Waiting for essential diagnostic tests

November 25, 2002

Increasing attention has focused on waiting lists for diagnostic procedures. A new study in CMAJ has found that only 37% of patients awaiting cardiac catheterization at a regional centre in Ontario underwent their procedure within the requested timeframe.

Madhu Natarajan and colleagues documented mortality and morbidity data for a group of 8030 patients referred for cardiac catheterization and identified predictors of cardiac events that occurred while patients were waiting for the procedure. In addition to finding that so few patients underwent the procedure within the specified time, 109 patients (1.4%) had a major cardiac event while waiting. Fifty patients awaiting catheterization died during the median wait of 27 days.

The authors state their findings represent a benchmark by which the effects of increased capacity and prioritization schemes can be measured. They also suggest developing central booking systems, specifying minimal acceptable criteria for cardiac catheterization, better systems to prioritize and monitor changes in patients' status and specifying maximum waiting times for patients at low risk as potential ways for reducing waiting times for cardiac catheterization.

In a related commentary, Justin Ezekowitz and Paul Armstrong state the need for better risk stratification of both inpatients and outpatients, and for systematic monitoring of the catheterization process, has never been greater.
p. 1233 The risks of waiting for cardiac catheterization: a prospective study
-- M.K. Natarajan et al
p. 1247 The waiting game: facing the consequences
-- J.A. Ezekowitz, P.W. Armstrong

Canadian Medical Association Journal

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