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Related Experiment Videos

Fairness in the coronary angiography queue.

D A Alter1, A S Basinski, E A Cohen

  • 1Sunnybrook & Women's College Health Sciences Centre, Ont.

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
|October 26, 1999
PubMed
Summary
This summary is machine-generated.

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Waiting times for coronary angiography reflect clinical urgency but are also influenced by physician affiliation. This impacts patient priority and access to care.

Area of Science:

  • Cardiology
  • Health Services Research

Background:

  • Coronary angiography waiting lists often lack explicit criteria, potentially deprioritizing clinically urgent patients.
  • Patient priority may not align with clinical acuity due to informal queuing practices.

Purpose of the Study:

  • To investigate clinical and nonclinical factors influencing patient waiting times for coronary angiography.
  • To assess the impact of physician referral patterns on angiography access.

Main Methods:

  • A prospective cohort study followed 357 patients from triage to angiography or adverse event.
  • Physician hospital affiliation and a retrospective clinical urgency rating scale were analyzed.
  • Waiting times were compared against recommended maximum waiting times (RMWT) across referral groups.

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Main Results:

  • Clinical factors partially aligned with urgency ratings, showing moderate agreement with actual waiting times (kappa = 0.53).
  • Physician affiliation was a significant independent predictor of waiting time (p < 0.001).
  • Physician affiliation explained 9.3% of waiting time variation, compared to 45.6% for all clinical factors.

Conclusions:

  • Informal coronary angiography queuing systems incorporate clinical acuity but are significantly swayed by nonclinical factors.
  • Physician relationships with the catheterization facility influence patient access to timely procedures.