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Updated: Aug 6, 2026
Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Socioeconomic Disparities in Surgical Wait Times for Elective Hysterectomy
Sarah Shamiya1, Nupur Dogra1, Aliya Allen-Valley2
1Trillium Health Partners & The Institute for Better Health, Mississauga, ON; University of Toronto, Department of Obstetrics & Gynecology, Toronto, ON.
Objective:
To evaluate the impact of socioeconomic status (SES) on wait times for elective hysterectomy across benign and malignant indications in a public health care system.
Methods:
This retrospective cohort study analyzed elective hysterectomies performed between 2022 and 2024 in a Canadian hospital network serving ∼1.5 million people, where ∼70% identify as racialized. SES was defined using the 2021 Ontario Marginalization Index material resources dimension, a validated neighbourhood-level indicator of deprivation. The primary outcome was wait time, defined as the time from the decision to treat to the procedure date. Negative binomial regression assessed the relationship between SES and wait times.
Results:
Of 1498 hysterectomies, 730 were for benign and 768 for cancer indications. For benign hysterectomy, patients in the lowest SES quintile (Q5) experienced 26% longer adjusted wait times than the highest SES quintile (Q1) (rate ratio 1.26; 95% CI 1.10-1.45, P = 0.001). No significant wait time differences were observed for cancer-related hysterectomy between Q1 and Q5 (median 27 vs. 24 days, P = 0.239).
Conclusions:
Significant SES-based disparities exist in access to benign hysterectomy within a publicly funded health care system. Patients from more marginalized neighbourhoods experience longer waits, highlighting the need for targeted strategies to improve equity in gynaecologic surgical care.