Boris Sobolev, Lisa Kuramoto

Analysis of Waiting-Time Data in Health Services Research

• Gebundenes Buch

Produktbeschreibung

Why some patients wait longer than others remains an important question. This book is a reference for health services researchers looking for statistical tools with which to study waiting times. The book offers detailed coverage of statistical concepts and methods for the analysis and interpretation of waiting-time data. It provides analysis from health services research perspective, rather than operations management, and contains a collection of examples.

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In health care systems that provide universal access to care, efforts to contain costs for standby hospital capacity usually result in wait lists for surgical procedures. When access to health care is rationed by such wait lists, the length of time that patients are required to wait is usually uncertain. This uncertainty is a natural product of stochastic variation in service time and in the percentage of urgent cases in any queuing system. However, in a queue for elective (nonemergency) procedures, waiting-time uncertainty has many additionalcauses. Forinstance,decisionsofbothpatientsandcareprovidersmayoverrideaqueuediscipline. Alternatively, the lack of a hospital resource, such as beds in the intensive care unit, may change queuing practices in favor of services that would not require the resource. Waiting time is often compared between regions, hospitals, periods, or surgical services to evaluate p- icy and performance. However, surprisingly little attention has been given tothe variation in times spent in a single queue. Why some patients wait longer than others remains an important question in health services - search. Itisunclear,forexample, whether timetoservicevariesmorethanwouldbeexpected throughchance alone after differences in clinical condition are taken into account. Another important issue is preferential allocation of hospital resources. It also remains unclear whether patients of low priority are admitted directly as a way to circumvent long wait lists or to substitute for cancellations on the operating room schedule.

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Produktdetails

• Verlag: Springer / Springer New York / Springer, Berlin
• Artikelnr. des Verlages: 12171507, 978-0-387-76421-4
• 2008 edition
• Seitenzahl: 214
• Erscheinungstermin: 26. Dezember 2007
• Englisch
• Abmessung: 263mm x 187mm x 27mm
• Gewicht: 600g
• ISBN-13: 9780387764214
• ISBN-10: 0387764216
• Artikelnr.: 23129570

Autorenporträt

Boris Sobolev is Associate Professor in the Department of Health Care and Epidemiology at the University of British Columbia. Lisa Kuramoto is a Statistical Analyst with the Vancouver Coastal Health Services Research Institute.

Inhaltsangabe

Data, Questions and Methods.- Health services research on access to care.- Waiting-time data used in this book.- Waits and outcomes: What should be reported?.- Waiting-time Studies.- Overview of waiting times and other variables.- Variation and access probabilities.- Factors influencing waiting times.- Surgery after target access time.- Adverse events while waiting.- Intermediate events.- Survival benefit of coronary artery bypass grafting.

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Data, Questions and Methods.- Health services research on access to care.- Waiting-time data used in this book.- Waits and outcomes: What should be reported?.- Waiting-time Studies.- Overview of waiting times and other variables.- Variation and access probabilities.- Factors influencing waiting times.- Surgery after target access time.- Adverse events while waiting.- Intermediate events.- Survival benefit of coronary artery bypass grafting.

Rezensionen

From the reviews: "Sobolev and Kuramoto ... offer fellow researchers a guide to methodology for studying how long patients in a universal health-care system wait for elective or other non-emergency surgery. In addition to providing statistical tools, they set out the entire research process, from framing the question to interpreting results." (SciTech Book News, June, 2008)