The importance of patient expectations as a determinant of satisfaction with waiting times for hip and knee replacement surgery.

Objectives: The disconfirmation model hypothesizes that satisfaction is a function of a perceived discrepancy from an initial expectation. Our objectives were: (1) to test the disconfirmation model as it applies to patient satisfaction with waiting time (WT) and (2) to build an explanatory model of the determinants of satisfaction with WT for hip and knee replacement.

Methods: We mailed 1000 questionnaires to 2 random samples: patients waiting or those who had received a joint replacement within the preceding 3-12 months.

'There are too many of us to fix.' Patients' views of acceptable waiting times for hip and knee replacement.

Objectives: To assess patients' views of maximum acceptable waiting times (MAWT) for hip and knee replacement, associated factors and the accuracy of self-reported waiting times.

Methods: We mailed 1000 questionnaires each to two random samples of patients either waiting for or who had received an arthroplasty within the preceding 3-12 months. We used linear regression to assess the determinants of patient MAWT, and content analysis to assess reasons for MAWT and ideal waiting time.

Willingness of patients to change surgeons for a shorter waiting time for joint arthroplasty.

Background: To improve access to care, many jurisdictions have proposed waiting-time benchmarks and guarantees. We assessed the willingness of patients to consider changing their surgeon to one with a shorter waiting time for arthroplasty.

Methods: We mailed a questionnaire to 2 random samples of patients who either were awaiting hip or knee replacement arthroplasty or had had one of these procedures within the preceding 3-12 months.

Appropriateness of healthcare interventions: concepts and scoping of the published literature.

Objectives: This report is a scoping review of the literature with the objective of identifying definitions, conceptual models and frameworks, as well as the methods and range of perspectives, for determining appropriateness in the context of healthcare delivery.

Methods: To lay groundwork for future, intervention-specific research on appropriateness, this work was carried out as a scoping review of published literature since 1966. Two reviewers, with two screens using inclusion/exclusion criteria based on the objective, focused the research and articles chosen for review.

Priority-setting for children's mental health: clinical usefulness and validity of the priority criteria score.

Objective: The 17-item PCS was designed for priority-setting and queue management of children and adolescents referred for mental health services. Here we assess aspects of the validity of the Children's Mental Health (CMH) Priority Criteria Score (PCS), developed by the Western Canada Waiting List Project (WCWL). The PCS was evaluated across clinical settings of increasing acuity and in terms of its relationship to two variables reflecting criteria-related validity and actual wait times.

Patient and surgeon views on maximum acceptable waiting times for joint replacement.

Objective: To assess patient and surgeon views on maximum acceptable waiting times (MAWT) for hip and knee replacement, their determinants and their relationship to levels of urgency based on the Western Canada Waiting List Priority Criteria Score (PCS).

Methods: At the decision date for surgery, orthopaedic surgeons assessed consecutive patients with the PCS and MAWT. Patients were surveyed 3-12 months post-surgery for MAWT and potential determinants.

A systematic literature review of the evidence on benchmarks for cataract surgery waiting time.

Background: This review offered critical input to the work of Canadian federal-provincial-territorial Deputy Ministers of Health on establishing evidence-based benchmarks for waiting times (WTs) for cataract surgery. The study purpose was to synthesize the evidence regarding the relations among patient characteristics, WT, and health outcomes for patients on waiting lists for cataract surgery.

Methods: A systematic literature review was conducted using the Cochrane methodology.

A bird can't fly on one wing: patient views on waiting for hip and knee replacement surgery.

Objectives: To obtain patients' perspectives on acceptable waiting times for hip or knee replacement surgery.

Methods: A questionnaire with both open- and close-ended items was mailed to 432 consecutive patients who had hip or knee replacement surgery 3-12 months previously in Saskatchewan, Canada. A content analysis was used to analyse the text data from the open-ended questions.

The Western Canada Waiting List Project: development of a priority referral score for hip and knee arthroplasty.

Background: Recognizing the concerns about long waiting times to see some specialists in Canada, and the burden this places on both primary care and specialist clinicians, the Western Canada Waiting List (WCWL) undertook the Primary Care Project. The goal was to develop a valid, reliable, standardized prioritization tool for use by primary care providers in making referrals to specialists. WCWL is a 20-partner collaboration committed to addressing long waiting times to access scheduled health care services.

Patient and physician perspectives of maximum acceptable waiting times for cataract surgery.

Background: Lengthy waiting times for cataract surgery are an important issue in countries with publicly funded health care systems. To improve the fairness, timeliness, and certainty of waiting-time management, the Western Canada Waiting List Project has developed priority criteria scores (PCSs) related to urgency and linked to maximum acceptable waiting times (MAWTs). The purpose of our study was to compare patient and physician perspectives of MAWT for different levels of urgency.

The prioritization of patients on waiting lists for cataract surgery: validation of the Western Canada waiting list project cataract priority criteria tool.

Purpose: To assess the validity of the Cataract Priority Criteria Score (PCS), developed by the Western Canada Waiting List (WCWL) Project to determine patient prioritization for cataract surgery.

Methods: Ophthalmologists assessed consecutive patients with the PCS and a visual analogue scale of urgency (VAS Urgency). Patients were mailed questionnaires pre- and post-surgery.

Determinants of patient and surgeon perspectives on maximum acceptable waiting times for hip and knee arthroplasty.

Objectives: Lengthy waiting times for hip and knee arthroplasty have raised concerns about equitable and timely access to care. The Western Canada Waiting List project has developed priority criteria scores linked to maximum acceptable waiting times (MAWT) for different levels of priority. Our study purpose was to assess the determinants of patient- and surgeon-rated MAWT, and to test whether the anticipated waiting time has an independent influence after adjusting for age, sex and patient urgency.

Prioritization of patients on waiting lists for hip and knee replacement: validation of a priority criteria tool.

Objectives: This study tested the reliability and validity of the Western Canada Waiting List Project priority criteria score (PCS) for prioritizing patients waiting for hip and knee arthroplasty.

Methods: Sixteen orthopedic surgeons assessed 233 consecutive patients at consultation for hip or knee arthroplasty. Measures included the PCS, a visual analogue scale of urgency (VAS urgency), and maximum acceptable waiting time (MAWT).

Prioritization of patients on scheduled waiting lists: validation of a scoring system for hip and knee arthroplasty.

Introduction: The hip and knee replacement priority criteria tool (HKPT) is 1 of 5 tools developed by the Western Canada Waiting List Project for setting priorities among patients awaiting elective procedures. We set out to assess the validity of the HKPT priority criteria score (PCS) and map the maximum acceptable waiting times (MAWTs) for patients to levels of urgency.

Methods: Two studies were used to assess convergent and discriminant validity.

Improving the management of waiting lists for elective healthcare services: public perspectives on proposed solutions.

An innovative approach to managing waiting lists and access to elective care, and one that is more fair and consistent with the 'guarantee of access' as stipulated in the Canada Health Act, has been developed by a partnership of medical associations, provincial ministries of health, regional health authorities and research centres. Operating as the Western Canada Waiting List Project, this group has developed beta versions of waiting list prioritization tools in five problematic clinical areas: hip and knee joint replacement; cataract removal surgery; general surgery; children's mental health services; and MRI scanning.