Evidence map›Paper›PMID 38114259›Full record

ArticleCMAJ open

Social determinants of access to timely elective surgery in Ontario, Canada: a cross-sectional population level study.

Pieter de Jager, Dionne Aleman, Nancy Baxter, Chaim Bell, Merve Bodur, Andrew Calzavara, Robert Campbell, Michael Carter, Scott Emerson, Anna Gagliardi and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Association of marginalization and PSMA-PET in prostate cancer An analysis of the Ontario PSMA-PET Registry for Recurrent Prostate Cancer.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2025
    Article
  3. Article
4 · The record

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5 · Who and what money

Authors and funding

19 authors.

Pieter de JagerDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont. Pieter.deJager@nshealth.ca.
Dionne AlemanDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Nancy BaxterDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Chaim BellDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Merve BodurDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Andrew CalzavaraDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Robert CampbellDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Michael CarterDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Scott EmersonDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Anna GagliardiDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Jonathan IrishDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Danielle MartinDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Samantha LeeDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Marcy Saxe-BraithwaiteDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Pardis SeyediDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Julie TakataDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Suting YangDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
Claudia ZanchettaDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.
David UrbachDepartment of Anesthesia, Pain Management & Peri-operative Medicine (de Jager), Dalhousie University, Halifax, NS; Department of Mechanical and Industrial Engineering (Aleman, Bodur, Carter, Seyedi), University of Toronto, Toronto, Ont.; University of Melbourne School of Population and Global Health (Baxter), Carlton, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Human Early Learning Partnership (Emerson), School of Population and Public Health, The University of British Columbia, Vancouver, BC; Toronto General Research Institute (Gagliardi), and Otolaryngology, Head and Neck Surgery (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.; Nova Scotia Health Authority (Saxe-Braithwaite), Halifax, NS; Women's College Hospital (Takata); Ontario Health (Yang); Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Surgery, Toronto, Ont.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEquitable access to surgical care has clinical and policy implications. We assess the association between social disadvantage and wait times for elective surgical procedures in Ontario.

methodsWe conducted a cross-sectional analysis using administrative data sets of adults receiving nonurgent inguinal hernia repair, cholecystectomy, hip arthroplasty, knee arthroplasty, arthroscopy, benign uterine surgery and cataract surgery from April 2013 to December 2019. We assessed the relation between exceeding target wait times and the highest versus lowest quintile of marginalization dimensions by use of generalized estimating equations logistic regression.

resultsOf the 1 385 673 procedures included, 174 633 (12.6%) exceeded the target wait time. Adjusted analysis for cataract surgery found significantly increased odds of exceeding wait times for residential instability (adjusted odd ratio [OR] 1.16, 95% confidence interval [CI] 1.11-1.21) and recent immigration (adjusted OR 1.12, 95% CI 1.07-1.18). The highest deprivation quintile was associated with 18% (adjusted OR 1.18, 95% CI 1.12-1.24) and 20% (adjusted OR 1.20, 95% CI 1.12-1.28) increased odds of exceeding wait times for knee and hip arthroplasty, respectively. Residence in areas where higher proportions of residents self-identify as being part of a visible minority group was independently associated with reduced odds of exceeding target wait times for hip arthroplasty (adjusted OR 0.82, 95% CI 0.75-0.91), cholecystectomy (adjusted OR 0.68, 95% CI 0.59-0.79) and hernia repair (adjusted OR 0.65, 95% CI 0.56-0.77) with an opposite effect in benign uterine surgery (adjusted OR 1.28, 95% CI 1.17-1.40).

interpretationSocial disadvantage had a small and inconsistent impact on receiving care within wait time targets. Future research should consider these differences as they relate to resource distribution and the organization of clinical service delivery.

Identifiers

PMID38114259
PMCPMC10743664

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