ArticleCMAJ open
Patient and operational factors affecting wait times in a bariatric surgery program in Toronto: a retrospective cohort study.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effectiveness of different patient referral systems to shorten waiting times for elective surgeries: systematic review.BMC health services research · 2021Pooled it
- Resource utilization and disaggregated cost analysis of bariatric surgery in the Australian public healthcare system.The European journal of health economics : HEPAC : health economics in prevention and care · 2022Article
- Insurance-Related Delay in Access to Bariatric Surgery, Is It Helpful as Is Thought?Obesity surgery · 2020Article
- Comparison of Comorbidity Treatment and Costs Associated With Bariatric Surgery Among Adults With Obesity in Canada.JAMA network open · 2020Article
- Earlier Provision of Gastric Bypass Surgery in Canada Enhances Surgical Benefit and Leads to Cost and Comorbidity Reduction.Frontiers in public health · 2020Article
- Design, planning and implementation lessons learnt from a surgical multi-centre randomised controlled trial.Trials · 2019Article
- Non-alcoholic fatty liver disease and obesity: the role of the gut bacteria.European journal of nutrition · 2019Review
- Improving the Referral Process, Timeliness, Effectiveness, and Equity of Access to Specialist Medical Services Through Electronic Consultation: Pilot Study.JMIR medical informatics · 2019Article
- Optimizing Bariatric Surgery Multidisciplinary Follow-up: a Focus on Patient-Centered Care.Obesity surgery · 2017Article
Corrections and comments
- Commented on by
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncreasing rates of obesity have led to growing demand for bariatric surgery. This has implications for wait times, particularly in publicly funded programs. This study examined the impact of patient and operational factors on wait times in a multidisciplinary bariatric surgery program.
methodsA retrospective study was conducted involving patients who were referred to a tertiary care centre (University Health Network, Toronto Western Hospital, Toronto) for bariatric surgery between June 2008 and July 2011. Patient characteristics, dates of clinical assessments and records describing operational changes were collected. Univariable analysis and multivariable log-linear and parametric time-to-event regressions were performed to determine whether patient and operational covariates were associated with the wait time for bariatric surgery (i.e., length of preoperative evaluation).
resultsOf the 1664 patients included in the analysis, 724 underwent surgery with a mean wait time of 440 (standard deviation 198) days and a median wait time of 445 (interquartile range 298-533) days. Wait times ranged from 3 months to 4 years. Univariable and multivariable analyses showed that patients with active substance use (β = 0.3482, p = 0.02) and individuals who entered the program in more recent operational periods (β = 0.2028, p < 0.001) had longer wait times. Additionally, the median time-to-surgery increased over 3 discrete operational periods (characterized by specific program changes related to scheduling and staffing levels, and varying referral rates and defined surgical targets; p < 0.001).
interpretationSome patients could be identified at referral as being at risk for longer wait times. We also found that previous operational decisions significantly increased the wait time in the program since its inception. Therefore, careful consideration must be devoted to process-level decision-making for multistage bariatric surgical programs, because managerial and procedural changes can affect timely access to treatment.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.