Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions

Diego A. Martinez, Haoxiang Zhang, Magdalena Bastias, Felipe Feijoo, Jeremiah Hinson, Rodrigo Martinez, Jocelyn Dunstan, Scott Levin, Diana Prieto

Research output: Contribution to journalArticle

Abstract

Background: Most data on mortality and prognostic factors of universal healthcare waiting lists come from North America, Australasia, and Europe, with little information from South America. We aimed to determine the relationship between medical center-specific waiting time and waiting list mortality in Chile. Method: Using data from all new patients listed in medical specialist waitlists for non-prioritized health problems from 2008 to 2015 in three geographically distant regions of Chile, we constructed hierarchical multivariate survival models to predict mortality risk at two years after registration for each medical center. Kendall rank correlation analysis was used to measure the association between medical center-specific mortality hazard ratio and waiting times. Result: There were 987,497 patients waiting for care at 77 medical centers, including 33,546 (3.40%) who died within two years after registration. Male gender (hazard ratio [HR] = 1.17, 95% confidence interval [CI] 1.1-1.24), older age (HR = 2.88, 95% CI 2.72-3.05), urban residence (HR = 1.19, 95% CI 1.09-1.31), tertiary care (HR = 2.2, 95% CI 2.14-2.26), oncology (HR = 3.57, 95% CI 3.4-3.76), and hematology (HR = 1.6, 95% CI 1.49-1.73) were associated with higher risk of mortality at each medical center with large region-to-region variations. There was a statistically significant association between waiting time variability and death (Z = 2.16, P = 0.0308). Conclusion: Patient wait time for non-prioritized health conditions was associated with increased mortality in Chilean hospitals.

Original languageEnglish (US)
Article number6526
JournalBMC public health
Volume19
Issue number1
DOIs
StatePublished - Feb 26 2019

Fingerprint

Waiting Lists
Confidence Intervals
Mortality
Chile
Australasia
South America
Health
Hematology
Tertiary Healthcare
North America
Hospital Mortality
Patient Care
Delivery of Health Care
Survival

Keywords

  • Delivery of health care
  • Engineering
  • Health equity
  • Mortality
  • Waiting lists

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions. / Martinez, Diego A.; Zhang, Haoxiang; Bastias, Magdalena; Feijoo, Felipe; Hinson, Jeremiah; Martinez, Rodrigo; Dunstan, Jocelyn; Levin, Scott; Prieto, Diana.

In: BMC public health, Vol. 19, No. 1, 6526, 26.02.2019.

Research output: Contribution to journalArticle

Martinez, Diego A. ; Zhang, Haoxiang ; Bastias, Magdalena ; Feijoo, Felipe ; Hinson, Jeremiah ; Martinez, Rodrigo ; Dunstan, Jocelyn ; Levin, Scott ; Prieto, Diana. / Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions. In: BMC public health. 2019 ; Vol. 19, No. 1.
@article{440454a3251d426ba7cf40e969ce1bde,
title = "Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions",
abstract = "Background: Most data on mortality and prognostic factors of universal healthcare waiting lists come from North America, Australasia, and Europe, with little information from South America. We aimed to determine the relationship between medical center-specific waiting time and waiting list mortality in Chile. Method: Using data from all new patients listed in medical specialist waitlists for non-prioritized health problems from 2008 to 2015 in three geographically distant regions of Chile, we constructed hierarchical multivariate survival models to predict mortality risk at two years after registration for each medical center. Kendall rank correlation analysis was used to measure the association between medical center-specific mortality hazard ratio and waiting times. Result: There were 987,497 patients waiting for care at 77 medical centers, including 33,546 (3.40{\%}) who died within two years after registration. Male gender (hazard ratio [HR] = 1.17, 95{\%} confidence interval [CI] 1.1-1.24), older age (HR = 2.88, 95{\%} CI 2.72-3.05), urban residence (HR = 1.19, 95{\%} CI 1.09-1.31), tertiary care (HR = 2.2, 95{\%} CI 2.14-2.26), oncology (HR = 3.57, 95{\%} CI 3.4-3.76), and hematology (HR = 1.6, 95{\%} CI 1.49-1.73) were associated with higher risk of mortality at each medical center with large region-to-region variations. There was a statistically significant association between waiting time variability and death (Z = 2.16, P = 0.0308). Conclusion: Patient wait time for non-prioritized health conditions was associated with increased mortality in Chilean hospitals.",
keywords = "Delivery of health care, Engineering, Health equity, Mortality, Waiting lists",
author = "Martinez, {Diego A.} and Haoxiang Zhang and Magdalena Bastias and Felipe Feijoo and Jeremiah Hinson and Rodrigo Martinez and Jocelyn Dunstan and Scott Levin and Diana Prieto",
year = "2019",
month = "2",
day = "26",
doi = "10.1186/s12889-019-6526-6",
language = "English (US)",
volume = "19",
journal = "BMC Public Health",
issn = "1471-2458",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions

AU - Martinez, Diego A.

AU - Zhang, Haoxiang

AU - Bastias, Magdalena

AU - Feijoo, Felipe

AU - Hinson, Jeremiah

AU - Martinez, Rodrigo

AU - Dunstan, Jocelyn

AU - Levin, Scott

AU - Prieto, Diana

PY - 2019/2/26

Y1 - 2019/2/26

N2 - Background: Most data on mortality and prognostic factors of universal healthcare waiting lists come from North America, Australasia, and Europe, with little information from South America. We aimed to determine the relationship between medical center-specific waiting time and waiting list mortality in Chile. Method: Using data from all new patients listed in medical specialist waitlists for non-prioritized health problems from 2008 to 2015 in three geographically distant regions of Chile, we constructed hierarchical multivariate survival models to predict mortality risk at two years after registration for each medical center. Kendall rank correlation analysis was used to measure the association between medical center-specific mortality hazard ratio and waiting times. Result: There were 987,497 patients waiting for care at 77 medical centers, including 33,546 (3.40%) who died within two years after registration. Male gender (hazard ratio [HR] = 1.17, 95% confidence interval [CI] 1.1-1.24), older age (HR = 2.88, 95% CI 2.72-3.05), urban residence (HR = 1.19, 95% CI 1.09-1.31), tertiary care (HR = 2.2, 95% CI 2.14-2.26), oncology (HR = 3.57, 95% CI 3.4-3.76), and hematology (HR = 1.6, 95% CI 1.49-1.73) were associated with higher risk of mortality at each medical center with large region-to-region variations. There was a statistically significant association between waiting time variability and death (Z = 2.16, P = 0.0308). Conclusion: Patient wait time for non-prioritized health conditions was associated with increased mortality in Chilean hospitals.

AB - Background: Most data on mortality and prognostic factors of universal healthcare waiting lists come from North America, Australasia, and Europe, with little information from South America. We aimed to determine the relationship between medical center-specific waiting time and waiting list mortality in Chile. Method: Using data from all new patients listed in medical specialist waitlists for non-prioritized health problems from 2008 to 2015 in three geographically distant regions of Chile, we constructed hierarchical multivariate survival models to predict mortality risk at two years after registration for each medical center. Kendall rank correlation analysis was used to measure the association between medical center-specific mortality hazard ratio and waiting times. Result: There were 987,497 patients waiting for care at 77 medical centers, including 33,546 (3.40%) who died within two years after registration. Male gender (hazard ratio [HR] = 1.17, 95% confidence interval [CI] 1.1-1.24), older age (HR = 2.88, 95% CI 2.72-3.05), urban residence (HR = 1.19, 95% CI 1.09-1.31), tertiary care (HR = 2.2, 95% CI 2.14-2.26), oncology (HR = 3.57, 95% CI 3.4-3.76), and hematology (HR = 1.6, 95% CI 1.49-1.73) were associated with higher risk of mortality at each medical center with large region-to-region variations. There was a statistically significant association between waiting time variability and death (Z = 2.16, P = 0.0308). Conclusion: Patient wait time for non-prioritized health conditions was associated with increased mortality in Chilean hospitals.

KW - Delivery of health care

KW - Engineering

KW - Health equity

KW - Mortality

KW - Waiting lists

UR - http://www.scopus.com/inward/record.url?scp=85062286074&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062286074&partnerID=8YFLogxK

U2 - 10.1186/s12889-019-6526-6

DO - 10.1186/s12889-019-6526-6

M3 - Article

VL - 19

JO - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

IS - 1

M1 - 6526

ER -