Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Aug 21:12:268.
doi: 10.1186/1472-6963-12-268.

Socioeconomic differences in waiting times for elective surgery: a population-based retrospective study

Alessio Petrelli  1 , Giuliana De Luca, Tania Landriscina, Giuseppe Costa
Affiliations

Socioeconomic differences in waiting times for elective surgery: a population-based retrospective study

Alessio Petrelli et al. BMC Health Serv Res. .

Abstract

Background: Widespread literature on inequity in healthcare access and utilization has been published, but research on socioeconomic differences in waiting times is sparse and the evidence is fragmentary and controversial. The objective of the present study is the analysis of the relationship between individual socioeconomic level and waiting times for in-hospital elective surgery.

Methods: We retrospectively studied the waiting times experienced by patients registered on hospital waiting lists for 6 important surgical procedures by using the Hospital Discharge Database (HDD) of the Piedmont Region (4,000,000 inhabitants in the North West of Italy) from 2006 to 2008. The surgical procedures analyzed were: coronary artery by-pass (CABG), angioplasty, coronarography, endarterectomy, hip replacement and cholecystectomy. Cox regression models were estimated to study the relationship between waiting times and educational level taking into account the confounding effect of the following factors: sex, age, comorbidity, registration period, and Local Health Authorities (LHA) as a proxy of supply.

Results: Median waiting times for low educational level were higher than for high educational level for all the selected procedures. Differences were particularly high for endarterectomy and hip replacement. For all considered procedures, except CABG, an inverse gradient between waiting times and educational level was observed: the conditional probabilities of undergoing surgery were lower among individuals with a low to middle level education than for individuals with a higher level of education after adjustment for sex, age, comorbidities, registration period, and LHAs. For most procedures the effect decreases over the follow up period.

Conclusions: The results of the study show evidence of inequalities in access to elective surgery in Italy. Implementation of policies aimed to promote national information initiatives that guarantee wider access to those with low socio-economic status is strongly recommended.

PubMed Disclaimer

References

    1. Coyte PC, Wright JG, Hawker GA, Bombardier C, Dittus RS, Paul JE, Freund DA, Ho E. Waiting times for knee-replacement surgery in the United States and Ontario. N Engl JMed. 1994;331:1068–1071. doi: 10.1056/NEJM199410203311607. - DOI - PubMed
    1. Cullis JG, Jones PR. Inpatient waiting: a discussion and policy proposal. BMJ. 1983;287:1483–1486. doi: 10.1136/bmj.287.6403.1483. - DOI - PMC - PubMed
    1. Willcox S, Seddon M, Dunn S, Edwards RT, Pearse J, Tu JV. Measuring and Reducing Waiting Times: A Cross-National Comparison of Strategies. Heal Aff. 2007;26(4):1078–1087. doi: 10.1377/hlthaff.26.4.1078. - DOI - PubMed
    1. Carlsen F, Kaarboe OM. Norwegian priority guidelines: estimating the distributional implications across age, gender and SES. Health Policy. 2010;95(2–3):264–270. - PubMed
    1. Sobolev B, Kuramoto L. Analysis of waiting-time data in Health Services Research. New York: Springer; 2008.