Children receiving medical treatment in hospital 370 (R).
(photo credit: Jorge Lopez / Reuters)
There are huge variations in the number of days that patients have to wait for elective (non-emergency) surgery in the country’s public hospitals, according to the Health Ministry’s first-ever survey of medical centers released on Thursday.
In addition, some types of operations can be offered from an average of 27 days (endarterectomy, removing a clot inside large blood vessel) to 122 days for non-esthetic straightening of the septum in the nose.
There are also significant difference in waiting times for different procedures in a single hospital.
The data were requested by the ministry to help the German Committee on Promoting the Public Health System, which has been meeting for a year with Health Minister Yael German at its head. However, the ministry will now ask for the public hospitals to report on their elective-surgery queues on a regular basis. Long lines for surgery in public hospitals induce many people to “opt out” by purchasing private or supplementary health-insurance policies, which increases health expenditures and encourage surgeons to work in private hospitals.
The health minister said she requested the data to promote transparency in the public health system and spur higher efficiency. The data covered 16 of the public hospitals during the fourth quarter of 2013, but did not include the two Hadassah University Medical Centers due to the financial crisis it has undergone in the past year.
The 13-page document was written by Prof. Arnon Afek, the head of the ministry’s medical branch who next week will become the ministry’s director- general, as well as by planning, accounting and budgeting officials in the ministry. The ministry said the mapping out of the waits for hospital surgery will improve control by hospital and health fund directors and make it easier to shift medical staff from one type of surgery with a long queue to another with a shorter queue and to lengthen the hours of surgical theaters.
Queues for elective surgery depend not only on the number of available doctors and nurses but also by Treasury- mandated requirements, such as capping (limiting the amount of procedures a hospital can offer), the size of available operating rooms, the need to postpone non-emergency surgery to rush emergency cases into operating theaters and the need to perform more complicated operations in the morning when more veteran surgeons are available, the document said.
Big-city tertiary hospitals accept more difficult cases, so the operations there generally take longer than in smaller hospitals in the periphery. Arrangements by the four health funds with specific hospitals, some of which are owned by the insurer, can also cause “traffic jams,” which means longer waiting times for patients because competing hospitals are ruled out.
The disparity in waiting times in various hospitals was demonstrated in different types of surgery. Joint replacement (not including hips and knees) took an average of six days in Tel Aviv Sourasky Medical Center, 94 days at Sheba at Tel Hashomer and 86 at Assaf Harofeh in Tzrifin. Knee-replacement surgery required an average wait of eight days at Wolfson in Holon, 69 days at Western Galilee Government Hospital in Nahariya, 107 at Barzilai Medical Center in Ashkelon, 128 at Jerusalem’s Shaare Zedek, 95 at Hillel Yaffe in Hadera and 366 days at Bnei Zion Medical Center in Haifa.
The wait for spinal surgery (including repair of scoliosis) was eight days at Wolfson, 24 at Shaare Zedek and 48 at Barzilai.
For bariatric (weight loss in the obese) surgery, patients had to wait an average of six days at Wolfson, 40 at Barzilai and 128 days at Shaare Zedek.
Removal of adenoids or tonsils carried a wait of 29 days at Bnei Zion and 171 days at Ziv Medical Center in Safed. Inserting a stent to treat an aneurysm took an average of seven days at Kaplan in Rehovot and more than seven times that – 50 days – at Soroka Medical Center in Beersheba.