Article Figures & Tables
Figures
- Figure 1:
Summary of data management.
- Figure 2:
Forest plots showing the association between odds of exceeding surgical wait time targets by marginalization subdomains for (A) cataract and (B) benign uterine surgery. Note: Q = quintile.
- Figure 3:
Forest plots showing the association between risk of exceeding surgical wait time targets by marginalization subdomains for (A) knee arthroscopy and (B) knee arthroplasty. Note: Q = quintile.
- Figure 4:
Forest plots showing the association between risk of exceeding surgical wait time targets by marginalization subdomains for (A) cholecystectomy and (B) inguinal hernia repair. Note: Q = quintile.
Tables
Characteristic No. (%)† Priority 4
n = 124 545 (9.0)Overall
n = 174 633 (12.60)Priority 3
n = 50 088 (3.6)Age category, yr 18–49 23 066 (7.5) 11 315 (14.3) 11 751 (5.1) 50–59 23 965 (10.5) 8631 (17.0) 15 334 (8.7) 60–69 47 031 (13.9) 12 482 (22.1) 34 549 (12.3) 70–79 55 377 (15.7) 12 226 (25.9) 43 151 (14.1) ≥ 80 25 194 (15.8) 5434 (26.3) 19 760 (14.2) Sex Female 106 899 (12.8) 31 793 (20.5) 75 106 (11.0) Male 67 734 (12.4) 18 295 (18.5) 49 439 (11.0) Rural residence‡ No 147 823 (12.2) 42 937 (19.7) 104 886 (10.6) Yes 26 810 (15.2) 7151 (19.7) 19 659 (14.0) Region Eastern 33 789 (13.4) 9243 (18.8) 24 546 (12.1) GTHA 54 205 (10.8) 18 903 (19.9) 35 302 (8.7) Toronto 19 286 (8.8) 5793 (13.8) 13 493 (7.6) Western Ontario 51 979 (16.9) 11 522 (23.4) 40 457 (15.7) Northern Ontario 15 374 (14.7) 4627 (24.6) 10 747 (12.5) Comorbidity score category§ 0–4 32 161 (13.0) 8954 (19.4) 23 207 (11.5) 5–6 37 689 (12.8) 10 881 (19.8) 26 808 (11.2) 7–8 38 198 (12.5) 11 201 (19.7) 26 997 (10.8) 9–10 30 318 (12.4) 8779 (19.6) 21 539 (10.8) ≥ 11 36 267 (12.4) 10 273 (20.0) 25 994 (10.8) Hospital type¶ Non-teaching 123 093 (11.7) 39 358 (18.8) 83 735 (9.9) Teaching 51 540 (15.6) 10 730 (24.2) 40 810 (14.3) Year 2013 16 397 (10.4) 6766 (18.9) 9631 (7.9) 2014 19 830 (10.0) 7101 (16.5) 12 729 (8.2) 2015 22 244 (11.2) 6833 (17.3) 15 411 (9.7) 2016 27 213 (13.3) 7857 (21.0) 19 356 (11.6) 2017 30 118 (14.6) 7428 (22.5) 22 690 (13.1) 2018 29 852 (14.2) 7212 (21.6) 22 640 (12.8) 2019 28 979 (13.8) 6891 (21.6) 22 088 (12.4) Procedure Cataract 81 537 (14.9) 11 106 (29.1) 70 431 (13.8) Knee arthroplasty 37 756 (23.9) 12 762 (40.1) 24 994 (19.8) Hip arthroplasty 18 607 (20.4) 6722 (34.5) 11 885 (16.6) Arthroscopy (knee) 10 632 (7.2) 5158 (14.9) 5474 (4.9) Cholecystectomy 4398 (3.6) 2773 (6.2) 1625 (2.1) Inguinal hernia 4703 (4.8) 2533 (8.2) 2170 (3.2) Benign uterine** 17 000 (7.6) 9034 (16.5) 7966 (4.7) Note: GTHA = Greater Toronto and Hamilton Area.
↵* The Wait Time Information System classifies procedure priority level. Level 1 is the most urgent, requiring immediate transfer to the operating room. This is followed by levels 2, 3 and 4, requiring urgent, semi-urgent and elective surgical intervention. The target wait time for level 3 is 84 days or fewer, and for level 4, 182 days or fewer.
↵† Percentage refers to the percent of procedures exceeding wait time divided by the total number of procedures by patient characteristic and priority level.
↵‡ Rural residence includes residences in all territories lying outside population centres with more than 10 000 residents. Regions defined as per Canada Post Corporation.
↵§ Comorbidity score category: sum of Aggregated Diagnosis Groups. Estimated using Aggregated Diagnosis Groups calculated with The Johns Hopkins ACG System version 10 software, based on subjects’ health care utilization records in the Discharge Abstract Database, Same Day Surgery Database and Ontario Health Insurance Plan database.
↵¶ Teaching Status: teaching hospitals are those classified as Group A under the Public Hospitals Act. (13)
↵** Benign uterine disease requiring surgical treatment consists of a mixture of hysterectomy (28%), hysteroscopic endometrial ablation (16%) and other benign diseases (56%). “Other benign diseases” is primarily composed of resection of endometrial polyps, myomectomy and adhesion lysis.
Variable‡ No. (%)§ Priority 4
n = 124 545 (9.0)Overall
n = 174 633 (12.6)Priority 3
n = 50 088 (3.6)Dependency quintile 1 29 015 (11.0) 9347 (18.9) 19 668 (9.2) 2 30 245 (12.1) 8968 (19.6) 21 277 (10.4) 3 31 884 (12.7) 8915 (19.5) 22 969 (11.2) 4 34 829 (13.0) 9888 (20.0) 24 941 (11.4) 5 48 660 (13.8) 12 970 (20.3) 35 690 (12.3) Deprivation quintile 1 37 833 (12.8) 10 852 (21.6) 26 981 (11.0) 2 36 097 (12.5) 10 389 (20.0) 25 708 (10.8) 3 35 255 (12.8) 10 302 (19.7) 24 953 (11.2) 4 34 378 (12.8) 9690 (18.8) 24 688 (11.3) 5 31 070 (12.1) 8855 (18.3) 22 215 (10.6) Instability quintile 1 30 565 (11.7) 9613 (19.7) 20 952 (9.9) 2 34 392 (12.6) 10 059 (19.8) 24 333 (10.9) 3 35 351 (12.7) 9897 (19.3) 25 454 (11.3) 4 35 281 (13.1) 9737 (19.4) 25 544 (11.6) 5 39 044 (12.8) 10 782 (20.2) 28 262 (11.3) Proportion of residents who self-identify as being part of a visible minority group 1 41 034 (14.8) 11 091 (20.3) 29 943 (13.4) 2 39 468 (13.6) 10 589 (19.7) 28 879 (12.2) 3 35 779 (13.1) 9947 (21.7) 25 832 (11.4) 4 31 614 (11.9) 9135 (20.6) 22 479 (10.1) 5 26 738 (9.6) 9326 (16.7) 17 412 (7.8) Immigrated last 5 years 1 112 226 (13.4) 30 755 (20.1) 81 471 (11.9) 2 31 301 (11.9) 9294 (20.1) 22 007 (10.2) 3 31 106 (10.8) 10 039 (18.2) 21 067 (9.1) ↵* Individual patients were assigned to marginalization quintiles based on community, not individual characteristics.
↵† The Wait Time Information System classifies procedure priority level. Level 1 is the most urgent, requiring immediate transfer to the operating room. This is followed by levels 2, 3 and 4, requiring urgent, semi-urgent and elective surgical intervention. The target wait time for level 3 is 84 days or fewer, and for level 4, 182 days or fewer.
↵‡ To categorize levels of marginalization, all dissemination areas in Ontario were ranked within each domain (or sub-domain) and assigned to a quintile, with quintile 1 representing the dissemination areas with the lowest marginalization and quintile 5 the highest. For recent immigration, more than 50% of dissemination areas had 0 recent immigrants, which led to the creation of only 3 categories (i.e., the lower 3 quintiles combined, and the fourth and fifth quintiles).
↵§ Percentage refers to the percent of procedures exceeding wait time divided by the total number of procedures by patient characteristic and priority level.
- Table 3:
Unadjusted and adjusted risk of prolonged surgical wait times for cataract and benign uterine surgery, according to neighbourhood marginalization measures and patient and hospital factors*†
Patient characteristic‡ Cataract surgery Benign uterine surgery§ OR (95% CI) Adjusted OR¶ (95% CI) OR (95% CI) Adjusted OR¶ (95% CI) Age, yr (ref. 40) 50 1.10 (1.07–1.14) 1.10 (1.06–1.14) 0.94 (0.92–0.96) 0.90 (0.89–0.92) 60 1.33 (1.27–1.40) 1.33 (1.26–1.40) 0.75 (0.72–0.79) 0.68 (0.65–0.71) 70 1.61 (1.52–1.70) 1.62 (1.54–1.72) 0.61 (0.57–0.64) 0.51 (0.48–0.55) 80 1.79 (1.70–1.89) 1.83 (1.73–1.94) 0.57 (0.52–0.63) 0.48 (0.43–0.53) Comorbidity score (per 5-unit increase)** 0.99 (0.98–1.00) 0.97 (0.96–0.98) 0.97 (0.94–1.00) 1.01 (0.98–1.05) Priority level (ref. (4)) Priority 3 2.65 (2.56–2.74) 2.85 (2.75–2.95) 3.99 (3.85–4.13) 4.72 (4.55–4.90) Sex (ref. male) Female 1.13 (1.12–1.15) 1.14 (1.12–1.16) – 0.85 (0.79–0.91) Rural (ref. non-rural)†† 1.33 (1.27–1.38) 1.30 (1.24–1.37) 1.00 (0.94–1.07) 1.67 (1.56–1.80) Region (ref. Toronto) Eastern 1.55 (1.49–1.61) 1.59 (1.51–1.68) 1.63 (1.53–1.73) 1.47 (1.38–1.56) GTHA 1.08 (1.04–1.12) 1.06 (1.01–1.10) 1.13 (1.06–1.19) 2.08 (1.93–2.25) Western 1.63 (1.57–1.70) 1.67 (1.59–1.75) 1.22 (1.15–1.30) 4.47 (4.08–4.90) Northern 0.98 (0.93–1.04) 1.04 (0.97–1.12) 3.30 (3.05–3.56) 1.01 (0.98–1.05) Hospital type (ref. non-teaching)‡‡ Teaching 0.94 (0.92–0.97) 0.85 (0.82–0.88) 1.90 (1.83–1.98) 2.19 (2.11–2.28) Year (ref. 2013) 2014 1.10 (1.06–1.15) 1.12 (1.08–1.16) 0.92 (0.86–0.98) 2.19 (2.11–2.28) 2015 1.48 (1.42–1.54) 1.53 (1.47–1.59) 0.93 (0.88–0.99) 0.90 (0.85–0.96) 2016 2.10 (2.01–2.19) 2.21 (2.12–2.30) 0.95 (0.89–1.01) 0.95 (0.89–1.01) 2017 2.40 (2.30–2.50) 2.55 (2.45–2.66) 0.96 (0.91–1.02) 1.00 (0.94–1.07) 2018 2.29 (2.20–2.39) 2.38 (2.28–2.48) 0.88 (0.83–0.94) 1.04 (0.98–1.11) 2019 2.15 (2.06–2.24) 2.20 (2.11–2.29) 0.85 (0.79–0.90) 0.96 (0.90–1.03) Dependency quintile 2 0.95 (0.92–0.99) 0.93 (0.89–0.96) 0.98 (0.93–1.04) 1.01 (0.96–1.07) 3 0.91 (0.88–0.94) 0.88 (0.84–0.91) 0.98 (0.93–1.04) 1.01 (0.95–1.07) 4 0.88 (0.84–0.91) 0.82 (0.79–0.85) 0.93 (0.88–0.99) 1.00 (0.94–1.06) 5 0.92 (0.89–0.95) 0.81 (0.78–0.85) 0.87 (0.82–0.92) 0.98 (0.92–1.04) Deprivation quintile 2 0.94 (0.91–0.97) 0.93 (0.90–0.96) 1.00 (0.95–1.06) 1.01 (0.96–1.07) 3 0.92 (0.89–0.95) 0.90 (0.87–0.93) 1.03 (0.97–1.09) 1.06 (1.00–1.13) 4 0.87 (0.84–0.90) 0.84 (0.81–0.87) 1.07 (1.01–1.13) 1.10 (1.03–1.17) 5 0.82 (0.79–0.86) 0.77 (0.74–0.81) 1.06 (1.00–1.12) 1.04 (0.98–1.12) Instability quintile 2 0.96 (0.93–0.99) 0.97 (0.93–1.00) 0.95 (0.90–1.01) 0.99 (0.94–1.05) 3 0.96 (0.93–0.99) 0.98 (0.95–1.02) 0.91 (0.86–0.96) 0.96 (0.90–1.02) 4 1.00 (0.96–1.03) 1.08 (1.04–1.13) 0.92 (0.87–0.97) 0.95 (0.89–1.01) 5 1.02 (0.98–1.06) 1.16 (1.11–1.21) 0.94 (0.89–1.00) 0.91 (0.85–0.98) Visible minority quintile 2 0.92 (0.88–0.96) 0.96 (0.91–1.01) 0.99 (0.93–1.06) 0.92 (0.86–0.98) 3 0.96 (0.92–1.00) 1.05 (1.00–1.11) 1.20 (1.12–1.28) 1.09 (1.01–1.17) 4 0.98 (0.94–1.02) 1.06 (1.00–1.13) 1.22 (1.14–1.30) 1.10 (1.01–1.19) 5 0.77 (0.74–0.81) 0.83 (0.78–0.89) 1.47 (1.37–1.57) 1.28 (1.17–1.40) Recent immigration 2 1.00 (0.97–1.03) 1.04 (1.00–1.09) 1.10 (1.04–1.15) 1.00 (0.95–1.06) 3 1.00 (0.97–1.04) 1.12 (1.07–1.18) 1.24 (1.17–1.30) 1.09 (1.02–1.17) Note: CI = confidence interval, GTHA = Greater Toronto and Hamilton Area, OR = odds ratio.
↵* Unless otherwise stated, the reference group for presented odds ratios is quintile 1.
↵† The Wait Time Information System classifies procedure priority level. Level 1 is the most urgent, requiring immediate transfer to the operating room. This is followed by levels 2, 3 and 4, requiring urgent, semi-urgent and elective surgical intervention. The target wait time for level 3 is 84 days or fewer, and for level 4, 182 days or fewer.
↵‡ Levels of marginalization was categorized by ranking all dissemination areas in Ontario within each domain (or sub-domain) and assigned to a quintile, with quintile 1 representing the dissemination area with the lowest marginalization and quintile 5 (or quintile 3 in the case of “immigrated last 5 years”) the highest.
↵§ Benign uterine disease requiring surgical treatment consists of a mixture of hysterectomy (28%), hysteroscopic endometrial ablation (16%) and other benign diseases (56%). “Other benign diseases” is primarily composed of resection of endometrial polyps, myomectomy and adhesion lysis.
↵¶ Adjusted odds ratios were calculated by adjusting for all the variables in the table.
↵** Comorbidity score category: sum of Aggregated Diagnosis Groups. Estimated using Aggregated Diagnosis Groups calculated with The Johns Hopkins ACG System Version 10 software, based on subjects’ health care utilization records in the Discharge Abstract Database, Same Day Surgery Database and Ontario Health Insurance Plan database.
↵†† Rural residence includes residences in all territories lying outside population centres with > 10 000 residents. Regions defined as per Canada Post Corporation.
↵‡‡ Teaching Status: teaching hospitals are those classified as Group A under the Public Hospitals Act. (13)
- Table 4:
Unadjusted and adjusted factors associated with prolonged surgical wait times for knee and hip arthroplasty*†
Patient characteristic Knee arthroplasty Hip arthroplasty OR (95% CI) Adjusted OR‡ (95% CI) OR (95% CI) Adjusted OR‡ (95% CI) Age, yr (ref. 40) 50 1.14 (1.09–1.19) 1.17 (1.12–1.23) 0.86 (0.82–0.90) 0.89 (0.84–0.94) 60 1.21 (1.12–1.30) 1.27 (1.18–1.37) 0.74 (0.68–0.80) 0.78 (0.72–0.85) 70 1.19 (1.10–1.29) 1.28 (1.17–1.39) 0.69 (0.64–0.75) 0.75 (0.69–0.81) 80 1.10 (1.02–1.19) 1.18 (1.09–1.28) 0.66 (0.61–0.71) 0.71 (0.66–0.77) Comorbidity score (per 5-unit increase)§ 0.92 (0.91–0.94) 0.93 (0.91–0.94) 0.88 (0.86–0.90) 0.90 (0.88–0.92) Priority level (ref. (4))¶ Priority 3 2.57 (2.50–2.65) 3.10 (3.01–3.20) 2.54 (2.45–2.64) 3.01 (2.89–3.13) Sex (ref. male) Female 1.06 (1.03–1.08) 1.08 (1.06–1.11) 0.96 (0.93–0.99) 0.99 (0.95–1.02) Rural (ref. non-rural)** 1.15 (1.10–1.20) 0.89 (0.85–0.93) 1.23 (1.17–1.30) 0.96 (0.91–1.02) Region (ref. Toronto) Eastern 1.48 (1.39–1.57) 1.87 (1.75–2.00) 1.68 (1.55–1.81) 1.82 (1.68–1.98) GTHA 2.08 (1.96–2.19) 2.43 (2.29–2.57) 1.82 (1.70–1.95) 2.03 (1.89–2.19) Western 4.87 (4.60–5.15) 6.53 (6.12–6.97) 4.14 (3.86–4.43) 4.71 (4.35–5.10) Northern 2.40 (2.24–2.57) 2.67 (2.47–2.88) 2.05 (1.89–2.23) 1.77 (1.60–1.96) Hospital type (ref. non-teaching)†† Teaching 1.05 (1.01–1.08) 1.33 (1.29–1.37) 1.35 (1.30–1.40) 1.66 (1.60–1.73) Year (ref. 2013) 2014 0.89 (0.85–0.94) 0.90 (0.85–0.95) 0.88 (0.82–0.94) 0.89 (0.83–0.96) 2015 0.86 (0.82–0.91) 0.93 (0.89–0.99) 0.94 (0.88–1.01) 1.02 (0.95–1.10) 2016 1.08 (1.03–1.13) 1.21 (1.15–1.27) 1.04 (0.97–1.11) 1.17 (1.09–1.26) 2017 1.19 (1.13–1.25) 1.42 (1.35–1.49) 1.11 (1.03–1.18) 1.35 (1.26–1.45) 2018 1.14 (1.09–1.20) 1.36 (1.29–1.44) 1.00 (0.93–1.06) 1.22 (1.14–1.31) 2019 1.04 (0.99–1.09) 1.26 (1.19–1.32) 1.00 (0.93–1.06) 1.23 (1.15–1.32) Dependency quintile 2 1.00 (0.95–1.05) 1.03 (0.98–1.08) 1.06 (0.99–1.13) 1.06 (0.99–1.13) 3 1.00 (0.95–1.05) 1.05 (0.99–1.10) 1.00 (0.94–1.07) 1.01 (0.94–1.07) 4 0.99 (0.95–1.05) 1.04 (0.99–1.10) 1.00 (0.94–1.06) 1.02 (0.95–1.09) 5 0.97 (0.92–1.01) 1.03 (0.98–1.09) 0.96 (0.91–1.02) 0.98 (0.92–1.05) Deprivation quintile 2 1.01 (0.97–1.06) 1.01 (0.97–1.06) 1.02 (0.97–1.08) 1.04 (0.99–1.10) 3 1.12 (1.07–1.17) 1.12 (1.07–1.17) 1.07 (1.01–1.13) 1.10 (1.03–1.16) 4 1.15 (1.10–1.21) 1.17 (1.11–1.22) 1.12 (1.06–1.18) 1.17 (1.10–1.25) 5 1.16 (1.10–1.21) 1.18 (1.12–1.24) 1.13 (1.06–1.20) 1.20 (1.12–1.28) Instability quintile 2 0.98 (0.94–1.03) 1.01 (0.97–1.06) 1.06 (0.99–1.12) 1.08 (1.01–1.15) 3 1.00 (0.96–1.05) 1.01 (0.96–1.06) 1.05 (0.99–1.11) 1.05 (0.99–1.12) 4 1.00 (0.96–1.05) 0.98 (0.93–1.03) 1.05 (0.99–1.11) 1.03 (0.96–1.10) 5 1.06 (1.00–1.11) 0.97 (0.92–1.03) 1.11 (1.04–1.18) 1.05 (0.98–1.13) Visible minority quintile 2 0.98 (0.94–1.02) 0.97 (0.93–1.01) 0.95 (0.90–1.00) 0.95 (0.90–1.00) 3 1.00 (0.95–1.05) 0.95 (0.90–1.00) 0.98 (0.93–1.04) 0.94 (0.88–1.00) 4 1.07 (1.01–1.13) 0.96 (0.90–1.02) 0.97 (0.91–1.03) 0.88 (0.81–0.95) 5 1.28 (1.20–1.36) 1.05 (0.97–1.13) 0.93 (0.86–1.01) 0.82 (0.75–0.91) Recent immigration 2 1.06 (1.02–1.11) 1.02 (0.97–1.06) 1.02 (0.97–1.07) 1.00 (0.95–1.06) 3 1.25 (1.20–1.31) 1.09 (1.03–1.16) 1.03 (0.97–1.10) 1.02 (0.95–1.10) Note: CI = confidence interval, GTHA = Greater Toronto and Hamilton Area, OR = odds ratio.
↵* Unless otherwise stated, the reference group for presented odds ratios is quintile 1.
↵† Levels of marginalization was categorized by ranking all dissemination areas in Ontario within each domain (or sub-domain) and assigned to a quintile, with quintile 1 representing the dissemination area with the lowest marginalization and quintile 5 (or quintile 3 in the case of “immigrated last 5 years”) the highest.
↵‡ Adjusted odds ratios were calculated by adjusting for all the variables in the table.
↵§ Comorbidity score category: Sum of Aggregated Diagnosis Groups (ADGs). Estimated using ADGs calculated with The Johns Hopkins ACG System Version 10 software, based on subjects’ health care utilization records in the Discharge Abstract Database, Same-Day Surgery Database, and Ontario Health Insurance Plan database.
↵¶ The Wait Time Information System classifies procedure priority level. Level 1 is the most urgent, requiring immediate transfer to the operating room. This is followed by levels 2, 3 and 4, requiring urgent, semi-urgent and elective surgical intervention. The target wait time for level 3 is 84 days or fewer, and for level 4, 182 days or fewer.
↵** Rural residence includes residences in all territories lying outside population centres with > 10 000 residents. Regions defined as per Canada Post Corporation.
↵†† Teaching status: teaching hospitals are those classified as Group A under the Public Hospitals Act. (13)
- Table 5:
Unadjusted and adjusted factors associated with prolonged surgical wait time for cholecystectomy and inguinal hernia repair*
Patient characteristic† Cholecystectomy Inguinal hernia repair OR (95% CI) Adjusted OR‡ (95% CI) OR (95% CI) Adjusted OR‡ (95% CI) Age, yr (ref. 40) 50 1.05 (1.01–1.11) 1.06 (1.01–1.11) 1.06 (1.02–1.09) 1.06 (1.03–1.10) 60 1.05 (0.98–1.13) 1.04 (0.96–1.11) 1.04 (0.99–1.09) 1.04 (0.99–1.10) 70 0.98 (0.90–1.07) 0.95 (0.87–1.04) 0.96 (0.91–1.02) 0.94 (0.88–1.01) 80 0.84 (0.75–0.94) 0.79 (0.70–0.90) 0.84 (0.77–0.91) 0.79 (0.72–0.86) Comorbidity score (per 5-unit increase)§ 0.95 (0.91–1.00) 0.96 (0.91–1.01) 0.97 (0.93–1.02) 1.01 (0.96–1.06) Priority level (ref. (4))¶ Priority 3 3.05 (2.86–3.25) 3.85 (3.60–4.11) 2.69 (2.53–2.86) 3.47 (3.25–3.70) Sex (ref. male) Female 1.06 (0.99–1.13) 1.09 (1.01–1.17) 1.11 (1.01–1.22) 1.12 (1.02–1.24) Rural (ref. non-rural)** 1.10 (0.99–1.21) 0.78 (0.69–0.87) 1.05 (0.96–1.15) 0.85 (0.77–0.95) Region (ref. Toronto) Eastern 1.44 (1.26–1.63) 0.98 (0.84–1.13) 1.30 (1.15–1.46) 0.97 (0.85–1.12) GTHA 1.13 (1.00–1.27) 1.01 (0.89–1.15) 1.31 (1.18–1.46) 1.09 (0.97–1.22) Western 1.80 (1.60–2.03) 1.43 (1.24–1.66) 1.70 (1.52–1.91) 1.39 (1.21–1.59) Northern 3.36 (2.93–3.85) 2.26 (1.90–2.67) 3.20 (2.80–3.65) 2.01 (1.71–2.35) Hospital type (ref. non-teaching)†† Teaching 2.60 (2.42–2.79) 3.02 (2.80–3.26) 2.87 (2.68–3.07) 3.53 (3.28–3.80) Year (ref. 2013) 2014 0.88 (0.79–0.99) 0.92 (0.82–1.03) 0.82 (0.74–0.92) 0.85 (0.76–0.95) 2015 0.87 (0.78–0.97) 0.94 (0.84–1.05) 0.87 (0.78–0.97) 0.91 (0.81–1.02) 2016 0.73 (0.65–0.82) 0.77 (0.69–0.87) 0.75 (0.67–0.84) 0.81 (0.73–0.91) 2017 0.77 (0.69–0.86) 0.85 (0.75–0.95) 0.76 (0.68–0.85) 0.83 (0.74–0.93) 2018 0.69 (0.62–0.78) 0.79 (0.70–0.89) 0.71 (0.63–0.79) 0.81 (0.72–0.91) 2019 0.80 (0.72–0.90) 0.94 (0.84–1.06) 0.76 (0.68–0.85) 0.90 (0.80–1.01) Dependency quintile 2 1.16 (1.04–1.29) 1.04 (0.93–1.15) 1.02 (0.92–1.13) 0.95 (0.86–1.05) 3 1.27 (1.14–1.41) 1.10 (0.99–1.23) 1.04 (0.94–1.15) 0.96 (0.86–1.07) 4 1.24 (1.12–1.38) 1.10 (0.98–1.23) 1.02 (0.92–1.12) 0.98 (0.88–1.09) 5 1.30 (1.17–1.44) 1.16 (1.03–1.31) 1.00 (0.90–1.10) 0.97 (0.87–1.09) Deprivation quintile 2 1.11 (1.00–1.23) 1.16 (1.04–1.29) 0.96 (0.88–1.06) 1.02 (0.92–1.12) 3 1.08 (0.97–1.21) 1.15 (1.02–1.28) 0.98 (0.89–1.07) 1.05 (0.95–1.16) 4 1.16 (1.05–1.30) 1.21 (1.08–1.36) 1.03 (0.93–1.13) 1.08 (0.97–1.20) 5 1.26 (1.13–1.41) 1.32 (1.17–1.49) 0.94 (0.85–1.05) 0.96 (0.85–1.07) Instability quintile 2 1.01 (0.90–1.12) 0.89 (0.80–1.00) 0.99 (0.90–1.10) 0.91 (0.82–1.01) 3 1.22 (1.10–1.36) 1.03 (0.92–1.15) 1.02 (0.93–1.13) 0.92 (0.83–1.03) 4 1.17 (1.05–1.31) 0.94 (0.84–1.06) 0.99 (0.90–1.10) 0.90 (0.80–1.00) 5 1.28 (1.15–1.43) 0.98 (0.86–1.11) 1.13 (1.02–1.25) 0.99 (0.88–1.11) Visible minority quintile 2 1.16 (1.05–1.28) 1.07 (0.97–1.19) 1.01 (0.92–1.11) 0.95 (0.86–1.04) 3 1.21 (1.09–1.35) 1.05 (0.94–1.18) 1.10 (0.99–1.21) 0.97 (0.86–1.08) 4 0.93 (0.83–1.05) 0.86 (0.75–0.99) 1.00 (0.90–1.12) 0.86 (0.75–0.98) 5 0.68 (0.59–0.79) 0.68 (0.57–0.81) 0.69 (0.61–0.79) 0.65 (0.56–0.77) Recent immigration 2 0.94 (0.86–1.03) 0.99 (0.90–1.09) 0.93 (0.85–1.01) 0.95 (0.86–1.04) 3 0.74 (0.66–0.82) 0.91 (0.80–1.03) 0.82 (0.74–0.90) 0.97 (0.85–1.10) Note: CI = confidence interval, GTHA = Greater Toronto and Hamilton Area, OR = odds ratio.
↵* Unless otherwise stated, the reference group for presented odds ratios is quintile 1.
↵† Levels of marginalization was categorized by ranking all dissemination areas in Ontario within each domain (or sub-domain) and assigned to a quintile, with quintile 1 representing the dissemination area with the lowest marginalization and quintile 5 (or quintile 3 in the case of “immigrated last 5 years”) the highest.
↵‡ Adjusted odds ratios were calculated by adjusting for all the variables in the table.
↵§ Comorbidity score category: Sum of Aggregated Diagnosis Groups (ADGs). Estimated using Aggregated Diagnosis Groups (ADGs) calculated with The Johns Hopkins ACG System Version 10 software, based on subjects’ health care utilization records in the Discharge Abstract Database, Same-Day Surgery Database, and Ontario Health Insurance Plan database.
↵¶ The Wait Time Information System classifies procedure priority level. Level 1 is the most urgent, requiring immediate transfer to the operating room. This is followed by levels 2, 3 and 4, requiring urgent, semi-urgent and elective surgical intervention. The target wait time for level 3 is 84 days or fewer, and for level 4, 182 days or fewer.
↵** Rural residence includes residences in all territories lying outside population centres with > 10 000 residents. Regions defined as per Canada Post Corporation.
↵†† Teaching Status: teaching hospitals are those classified as Group A under the Public Hospitals Act. (13)
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