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Access to Spine Care: A Tale of Two Cities

Published online by Cambridge University Press:  02 December 2014

R. John Hurlbert ,
Ralph Mobbs  and
Charles Teo
R. John Hurlbert
Affiliation:
University of Calgary Spine Program and Department of Clinical Neurosciences, Foothills Hospital and Medical Centre, Calgary, AB, Canada
Ralph Mobbs
Affiliation:
Prince of Wales Public and Private Hospital, Randwick, New South Wales, Australia
Charles Teo
Affiliation:
Prince of Wales Public and Private Hospital, Randwick, New South Wales, Australia
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Abstract:

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Introduction:

As governments struggle with increasing demand for accountability within the Canadian Health Care System and set wait-time standards, it is important to objectify data to allow a true understanding of present limitations and to facilitate comparisons to other systems. The purpose of this study was to compare wait list times for a cohort of patients requiring spinal surgery in Calgary, Alberta to a similar cohort in Sydney, Australia.

Methods:

From January 1 until June 30, 2006 all outpatients admitted for spinal surgery to the Foothills Hospital were identified by the surgeons’ office. Two time periods were quantified from their charts: (1) time from referral to surgical consultation; and (2) time from surgical consultation to operative intervention. From July 1 until December 31, 2006 patients were similarly identified through Neurosurgical offices at the Prince of Wales Public and Private Hospitals in Sydney, Australia.

Results:

Four hundred ninety-one surgical patients were captured during the six month period in Calgary and 155 patients during the subsequent six months in Sydney. The majority of patients in Sydney were treated in the Private Health Care system. Public patients in Sydney have access to a surgical consultant twice as fast as public patients in Calgary while private patients have access ten times faster. Access to operating room time within the public system is a rate limiting step in both countries. However, Sydney private patients receive their surgery four times faster than Calgary patients.

Conclusions:

Compared to Calgary, access to specialized spine care in Sydney appears more efficient not only in the Private but also the Public Health Care System. Part of this efficiency may arise from offloading from the public into the private system. Solutions proposed to reduce wait list times should consider benefits of a Private Health Care System.

Résumé:

<span class='bold'>RÉSUMÉ:</span><span class='bold'><span class='italic'>Introduction:</span></span>

Les gouvernements font face à des demandes de plus en plus pressantes de reddition de compte en ce qui concerne le système de santé canadien et des standards de temps d’attente fixes. Il est donc important d’avoir des données objectives pour une bonne compréhension des limites actuelles et pour faciliter les comparaisons à d’autres systèmes. Le but de cette etude était de comparer les temps d’attente de patients qui ont besoin d’une chirurgie spinale à Calgary, en Alberta, à une cohorte similaire à Sydney, en Australie.

<span class='bold'><span class='italic'>Méthodes:</span></span>

Tous les patients externes admis pour une chirurgie spinale au Foothills Hospital entre le 1er janvier et le 30 juin 2006 ont été identifiés par le bureau du chirurgien. À partir de leurs dossiers, nous avons éterminé : 1) l’intervalle entre la demande de consultation en chirurgie et le moment de la consultation; 2) l’intervalle entre la consultation et la chirurgie. Entre le 1er juillet et le 31 écembre 2006, nous avons obtenu des données identiques de bureaux de neurochirurgiens au Prince of Wales Public Hospital et au Prince of Wales Private Hospital de Sydney, en Australie.

<span class='bold'><span class='italic'>Résultats:</span></span>

Quatre cent quatre-vingt-dix patients ont été recensés à Calgary pendant la première période de six mois et 155 patients à Sydney pendant les six mois suivants. La majorité des patients de Sydney ont été traités dans le système de santé privé. Les patients du système public à Sydney ont accès à un consultant deux fois plus rapidement que les patients du système public à Calgary, alors que les patients du ystème privé ont accès dix fois plus rapidement. L’accès au temps opératoire dans le système public est une étape limitante dans les deux pays. Cependant les patients du système privé à Sydney ont leur chirurgie quatre fois plus rapidement que les patients de Calgary.

<span class='bold'><span class='italic'>Résultats:</span></span>Conclusions:

L’accès aux soins spinaux spécialisés à Sydney semble plus efficient qu’à Calgary, non seulement dans le système de santé privé mais aussi dans le système public. Cette efficience peut être due en partie à une décharge du système de santé public vers le système privé. Les solutions proposées pour réduire le temps d’attente devraient considérer les benefices d’un système de santé privé.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 35 , Issue 3 , July 2008 , pp. 308 - 313
Copyright
Copyright © The Canadian Journal of Neurological 2008

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