Coyte P C, Wright J G, Hawker G A, Bombardier C, Dittus R S, Paul J E, Freund D A, Ho E
Department of Health Administration and Institute for Policy Analysis, University of Toronto, Canada.
N Engl J Med. 1994 Oct 20;331(16):1068-71. doi: 10.1056/NEJM199410203311607.
Canada, which has universal single-payer health insurance, is often criticized for waiting times for surgery that are longer than those in the United States. We compared waiting times for orthopedic consultations and knee-replacement surgery and patients' acceptance of them in the United States and in the province of Ontario, Canada.
A stratified random sample of 1486 Medicare recipients (629 from the U.S. national sample, 428 from Indiana, and 429 from western Pennsylvania) and 516 people from Ontario who had been hospitalized for knee replacement between 1985 and 1989 were surveyed by mail in 1992. Patients were asked how long they had waited to see an orthopedic surgeon and to have surgery, the acceptability of these waiting times, and their overall satisfaction with surgery.
About 80 percent of the questionnaires were returned, but not all the respondents answered all the questions. The rate of response to specific questions was about 60 to 65 percent in both countries. The median waiting time for an initial orthopedic consultation was two weeks in the United States and four weeks in Ontario. The median waiting time for knee replacement after the operation had been planned was three weeks in the United States and eight weeks in Canada. In the United States, 95 percent of patients in the national sample considered their waiting time for surgery acceptable, as compared with 85.1 percent in Ontario. Overall satisfaction with surgery ("very or somewhat satisfied") was 85.3 percent for all U.S. respondents and 83.5 percent for Canadian respondents.
Waiting times for initial orthopedic consultation and for knee-replacement surgery were longer in Ontario than in the United States, but overall satisfaction with surgery was similar.
拥有全民单一支付者医疗保险的加拿大，常因手术等待时间长于美国而受到批评。我们比较了美国和加拿大安大略省骨科会诊及膝关节置换手术的等待时间以及患者对这些等待时间的接受程度。
1992年，我们通过邮件对1486名医疗保险受益人的分层随机样本（629名来自美国全国样本，428名来自印第安纳州，429名来自宾夕法尼亚州西部）以及1985年至1989年间因膝关节置换而住院的516名安大略省居民进行了调查。患者被问及他们等待看骨科医生及进行手术的时间、这些等待时间的可接受性以及他们对手术的总体满意度。
约80%的问卷被返还，但并非所有受访者都回答了所有问题。两国对特定问题的回答率约为60%至65%。美国初次骨科会诊的中位等待时间为两周，安大略省为四周。计划手术后膝关节置换的中位等待时间在美国为三周，在加拿大为八周。在美国，全国样本中95%的患者认为他们的手术等待时间可以接受，而安大略省这一比例为85.1%。所有美国受访者对手术的总体满意度（“非常满意或有些满意”）为85.3%，加拿大受访者为83.5%。
安大略省初次骨科会诊及膝关节置换手术的等待时间比美国长，但对手术的总体满意度相似。
