Do as I say, not as I do: a survey of public impressions of queue-jumping and preferential access

Friedman, Steven; Schofield, Lee; Tirkos, Sam

doi:10.1097/mej.0b013e32825f54a4

Cited by 7 publications

(10 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Queue jumping means that urgent patients can skip the queue and jump to any position on a waiting list because of their treatment priority [73]. If more urgent patients arrive, units would like delay the treatment for the semi-urgent and elective patients in order to serve high priority patients in time, indirectly making these non-urgent patients wait longer.…”

Section: Resultsmentioning

confidence: 99%

Discovering the Impact of Preceding Units' Characteristics on the Wait Time of Cardiac Surgery Unit from Statistic Data

Liu

Xiao

2011

PLoS ONE

View full text Add to dashboard Cite

IntroductionPrior research shows that clinical demand and supplier capacity significantly affect the throughput and the wait time within an isolated unit. However, it is doubtful whether characteristics (i.e., demand, capacity, throughput, and wait time) of one unit would affect the wait time of subsequent units on the patient flow process. Focusing on cardiac care, this paper aims to examine the impact of characteristics of the catheterization unit (CU) on the wait time of cardiac surgery unit (SU).MethodsThis study integrates published data from several sources on characteristics of the CU and SU units in 11 hospitals in Ontario, Canada between 2005 and 2008. It proposes a two-layer wait time model (with each layer representing one unit) to examine the impact of CU's characteristics on the wait time of SU and test the hypotheses using the Partial Least Squares-based Structural Equation Modeling analysis tool.ResultsResults show that: (i) wait time of CU has a direct positive impact on wait time of SU (); (ii) capacity of CU has a direct positive impact on demand of SU (); (iii) within each unit, there exist significant relationships among different characteristics (except for the effect of throughput on wait time in SU).ConclusionCharacteristics of CU have direct and indirect impacts on wait time of SU. Specifically, demand and wait time of preceding unit are good predictors for wait time of subsequent units. This suggests that considering such cross-unit effects is necessary when alleviating wait time in a health care system. Further, different patient risk profiles may affect wait time in different ways (e.g., positive or negative effects) within SU. This implies that the wait time management should carefully consider the relationship between priority triage and risk stratification, especially for cardiac surgery.

show abstract

Section: Resultsmentioning

confidence: 99%

Discovering the Impact of Preceding Units' Characteristics on the Wait Time of Cardiac Surgery Unit from Statistic Data

Liu

Xiao

2011

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…With the exception of paying for faster access, our participants confirmed activities described in previous studies, including calling upon doctors and other health care professionals to expedite appointments and order further tests. 6,7 Our study highlights the role of health care professionals in facilitating access to care for patients with cancer. Many patients may have had limited interaction with the health care system (particularly at the secondary and tertiary level) before their cancer diagnosis and may find the system complex and difficult to navigate.…”

Section: Discussionmentioning

confidence: 99%

“…5 To date, much of the literature has been negatively framed (i.e., "queue-jumping" [receiving personally convenient care at the expense of others]). [6][7][8] Physicians are increasingly expected to advocate for patients; [9][10][11][12][13] in fact, physician as health advocate is a core competency of medical training in Canada.…”

mentioning

confidence: 99%

The role of patient and physician advocacy in reducing wait times for cancer care: a qualitative analysis

2017

View full text Add to dashboard Cite

Background: There is growing interest in the role of physician as health advocate; however, few studies have documented advocacy from the patient's perspective. To address this gap, we examined the experiences of patients with cancer from the onset of symptoms to the start of treatment in Newfoundland and Labrador and aimed to describe wait times and efforts to improve timeliness of care from the patients' perspective. Methods:We conducted qualitative interviews with 60 participants aged 19 years or more with breast, colorectal, lung or prostate cancer who were recruited from a survey of patients with cancer that was carried out as an earlier part of a larger study. All survey participants had received care at regional cancer clinics in Newfoundland and Labrador and were selected by means of purposive sampling based on their type of cancer, level of satisfaction with care and place of residence (urban, semiurban or rural). Interviews were transcribed verbatim and coded by means of a thematic approach.Results: Participants described actions taken by themselves, their families/friends or members of their health care team to reduce their wait for a diagnosis and/or treatment. In all instances, participants believed that these actions resulted in more timely care. Participants reported that "insider knowledge" of health care professionals (whether friends, family members or members of the care team) was particularly valuable in reducing delays. Interpretation:The use of advocacy was relatively commonplace. The role of advocacy, whether it originates from patient or caregiver, is important to ensure access to timely, good-quality cancer care. Abstract Research E774CMAJ OPEN, 5(4)

show abstract

“…[43,46,51,54,61] When it was considered alongside health gain and 'value for money,' participants appeared willing to sacrifice 'value for money' (system efficiency) in order to help the severely ill patients, as long as they could realize a 'large' health gain through treatment. [50] …”

Section: Severity Of Illness/current Health Statementioning

confidence: 98%

“…Sample size varied from 16 to 3241 members of the public, and depended upon the method used to elicit their views. Approximately three-quarters of the studies (25 of 34) had administered structured surveys (in person: 11 studies; [41][42][43][44][45][46][47][48][49][50] by telephone: one study; [51] and self-administered: 13 studies [52][53][54][55][56][57][58][59][60][61][62][63] ) to, typically, more than 100 participants. The remaining studies employed one or more focus groups (three studies [17,64,65] ) or small-group discussions (five studies [28,[66][67][68][69] ) of no more than 25 participants per session.…”

Section: Synthesis and Analysis Of Information Collectedmentioning

confidence: 99%

Societal Values in the Allocation of Healthcare Resources

Stafinski

Menon

Marshall

et al. 2011

The Patient: Patient-Centered Outcomes Research

View full text Add to dashboard Cite

Over the past decade, public distrust in unavoidable value-laden decisions on the allocation of resources to new health technologies has grown. In response, healthcare organizations have made considerable efforts to improve their acceptability by increasing transparency in decision-making processes. However, the social value judgments (distributive preferences of the public) embedded in them have yet to be defined. While the need to explicate such judgments has become widely recognized, the most appropriate approach to accomplishing this remains unclear. The aims of this review were to identify factors around which distributive preferences of the public have been sought, create a list of social values proposed or used in current resource allocation decision-making processes for new health technologies, and review approaches to eliciting such values from the general public. Social values proposed or used in making resource allocation decisions for new health technologies were identified through three approaches: (i) a comprehensive review of published, peer-reviewed, empirical studies of public preferences for the distribution of healthcare; (ii) an analysis of non-technical factors or social value statements considered by technology funding decision-making processes in Canada and abroad; and (iii) a review of appeals to funding decisions on grounds in part related to social value judgments. A total of 34 empirical studies, 10 technology funding decision-making processes, and 12 appeals to decisions were identified and reviewed. The key factors/patient characteristics addressed through policy statements and around which distributive preferences of the public have been sought included severity of illness, immediate need, age (and its relationship to lifetime health), health gain (amount and final outcome/health state), personal responsibility for illness, caregiving responsibilities, and number of patients who could benefit (rarity). Empirical studies typically examined the importance of these factors in isolation. Therefore, the extent to which preferences around one factor may be modified in the presence of others is still unclear. Research that seeks to clarify interactions among factors by asking the public to weigh several of them at once is needed to ensure the relevance of elicited preferences to real-world technology funding decisions.

show abstract

Do as I say, not as I do: a survey of public impressions of queue-jumping and preferential access

Cited by 7 publications

References 11 publications

Discovering the Impact of Preceding Units' Characteristics on the Wait Time of Cardiac Surgery Unit from Statistic Data

Discovering the Impact of Preceding Units' Characteristics on the Wait Time of Cardiac Surgery Unit from Statistic Data

The role of patient and physician advocacy in reducing wait times for cancer care: a qualitative analysis

Societal Values in the Allocation of Healthcare Resources

Contact Info

Product

Resources

About