• Open Access

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

Authors

  • Barbara L. Conner-Spady PhD,

    1. Research Assistant, Department of Community Health Sciences, University of Calgary, Calgary and Research Assistant, Western Canada Waiting List Project, Calgary, AB, Canada
    Search for more papers by this author
  • Geoffrey H. Johnston MD MBA FRCSC,

    1. Professor, Western Canada Waiting List Project, Calgary, AB, Canada and Professor, University of Saskatchewan, Saskatoon, SK, Canada
    Search for more papers by this author
  • Claudia Sanmartin PhD,

    1. Senior Analyst, Western Canada Waiting List Project, Calgary, AB, Canada and Senior Analyst, Statistics Canada, Ottawa, ON, Canada
    Search for more papers by this author
  • John J. McGurran MSc,

    1. Project Director, Western Canada Waiting List Project, Calgary, AB, Canada and Project Director, Department of Public Health Sciences, University of Toronto, Toronto, ON, Canada
    Search for more papers by this author
  • Tom W. Noseworthy MD MSc MPH,

    1. Professor, Department of Community Health Sciences, University of Calgary, Calgary and Professor, Western Canada Waiting List Project, Calgary, AB, Canada
    Search for more papers by this author
  • the Saskatchewan Surgical Care Network/Western Canada Waiting List Project Research and Evaluation Working Group Committee

    Search for more papers by this author
    • 1

      SSCN/WCWL Research and Evaluation Working Group Committee: Chair – Rob Weiler, Jeff Brown, Candice Bryden, Doug Calder, Lauren Donnelly, Laurie Gander, David Johnson, Derrick Larsen, Sheena McRae, Mark Ogrady and Trent Truscott.


Tom Noseworthy
University of Calgary
Room G36, Heritage Medical Research Building
Department of Community Health Sciences
3330 Hospital Drive NW
Calgary
AB T2N 4N1
Canada
E-mail: tnosewor@ucalgary.ca

Abstract

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.

Results  The sample of 303 (response rate 70%) was 59% female with a mean age of 70 years (SD 11). The median waiting time from the decision date to surgery was 17 weeks. Individuals who rated their waiting time very acceptable (48%) had a median waiting time of 13 weeks compared with a median waiting time of 22 weeks for those who rated it unacceptable (23%). The two most common determinants of acceptability were patient expectations and pain and its impact on patient quality of life. The median maximum acceptable waiting time was 13 weeks and median ideal waiting time, 8.6 weeks. Seventy-nine per cent felt that those in greater need (higher severity) should go before them on the waiting list. Patient ratings of maximum acceptable waiting time were based on: pain and loss of mobility, time needed to prepare for surgery, and severity at the time of seeing the surgeon. In consideration of changing their surgeon to one with a shorter waiting list, 68% would not.

Conclusions  Patient views on waiting times are not only related to quality of life issues, but also to prior expectations and notions of fairness and priority. Understanding patient views on waiting for surgery has implications for better management of waiting times and experiences for joint replacement.

Ancillary