Equity and need when waiting for total hip replacement surgery.
OBJECTIVE
To explore sociodemographic and health status factors associated with waiting times both for first outpatient appointment and for total hip replacement surgery (THR).


METHODS
A survey of THR in five former English regions was conducted between September 1996 and October 1997. Every patient listed for THR was asked to fill out a questionnaire preoperatively. This questionnaire included the 12-item Oxford Hip Score (OHS) questionnaire and two questions on the length of time patients waited for an outpatient appointment and subsequently for their operation.


RESULTS
From multiple logistic regression analyses, region, private vs. public sector, housing tenure and preoperative OHS were all independently associated with a waiting time for an outpatient appointment for > 3 months. Region, housing tenure and gender were also independently associated with a wait of >or= 6 months on the surgical waiting list.


CONCLUSIONS
A large proportion of patients had long waiting times both for an outpatient appointment and while on a surgical waiting list. There were significant differences in waiting time according to social, geographical and health care system factors. Patients with a worse pain and disability at surgery waited longer for an outpatient appointment. The longer patient waited, the worse was their pain and disability, suggesting that patients were not prioritized by these criteria. Benefits of prioritizing should be tested.
Fitzpatrick
Ray
R
Department of Public Health, Institute of Health Sciences, University of Oxford, Oxford, UK. raymond.fitzpatrick@dphpc.oxford.ac.uk
Norquist
Josephine M
JM
Reeves
Barnaby C
BC
Morris
Richard W
RW
Murray
David W
DW
Gregg
Paul J
PJ
D000368:Aged; D000553:Ambulatory Care; D019644:Arthroplasty, Replacement, Hip; D003710:Demography; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006302:Health Services Research; D016304:Hospitals, Private; D006779:Hospitals, Public; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012923:Social Class; D012935:Social Justice; D013222:State Medicine; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom; D014850:Waiting Lists