The Impact of Outpatient Booking Systems on Waiting Times for Investigation of Suspected Cancer: The Case of Post-Menopausal Bleeding

Abstract

Background

A 2-week waiting time from primary care referral to first specialist assessment is recommended for patients with symptoms of suspected cancer, such as post-menopausal bleeding (PMB). We compared 2 different booking systems in relation to the observed waiting time for patients with suspected uterine cancer.

Methods

Data were collected concurrently between July 2009 and August 2010, and captured the duration of waiting time from referral to specialist assessment for each woman with PMB. A comparison of 2 outpatient booking systems on waiting times was undertaken for 2 District Health Boards (DHBs) in New Zealand. DHB1 uses a centralized booking system, and DHB2 uses a clinic-based system.

Results

A total of 147 women were included in the timing analysis. At DHB1, 2 of 90 women (2%) were seen within 2 weeks and 61 of 90 women (68%) waited more than 42 days. At DHB2, 24 of 57 women (42%) were seen within 2 weeks and 19 of 57 women (33%) waited more than 42 days. Overall, only 18% of women in this study were seen within the 2-week time-frame and 80 of 147 women (54%) waited more than 42 days from referral to specialist assessment.

Conclusions

In this study, a clinic-based booking system was associated with shorter waiting times compared with a centralized booking system in 2 reasonably comparable DHB services. Waiting times were longer than the recommended guidelines, regardless of booking system. Further research is needed to clarify the effects of these different booking systems on waiting times.