How to report and monitor the performance of waiting list management.
OBJECTIVE
Potential problems concerning waiting list management are often monitored using mean waiting times based on empirical samples. However, the appropriateness of mean waiting time as an indicator of access can be questioned if a waiting list is not managed well, e.g., if the queue discipline is violated. This study was performed to find out about the queue discipline in waiting lists for elective surgery to reveal potential discrepancies in waiting list management.


METHODS
There were 1,774 waiting list patients for hallux valgus or varicose vein surgery or sterilization. The waiting time distributions of patients receiving surgery and of patients still waiting for an operation are presented in column charts. The charts are compared with two model charts. One model chart presents a high queue discipline (first in-first out) and another a poor queue discipline (random) queue.


RESULTS
There were significant differences in waiting list management across hospitals and patient categories. Examples of a poor queue discipline were found in queues for hallux valgus and varicose vein operations.


CONCLUSIONS
A routine waiting list reporting should be used to guarantee the quality of waiting list management and to pinpoint potential problems in access. It is important to monitor not only the number of patients in the waiting list but also the queue discipline and the balance between demand and supply of surgical services. The purpose for this type of reporting is to ensure that the priority setting made at health policy level also works in practise.
Torkki
Markus
M
Helsinki University Central Hospital.
Linna
Miika
M
Seitsalo
Seppo
S
Paavolainen
Pekka
P
D019352:Censuses; D003628:Database Management Systems; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005387:Finland; D006215:Hallux Valgus / Q000601:surgery; D006292:Health Priorities; D006297:Health Services Accessibility / Q000458:organization & administration*; D006779:Hospitals, Public / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008330:Management Audit; D013245:Sterilization, Reproductive; D013996:Time and Motion Studies; D014648:Varicose Veins / Q000601:surgery; D014850:Waiting Lists