Determinants of wait time for infant inguinal hernia repair in a Canadian children's hospital.
BACKGROUND
Longer wait time for infant inguinal hernia (IH) repair is associated with higher complication rates. We wished to determine if socioeconomic and demographic factors influence wait times for IH repair.


METHODS
Children <2 years old with IH at a Canadian children's hospital were retrospectively reviewed. Days from diagnosis to surgical consultation (W1) and from consultation to repair (W2) were collected along with demographic, medical, and socioeconomic data. Linear regression analysis was performed.


RESULTS
A total of 131 patients were appropriate for analysis (82.4% male). Median distance to hospital was 27.5 km (IQR=10.5-50.4) and median income was $34,477 (IQR=30,127-41,986). Median W1, W2, and Wtotal (W1+W2) were 24 (IQR=8-48), 43 (IQR=21-69) and 79 (IQR=38-112) days, respectively. Wait times were shorter in infants who were male (p=0.044), symptomatic (p<0.001), diagnosed in the ED (p<0.001), or had an incarcerated hernia (p=0.006). They were longer for premature infants (p=0.009) and those with significant comorbidities (p=0.018). Neither income (p=0.328) nor distance from hospital (p=0.292) was associated with longer wait times.


CONCLUSIONS
Wait times for IH repair were appropriately influenced by medical risk factors. Income and distance to hospital did not appear to influence wait times. A population-based study is needed to determine if these findings reflect a general trend within the Canadian health care system.
Department of Surgery, University of Toronto, Toronto, ON, Canada.
Nada
N
Gawad
Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Dafydd A
DA
Davies
Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada. Electronic address: jacob.langer@sickkids.ca.
Jacob C
JC
Langer
D058070:Asymptomatic Diseases; D002170:Canada; D015897:Comorbidity; D005260:Female; D006552:Hernia, Inguinal / Q000150:complications / Q000601:surgery*; D006776:Hospitals, Pediatric; D006801:Humans; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D012111:Residence Characteristics; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014850:Waiting Lists
Access to care; Inguinal hernia; Socioeconomic determinants of health; Wait time