{"id":17131,"date":"2023-12-19T11:27:34","date_gmt":"2023-12-19T16:27:34","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=17131"},"modified":"2023-12-20T10:31:05","modified_gmt":"2023-12-20T15:31:05","slug":"social-determinants-of-access-to-timely-elective-surgery-in-ontario-canada-a-cross-sectional-population-level-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/social-determinants-of-access-to-timely-elective-surgery-in-ontario-canada-a-cross-sectional-population-level-study\/","title":{"rendered":"Social determinants of access to timely elective surgery in Ontario, Canada: a cross-sectional population level study"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Equitable access to surgical care has clinical and policy implications. We assess the association between social disadvantage and wait times for elective surgical procedures in Ontario.<\/p>\n<p><strong>Methods<\/strong> \u2014 We conducted a cross-sectional analysis using administrative data sets of adults receiving nonurgent inguinal hernia repair, cholecystectomy, hip arthroplasty, knee arthroplasty, arthroscopy, benign uterine surgery and cataract surgery from April 2013 to December 2019. We assessed the relation between exceeding target wait times and the highest versus lowest quintile of marginalization dimensions by use of generalized estimating equations logistic regression.<\/p>\n<p><strong>Results<\/strong> \u2014 Of the 1 385 673 procedures included, 174 633 (12.6%) exceeded the target wait time. Adjusted analysis for cataract surgery found significantly increased odds of exceeding wait times for residential instability (adjusted odd ratio [OR] 1.16, 95% confidence interval [CI] 1.11\u20131.21) and recent immigration (adjusted OR 1.12, 95% CI 1.07\u20131.18). The highest deprivation quintile was associated with 18% (adjusted OR 1.18, 95% CI 1.12\u20131.24) and 20% (adjusted OR 1.20, 95% CI 1.12\u20131.28) increased odds of exceeding wait times for knee and hip arthroplasty, respectively. Residence in areas where higher proportions of residents self-identify as being part of a visible minority group was independently associated with reduced odds of exceeding target wait times for hip arthroplasty (adjusted OR 0.82, 95% CI 0.75\u20130.91), cholecystectomy (adjusted OR 0.68, 95% CI 0.59\u20130.79) and hernia repair (adjusted OR 0.65, 95% CI 0.56\u20130.77) with an opposite effect in benign uterine surgery (adjusted OR 1.28, 95% CI 1.17\u20131.40).<\/p>\n<p><strong>Interpretation<\/strong> \u2014 Social disadvantage had a small and inconsistent impact on receiving care within wait time targets. Future research should consider these differences as they relate to resource distribution and the organization of clinical service delivery.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Equitable access to surgical care has clinical and policy implications. We assess the association between social disadvantage and wait times for elective surgical procedures in Ontario. Methods \u2014 We conducted a cross-sectional analysis using administrative data sets of adults receiving nonurgent inguinal hernia repair, cholecystectomy, hip arthroplasty, knee arthroplasty, arthroscopy, benign uterine surgery [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[20,19,18,25],"migration-helper-qa-sample-set":[],"class_list":["post-17131","journal_article","type-journal_article","status-publish","hentry","topic-health-and-health-care-inequality","topic-marginalized-populations","topic-racialized-communities","topic-surgery"],"acf":{"citation":"de Jager P, Aleman D, Baxter N, Bell C, Bodur M, Calzavara A, Campbell R, Carter M, Emerson S, Gagliardi A, Irish J, Martin D, Lee S, Saxe-Braithwaite M, Seyedi P, Takata J, Yang S, Zanchetta C, Urbach D. <em>CMAJ Open<\/em>. 2023; 11(6):1164-80. Epub 2023 Dec 19.","source_url":"https:\/\/doi.org\/10.9778\/cmajo.20230001","ices_scientist":[1177,1343,1172,1203,1201,17132],"site":[6733],"research_program":[6746],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Social determinants of access to timely elective surgery in Ontario, Canada: a cross-sectional population level study<\/title>\n<meta name=\"description\" content=\"Background \u2014 Equitable access to surgical care has clinical and policy implications. 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