%0 Journal Article
%T Expectations Confounded: Patients Are Satisfied with THR and TKR Delivery in Australian Public Hospitals¡ªA Multisite Case Study
%A Julie Lynette Walters
%A Shylie Mackintosh
%A Lorraine Sheppard
%J ISRN Public Health
%D 2012
%R 10.5402/2012/947828
%X Background. The popular media infer that satisfaction with waiting lists for total hip or knee replacement surgery is poor; however, there is little supporting evidence for this. The purpose of this study was to describe patients satisfaction with the service they received for joint replacement surgery in a public hospital. Methods. A cross-sectional design was used to survey 450 patients. Data was analysed descriptively and chi-squared analyses (significance level of ) were used to examine associations between variables. Results. The response rate was 71%. Nearly three-quarters ( ) of the sample were ¡°very happy¡± with the service and 92.0% ( ) indicated that they would have their surgery again. Satisfaction was significantly associated with waiting time to the first appointment (chi-square; ), whether the patients enquired about their waiting time (chisquare; ), and the number of preoperative appointments (chisquare; ). Most participants reported a maximum acceptable waiting period for initial appointment of less than 6 months but nearly half waited longer. Conclusions. The perception that patients are unhappy with elective surgery services in Australia may be unfounded despite many waiting longer than they consider appropriate. 1. Introduction There is emotive discussion in the popular press and the health literature surrounding the provision of elective surgery in publicly funded health systems in western countries [1, 2]. This is particularly related to the length of waiting lists, despite the current evidence regarding the clinical impact of long waiting lists being ambiguous¡ªsome studies suggest that patients deteriorate over time [3¨C6], while others report no change in clinical status. In Australia and elsewhere, total hip (THR) and total knee replacement (TKR) surgery are commonly used procedures in the treatment of end-stage osteoarthritis [7, 8]. Because of their commonality, they receive considerable attention and their waiting lists are easily compared to the national standards and are therefore convenient measures of how successfully the government or health service is delivering health care. Whether or not this is a fair assessment, the focus on waiting lists has encouraged governments and hospitals to introduce processes to monitor and manage waiting lists for publicly funded health services. For example, in 1996, New Zealand trialled ¡°financially sustainable thresholds¡± for elective surgery, where health services could determine the number of elective surgeries performed based on their ability to fund them [9, 10]. In 2004, Australia
%U http://www.hindawi.com/journals/isrn.public.health/2012/947828/