Evidence map›Paper›PMID 39116181›Full record

ArticlePloS one2024

Surgeon- and hospital-level variation in wait times for scheduled non-urgent surgery in Ontario, Canada: A cross-sectional population-based 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 PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–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

6 citing papers in PubMed.

  1. Article
  2. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Article
  3. Single-entry models as an ethical approach to decreasing surgical wait times.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Article
  4. Article
  5. Early Adoption of Thyroid Radiofrequency Ablation in Canada: Physician Experiences, Barriers, and Facilitators to Implementation.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
    Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Pieter de JagerDepartment of Anesthesia, Pain Management & Peri operative Medicine, Dalhousie University, Halifax, NS, Canada.ORCID 0000-0002-3085-9532
Dionne AlemanDepartment of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada.
Nancy BaxterUniversity of Melbourne School of Population and Global Health, Carlton, Australia.
Chaim BellDepartment of Medicine, Sinai Health System, Toronto, Ontario, Canada.
Merve BodurDepartment of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada.
Andrew CalzavaraICES Central, Toronto, Ontario, Canada.
Robert CampbellDepartment of Ophthalmology, Queen's University, Kingston, Ontario, Canada.
Michael CarterDepartment of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0001-8423-6747
Scott EmersonHuman Early Learning Partnership, School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada.
Anna GagliardiToronto General Research Institute, Toronto, Ontario, Canada.
Jonathan IrishDepartment of Otolaryngology, Head and Neck Surgery, University Health Network, Toronto, Ontario, Canada.
Danielle MartinDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Samantha LeeICES Central, Toronto, Ontario, Canada.
Marcy SaxeBraithwaiteNova Scotia Health Authority, Halifax, NS, Canada.
Pardis SeyediDepartment of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada.
Julie TakataDepartment of Surgery, Women's College Hospital, Surgery, Toronto, Ontario, Canada.
Suting YangOntario Health, Toronto, Ontario, Canada.
Claudia ZanchettaAccess to Care, Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada.
David R UrbachDepartment of Surgery, Women's College Hospital, Surgery, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCanadian health systems fare poorly in providing timely access to elective surgical care, which is crucial for quality, trust, and satisfaction.

methodsWe conducted a cross-sectional analysis of surgical wait times for adults receiving non-urgent cataract surgery, knee arthroplasty, hip arthroplasty, gallbladder surgery, and non-cancer uterine surgery in Ontario, Canada, between 2013 and 2019. We obtained data from the Wait Times Information System (WTIS) database. Inter- and intra-hospital and surgeon variations in wait time were described graphically with caterpillar plots. We used non-nested 3-level hierarchical random effects models to estimate variation partition coefficients, quantifying the proportion of wait time variance attributable to surgeons and hospitals.

resultsA total of 942,605 procedures at 107 healthcare facilities, conducted by 1,834 surgeons, were included in the analysis. We observed significant intra- and inter-provider variations in wait times across all five surgical procedures. Inter-facility median wait time varied between six-fold for gallbladder surgery and 15-fold for knee arthroplasty. Inter-surgeon variation was more pronounced, ranging from a 17-fold median wait time difference for cataract surgery to a 216-fold difference for non-cancer uterine surgery. The proportion of variation in wait times attributable to facilities ranged from 6.2% for gallbladder surgery to 23.0% for cataract surgery. In comparison, surgeon-related variation ranged from 16.0% for non-cancer uterine surgery to 28.0% for cataract surgery. IMPLICATIONS: There is extreme variability in surgical wait times for five common, high-volume, non-urgent surgical procedures. Strategies to address surgical wait times must address the variation between service providers through better coordination of supply and demand. Approaches such as single-entry models could improve surgical system performance.

Indexed as

Elective Surgical ProceduresSurgeonsWaiting ListsAdultAgedCross-Sectional StudiesFemaleHospitalsHumansMaleMiddle AgedOntarioTime Factors

Identifiers

PMID39116181
PMCPMC11309399

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.