Do women spend longer on wait lists for coronary bypass surgery? Analysis of a population-based registry in British Columbia, Canada.
BACKGROUND
Studies have shown patients who are delayed for surgical cardiac revascularization are faced with increased risks of symptom deterioration and death. This could explain the observation that operative mortality among persons undergoing coronary artery bypass surgery (CABG) is higher among women than men. However, in jurisdictions that employ priority wait lists to manage access to elective cardiac surgery, there is little information on whether women wait longer than men for CABG. It is therefore difficult to ascertain whether higher operative mortality among women is due to biological differences or to delayed access to elective CABG.


METHODS
Using records from a population-based registry, we compared the wait-list time between women and men in British Columbia (BC) between 1990 and 2000. We compared the number of weeks from registration to surgery for equal proportions of women and men, after adjusting for priority, comorbidity and age.


RESULTS
In BC in the 1990 s, 9,167 patients aged 40 years and over were registered on wait lists for CABG and spent a total of 136,071 person-weeks waiting. At the time of registration for CABG, women were more likely to have a comorbid condition than men. We found little evidence to suggest that women waited longer than men for CABG after registration, after adjusting for comorbidity and age, either overall or within three priority groups.


CONCLUSIONS
Our findings support the hypothesis that higher operative mortality during elective CABG operations observed among women is not due to longer delays for the procedure.
Department of Health Care and Epidemiology, University of British Columbia (BC), Vancouver, Canada. alevy@cheos.ubc.ca
Adrian R
AR
Levy
Boris G
BG
Sobolev
Lisa
L
Kuramoto
Robert
R
Hayden
Stuart M
SM
MacLeod
D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000453:epidemiology; D001955:British Columbia / Q000453:epidemiology; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000453:epidemiology; D004066:Digestive System Diseases / Q000453:epidemiology; D005260:Female; D006292:Health Priorities / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D018579:Patient Selection; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012042:Registries; D012720:Severity of Illness Index; D014850:Waiting Lists; D016387:Women's Health