What are the costs of queuing for hip fracture surgery in Canada?

doi:10.1016/0167-6296(95)00036-4

Journal of Health Economics

Volume 15, Issue 2, April 1996, Pages 161-185

https://doi.org/10.1016/0167-6296(95)00036-4 Get rights and content

Abstract

This paper investigates the effect of wait time for hip fracture surgery in Canada on post-surgery length of stay in hospital and inpatient mortality. After controlling for observed and unobserved patient and hospital characteristics, pre-surgery delay has little effect on either of the two outcome variables. Patients from higher income postal-codes experience only slightly shorter delays, and income has no substantial effect on post-surgery outcomes. For hip fracture patients surgery delay may lead to greater pre-surgery inpatient costs and more patient discomfort, but we find no evidence of a detrimental impact on post-surgery outcomes.

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No evidence is found for varicose veins and inguinal hernia. In the economics literature, Hamilton et al. (1996) analyse the impact of waits following hip fracture on the probability of death and further hospitalization in Canada, finding no effect. A similar result for England is obtained by Hamilton and Bramley-Harker (1999).
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Martin and Smith [16] find (amongst other indicators) that poverty is an important determinant for variation in length of stay (LOS). Welch [25] concludes that amongst a US patient population high social status reduces the LOS, and Hamilton et al. [8] find that in a Canadian setting high income may be associated with a smaller reduction in LOS. To conclude, we have found some evidence (published in the 1980s and 1990s) on the association between overall hospital costs and/or length of stay and patient characteristics.
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In order to define the optimum timing of surgery for a hip fracture, we performed a systematic review of published evidence. Data was extracted by two independent reviewers and the methodology of each study was assessed. Fifty-two studies involving 291,413 patients were identified. Outcomes measured were mortality, post-operative complications, length of hospital stay and percentage of patients discharged home.
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In conclusion early surgery (within 48 h of admission) after a hip fracture reduces hospital stay and may also reduce complications and mortality.
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We examined the medical records (n = 125) of patients who underwent a unilateral, primary, tricompartment TKA with a postoperative CFNB by 1 surgeon at one institution in an 18-month period beginning January 2004. Each of the 10 patients discharged home with an ambulatory CFNB (cases) was matched with a patient with a hospital-only CFNB (controls) for age, gender, body mass index, and health status. Financial data were extracted from the hospital microcosting database.
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Scientific articleWhat are the costs of queuing for hip fracture surgery in Canada?

Abstract

Injury

British Journal of Anaesthesia

Injury

Injury

The relationship between health insurance coverage and clinical outcomes among women with breast cancer

The New England Journal of Medicine

The injury fact book

Outcome of rationing access to open-heart surgery: Effect of the wait for elective surgery on patient outcome

Canadian Medical Association Journal

Practical nonparametric statistics

Waiting times for knee-replacement surgery in the United States and Ontario

The New England Journal of Medicine

A policy analysis of hospital waiting lists

Journal of Policy Analysis and Management

Comparison of uninsured and privately insured hospital patients

JAMA

A method for minimizing the impact of distributional assumptions in econometric models for duration data

Econometrica

Scientific article
What are the costs of queuing for hip fracture surgery in Canada?