Waiting for care: what to expect?

What is it about?

The book places the analysis of waiting-time data within the paradigm of health services research, the study of outcomes of health care delivery to a population. We suggest two uses for this book. First, it is intended as a reference for health services researchers who are looking for statistical tools with which to study waiting times for health services. The book provides coverage of statistical concepts and methods for the analysis and interpretation of waiting-time data, such as time-to-event analysis, discrete-time regression models, competing risks, and pseudovalues regression models. Second, the book is a workbook for a range of professionals in the healthcare community, offering a collection of examples of waiting-time data analysis in health services research. It gives a practical perspective, from framing the study question through interpretation of results, describe and compare waiting experiences, how to study the impact of factors associated with waiting times, and how to use appropriate statistical techniques.

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Why is it important?

In health care systems with universal access to care, efforts to contain costs result in wait lists for surgical procedures. The length of time that patients are required to wait is usually uncertain. This uncertainty is a natural product of random variation in service time and arrival of urgent cases. In a queue for elective procedures, waiting-time uncertainty has many additional causes. For instance, decisions of both patients and care providers may override a queue discipline. Alternatively, the lack of a hospital resource, such as beds in the intensive care unit, may change queuing practices in favor of services that would not require the resource.