Smith T
Tayside Health Board, Dundee.
BMJ. 1994 Sep 3;309(6954):593-6.
To determine whether the period spent on the true inpatient waiting list is a valid indication of the total time that patients have to wait for an operation; and to assess the feasibility of monitoring the total "postreferral waiting time" by using existing computerised information systems.
Three randomly selected Scottish hospitals.
Waiting list patients admitted to hospital for operations during June to August 1993 in six major specialties, separate attention being focused on cataract operations and hip and knee replacements.
The total time that patients have to wait for an operation after the initial general practitioner referral--the postreferral waiting time--compared with that spent at the final stage of the process on the true inpatient waiting list.
In the specialties investigated roughly half (58 days; 53%) of the average postreferral wait of 110 days was spent on the true inpatient waiting list, one third (35 days; 32%) being spent on the outpatient waiting list and one sixth (17 days; 15%) waiting between waiting lists. Only a quarter of cataract patients (73/292) were treated within three months of general practitioner referral compared with over three quarters (228/292) within three months of being placed on the inpatient waiting list. Nevertheless, within a year over 99% of patients (290) had been treated whichever date was taken as the starting point.
Monitoring postreferral waiting times would provide a much more accurate picture for purchasers and patients of waiting times for treatment than is obtained by focusing exclusively on the true inpatient waiting list and facilitate fairer comparisons between NHS trusts in national league tables. Stringent national and local monitoring is essential to ensure (a) that future reductions in the time waiting on true inpatient waiting lists are not gained at the expense of longer periods waiting to be placed on the lists, and (b) that no increases occur in the number of patients placed instead on deferred waiting lists or exempted from the normal maximum waiting time guarantees.
确定在真正的住院等候名单上所花费的时间是否能有效反映患者等待手术的总时间；并评估利用现有计算机信息系统监测“转诊后总等待时间”的可行性。
随机选取的三家苏格兰医院。
1993年6月至8月期间因手术而入院的等候名单上的患者，涉及六个主要专科，其中白内障手术以及髋关节和膝关节置换手术被单独重点关注。
患者在初次由全科医生转诊后等待手术的总时间——转诊后等待时间——并与在该过程最后阶段在真正的住院等候名单上所花费的时间进行比较。
在所调查的专科中，平均转诊后等待110天的时间里，约一半（58天；53%）花在了真正的住院等候名单上，三分之一（35天；32%）花在了门诊等候名单上，六分之一（17天；15%）花在了等候名单之间的等待上。只有四分之一的白内障患者（73/292）在全科医生转诊后的三个月内接受了治疗，而在被列入住院等候名单后的三个月内，超过四分之三（228/292）的患者接受了治疗。然而，无论以哪个日期作为起点，一年内超过99%的患者（290名）都接受了治疗。
监测转诊后等待时间将为购买者和患者提供比仅关注真正的住院等候名单更准确的治疗等待时间情况，并有助于在全国排名表中对国民健康服务信托基金进行更公平的比较。严格的国家和地方监测对于确保以下两点至关重要：（a）未来真正住院等候名单上等待时间的减少不会以等待列入名单的时间延长为代价；（b）被列入延期等候名单或免除正常最长等待时间保障的患者数量不会增加。
