Impact of age and diagnosis on waiting times between important healthcare events among children 0 to 19 years cared for in pediatric units: the Canadian Childhood Cancer Surveillance and Control Program.
BACKGROUND
The objectives were to describe and compare waiting times to diagnosis and treatment of children and adolescents who accessed pediatric oncology centers in Canada for healthcare, and to assess the effects and relative contributions of age, sex, and diagnosis to waiting times.


METHODS
Waiting times were assessed for 2,365 children (0 to 14 y) and 375 adolescents (15 to 19 y) diagnosed with cancer between 1995 and 2000 inclusive and followed by the Treatment and Outcome Surveillance system of the Canadian Children's Cancer Surveillance and Control Program. Differences were assessed using the chi2 test, Fisher exact test, and Wilcoxon test statistic.


RESULTS
Median waiting times between first assessment by treating oncologist or surgeon and definitive diagnostic procedure, and the subsequent interval to first therapeutic event, were 2 days each. Significant variation existed in both periods when stratified by age and diagnosis but not sex. The most significant differences between age groups were eliminated when stratified by diagnosis.


CONCLUSIONS
This analysis suggests that once they enter the healthcare system, children and adolescents treated in pediatric centers in Canada experience short waiting times to key diagnostic and treatment events. Differences in wait times between the 2 age groups are not clinically significant and can be attributed to the differences in the types of cancer experienced by adolescents compared with children.
Klein-Geltink
Julia
J
Public Health Agency of Canada, Ottawa, Ontario, Canada. juliekg@rogers.com
Pogany
Lisa
L
Mery
Leslie S
LS
Barr
Ronald D
RD
Greenberg
Mark L
ML
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002170:Canada; D002173:Cancer Care Facilities / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care; D011159:Population Surveillance; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists