Is there a relation between waiting‐list length and surgery rate?

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Abstract
The aim of this study was to investigate whether the differences in waiting‐list lengths between hospitals can result from differences in demand for surgery. We compared waiting‐list lengths for seven surgical procedures to the rates of these procedures. The numbers of procedures were obtained from the 1987 Finnish Hospital Discharge Register, and the numbers of patients on the waiting lists were obtained from an inquiry made to Finnish hospitals in 1987. Correlation coefficients were calculated between population‐based waiting‐list lengths and procedure rates Significant, positive correlations were found between population‐based waiting‐list lengths and rates for operations on hallux valgus, for herniorrhaphy and for hysterectomy. Rates for cholecystectomy and haemorrhoidectomy were also positively correlated with waiting‐list lengths, but these correlations were not statistically significant. There was no correlation for varicose‐vein operations, and a negative correlation for cataract extraction. These results suggest that insufficient resources are not the only reason for long waiting lists; but, both long waiting lists and a high rate of surgery can result from a high demand for surgery, influenced by physicians' decisions. If the waiting list is long because surgical treatment is preferred, the answer is not necessarily to increase resources, but to examine critically the indications for surgery.