title: Patients' Perspectives on Wait Times and the Referral-Consultation Process While Attending a Tertiary Diabetes and Endocrinology Centre: Is Econsultation an Acceptable Option?
abstract: The goal of this study was to establish patients' perspectives on the acceptability of wait times, the impact of wait times on their health and the possibility of using electronic consultations (eConsultations) to avoid visits to specialists. A 2-stage patient survey (self-administered and with a follow-up telephone call) and a chart audit was conducted on a sequential sample of patients attending their initial consultations in a tertiary diabetes and endocrinology centre. Patients' perspectives on actual and ideal wait times, the impact of waiting for access, the effectiveness of the referral-consultation process and attitudes toward eConsultations as an alternative to traditional referral-consultations were collected. The study involved 101 patients (22% for diabetes, 78% for endocrinologic conditions), whose comments were collated and categorized. Of the 101 patients who completed the survey, 61 also completed telephone interviews. The average wait time was 19 weeks; the median 10 weeks. More than 30% of patients waited longer than 6 months and 6% waited longer than 1 year. Overall, 90% of patients thought that the maximum wait time should be less than 3 months. While waiting, 58% of patients worried about a serious undiagnosed disease, 30% found their symptoms had affected their daily activities and 24% had to miss work or school due to symptoms. Of the patients, 46% considered eConsultation a viable alternative to face-to-face visits. Excessive wait times for specialist care remain barriers and have negative impacts on patients. Wait times significantly exceeded times patients considered acceptable. eConsultations provide acceptable alternatives for many patients, and they reduced the number of patients requiring traditional consultations.
authors: Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Division of Endocrinology and Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: ekeely@toh.on.ca.
authors: Erin
authors: E
authors: Keely
authors: Faculty of Medicine, University of Ottawa, Ontario, Canada.
authors: Lara
authors: L
authors: Traczyk
authors: Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada; CT Lamont Primary Healthcare Research Centre, Bruyere Research Institute, Ottawa, Ontario, Canada.
authors: Clare
authors: C
authors: Liddy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D004700:Endocrine System Diseases / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility / Q000592:standards / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012017:Referral and Consultation / Q000592:standards* / Q000639:trends; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000592:standards* / Q000639:trends; D062606:Tertiary Care Centers / Q000592:standards* / Q000639:trends; D014850:Waiting Lists; D055815:Young Adult
keywords: consultation en ligne; consultation wait-times; diabetes; diabète; eConsultation; endocrinologie; endocrinology; patient perspectives; points de vue des patients; temps d’attente pour la consultation; virtual; virtuel