TY - JOUR
T1 - A patient-centred approach toward surgical wait times for colon cancer
T2 - A population-based analysis
AU - Gillis, Amy
AU - Dixon, Matthew
AU - Smith, Andrew
AU - Law, Calvin
AU - Coburn, Natalie G.
PY - 2014/4
Y1 - 2014/4
N2 - Background: Administrative wait times reflect the time from the decision to treat until surgery; however, this does not reflect the total time a patient actually waits for treatment. Several factors may prolong the wait for colon cancer surgery. We sought to analyze the time from the date of surgical consultation to the date of surgery and any events within this time frame that may extend wait times. Methods: We retrospectively reviewed the cases of all adult patients in Ontario aged 18-80 years with diagnosed colon cancer who did not receive neoadjuvant therapy and underwent resection electively between Jan. 1, 2002, and Dec. 31, 2009. Wait times were measured from the date of surgical consultation to the date of surgery. We chose a wait time of 28 days, reflecting local administrative targets, as a comparative benchmark. We performed univariate and multivariate analyses to identify variables contributing to a waits longer than 28 days. Variables were analyzed in continuous linear and logistic regression models. Results: We included 10 223 patients in our study. The median wait time from initial surgical consultation to resection was 31 (range 0-182) days. Age older than 65 years had a negative impact on wait time. Preoperative services, including computed tomography, cardiac consultation, echocardiography, multigated acquisition scan, magnetic resonance imaging, colonoscopy and cardiac catheterization also significantly in - creased wait times. Wait times were longer in rural hospitals. Conclusion: Preoperative services significantly increased wait times between initial surgical consultation and surgery.
AB - Background: Administrative wait times reflect the time from the decision to treat until surgery; however, this does not reflect the total time a patient actually waits for treatment. Several factors may prolong the wait for colon cancer surgery. We sought to analyze the time from the date of surgical consultation to the date of surgery and any events within this time frame that may extend wait times. Methods: We retrospectively reviewed the cases of all adult patients in Ontario aged 18-80 years with diagnosed colon cancer who did not receive neoadjuvant therapy and underwent resection electively between Jan. 1, 2002, and Dec. 31, 2009. Wait times were measured from the date of surgical consultation to the date of surgery. We chose a wait time of 28 days, reflecting local administrative targets, as a comparative benchmark. We performed univariate and multivariate analyses to identify variables contributing to a waits longer than 28 days. Variables were analyzed in continuous linear and logistic regression models. Results: We included 10 223 patients in our study. The median wait time from initial surgical consultation to resection was 31 (range 0-182) days. Age older than 65 years had a negative impact on wait time. Preoperative services, including computed tomography, cardiac consultation, echocardiography, multigated acquisition scan, magnetic resonance imaging, colonoscopy and cardiac catheterization also significantly in - creased wait times. Wait times were longer in rural hospitals. Conclusion: Preoperative services significantly increased wait times between initial surgical consultation and surgery.
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U2 - 10.1503/cjs.026512
DO - 10.1503/cjs.026512
M3 - Article
C2 - 24666446
AN - SCOPUS:84900854766
SN - 0008-428X
VL - 57
SP - 94
EP - 100
JO - Canadian Journal of Surgery
JF - Canadian Journal of Surgery
IS - 2
ER -