Do women spend longer on wait lists for coronary bypass surgery? Analysis of a population-based registry in British Columbia, Canada

Using records from a population-based registry, we compared the wait-list time between women and men in British Columbia (BC) between 1990 and 2000. We compared the number of weeks from registration to surgery for equal proportions of women and men, after adjusting for priority, comorbidity and age.In BC in the 1990s, 9,167 patients aged 40 years and over were registered on wait lists for CABG and spent a total of 136,071 person-weeks waiting. At the time of registration for CABG, women were more likely to have a comorbid condition than men. We found little evidence to suggest that women waited longer than men for CABG after registration, after adjusting for comorbidity and age, either overall or within three priority groups.Our findings support the hypothesis that higher operative mortality during elective CABG operations observed among women is not due to longer delays for the procedure.In publicly funded health care systems, priority wait lists are commonly used to manage access to elective cardiac surgery [1]. While queuing according to urgency of intervention is designed to facilitate access to surgery within a clinically appropriate time [2], patients who are delayed for surgical cardiac revascularization are faced with increased risks of worsening symptoms [3] and death [4,5]. The additional risks incurred by longer delays may be of particular concern for women with cardiovascular disease because, at presentation, women are more likely than men to have comorbid medical conditions such as hypertension, diabetes or obesity [6-11]. These comorbid medical conditions may increase the amount of time that women wait for CABG.A number of studies have shown that the operative mortality among women undergoing CABG surgery is higher than that of men [12,13]. However, there is no information on whether women wait longer than men for CABG, after adjusting for age, severity of disease and comorbidity. It is therefore difficult to ascertain whether higher operative mortalit