Using administrative databases to measure waiting times for patients undergoing major cancer surgery in Ontario, 1993-2000.
OBJECTIVE
To determine how long patients in Ontario waited for major breast, colorectal, lung or prostate cancer surgery in the years 1993-2000.


METHODS
"Surgical waiting time" was defined as the interval from date of preoperative surgeon consult to date of hospital admission for surgery. We created patient cohorts by linking appropriate diagnosis and procedure codes from Canadian Institutes of Health Information data. Scrambled unique surgeon identifiers were obtained from Ontario Health Insurance Plan data. Changes in median surgical waiting times were assessed with univariate time-trend analyses and multilevel models. Models were controlled for year of surgery and other patient (age, gender, comorbid conditions, income level, area of residence) and hospital level characteristics (teaching status, procedure volume status).


RESULTS
Compared with 1993, median surgical waiting times in the year 2000 increased 36% for patients with breast cancer (to 19 d), 46% with colorectal (to 19 d), 36% with lung (to 34 d) and 4% with prostate cancer (to 83 d). Multilevel models confirmed significant increases in waiting times for all procedures. There were no concerning or consistent differences in waiting times among the categories of hospitals and patients examined.


CONCLUSIONS
There were significant increases in surgical waiting times among patients undergoing breast, colorectal, lung or prostate cancer surgery in Ontario over years 1993-2000. Administrative databases can be used to efficiently measure such waits.
Simunovic
Marko
M
Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario. marko.simunovic@hrcc.on.ca
Thériault
Marc-Erick
ME
Paszat
Lawrence
L
Coates
Angela
A
Whelan
Timothy
T
Holowaty
Eric
E
Levine
Mark
M
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