The effect of waiting times from general practitioner referral to MRI or orthopaedic consultation for the knee on patient-based outcomes.
OBJECTIVE
The purpose of this study was to test for the effect of waiting time from general practitioner (GP) referral to MRI or to orthopaedic consultation on outcomes of patients with knee problems, and to test whether any characteristics of trial participants predicted waiting time to MRI or orthopaedics.


METHODS
We undertook secondary analyses of data on 553 participants from a randomised trial who were recruited from 163 general practices during November 2002 to October 2004.


RESULTS
Of the patients allocated to MRI, 263 (94%) had an MRI, and of those referred to orthopaedics, 236 (86%) had an orthopaedic consultation. The median (interquartile range) waiting time in days from randomisation to MRI was 41.0 (21.0-71.0) and to orthopaedic appointment was 78.5 (54.5-167.5). Waiting time was found to have no significant effect on patient outcome for both the Short Form 36-item (SF-36) physical functioning score (p=0.570) and the Knee Quality of Life 26-item (KQoL-26) physical functioning score (p=0.268). There was weak evidence that males waited less time for their MRI (p=0.049) and older patients waited longer for their orthopaedic referral (p=0.049). For patients who resided in the catchment areas of some centres there were significantly longer waiting times for both MRI and orthopaedic appointment.


CONCLUSIONS
Where patients reside is a strong predictor of waiting time for access to services such as MRI or orthopaedics. There is no evidence to suggest, however, that this has a significant effect on physical well-being in the short term for patients with knee problems.
Department of Health Sciences, University of York, Heslington, York, UK. stephen.brealey@york.ac.uk
S
S
Brealey
L
L
Andronis
V
V
Dale
A J
AJ
Gibbon
F J
FJ
Gilbert
M
M
Hendry
K
K
Hood
D
D
King
C
C
Wilkinson
D000328:Adult; D000367:Age Factors; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D007719:Knee Joint / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D009985:Orthopedics / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists