title: Impact of wait time on outcome for inguinal hernia repair in infants.
abstract: BACKGROUND
  Prolonged surgical wait times are a problem in many health care systems. We used data from two pediatric surgical centers, one Canadian and one American, in order to determine if increased wait times are related to rates of incarceration and adverse outcomes.
  
  
  METHODS
  Data were collected for children under the age of 2 who presented with an inguinal hernia to either the emergency department or clinic in the two hospitals in 2002 and 2003.
  
  
  RESULTS
  Infants in the Canadian center were older at presentation and were more likely to present to the emergency department. Wait time for hernia repair was longer in the Canadian than the American hospital (99 +/- 103 vs. 27 +/- 53 days, P < 0.001). The incidence of incarceration was higher in the Canadian hospital, and infants in the Canadian center were more likely to have episodes of recurrent incarceration. Emergency department usage was greater in the Canadian hospital both at the time of diagnosis as well as during the waiting period for surgery.
  
  
  CONCLUSIONS
  Prolonged wait time for inguinal hernia repair in infants is associated with a higher rate of incarceration as well as greater usage of emergency department resources. These data are important for those surgeons working in systems with limited resources in which strategies to shorten wait times are necessary.
authors.affiliation: St. Louis Children's Hospital, Washington University School of Medicine, Saint Louis, MO, USA.
authors.forename: Li Ern
authors.initials: LE
authors.lastname: Chen
authors.forename: Mohammed
authors.initials: M
authors.lastname: Zamakhshary
authors.forename: Robert P
authors.initials: RP
authors.lastname: Foglia
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Coplen
authors.forename: Jacob C
authors.initials: JC
authors.lastname: Langer
mesh_terms: D002170:Canada; D004636:Emergency Service, Hospital; D005260:Female; D006552:Hernia, Inguinal / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014850:Waiting Lists