Situación y abordaje de lista de espera en un establecimiento de salud público en Santiago de Chile

Abstract

INTRODUCTION: Waiting lists are a well-known problem in public healthcare systems worldwide. For instance, England had over one million people in waiting lists for elective surgical procedures in 2000. Spain had over 360 000 patients in surgical waiting lists in 2007. Chile has been trying to manage waiting times through the GES (Explicit Guarantees in Healthcare) plan, which was established by the Chilean government in 2005. Waiting lists for the guaranteed-care diseases in the GES plan had 380 000 patients at the beginning of 2010, and that number was reduced to zero in 2011. Internationally, there are some descriptive studies about waiting lists that focus on variables such as waiting times and number of patients in the list. In Chile, however, this type of study is lacking. PURPOSE: This study aims to describe the characteristics of waiting lists for medical specialties between April and October 2011. It also aims to identify the components of management models in public healthcare centers, and to identify and analyze waiting-time frames of patients referred to a secondary or tertiary healthcare public center from a public primary healthcare center. METHODS: A descriptive cross-sectional study of the waiting list for first-time consultations for medical specialties was carried out. Referred patients were described and grouped using indicators of access to healthcare and waiting time between April and October 2011. Each consultation request or referral of a new patient was included in the waiting list and analyzed. RESULTS: There were 15 935 requests for consultations; 5 717 requests were resolved, and 8 544 were not (54% of the total requests for consultation). There was a mean waiting time of 498 days for non-resolved requests for consultation, and a mean of 141 days for resolved requests. The specialties in highest demand were orthopedic surgery and ophthalmology. The main waiting-list management processes were referral and reception of requests for consultation, contact of the patient, schedule of the consultation, and the medical appointment itself. RESULTS: There was low level of resolution of the waiting list, with completion of only 35% of the requests for consultation. There was also evidence of incomplete administrative procedures, as well as long waiting periods for first-time consultations on patients who were seen, up to 150 days. Patients who were not seen had a mean waiting period of almost 500 days. The management model was insufficient during the period of the study. Resolution was not timely; there was no increase in human resources. There was neither standardization of processes nor effective biomedical prioritization.

INTRODUCTION: Waiting lists are a well-known problem in public healthcare systems worldwide. For instance, England had over one million people in waiting lists for elective surgical procedures in 2000. Spain had over 360 000 patients in surgical waiting lists in 2007. Chile has been trying to manage waiting times through the GES (Explicit Guarantees in Healthcare) plan, which was established by the Chilean government in 2005. Waiting lists for the guaranteed-care diseases in the GES plan had 380 000 patients at the beginning of 2010, and that number was reduced to zero in 2011. Internationally, there are some descriptive studies about waiting lists that focus on variables such as waiting times and number of patients in the list. In Chile, however, this type of study is lacking. PURPOSE: This study aims to describe the characteristics of waiting lists for medical specialties between April and October 2011. It also aims to identify the components of management models in public healthcare centers, and to identify and analyze waiting-time frames of patients referred to a secondary or tertiary healthcare public center from a public primary healthcare center. METHODS: A descriptive cross-sectional study of the waiting list for first-time consultations for medical specialties was carried out. Referred patients were described and grouped using indicators of access to healthcare and waiting time between April and October 2011. Each consultation request or referral of a new patient was included in the waiting list and analyzed. RESULTS: There were 15 935 requests for consultations; 5 717 requests were resolved, and 8 544 were not (54% of the total requests for consultation). There was a mean waiting time of 498 days for non-resolved requests for consultation, and a mean of 141 days for resolved requests. The specialties in highest demand were orthopedic surgery and ophthalmology. The main waiting-list management processes were referral and reception of requests for consultation, contact of the patient, schedule of the consultation, and the medical appointment itself. RESULTS: There was low level of resolution of the waiting list, with completion of only 35% of the requests for consultation. There was also evidence of incomplete administrative procedures, as well as long waiting periods for first-time consultations on patients who were seen, up to 150 days. Patients who were not seen had a mean waiting period of almost 500 days. The management model was insufficient during the period of the study. Resolution was not timely; there was no increase in human resources. There was neither standardization of processes nor effective biomedical prioritization.