Did waiting times really decrease following a service reorganization? Results from a retrospective study in a pediatric rehabilitation program in Québec

Abstract

Purpose: To examine changes in waiting times and types of services received before, during and after a pediatric rehabilitation service reorganization including new admission procedures; To compare waiting time data available in the program’s administrative database and children’s medical files. Method: Waiting time was defined as the time elapsed between referral and accessing a service provided by any clinician in the program (program waiting time) or by any clinician within a discipline (discipline-specific waiting time). Services were categorized as individual, group treatment, or other. ANOVAs and χ² tests were used to examine changes in waiting times and type of services, respectively. Paired T-tests compared the program waiting times from the two databases. Results: Data were collected on 188 children (mean age: 4 years and 1 month). The program and occupational therapy waiting times were shorter following the service reorganization. For two disciplines, the proportion of children receiving individual treatment diminished over time, while group and other types of interventions increased. Program waiting times calculated using the two data sources did not differ significantly but differences in the available data highlighted administrative issues. Conclusions: Service reorganization can decrease waiting times and change the type of services offered over time.

Implications for Rehabilitation

• Service reorganization can improve accessibility by reducing the first waiting times.

• More researches are needed to understand the impact of the changes in the type of services provided on service accessibility and service quality.

• Service accessibility should be monitored using accurate data extending beyond those routinely collected.

Keywords::

• Accessibility to services
• health services research
• pediatric
• program evaluation
• quality of care
• waiting times

Acknowledgements

The authors thank all the families, clinicians and administrators who were involved in this study, and the research agents.

Declaration of Interest: At the time of the study, the first author was funded by scholarships from the Canadian Institutes of Health Research. The study was funded in part by the Québec Ministry of Health and Social Services and a Grant from the Office des Personnes Handicapées du Québec [Québec Office of Persons with Disability].