Risk Factors Associated with the Refusal of Surgery Vouchers: The Case of Central Portugal
Main Author: | |
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Publication Date: | 2022 |
Other Authors: | , |
Format: | Article |
Language: | por eng |
Source: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Download full: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15357 |
Summary: | Introduction: In Portugal, the rate of refusals regarding transfer between hospitals through surgery vouchers is high, which makes it difficult to meet maximum waiting times for elective surgeries. The objectives of this study are to examine how many vouchers were issued and refused between the third quarter of 2016 and the fourth quarter of 2019 and the risk factors associated with their refusal, in Central Portugal.Material and Methods: Data was obtained in the database of cancelled vouchers and the waiting list for surgery on the 31st December 2019. Multiple logistic regression was used to investigate risk factors.Results: The number of issued vouchers increased after 2018 and the rate of refusals has been above 55% since the 3rd quarter of 2018. Refusal was more likely for individuals aged 55 years or above (OR = 1.136; CI = 1.041 – 1.240; OR = 1.095; CI = 1.005 – 1.194; OR = 1.098; CI = 1.002 – 1.203, for the age bands 55 - 64, 65 - 74 and 75 - 84, respectively), for inpatient surgery when compared to ambulatory (OR = 2.498; CI = 2.343 – 2.663) and for Orthopaedics when compared to General Surgery (OR = 1.123; CI = 1.037 – 1.217). The odds of refusal also varied across hospitals (for example OR = 3.853; CI = 3.610 – 4.113; OR = 3.600; CI = 3.171 – 4.087; OR = 2.751; CI =3.383 – 3.175 e OR = 1.337; CI = 1.092 – 1.637, for hospitals identified as HO_2, HO_7, HO_4 and HO_6, respectively).Conclusion: In this study, we have confirmed that the number of issued surgery vouchers increased after the administrative reduction of maximum waiting times in 2018 and that the rate of transfer refusals has been increasing since 2016 and has remained above 55% from the third trimester of 2018 onwards. Some of the factors for which we obtained a positive association with refusal are age, inpatient surgery (compared to ambulatory) and Orthopaedics (compared to General Surgery). |
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Risk Factors Associated with the Refusal of Surgery Vouchers: The Case of Central PortugalFatores de Risco Associados à Recusa de Notas de Transferência e Vales Cirurgia: O Caso da Região Centro em PortugalElective Surgical ProceduresHealth Services AccessibilityPortugalRisk FactorsSurgical ProceduresWaiting ListsAcesso aos Serviços de SaúdeFatores de RiscoListas de EsperaPortugalProcedimentos CirúrgicosProcedimentos Cirúrgicos EletivosIntroduction: In Portugal, the rate of refusals regarding transfer between hospitals through surgery vouchers is high, which makes it difficult to meet maximum waiting times for elective surgeries. The objectives of this study are to examine how many vouchers were issued and refused between the third quarter of 2016 and the fourth quarter of 2019 and the risk factors associated with their refusal, in Central Portugal.Material and Methods: Data was obtained in the database of cancelled vouchers and the waiting list for surgery on the 31st December 2019. Multiple logistic regression was used to investigate risk factors.Results: The number of issued vouchers increased after 2018 and the rate of refusals has been above 55% since the 3rd quarter of 2018. Refusal was more likely for individuals aged 55 years or above (OR = 1.136; CI = 1.041 – 1.240; OR = 1.095; CI = 1.005 – 1.194; OR = 1.098; CI = 1.002 – 1.203, for the age bands 55 - 64, 65 - 74 and 75 - 84, respectively), for inpatient surgery when compared to ambulatory (OR = 2.498; CI = 2.343 – 2.663) and for Orthopaedics when compared to General Surgery (OR = 1.123; CI = 1.037 – 1.217). The odds of refusal also varied across hospitals (for example OR = 3.853; CI = 3.610 – 4.113; OR = 3.600; CI = 3.171 – 4.087; OR = 2.751; CI =3.383 – 3.175 e OR = 1.337; CI = 1.092 – 1.637, for hospitals identified as HO_2, HO_7, HO_4 and HO_6, respectively).Conclusion: In this study, we have confirmed that the number of issued surgery vouchers increased after the administrative reduction of maximum waiting times in 2018 and that the rate of transfer refusals has been increasing since 2016 and has remained above 55% from the third trimester of 2018 onwards. Some of the factors for which we obtained a positive association with refusal are age, inpatient surgery (compared to ambulatory) and Orthopaedics (compared to General Surgery).Introdução: Em Portugal, a recusa de Notas de Transferência e Vales Cirurgia é elevada, dificultando o cumprimento dos tempos máximos de resposta garantidos para cirurgias eletivas. Os objetivos deste estudo foram analisar a evolução de notas e vales emitidos/recusados para o período compreendido entre o terceiro trimestre de 2016 e o quarto trimestre de 2019 e os fatores de risco associados à sua recusa, na Região Centro, em Portugal.Material e Métodos: Os dados provêm da base de dados de notas/vales cancelados e da lista de inscritos para cirurgia a 31 de dezembro de 2019. Na análise dos fatores de risco recorremos à regressão logística múltipla.Resultados: A emissão de notas/vales aumentou após 2018 e as taxas de recusa de transferência mantiveram-se acima dos 55% a partir do terceiro trimestre de 2018. A chance de recusa foi maior para idades superiores a 55 anos (OR = 1,136; IC = 1,041 – 1,240; OR = 1,095; IC = 1,005 – 1,194; OR = 1,098; IC = 1,002 – 1,203, para as faixas etárias 55 - 64, 65 - 74 e 75 - 84, respetivamente) para a cirurgia convencional, quando comparada com ambulatório (OR = 2,498; IC = 2,343 – 2,663) e para a especialidade de Ortopedia, quando comparada com Cirurgia Geral (OR = 1,123; IC = 1,037 – 1,217). A chance de recusa variou também entre hospitais (por exemplo OR = 3,853; IC = 3,610 – 4,113; OR = 3,600; IC = 3,171 – 4,087; OR = 2,751; IC = 3,383 – 3,175 e OR = 1,337; IC= 1,092 – 1,637, para os hospitais de origem identificados como HO_2, HO_7, HO_4 e HO_6, respetivamente).Conclusão: Neste estudo confirmou-se que a emissão de notas de transferência/vales cirurgia aumentou após a redução legal dos tempos máximos de resposta garantidos em 2018 e que as taxas de recusa de transferência vinham já a registar uma tendência de aumento desde 2016, tendo-se mantido acima dos 55% a partir do terceiro trimestre de 2018. Alguns fatores para os quais se encontrou uma associação positiva com a recusa são a idade, a cirurgia convencional (em comparação com ambulatório) e a especialidade de Ortopedia (em comparação com Cirurgia Geral).Ordem dos Médicos2022-03-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15357Acta Médica Portuguesa; Vol. 35 No. 3 (2022): March; 201-208Acta Médica Portuguesa; Vol. 35 N.º 3 (2022): Março; 201-2081646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15357https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15357/6514https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15357/15208Direitos de Autor (c) 2022 Acta Médica Portuguesa - Ordem dos Médicosinfo:eu-repo/semantics/openAccessCruz, SaloméQuintal, CarlotaAntunes, Patrícia2023-07-23T03:00:55Zoai:ojs.www.actamedicaportuguesa.com:article/15357Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:38.234884Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Risk Factors Associated with the Refusal of Surgery Vouchers: The Case of Central Portugal Fatores de Risco Associados à Recusa de Notas de Transferência e Vales Cirurgia: O Caso da Região Centro em Portugal |
title |
Risk Factors Associated with the Refusal of Surgery Vouchers: The Case of Central Portugal |
spellingShingle |
Risk Factors Associated with the Refusal of Surgery Vouchers: The Case of Central Portugal Cruz, Salomé Elective Surgical Procedures Health Services Accessibility Portugal Risk Factors Surgical Procedures Waiting Lists Acesso aos Serviços de Saúde Fatores de Risco Listas de Espera Portugal Procedimentos Cirúrgicos Procedimentos Cirúrgicos Eletivos |
title_short |
Risk Factors Associated with the Refusal of Surgery Vouchers: The Case of Central Portugal |
title_full |
Risk Factors Associated with the Refusal of Surgery Vouchers: The Case of Central Portugal |
title_fullStr |
Risk Factors Associated with the Refusal of Surgery Vouchers: The Case of Central Portugal |
title_full_unstemmed |
Risk Factors Associated with the Refusal of Surgery Vouchers: The Case of Central Portugal |
title_sort |
Risk Factors Associated with the Refusal of Surgery Vouchers: The Case of Central Portugal |
author |
Cruz, Salomé |
author_facet |
Cruz, Salomé Quintal, Carlota Antunes, Patrícia |
author_role |
author |
author2 |
Quintal, Carlota Antunes, Patrícia |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Cruz, Salomé Quintal, Carlota Antunes, Patrícia |
dc.subject.por.fl_str_mv |
Elective Surgical Procedures Health Services Accessibility Portugal Risk Factors Surgical Procedures Waiting Lists Acesso aos Serviços de Saúde Fatores de Risco Listas de Espera Portugal Procedimentos Cirúrgicos Procedimentos Cirúrgicos Eletivos |
topic |
Elective Surgical Procedures Health Services Accessibility Portugal Risk Factors Surgical Procedures Waiting Lists Acesso aos Serviços de Saúde Fatores de Risco Listas de Espera Portugal Procedimentos Cirúrgicos Procedimentos Cirúrgicos Eletivos |
description |
Introduction: In Portugal, the rate of refusals regarding transfer between hospitals through surgery vouchers is high, which makes it difficult to meet maximum waiting times for elective surgeries. The objectives of this study are to examine how many vouchers were issued and refused between the third quarter of 2016 and the fourth quarter of 2019 and the risk factors associated with their refusal, in Central Portugal.Material and Methods: Data was obtained in the database of cancelled vouchers and the waiting list for surgery on the 31st December 2019. Multiple logistic regression was used to investigate risk factors.Results: The number of issued vouchers increased after 2018 and the rate of refusals has been above 55% since the 3rd quarter of 2018. Refusal was more likely for individuals aged 55 years or above (OR = 1.136; CI = 1.041 – 1.240; OR = 1.095; CI = 1.005 – 1.194; OR = 1.098; CI = 1.002 – 1.203, for the age bands 55 - 64, 65 - 74 and 75 - 84, respectively), for inpatient surgery when compared to ambulatory (OR = 2.498; CI = 2.343 – 2.663) and for Orthopaedics when compared to General Surgery (OR = 1.123; CI = 1.037 – 1.217). The odds of refusal also varied across hospitals (for example OR = 3.853; CI = 3.610 – 4.113; OR = 3.600; CI = 3.171 – 4.087; OR = 2.751; CI =3.383 – 3.175 e OR = 1.337; CI = 1.092 – 1.637, for hospitals identified as HO_2, HO_7, HO_4 and HO_6, respectively).Conclusion: In this study, we have confirmed that the number of issued surgery vouchers increased after the administrative reduction of maximum waiting times in 2018 and that the rate of transfer refusals has been increasing since 2016 and has remained above 55% from the third trimester of 2018 onwards. Some of the factors for which we obtained a positive association with refusal are age, inpatient surgery (compared to ambulatory) and Orthopaedics (compared to General Surgery). |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-03-02 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15357 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15357 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15357 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15357/6514 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15357/15208 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2022 Acta Médica Portuguesa - Ordem dos Médicos info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2022 Acta Médica Portuguesa - Ordem dos Médicos |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 35 No. 3 (2022): March; 201-208 Acta Médica Portuguesa; Vol. 35 N.º 3 (2022): Março; 201-208 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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