All the Wait Times | ScienceGate

Abstract Background Health care funding reforms are being used worldwide to improve system performance but may invoke unintended consequences. We assessed the effects of introducing a targeted hospital funding model, based on fixed price and volume, for hip fractures. We hypothesized the policy change was associated with reduction in wait times for hip fracture surgery, increase in wait times for non-hip fracture surgery, and increase in the incidence of after-hours hip fracture surgery. Methods This was a population-based, interrupted time series analysis of 49,097 surgeries for hip fractures, 10,474 for ankle fractures, 1,594 for tibial plateau fractures, and 40,898 for appendectomy at all hospitals in Ontario, Canada between April 2012 and March 2017. We used segmented regression analysis of interrupted monthly time series data to evaluate the impact of funding reform enacted April 1, 2014 on wait time for hip fracture repair (from hospital presentation to surgery) and after-hours provision of surgery (occurring between 1700 and 0700 h). To assess potential adverse consequences of the reform, we also evaluated two control procedures, ankle and tibial plateau fracture surgery. Appendectomy served as a non-orthopedic tracer for assessment of secular trends. Results The difference (95 % confidence interval) between the actual mean wait time and the predicted rate had the policy change not occurred was − 0.46 h (-3.94 h, 3.03 h) for hip fractures, 1.46 h (-3.58 h, 6.50 h) for ankle fractures, -3.22 h (-39.39 h, 32.95 h) for tibial plateau fractures, and 0.33 h (-0.57 h, 1.24 h) for appendectomy (Figure 1; Table 3). The difference (95 % confidence interval) between the actual and predicted percentage of surgeries performed after-hours − 0.90 % (-3.91 %, 2.11 %) for hip fractures, -3.54 % (-11.25 %, 4.16 %) for ankle fractures, 7.09 % (-7.97 %, 22.14 %) for tibial plateau fractures, and 1.07 % (-2.45 %, 4.59 %) for appendectomy. Conclusions We found no significant effects of a targeted hospital funding model based on fixed price and volume on wait times or the provision of after-hours surgery. Other approaches for improving hip fracture wait times may be worth pursuing instead of funding reform.

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An experimental study of Web switching behavior

Human Systems Management ◽

10.3233/hsm-2003-22204 ◽

2003 ◽

Vol 22 (2) ◽

pp. 87-93

Author(s):

James Otto ◽

Mohammad Najdawi ◽

William Wagner

Keyword(s):

Experimental Study ◽

Electronic Commerce ◽

Web Site ◽

Waiting Times ◽

Switching Behavior ◽

The Internet ◽

Wait Times ◽

Web Page ◽

Extensive Growth ◽

The Impact

With the extensive growth of the Internet and electronic commerce, the issue of how users behave when confronted with long download times is important. This paper investigates Web switching behavior. The paper describes experiments where users were subjected to artificially delayed Web page download times to study the impact of Web site wait times on switching behavior. Two hypotheses were tested. First, that longer wait times will result in increased switching behavior. The implication being that users become frustrated with long waiting times and choose to go elsewhere. Second, that users who switch will benefit, in terms of decreased download times, from their decision to switch.

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Investigating unmet need for healthcare using the European Health Interview Survey: a cross-sectional survey study of Luxembourg

BMJ Open ◽

10.1136/bmjopen-2021-048860 ◽

2021 ◽

Vol 11 (8) ◽

pp. e048860

Author(s):

Valerie Moran ◽

Marc Suhrcke ◽

Maria Ruiz-Castell ◽

Jessica Barré ◽

Laetitia Huiart

Keyword(s):

Dental Care ◽

Unmet Need ◽

Mental Healthcare ◽

Wait Times ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Interview Survey ◽

European Health ◽

Prescribed Medicines ◽

European Health Interview Survey

ObjectivesWe investigate the prevalence of unmet need arising from wait times, distance/transportation and financial affordability using the European Health Interview Survey. We explore associations between individual characteristics and the probability of reporting unmet need.DesignCross-sectional survey conducted between February and December 2014.Setting and participants4004 members of the resident population in private households registered with the health insurance fund in Luxembourg aged 15 years and over.Outcome measuresSix binary variables that measured unmet need arising from wait time, distance/transportation and affordability of medical, dental and mental healthcare and prescribed medicines among those who reported a need for care.ResultsThe most common barrier to access arose from wait times (32%) and the least common from distance/transportation (4%). Dental care (12%) was most often reported as unaffordable, followed by prescribed medicines (6%), medical (5%) and mental health (5%) care. Respondents who reported bad/very bad health were associated with a higher risk of unmet need compared with those with good/very good health (wait: OR 2.41, 95% CI 1.53 to 3.80, distance/transportation: OR 7.12, 95% CI 2.91 to 17.44, afford medical care: OR 5.35, 95% CI 2.39 to 11.95, afford dental care: OR 3.26, 95% CI 1.86 to 5.71, afford prescribed medicines: OR 2.22, 95% CI 1.04 to 4.71, afford mental healthcare: OR 3.58, 95% CI 1.25 to 10.30). Income between the fourth and fifth quintiles was associated with a lower risk of unmet need for dental care (OR 0.29, 95% CI 0.16 to 0.53), prescribed medicines (OR 0.38, 95% CI 0.17 to 0.82) and mental healthcare (OR 0.17, 95% CI 0.05 to 0.61) compared with income between the first and second quintiles.ConclusionsRecent and planned reforms to address waiting times and financial barriers to accessing healthcare may help to address unmet need. In addition, policy-makers should consider additional policies targeted at high-risk groups with poor health and low incomes.

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Current Perspectives on the Use of off the Shelf CAR-T/NK Cells for the Treatment of Cancer

Cancers ◽

10.3390/cancers13081926 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1926

Author(s):

Lauren C. Cutmore ◽

John F. Marshall

Keyword(s):

T Cells ◽

Nk Cells ◽

Wait Times ◽

Haematological Malignancies ◽

Car T Cells ◽

Car T ◽

Novel Approaches ◽

The Individual

CAR T cells have revolutionised the treatment of haematological malignancies. Despite this, several obstacles still prohibit their widespread use and efficacy. One of these barriers is the use of autologous T cells as the carrier of the CAR. The individual production of CAR T cells results in large variation in the product, greater wait times for treatment and higher costs. To overcome this several novel approaches have emerged that utilise allogeneic cells, so called “off the shelf” CAR T cells. In this Review, we describe the different approaches that have been used to produce allogeneic CAR T to date, as well as their current pre-clinical and clinical progress.

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Online Ratings of Primary Care Physicians: Comparison of Gender, Training, and Specialty

Journal of Patient Experience ◽

10.1177/23743735211007700 ◽

2021 ◽

Vol 8 ◽

pp. 237437352110077

Author(s):

Daliah Wachs ◽

Victoria Lorah ◽

Allison Boynton ◽

Amanda Hertzler ◽

Brandon Nichols ◽

...

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Waiting Times ◽

Wait Time ◽

Primary Care Providers ◽

Wait Times ◽

Care Providers ◽

Female Physicians ◽

Online Ratings ◽

And Gender

The purpose of this study was to explore patient perceptions of primary care providers and their offices relative to their physician’s philosophy (medical degree [MD] vs doctorate in osteopathic medicine [DO]), specialty (internal medicine vs family medicine), US region, and gender (male vs female). Using the Healthgrades website, the average satisfaction rating for the physician, office parameters, and wait time were collected and analyzed for 1267 physicians. We found female doctors tended to have lower ratings in the Midwest, and staff friendliness of female physicians were rated lower in the northwest. In the northeast, male and female MDs were rated more highly than DOs. Wait times varied regionally, with northeast and northwest regions having the shortest wait times. Overall satisfaction was generally high for most physicians. Regional differences in perception of a physician based on gender or degree may have roots in local culture, including proximity to a DO school, comfort with female physicians, and expectations for waiting times.

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Determinants of Long Immunization Clinic Wait Times in a Sub-Saharan African Country

Global Pediatric Health ◽

10.1177/2333794x211028211 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110282

Author(s):

Osayame Austine Ekhaguere ◽

Rosena Olubanke Oluwafemi ◽

Angela Oyo-Ita ◽

Burke Mamlin ◽

Paul Bondich ◽

...

Keyword(s):

Focus Group ◽

Critical Mass ◽

Wait Time ◽

Wait Times ◽

Group Discussions ◽

Middle Income ◽

Middle Income Countries ◽

Group Data ◽

Focus Group Data ◽

Sub Saharan

The wait time clients spend during immunization clinic visits in low- and middle-income countries is a not well-understood reported barrier to vaccine completion. We used a prospective, observational design to document the total time from client arrival-to-discharge and all sequential provider-client activities in 1 urban, semi-urban, and rural immunization clinic in Nigeria. We also conducted caregiver and provider focus group discussions to identify perceived determinants of long clinic wait times. Our findings show that the time from arrival-to-discharge varied significantly by the clinic and ranged between 57 and 235 minutes, as did arrival-to-all providers-client activities. Focus group data attributed workflow delays to clinic staff waiting for a critical mass of clients to arrive for their immunization appointment before starting the essential health education talk or opening specific vaccine vials. Additionally, respondents indicated that complex documentation processes caused system delays. Research on clinic workflow transformation and simplification of immunization documentation is needed.

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