What is it about?
We studied whether postoperative survival differed significantly among patients who waited for coronary bypass surgery longer than deemed medically appropriate, 6 weeks for patients needing semi-urgent surgery and 12 weeks for those needing non-urgent surgery.
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Why is it important?
We found a significant survival benefit from performing surgical revascularization within the time deemed acceptable to consultant surgeons for patients who require the treatment on a semi-urgent or non-urgent basis.
Perspectives
The Hospital Insurance and Diagnostics Act (1957), the Medical Insurance Act (1967), and the Canada Health Act (1984) laid the groundwork for a publicly administered health care system in Canada that is universal, accessible, portable, and comprehensive. As others have pointed out, the principle of accessibility was not originally intended to address the timeliness of access to elective, i.e., non-emergency, care. Wait lists for elective surgery have been commonly accepted in Canada on the premise of the most efficient use of hospital resources; the only alternative would be to have underutilization of capacity within the health care system. The health system's operational considerations alone may be irrelevant, as the Supreme Court of Canada agreed in a recent ruling that long healthcare wait times constitute deprivation of rights to personal inviolability guaranteed by the Charter of Rights and Freedoms. The analysis of postoperative deaths reported here provides further support for keeping the wait lists for elective CABG short.
Professor Boris Sobolev
University of British Columbia
Read the Original
This page is a summary of: Delay in admission for elective coronary-artery bypass grafting is associated with increased in-hospital mortality, BMC Health Services Research, September 2008, Springer Science + Business Media,
DOI: 10.1186/1472-6963-8-185.
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