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Are We Truly Addressing the Elective Surgery Backlog?

Daniel Jones1, Maulik Gandhi2

  • 1Trauma and Orthopaedics, Bradford Royal Infirmary, Bradford, GBR.

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|March 17, 2026
PubMed
Summary
This summary is machine-generated.

Coding errors significantly impact elective surgery waiting times. Acute cases miscoded as elective artificially shorten waitlists, highlighting a need for improved data accuracy in orthopaedic surgery.

Keywords:
accurate databacklogcodingelective surgerywaiting time

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Area of Science:

  • Health Sciences
  • Medical Informatics
  • Surgical Specialties

Background:

  • The UK faces extensive waiting lists in orthopaedics, with increasing numbers of patients awaiting elective surgery.
  • Acute orthopaedic cases may be incorrectly coded as elective, particularly during surges in referrals, impacting waiting time data.
  • Accurate coding is crucial for understanding and managing surgical waiting lists effectively.

Purpose of the Study:

  • To quantify the impact of coding errors on elective orthopaedic surgery waiting times.
  • To investigate the discrepancy between electronic booking codes and actual patient case notes.
  • To determine the extent to which miscoded acute cases influence reported elective waiting times.

Main Methods:

  • Retrospective analysis of 381 patients undergoing elective orthopaedic surgery between January 1, 2025, and March 31, 2025.
  • Comparison of electronic booking codes with patient case notes to verify coding accuracy (elective vs. acute).
  • Statistical analysis, including Mann-Whitney U test, to assess the significance of coding discrepancies on waiting times.

Main Results:

  • 44 out of 381 patients (11.55%) coded as elective were actually acute cases.
  • Mean waiting time for falsely coded elective cases was 10.86 days, versus 247.24 days for true elective cases.
  • Incorrect coding artificially reduced the mean waiting time by 27.14 days (11.01%), a statistically significant finding (p = 0.012).

Conclusions:

  • Inaccurate electronic coding significantly and artificially reduces reported orthopaedic surgery waiting times.
  • Human and software errors in Electronic Patient Record (EPR) systems likely contribute to miscoding.
  • Recommendations include reviewing EPR software, enhancing staff training, and optimizing cold-site operating to improve coding accuracy and patient care separation.