ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2025
Effect of single-entry referral models and team-based care on wait times for hip and knee joint replacement in Ontario: a simulation study.
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Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Changes in driving distance to specialist physicians in the era of virtual care: a population-based cohort study in Ontario, Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Indonesian Patients' Experiences and Emotional Attachment to Healthcare Services Abroad: A Qualitative Study.Patient preference and adherence · 2025Article
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20 authors.
Pardis SeyediDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Dionne AlemanDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Nancy N BaxterDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Chaim M BellDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Merve BodurDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Andrew CalzavaraDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Robert CampbellDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Michael CarterDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Pieter de JagerDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Scott D EmersonDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Jonathan IrishDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Danielle MartinDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Samantha LeeDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Jonathan PersitzDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Marcy Saxe-BraithwaiteDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Julie TakataDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Olivia VarkulDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Suting YangDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
Claudia ZanchettaDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont.
David R UrbachDepartment of Mechanical & Industrial Engineering (Seyedi, Aleman, Bodur, Carter), University of Toronto, Toronto, Ont.; Faculty of Medicine and Health (Baxter), The University of Sydney, Camperdown, Australia; Department of Medicine (Bell), Sinai Health System; Department of Medicine (Bell), University of Toronto Temerty Faculty of Medicine; ICES Central (Calzavara, Emerson, Lee), Toronto, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Department of Anesthesia, Pain Management & Perioperative Medicine (de Jager), Dalhousie University, Halifax, NS; Otolaryngology, Head and Neck Surgery Clinic (Irish), University Health Network; Department of Family and Community Medicine (Martin), University of Toronto; Division of Plastic, Reconstructive and Hand Surgery (Persitz), University Health Network, Toronto, Ont.; The Medfall Group (Saxe-Braithwaite), St. Catharines, Ont.; Women's College Hospital (Takata), Toronto, Ont.; University of Ottawa (Varkul), Ottawa, Ont.; Data and Decision Sciences (Yang), Ontario Health; Access to Care (Zanchetta), Ontario Health (Cancer Care Ontario); Department of Surgery (Urbach), Women's College Hospital, Toronto, Ont. david.urbach@wchospital.ca.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLong wait times for scheduled surgery are a major problem in Canadian health systems. We sought to determine the extent to which single-entry referral models (next available consultation), team-based care models (next available surgery regardless of consulting surgeon), or both could affect wait times for consultations and surgery.
methodsWe performed a discrete-event simulation study of wait times for consultations and surgeries for knee and hip joint replacement in Ontario's 5 postal regions using prospectively collected data on surgical wait times. We simulated the effects of coordinated referral models on the wait time for consultation (wait 1) and surgery (wait 2).
resultsCoordinated models led to larger reductions in high-outlier wait times (as reflected by the 90th percentile and the percentage of patients exceeding wait-time targets) than on median wait times when compared with the status quo. Single-entry referral models largely influenced wait 1, and team-based models of care affected only wait 2. Fully integrated models incorporating both single-entry referral and team-based care largely prevented patients from exceeding both wait-1 and wait-2 targets; the percentage of patients exceeding wait-1 targets in these models was 0% in all regions, and the percentage exceeding wait-2 targets was 0% except for Ontario West (2.0%, from 35.7% at baseline), East (1.1%, from 22.7% at baseline), and North (1.0%, from 25.1% at baseline).
interpretationCoordinated referral and practice models improve access to scheduled surgery in Canadian health systems. Implementation of these models could largely eliminate prolonged wait times for joint replacement surgery in Ontario.
Indexed as
Arthroplasty, Replacement, HipArthroplasty, Replacement, KneePatient Care TeamReferral and ConsultationWaiting ListsFemaleHumansOntarioTime Factors
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