Analysis of the surgical waiting list for conditions not covered by the Explicit Health Guarantees in orthopedics and traumatology in Chile.

Abstract

Introduction: Surgical waiting lists for conditions not covered by the Explicit Health Guarantees represent unmet needs and structural gaps within the Chilean public health system. The field of orthopedics and traumatology accounts for a high volume of pending procedures, with total knee arthroplasty being the most frequently delayed. The coexistence of deferrable pathologies not formally recorded, combined with the low efficiency in the use of operating rooms, aggravates this problem. This study aims to characterize the surgical waiting list for conditions not covered by the Explicit Health Guarantees in Chile between 2022 and 2024, with a focus on orthopedics and traumatology. Additionally, we identify the most delayed procedures, the most affected health services, and the current capacity for resolution.

Methods: A descriptive observational study based on official data requested from the Ministry of Health through transparency and public records, including the Department of Health Statistics and Information and the National Health Fund. Surgical procedures awaiting treatment were analyzed by specialty, region, establishment, sex, and age for the period from 2022 to 2024.

Results: Orthopedics and traumatology were the specialties with the highest number of pending procedures (22 to 24% of the total). Knee arthroplasty consistently ranked first, with over 20 000 cases annually. The O'Higgins Health Service had the highest burden. In 2022, the rate of arthroplasties performed on patients covered by the National Health Fund was four times lower than on patients covered by Social Security Health Institutions. No region achieved a surgical volume sufficient to reduce the waiting list significantly.

Conclusions: The problem of waiting lists in orthopedics is mainly due to organizational shortcomings. Creating the role of trauma emergency ward, optimizing the use of wards, and creating outpatient surgical units are short- and medium-term measures to reverse this trend.