Surgical wait list management in Canada during a pandemic: many challenges ahead

Surgical wait list management in Canada during a pandemic: many challenges ahead

Can J Surg 2020;63(1):E226-E228 | PDF

Sam M. Wiseman, MD; R. Trafford Crump, PhD; Jason M. Sutherland, PhD

Summary

The coronavirus disease 2019 (COVID-19) pandemic has had a massive impact on waits for elective operations, with tens of thousands of scheduled surgeries being cancelled or postponed across Canada. Provincial governments will likely not only reopen elective surgical capacity when it is deemed safe, but also target new funding to address the backlog of cases. There is a dearth of research on whether the provinces’ approaches to managing wait lists are equitable from a patients’ needs perspective or if they are associated with patients’ perception of outcomes. The surgical cost models used in the past won’t be useful to governments and hospital managers. New models based on hospitals’ marginal costs, associated with running on weekends or off-hours and social distancing parameters, will be needed. Surgeon input, collaboration and leadership during the strategy development, implementation and management of surgical wait lists postpandemic will be imperative, as these decisions will significantly affect the health and lives of many Canadians.


Accepted May 4, 2020

Affiliations: From the Department of Surgery, St. Paul’s Hospital, and the University of British Columbia, Vancouver, BC (Wiseman); the Department of Surgery, University of Calgary, Calgary, Alta. (Crump); and the Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, BC (Sutherland).

Competing interests: None declared.

Contributors: All authors contributed substantially to the conception, writing, and revision of this article and approved the final version for publication.

DOI: 10.1503/cjs.006620

Correspondence to: S.M. Wiseman, Department of Surgery, St. Paul’s Hospital & University of British Columbia, Rm C303, 1081 Burrard St, Vancouver BC V6Z 1Y6, smwiseman@providencehealth.bc.ca