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
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, ...
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.
Competing interests
No relevant disclosures.
References
- Greene J, Hall J. The comparability of emergency department waiting time performance data. Med J Aust 2012; 197: 345-348. 0_CBBCBEIJ
- Curtis AJ, Stoelwinder JU, McNeil JJ. Management of waiting lists needs sound data. Med J Aust 2009; 191: 423-424. 0_i1142863
- Paxton Partners. Elective surgery waiting list audit, Royal Women’s Hospital. Melbourne: Department of Human Services, 2009. http://www.health.vic.gov.au/hdss/esis/2009-10/waitinglistaudit_rwh290309.pdf (accessed Oct 2012).
- British Medical Association. BMA survey of A&E waiting times. London: Health Policy and Economic Research Unit, BMA, 2005. http://www.collemergencymed.ac.uk/code/document.asp?ID=3156 (accessed Oct 2012).