title: Health of patients on the waiting list: Opportunity to improve health in Canada?
abstract: BACKGROUND
  A number of countries have healthcare systems where access to elective surgery is constrained. The inevitable outcome is wait lists for surgery. The objective of this study is to report cross-sectional health data collected from a broad sample of patients awaiting elective surgery and shed light on potential non-surgical treatments to improve health.
  
  
  METHODS
  Prospective cross-sectional survey of patients newly enrolled on the surgical wait list in the Vancouver Coastal Health region. Multivariate regression models were used to estimate the associations between patient characteristics and health, pain and depression.
  
  
  METHODS
  Health status instruments were used to measure study participants' general health, pain, and depression immediately after they were enrolled on the wait list for one of the targeted elective surgeries.
  
  
  RESULTS
  A majority of patients reported some problems with pain or discomfort, and a large portion reported problems associated with anxiety or depression. Orthopedic patients were significantly more likely to report problems with mobility, usual activities and pain/discomfort. Neurosurgery patients were the most likely to report significant and severe depression.
  
  
  CONCLUSIONS
  The high rates of pain and depression not only have implications for patients' immediate health, but may also affect long-term surgical outcomes. This study draws attention to recognizing a wider array of morbidity, some potentially requiring non-surgical interventions, while patients wait for elective surgery. Policy options include re-examining the surgical triage system and expanding surgical capacity to match self-reported health.
authors.affiliation: Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, 201 - 2206 East Mall, Vancouver, BC, Canada. Electronic address: jsutherland@chspr.ubc.ca.
authors.forename: Jason Murray
authors.initials: JM
authors.lastname: Sutherland
authors.affiliation: The Children's Research Institute of the Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: R Trafford
authors.initials: RT
authors.lastname: Crump
authors.affiliation: Vancouver Coastal Health Authority, Vancouver, Canada.
authors.forename: Angie
authors.initials: A
authors.lastname: Chan
authors.affiliation: Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, 201 - 2206 East Mall, Vancouver, BC, Canada.
authors.forename: Guiping
authors.initials: G
authors.lastname: Liu
authors.affiliation: Vancouver Coastal Health Authority, Vancouver, Canada.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Yue
authors.affiliation: VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indiana University School of Medicine, Department of Medicine, Regenstrief Institute, Inc., Indianapolis, IN, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Bair
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D001955:British Columbia; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D013997:Time Factors; D014850:Waiting Lists
keywords: Access; Patient-reported outcomes; Surgery; Surgical wait list; Wait times