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Background Canada, which has universal single-payer health insurance, is often criticized for waiting times for surgery that are longer than those in the United States. We compared waiting times for orthopedic consultations and knee-replacement surgery and patients' acceptance of them in the United States and in the province of Ontario, Canada.
Methods A stratified random sample of 1486 Medicare recipients (629 from the U.S. national sample, 428 from Indiana, and 429 from western Pennsylvania) and 516 people from Ontario who had been hospitalized for knee replacement between 1985 and 1989 were surveyed by mail in 1992. Patients were asked how long they had waited to see an orthopedic surgeon and to have surgery, the acceptability of these waiting times, and their overall satisfaction with surgery.
Results About 80 percent of the questionnaires were returned, but not all the respondents answered all the questions. The rate of response to specific questions was about 60 to 65 percent in both countries. The median waiting time for an initial orthopedic consultation was two weeks in the United States and four weeks in Ontario. The median waiting time for knee replacement after the operation had been planned was three weeks in the United States and eight weeks in Canada. In the United States, 95 percent of patients in the national sample considered their waiting time for surgery acceptable, as compared with 85.1 percent in Ontario. Overall satisfaction with surgery ("very or somewhat satisfied") was 85.3 percent for all U.S. respondents and 83.5 percent for Canadian respondents.
Conclusions Waiting times for initial orthopedic consultation and for knee-replacement surgery were longer in Ontario than in the United States, but overall satisfaction with surgery was similar.
Source Information
From the Department of Health Administration and Institute for Policy Analysis, University of Toronto, the Institute for Clinical Evaluative Sciences, Sunnybrook Health Sciences Centre, and the Hearing Health Care Research Unit, all in Toronto (P.C.C.); the Department of Surgery, Division of Orthopaedics and Clinical Epidemiology, Hospital for Sick Children, Toronto (J.G.W.); the Department of Medicine, Division of Rheumatology, Women's College Hospital, Toronto (G.A.H.); the Department of Medicine, Division of Rheumatology, Wellesley Hospital, Toronto (C.B.); the Department of Medicine, Division of General Internal Medicine, Regenstrief Institute for Health Care, and Roudebush Veterans Affairs Medical Center, Indianapolis (R.S.D.); Bowen Research Center, Indiana University, Indianapolis (R.S.D., D.A.F.); the Research Triangle Institute, Research Triangle Park, N.C. (J.E.P.); and the University of Toronto, Toronto (E.H.).
Address reprint requests to Dr. Coyte at the Dept. of Health Administration, 2nd Fl., McMurrich Bldg., Faculty of Medicine, University of Toronto, 12 Queen's Park Cres. W., Toronto, ON M5S 1A8, Canada.
Related Letters:
Knee-Replacement Surgery in the United States and Ontario
Russell A.S., Sullivan D. J., Coyte P. C., Wright J. G.
Extract |
Full Text
N Engl J Med 1995;
332:822-823, Mar 23, 1995.
Correspondence
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