Differential seasonality in surgical waiting list discharges in Spain: implications for management

Abstract

Objective: To analyse the seasonal variability of surgical procedures with guaranteed maximum waiting times with a view to figure out whether there are differences between urgent admissions and need-sensitive procedures, and those supply-sensitive. Method: Retrospective longitudinal observational study with administrative data on hospital episodes of the National Health System for 14 autonomous communities, years 2003 to 2022, aggregated monthly. The elective supply-sensitive surgical procedures with guaranteed times were selected. Then, as to conduct, the comparative analyses, we selected need-sensitive elective procedures for aortic-coronary bypass surgery in patients over 40 years of age, percutaneous transluminal coronary angioplasty in patients over 40 years of age, and breast cancer surgery in adult women up to 85 years of age to compare differences in seasonal variability. Finally, in order to get a basal level of seasonal variation we used emergency admissions for hip fracture in patients over 65 years of age and admission for acute myocardial infarction in patients over 40 years of age. A multiplicative decomposition of the series was applied to calculate the seasonal rate of change, and a placebo test was applied to test the seasonal variability of health care delivery across comparison groups.