Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions
Abstract Background Most data on mortality and prognostic factors of universal healthcare waiting lists come from North America, Australasia, and Europe, with little information from South America. We aimed to determine the relationship between medical center-specific waiting time and waiting list m...
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| Format: | Article |
| Language: | English |
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BMC
2019-02-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-019-6526-6 |
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| author | Diego A. Martinez Haoxiang Zhang Magdalena Bastias Felipe Feijoo Jeremiah Hinson Rodrigo Martinez Jocelyn Dunstan Scott Levin Diana Prieto |
| author_facet | Diego A. Martinez Haoxiang Zhang Magdalena Bastias Felipe Feijoo Jeremiah Hinson Rodrigo Martinez Jocelyn Dunstan Scott Levin Diana Prieto |
| author_sort | Diego A. Martinez |
| collection | DOAJ |
| description | Abstract Background Most data on mortality and prognostic factors of universal healthcare waiting lists come from North America, Australasia, and Europe, with little information from South America. We aimed to determine the relationship between medical center-specific waiting time and waiting list mortality in Chile. Method Using data from all new patients listed in medical specialist waitlists for non-prioritized health problems from 2008 to 2015 in three geographically distant regions of Chile, we constructed hierarchical multivariate survival models to predict mortality risk at two years after registration for each medical center. Kendall rank correlation analysis was used to measure the association between medical center-specific mortality hazard ratio and waiting times. Result There were 987,497 patients waiting for care at 77 medical centers, including 33,546 (3.40%) who died within two years after registration. Male gender (hazard ratio [HR] = 1.17, 95% confidence interval [CI] 1.1–1.24), older age (HR = 2.88, 95% CI 2.72–3.05), urban residence (HR = 1.19, 95% CI 1.09–1.31), tertiary care (HR = 2.2, 95% CI 2.14–2.26), oncology (HR = 3.57, 95% CI 3.4–3.76), and hematology (HR = 1.6, 95% CI 1.49–1.73) were associated with higher risk of mortality at each medical center with large region-to-region variations. There was a statistically significant association between waiting time variability and death (Z = 2.16, P = 0.0308). Conclusion Patient wait time for non-prioritized health conditions was associated with increased mortality in Chilean hospitals. |
| first_indexed | 2024-12-11T19:02:51Z |
| format | Article |
| id | doaj.art-02f3d93c0cb94012948b6f7ce0ff45df |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-11T19:02:51Z |
| publishDate | 2019-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-02f3d93c0cb94012948b6f7ce0ff45df2022-12-22T00:53:58ZengBMCBMC Public Health1471-24582019-02-0119111110.1186/s12889-019-6526-6Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditionsDiego A. Martinez0Haoxiang Zhang1Magdalena Bastias2Felipe Feijoo3Jeremiah Hinson4Rodrigo Martinez5Jocelyn Dunstan6Scott Levin7Diana Prieto8Johns Hopkins University School of MedicineJohns Hopkins University Whiting School of EngineeringUniversity of Chile School of Public HealthPontifical Catholic University of Valparaíso School of Engineering, BrasilJohns Hopkins University School of MedicineUniversity of Chile School of Public HealthUniversity of Chile School of Public HealthJohns Hopkins University School of MedicineJohns Hopkins University Carey School of BusinessAbstract Background Most data on mortality and prognostic factors of universal healthcare waiting lists come from North America, Australasia, and Europe, with little information from South America. We aimed to determine the relationship between medical center-specific waiting time and waiting list mortality in Chile. Method Using data from all new patients listed in medical specialist waitlists for non-prioritized health problems from 2008 to 2015 in three geographically distant regions of Chile, we constructed hierarchical multivariate survival models to predict mortality risk at two years after registration for each medical center. Kendall rank correlation analysis was used to measure the association between medical center-specific mortality hazard ratio and waiting times. Result There were 987,497 patients waiting for care at 77 medical centers, including 33,546 (3.40%) who died within two years after registration. Male gender (hazard ratio [HR] = 1.17, 95% confidence interval [CI] 1.1–1.24), older age (HR = 2.88, 95% CI 2.72–3.05), urban residence (HR = 1.19, 95% CI 1.09–1.31), tertiary care (HR = 2.2, 95% CI 2.14–2.26), oncology (HR = 3.57, 95% CI 3.4–3.76), and hematology (HR = 1.6, 95% CI 1.49–1.73) were associated with higher risk of mortality at each medical center with large region-to-region variations. There was a statistically significant association between waiting time variability and death (Z = 2.16, P = 0.0308). Conclusion Patient wait time for non-prioritized health conditions was associated with increased mortality in Chilean hospitals.http://link.springer.com/article/10.1186/s12889-019-6526-6Waiting listsHealth equityMortalityDelivery of health careEngineering |
| spellingShingle | Diego A. Martinez Haoxiang Zhang Magdalena Bastias Felipe Feijoo Jeremiah Hinson Rodrigo Martinez Jocelyn Dunstan Scott Levin Diana Prieto Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions BMC Public Health Waiting lists Health equity Mortality Delivery of health care Engineering |
| title | Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions |
| title_full | Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions |
| title_fullStr | Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions |
| title_full_unstemmed | Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions |
| title_short | Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions |
| title_sort | prolonged wait time is associated with increased mortality for chilean waiting list patients with non prioritized conditions |
| topic | Waiting lists Health equity Mortality Delivery of health care Engineering |
| url | http://link.springer.com/article/10.1186/s12889-019-6526-6 |
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