A clinical audit of patients on an orthopaedic waiting list for greater than two years

N Z Med J. 1992 Jul 8;105(937):266-8.

Abstract

Aims: the aims of this paper were to review a group of 142 patients who had been on an orthopaedic waiting list for more than two years, both by postal audit and by clinical assessment, and to determine the fates of these patients.

Method: all patients who had been on the orthopaedic waiting list for more than two years were written to, asking them to attend a preadmission clinic if they still required surgery. Those who attended the clinic were reassessed with regard to their orthopaedic problem and general state of health. Preadmission summaries, radiographs and waiting list details were analysed with respect to time spent on the waiting list, changes in clinical and radiographic findings and changes in diagnosis or proposed operation. The number of patients removed from the waiting list and the reason for removal was noted.

Results: One hundred and thirty-four of 142 patients replied. One hundred and three attended the preadmission clinic. A change of diagnosis was made for four patients and nine patients underwent a different operation than that originally proposed. Thirty-four patients were removed from the waiting list after reassessment. Of the 142 original patients only 69 (49%) remained on the waiting list. A number of patients deteriorated significantly while on the waiting list.

Conclusion: a significant number of patients on a long orthopaedic waiting list may no longer require surgery. A number of patients can be expected to deteriorate significantly while on the waiting list. Postal audits alone are insufficient to determine who on the waiting list still requires surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Health Services Research
  • Health Status*
  • Hospitals, Public
  • Humans
  • Male
  • Medical Audit
  • Middle Aged
  • New Zealand
  • Orthopedics / standards*
  • Orthopedics / statistics & numerical data
  • Outcome Assessment, Health Care
  • Time Factors
  • Waiting Lists*