ArticleCanadian journal of surgery. Journal canadien de chirurgie2013
Impact of a regional acute care surgery model on patient access and outcomes.
Article in Canadian journal of surgery. Journal canadien de chirurgie, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Acute Care Surgery Models Worldwide: A Systematic Review.World journal of surgery · 2020Pooled it
- Spatial Accessibility to Emergency Departments and Surgical Treatment for Patients with Acute Appendicitis in South Korea.Yonsei medical journal · 2025Article
- The Optimal Distribution of Surgery in Low- and Middle-Income Countries: A Proposed Matrix for Determining Country-Level Organization of Surgical Services - A Response to the Recent Commentaries.International journal of health policy and management · 2022Article
- Impact of the acute care surgery model on resident operative experience in emergency general surgery.Canadian journal of surgery. Journal canadien de chirurgie · 2021Article
- Conceptualizing the Organization of Surgical Services Comment on "Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries".International journal of health policy and management · 2021Article
- The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador.World journal of surgery · 2020Article
- Pro-con debate on regionalization of emergency general surgery: controversy or common sense?Trauma surgery & acute care open · 2019Article
- Racial/Ethnic Disparities in Longer-term Outcomes Among Emergency General Surgery Patients: The Unique Experience of Universally Insured Older Adults.Annals of surgery · 2018Article
- Regional consolidation of orthopedic surgery: impacts on hip fracture surgery access and outcomes.Canadian journal of surgery. Journal canadien de chirurgie · 2017Article
- Specialization in acute care surgery in low-income and middle-income countries.Trauma surgery & acute care open · 2017Article
- Allocating operating room resources to an acute care surgery service does not affect wait-times for elective cancer surgeries: a retrospective cohort study.World journal of emergency surgery : WJES · 2014Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe consolidation of acute care surgery (ACS) services at 3 of 6 hospitals in a Canadian health region sought to alleviate a relative shortage of surgeons able to take emergency call. We examined how this affected patient access and outcomes.
methodsUsing the generalized linear model and statistical process control, we analyzed ACS-related episodes that occurred between 39 months prior to and 17 months after the model's implementation (n = 14,713).
resultsTime to surgery increased after the consolidation. Wait times increased primarily for patients presenting at nonreferral hospitals who were likely to require transfer to a referral hospital. Although ACS teams enabled referral hospitals to handle a much higher volume of patients without increasing within-hospital wait times, overall system wait times were lengthened by the growing frequency of patient transfers. Wait times for inpatient admission were difficult to interpret because there was a trend toward admitting patients directly to the ACS service, bypassing the emergency department (ED). For patients who did go through the ED, wait times for inpatient admission increased after the consolidation; however, this trend was cancelled out by the apparently zero waits of patients who bypassed the ED. Regionalization showed no impact on length of stay, readmissions, mortality or complications.
conclusionConsolidation enabled the region to ensure adequate surgical coverage without harming patients. The need to transfer patients who presented at nonreferral hospitals led to longer waits.
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