SynthesisBMJ open2017
What is the influence of single-entry models on access to elective surgical procedures? A systematic review.
Synthesis in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses 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
31 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Patient and provider perspective with the use of a central intake system (CIS) for surgical waitlist management: a systematic review.BMJ open · 2025Pooled it
- The effectiveness of different patient referral systems to shorten waiting times for elective surgeries: systematic review.BMC health services research · 2021Pooled it
- Pooled it
- Mapping strategies for reducing inequalities in adult elective surgical care in the United Kingdom: a living scoping review.BMC health services research · 2026Article
- COVID-related delays in non-urgent adult surgeries: comparing population-based results from two Canadian provinces.Frontiers in surgery · 2025Article
- Exploratory analysis using discrete event simulation modelling of the wait times and service costs associated with the maximum wait time guarantee policy applied in a rheumatology central intake clinic.Health systems (Basingstoke, England) · 2025Article
- Article
- Improving access to chronic pain care with central referral and triage: The 6-year findings from a single-entry model.Canadian journal of pain = Revue canadienne de la douleur · 2024Article
- Mapping a shared care model in complex gastrointestinal surgery: A qualitative study of queues and stakeholders within a Canadian general surgery practice.Healthcare management forum · 2023Article
- Referring and Specialist Physician Gender and Specialist Billing.JAMA network open · 2023Article
- Delivery and Prioritization of Surgical Care in Canada During COVID-19: An Environmental Scan.International journal of health policy and management · 2023Article
- A Simulation Modelling Study of Referral Distribution Policies in a Centralized Intake System for Surgical Consultation.Journal of medical systems · 2022Article
- Wait time management strategies at centralized intake system for hip and knee replacement surgery: A need for a blended evidence-based and patient-centered approach.Osteoarthritis and cartilage open · 2022Article
- Article
- Exploring the implementation and underlying mechanisms of centralized referral systems to access specialized health services in Quebec.BMC health services research · 2021Article
- Alternative care providers in rheumatoid arthritis patient care: a queueing and simulation analysis.Health systems (Basingstoke, England) · 2021Article
- Article
- Variation in surgical demand and time to hip fracture repair: a Canadian database study.BMC health services research · 2020Article
- Modelling the backlog of COVID-19 cases for a surgical group.Canadian journal of surgery. Journal canadien de chirurgie · 2020Article
- Confronting the COVID-19 surgery crisis: time for transformational change.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundSingle-entry models (SEMs) for the management of patients awaiting elective surgical services are designed to increase access and flow through the system of care. We assessed scope of use and influence of SEMs on access (waiting times/throughput) and patient-centredness (patient/provider acceptability).
methodsSystematic review of articles published in 6 relevant electronic databases included studies from database inception to July 2016. Included studies needed to (1) report on the nature of the SEM; (2) specify elective service and (3) address at least 1 of 3 research questions related to (1) scope of use of SEMs; (2) influence on timeliness and access; (3) patient-centredness and acceptability. Article quality was assessed using a modified Downs and Black checklist.
results11 studies from Canada, Australia and the UK were included with mostly weak observational design-2 simulations, 5 before-after, 2 descriptive and 2 cross-sectional studies. 9 studies showed a decrease in patient waiting times; 6 showed that more patients were meeting benchmark waiting times; and 5 demonstrated that waiting lists decreased using an SEM as compared with controls. Patient acceptability was examined in 6 studies, with high levels of satisfaction reported. Acceptability among general practitioners/surgeons was mixed, as reported in 1 study. Research varied widely in design, scope, reported outcomes and overall quality.
conclusionsThis is the first review to assess the influence of SEMs on access to elective surgery for adults. This review demonstrates a potential ability for SEMs to improve timeliness and patient-centredness of elective services; however, the small number of low-quality studies available does not support firm conclusions about the effectiveness of SEMs to improve access. Further evaluation with higher quality designs and rigour is required.
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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.