title: Predicting joint replacement waiting times.
abstract: Currently, the median waiting time for total hip and knee replacement in Ontario is greater than 6 months. Waiting longer than 6 months is not recommended and may result in lower post-operative benefits. We developed a simulation model to estimate the proportion of patients who would receive surgery within the recommended waiting time for surgery over a 10-year period considering a wide range of demand projections and varying the number of available surgeries. Using an estimate that demand will grow by approximately 8.7% each year for 10 years, we determined that increasing available supply by 10% each year was unable to maintain the status quo for 10 years. Reducing waiting times within 10 years required that the annual supply of surgeries increased by 12% or greater. Allocating surgeries across regions in proportion to each region's waiting time resulted in a more efficient distribution of surgeries and a greater reduction in waiting times in the long-term compared to allocation strategies based only on the region's population size.
authors.affiliation: Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Cipriano
authors.forename: Bert M
authors.initials: BM
authors.lastname: Chesworth
authors.forename: Chris K
authors.initials: CK
authors.lastname: Anderson
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Zaric
mesh_terms: D019643:Arthroplasty, Replacement / Q000706:statistics & numerical data* / Q000639:trends; D003198:Computer Simulation; D006292:Health Priorities; D006801:Humans; D015337:Multicenter Studies as Topic; D009864:Ontario; D012042:Registries; D013598:Systems Theory; D014850:Waiting Lists