Health service costs for patients on the waiting list.
OBJECTIVE
To find out if the cost of health services was artificially increased because of a delay in surgery due to a lack of resources.


METHODS
A retrospective cohort study.


METHODS
Three urban hospitals in Calgary, Alta.


METHODS
The study cohort comprised 4441 patients (1 index procedure for each patient).


METHODS
Cholecystectomy, discectomy, hysterectomy, total knee and total hip replacements.


METHODS
The costs for physician claims, use of home care and pharmaceutical prescriptions 1 year before and after the selected procedures, using 1997/98 administrative records and waiting times maintained by Alberta Health and Wellness and Calgary Regional Health Authority.


RESULTS
The median wait for joint surgery (88 d for knee replacements and 65 d for hip replacements) was longer than for the other selected procedures (29 d for cholecystectomies, 21 d for discectomies and 42 d for hysterectomies). Total per patient physician claim costs decreased after surgery (cholecystectomy--30%, discectomy--24%, hip replacement--6%, hysterectomy--23% and knee replacement--4%). Seeing the procedure specialist more than once preoperatively was associated with a greater decrease in postoperative physician claim costs. Longer waits were not associated with more physician claim costs or Blue Cross prescriptions claim costs for seniors (> or = 65 yr) in the year before or after surgery nor were they associated with more physician claim costs during the actual wait compared with a matched postoperative time period.


CONCLUSIONS
No evidence was found to suggest that waiting for 1 of 5 common surgical procedures is correlated with greater health service expenditures pre- or postoperatively. In this study, wait time is not a proxy for health service use nor do health service costs decrease markedly after surgery.
Quan
Hude
H
Department of Community Heolth Sciences, University of Calgary, Alta. hquan@ucalgary.ca
Lafreniere
Rene
R
Johnson
David
D
D000416:Alberta; D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D019645:Arthroplasty, Replacement, Knee / Q000191:economics*; D002763:Cholecystectomy / Q000191:economics*; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D017586:Diskectomy / Q000191:economics*; D015276:Health Care Rationing; D005102:Health Expenditures; D006302:Health Services Research; D006786:Hospitals, Urban; D006801:Humans; D007044:Hysterectomy / Q000191:economics*; D014850:Waiting Lists