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International comparison of waiting times for selected cardiovascular procedures
R J Carroll1, S D Horn, B Soderfeldt
1Department of Medicine, Loyola University Medical Center, Maywood, IL 60153.
Insights
Patients in different healthcare systems face varying wait times for cardiovascular procedures. Studies show longer waits in systems outside the U.S. non-VA hospitals, particularly for elective surgeries.
Area of Science:
- Cardiovascular medicine
- Health services research
- Comparative healthcare systems
Background:
- National healthcare systems often face criticism for extended waiting times for high-technology procedures.
- Objective data comparing U.S. healthcare systems with international counterparts regarding procedure wait times are limited.
Purpose of the Study:
- To compare waiting times for cardiovascular procedures across five distinct healthcare delivery and financing systems.
- To provide objective data on wait times for coronary angiography and coronary artery bypass surgery.
Main Methods:
- A mailed questionnaire was distributed to directors of cardiac catheterization labs, cardiac surgery departments, and cardiology clinics.
- Respondents represented the United States (including VA system), Canada, the United Kingdom, and Sweden.
- The questionnaire assessed estimated wait times for specific case scenarios of elective and urgent procedures.
Main Results:
- Significant differences in waiting times (p < 0.00001) were observed across all five systems for all four procedural scenarios.
- Waiting times were significantly longer in all compared systems than in non-VA U.S. hospitals, except for urgent surgery in U.S. VA hospitals.
- The United Kingdom, Sweden, and Canada reported the longest waiting times, with some elective procedures exceeding 9 months.
Conclusions:
- Physicians perceive longer waiting times for cardiac catheterization and coronary artery bypass surgery in healthcare systems structured differently from the U.S. non-VA model.
- The findings highlight significant inter-system variations in access to timely cardiovascular care.
Objectives:
This study was designed to compare waiting times for cardiovascular procedures in five different health care delivery/financing systems.
Background:
A recurrent criticism of national health care systems is long waiting times, or "queues," for high technology procedures. However, no objective data exist comparing waiting times in the United States with those in other systems.
Methods:
Directors of cardiac catheterization laboratories, directors of cardiac surgery in the United States, U.S. Department of Veterans Affairs (VA) system, Canada and the United Kingdom and directors of cardiology clinics in Sweden were asked to respond to a mailed questionnaire as to how long it would take to obtain coronary angiography or coronary artery bypass surgery, or both, for specified case scenarios at their institutions.
Results:
Significant differences in waiting times (p < 0.00001) were found among the systems for all four scenarios (elective and urgent angiography, elective and urgent bypass surgery). Compared with non-VA hospitals in the United States, waiting times were significantly longer in all systems, with the exception of waiting times for urgent surgery in the U.S. VA hospitals (p = 0.9). The longest waiting times for all four procedures were reported in the United Kingdom, Sweden and Canada, with some waiting times for elective procedures > 9 months.
Conclusions:
Physicians report that patients treated in health care systems structured differently from the non-VA hospital system in the United States wait significantly longer for cardiac catheterization and coronary artery bypass surgery.