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14 WAIT TIMES FOR GASTROENTEROLOGICAL (GI) CONSULTATION AND INVESTIGATION: A NOVEL APPROACH TO RESOURCE PLANNING IN GASTROENTEROLOGY D Leddin1, R Hunt2, D Armstrong2, A Barkun3, R Hollingworth4, W Paterson5, Y Chen2 BACKGROUND: Anecdotal reports suggest wait times for GI health care in Canada are excessive but there are no data to support this or to define and address problems of patient access.
1Dalhousie University, Halifax, Nova Scotia; 2McMaster University, Hamilton, Ontario; 3McGill University, Montreal, Quebec; 4Credit Valley Hospital, Mississauga, Ontario; 5Queen’s University, Kingston, Ontario
AIMS: 1) To document wait times between patient referral and GI specialist consultation or investigation in Canada, and 2) to compare actual with target wait times as defined by a consensus panel to identify problems of access to GI care.
METHODS: GI specialists, as listed in the 2004 Canadian Medical Directory and Canadian Association of Gastroenterology (CAG) membership database, were invited to participate in the Practice Audit in Gastroenterology (PAGE) IV program. Treating physicians entered data at point-of-care using a hand-held personal digital assistant lent to them for the five days of the audit. Physicians recorded date of first referral, date of consultation and/or procedural visit and related details. Data were downloaded to a central, secure server and analyzed according to a predefined statistical analysis plan.
RESULTS: From January through June 2005, 181 of an estimated 550 GI specialists nationwide recorded data on ~5400 patient referrals. Analysis of this interim dataset showed that median national wait times from referral to consultation, consultation to procedure and referral to procedure (total wait time-TWT) were approximately 10, 7 and 15 weeks, respectively. Median TWTs (weeks) were longer for patients referred from primary care (16) vs other sources (6.5) and for practices offering average-risk screening colonoscopy (16 vs 12) and were shorter, although still excessive, if alarm features were present (8.4 vs 21). Compared with target times set by the consensus panel, median TWT were prolonged for patients with suspected cancer (4.5 vs 2), suspected IBD (17 vs 2), documented iron deficiency anemia (13 vs 8), positive fecal occult blood test results (11 vs 8), chronic diarrhea/constipation (21 vs 8), and dyspepsia with (11 vs 8) and without (21 vs 8) alarm symptoms.
CONCLUSIONS: Preliminary findings confirm that wait times for GI care are excessive. There are many possible reasons for this and appropriate reduction in wait times will require collaboration between the CAG, provincial gastroenterology associations, and provincial and federal government to meet the CAG’s goal of ensuring access to GI specialist care for all Canadian patients within eight weeks of referral.
Supported by AstraZeneca Canada Inc