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BMC Health Services Research

, 1:3

First Online: 17 April 2001Received: 30 January 2001Accepted: 17 April 2001DOI: 10.1186-1472-6963-1-3

Cite this article as: D-Souza, D.P., Martin, D.K., Purdy, L. et al. BMC Health Serv Res 2001 1: 3. doi:10.1186-1472-6963-1-3

Abstract

BackgroundWhy waiting lists arise and how to address them remains unclear, and an improved understanding of these waiting list -dynamics- could lead to better management. The purpose of this study is to understand how the current shortage in radiation therapy in Ontario developed; the implications of prolonged waits; who is held accountable for managing such delays; and short, intermediate, and long-term solutions.

MethodsA case study of the radiation therapy shortage in 1998-99 at Princess Margaret Hospital, Toronto, Ontario, Canada. Relevant documents were collected; semi-structured, face-to-face interviews with ten administrators, health care workers, and patients were conducted, audio-taped and transcribed; and relevant meetings were observed.

ResultsThe radiation therapy shortage arose from a complex interplay of factors including: rising cancer incidence rates; broadening indications for radiation therapy; human resources management issues; government funding decisions; and responsiveness to previous planning recommendations. Implications of delays include poorer cancer control rates; patient suffering; and strained doctor-patient relationships. An incompatible relationship exists between moral responsibility, borne by government, and legal liability, borne by physicians. Short-term solutions include re-referral to centers with available resources; long-term solutions include training and recruiting health care workers, improving workload standards, increasing compensation, and making changes to the funding formula.

ConclusionHuman resource planning plays a critical role in the causes and solutions of waiting lists. Waiting lists have harsh implications for patients. Accountability relationships require realignment.

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Autor: David P D-Souza - Douglas K Martin - Laura Purdy - Andrea Bezjak - Peter A Singer

Fuente: https://link.springer.com/







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