dermatology and otolaryngology, were included. WT offered to HMO members for non-urgent care was calculated for two scenarios: "specific" physician and "any" physician in the region. Distribution of offered WT was calculated separately for each specialty and geographical region, combined to create the nationwide distribution.
The methodology was tested on data extracted between December 2018-June 2019. Estimated national median WT for "specific" physician, ranged from 9 days (ophthalmology/gynecology) to 20 days (dermatology), with large variation between geographic regions. WT were 26-56 % shorter for "any" than for "specific" physician.
This novel method offers a solution for ongoing national WT measurement, using computerized scheduling systems. It integrates two scenarios for appointment scheduling and allows identification of differences between specialties and regions, setting the ground for interventions to strengthen public healthcare systems.
在医疗保健系统中监测等待时间（WT）至关重要，因为长的 WT 与不良健康结果、降低患者满意度和增加私人融资有关。
描述一种用于常规监测公共医疗保健系统中基于社区的非紧急专科预约 WT 的方法。
该方法基于以色列所有健康维护组织（HMO）的计算机化预约安排系统中的数据。数据包括社区专科医生的前 50 个可用预约和实际就诊次数。纳入了最常见的五个专科：骨科、眼科、妇科、皮肤科和耳鼻喉科。为非紧急护理向 HMO 成员提供的 WT 计算了两种情况：“特定”医生和“任何”医生在该地区。分别为每个专科和地理区域计算提供的 WT 分布，并将其组合以创建全国分布。
该方法在 2018 年 12 月至 2019 年 6 月之间提取的数据上进行了测试。估计全国范围内“特定”医生的 WT 中位数范围从 9 天（眼科/妇科）到 20 天（皮肤科），不同地理区域之间差异很大。对于“任何”医生来说，WT 比“特定”医生短 26-56%。
该新方法为使用计算机化预约系统进行持续的全国 WT 测量提供了一种解决方案。它整合了预约安排的两种情况，并允许识别专科和地区之间的差异，为加强公共医疗保健系统的干预措施奠定了基础。
