INTERNATIONAL COMPARISON OF WAITING-TIMES FOR SELECTED CARDIOVASCULAR PROCEDURES

Objectives. This study was designed to compare waiting times for cardiovascular procedures in five different health care delivery/financing systems. Background. A recurrent criticism of national health care systems is long waiting times, or ''queues,'' for high technology procedures. However, no objective data exist comparing waiting times in the United States with those in other systems. Methods. Directors of cardiac catheterization laboratories, directors of cardiac surgery in the United States, U.S. Department of Veterans Affairs (VA) system, Canada and the United Kingdom and directors of cardiology clinics in Sweden were asked to respond to a mailed questionnaire as to how long it would take to obtain coronary angiography or coronary artery bypass surgery, or both, for specified case scenarios at their institutions. Results. Significant differences in waiting times (p < 0.00001) were found among the systems for all four scenarios (elective and urgent angiography, elective and urgent bypass surgery). Compared with non-VA hospitals in the United States, waiting times were significantly longer in all systems, with the exception of waiting times for urgent surgery in the U.S. VA hospitals (p = 0.9). The longest waiting times for all four procedures were reported in the United Kingdom, Sweden and Canada, with some waiting times for elective procedures >9 months. Conclusions. Physicians report that patients treated in health care systems structured differently from the non VA hospital system in the United States wait significantly longer for cardiac catheterization and coronary artery bypass surgery.