Letters
Emergency medicine
Volume 197 - Issue 11

The comparability of emergency department waiting time performance data

Authors:  Jessica Greene and Jane Hall

Med J Aust 2012; 197 (11): 618. || doi: 10.5694/mja12.11496
Published online: 10 December 2012
In reply: We thank Considine and colleagues for their interest in our recent article. Our research documented a relationship between the reported urgency mix of patients in emergency departments and waiting time performance, and we discussed possible explanations for the relationship, including “undertriaging”.1 We were explicit that the study did not provide evidence of undertriaging, but argued that it was a possibility worthy of consideration, ...
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In reply: We thank Considine and colleagues for their interest in our recent article. Our research documented a relationship between the reported urgency mix of patients in emergency departments and waiting time performance, and we discussed possible explanations for the relationship, including “undertriaging”.1 We were explicit that the study did not provide evidence of undertriaging, but argued that it was a possibility worthy of consideration, since gaming of hospital performance indicators has been documented in Australia and overseas.

Considine and colleagues questioned the strength of our evidence that hospitals engage in gaming. We cited two articles as evidence. One was by Curtis and colleagues, who discussed the 2009 audit of the Royal Women’s Hospital that found “systematic manipulation of data to meet waiting list targets”.2,3 The second was a British Medical Association survey which found that 16% of emergency departments in England reported manipulating data in order to meet waiting time targets.4 We find this evidence compelling, and believe that undertriaging should not be ruled out as a potential explanation for our findings without empirical study.

Authors

  • Jessica Greene1
  • Jane Hall2
  • 1. Planning, Public Policy and Management, University of Oregon, Eugene, Ore, USA.
  • 2. Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW.

Correspondence: jessicag@uoregon.edu

Competing interests

No relevant disclosures.

References

View this article on Wiley Online Library

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