[Impact of an intervention on the waiting-list for medical specialists in a health area].
OBJECTIVE
To evaluate the impact on waiting-lists and waiting time of an intervention that modified the appointment system in specialist out-patients.


METHODS
Intervention study. Intervention group, medical specialists (MS); and control group, surgical specialists (SS). Comparison of variables. Analysis at one year (1997) and at two years (1998) of the intervention in the two groups.Setting. Area 20 of the health board for the Community of Valencia, a Southern county in the province of Alicante, which had 12 health districts and included specialist care.


METHODS
The first-visit diary for medical and surgical specialist clinics.Interventions. Redistribution of MS first visits in proportion with the population over 14 by areas. Health centre self-management of specialist appointments. Introduction of visits of choice and second-visit re-scheduling from specialist care. Introduction of clinical protocols for action and referral.


METHODS
Referral percentage. Patients seen in primary care and at medical and surgical specialist clinics. Days waiting to be seen by a specialist. Patients on waiting list. Index of waiting for consultations.


RESULTS
Referral ranged between 5.1% and 5.8%. There was a significant drop (P<.05) in the mean number of days an MS patient had to wait vs the SS (37 vs 48 in 1997 and 34 vs 50 in 1998), and in the number of MS consultations being waited for. There was a significant difference in the index of waiting for a consultation (P<.05) in favour of MS (17.74 vs 25.45 in 1997, and 16.77 vs 34.92).


CONCLUSIONS
The intervention optimised specialist medical health care in terms of the number of consultations and reduction of waiting time, with an improvement of these variables against SS.
Cano Montoro
J G
JG
Centro de Salud de Orihuela. Grupo de Investigación Clínica del Sureste (GICS). Orihuela (Alicante). España. cano_jga@gva.es
Medina Ferrer
E
E
Custardoy Olavarrieta
J
J
Pineda Cuenca
M
M
Orozco Beltrán
D
D
Quirce Andrés
F
F
D000293:Adolescent; D000328:Adult; D002391:Catchment Area, Health / Q000706:statistics & numerical data*; D006801:Humans; D008511:Medicine; D013030:Spain; D013038:Specialization; D013997:Time Factors; D014850:Waiting Lists