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A patient-centred approach toward surgical wait times for colon cancer: a population-based analysis

Gillis A, Dixon M, Smith A, Law C, Coburn NG. Can J Surg. 2014; 57(2):94-100.

Background — Administrative wait times reflect the time from the decision to treat until surgery; however, this does not reflect the total time a patient actually waits for treatment. Several factors may prolong the wait for colon cancer surgery. The authors sought to analyze the time from the date of surgical consultation to the date of surgery and any events within this time frame that may extend wait times.

Methods — The authors retrospectively reviewed the cases of all adult patients in Ontario aged 18-80 years with diagnosed colon cancer who did not receive neoadjuvant therapy and underwent resection electively between Jan. 1, 2002, and Dec. 31, 2009. Wait times were measured from the date of surgical consultation to the date of surgery. They chose a wait time of 28 days, reflecting local administrative targets, as a comparative benchmark. The authors performed univariate and multivariate analyses to identify variables contributing to a waits longer than 28 days. Variables were analyzed in continuous linear and logistic regression models.

Results — The authors included 10 223 patients in our study. The median wait time from initial surgical consultation to resection was 31 (range 0-182) days. Age older than 65 years had a negative impact on wait time. Preoperative services, including computed tomography, cardiac consultation, echocardiography, multigated acquisition scan, magnetic resonance imaging, colonoscopy and cardiac catheterization also significantly increased wait times. Wait times were longer in rural hospitals.

Conclusion — Preoperative services significantly increased wait times between initial surgical consultation and surgery.

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Keywords: Colorectal cancer Surgery Access to health care

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