Table 2.
Logistic regression analysis showing associations between hospital trusts forming the upper quarter of numbers of patients with prolonged waits for inpatient elective surgery, with hospital capacity, private provision, and markers of population ill health, by specialty. Values are odds ratios (95% confidence intervals, P values)
| General surgery
|
Ear, nose, and throat surgery
|
Ophthalmic surgery
|
Trauma or orthopaedic surgery
|
|
|---|---|---|---|---|
| NHS capacity
|
||||
| No of operating theatres: | ||||
| Simple model | 1.64 (0.93 to 2.86, P=0.085) | 1.39 (0.80 to 2.42, P=0.24) | 1.03 (0.57 to 1.86, P=0.92) | 1.25 (0.73 to 2.15, P=0.41) |
| Adjusted model | 0.99 (0.47 to 2.07, P=0.97) | 1.04 (0.49 to 2.21, P=0.92) | 0.62 (0.25 to 1.56, P=0.31) | 0.86 (0.38 to 1.92, P=0.71) |
| No of dedicated day case theatres: | ||||
| Simple model | 1.28 (0.85 to 1.91, P=0.23) | 1.22 (0.77 to 1.93, P=0.39) | 1.04 (0.58 to 1.85, P=0.90) | 1.07 (0.70 to 1.64, P=0.74) |
| Adjusted model | 1.04 (0.66 to 1.64, P=0.88) | 1.10 (0.64 to 1.88, P=0.74) | 1.01 (0.51 to 1.99, P=0.98) | 1.08 (0.64 to 1.83, P=0.78) |
| Average daily No of available beds: | ||||
| Simple model | 1.56 (0.93 to 2.60, P=0.092) | 1.30 (0.76 to 2.24, P=0.34) | 1.24 (0.69 to 2.22, P=0.47) | 1.12 (0.66 to 1.89, P=0.68) |
| Adjusted model | 1.49 (0.83 to 2.64, P=0.18) | 1.57 (0.85 to 2.90, P=0.15) | 2.10 (1.00 to 4.39, P=0.05) | 2.04 (1.01 to 4.11, P=0.046) |
| Bed occupancy rate (%): | ||||
| Simple model | 1.11 (0.72 to 1.72, P=0.64) | 1.65 (1.00 to 2.73, P=0.05) | 0.96 (0.56 to 1.64, P=0.88) | 1.39 (0.86 to 2.24, P=0.18) |
| Adjusted model | 1.15 (0.72 to 1.83, P=0.57) | 1.69 (0.98 to 2.92, P=0.058) | 0.96 (0.54 to 1.70, P=0.88) | 1.42 (0.84 to 2.41, P=0.19) |
| No of anaesthetists per 100 beds: | ||||
| Simple model | 1.75 (1.11 to 2.74, P=0.015) | 1.47 (0.90 to 2.41, P=0.13) | 1.47 (0.85 to 2.52, P=0.17) | 1.79 (1.10 to 2.90, P=0.019) |
| Adjusted model | 1.76 (1.05 to 2.95, P=0.033) | 1.39 (0.80 to 2.42, P=0.25) | 1.45 (0.80 to 2.63, P=0.22) | 1.44 (0.83 to 2.49, P=0.20) |
| Specialty specific No of surgeons per 100 beds: | ||||
| Simple model | 1.15 (0.74 to 1.78, P=0.54) | 1.07 (0.65 to 1.75, P=0.78) | 1.53 (0.85 to 2.75, P=0.16) | 1.84 (1.12 to 3.03, P=0.016) |
| Adjusted model | 1.02 (0.60 to 1.72, P=0.95) | 0.99 (0.57 to 1.73, P=0.97) | 1.89 (0.92 to 3.88, P=0.081) | 1.93 (1.01 to 3.70, P=0.047) |
| Independent sector activity | ||||
| No of private hospitals and clinics: | ||||
| Simple model | 1.32 (0.77 to 2.27, P=0.31) | 1.31 (0.75 to 2.28, P=0.35) | 1.11 (0.55 to 2.23, P=0.78) | 1.32 (0.71 to 2.48, P=0.38) |
| Adjusted model | 1.13 (0.64 to 2.00, P=0.67) | 1.16 (0.64 to 2.11, P=0.62) | 1.07 (0.51 to 2.24, P=0.85) | 1.09 (0.56 to 2.14, P=0.79) |
| No of beds in private hospitals and clinics: | ||||
| Simple model | 1.74 (0.99 to 3.05, P=0.054) | 1.43 (0.79 to 2.57, P=0.23) | 1.08 (0.54 to 2.16, P=0.82) | 1.56 (0.86 to 2.83, P=0.14) |
| Adjusted model | 2.00 (1.00 to 4.01, P=0.051) | 1.06 (0.51 to 2.19, P=0.87) | 1.08 (0.47 to 2.49, P=0.86) | 1.31 (0.62 to 2.79), P=0.48) |
| Markers of healthcare need | ||||
| Proportion of population aged >65: | ||||
| Simple model | 1.13 (0.74 to 1.73, P=0.57) | 0.80 (0.50 to 1.30, P=0.37) | 0.74 (0.43 to 1.25, P=0.26) | 0.92 (0.59 to 1.44, P=0.72) |
| Adjusted model | 1.07 (0.63 to 1.82, P=0.80) | 0.78 (0.43 to 1.40, P=0.41) | 0.59 (0.29 to 1.18, P=0.13) | 0.93 (0.53 to 1.64, P=0.80) |
| Jarman score: | ||||
| Simple model | 1.18 (0.76 to 1.85, P=0.45) | 0.87 (0.52 to 1.46, P=0.61) | 0.92 (0.52 to 1.62, P=0.77) | 0.87 (0.54 to 1.40, P=0.55) |
| Adjusted model | 1.07 (0.60 to 1.92, P=0.81) | 0.83 (0.43 to 1.58, P=0.57) | 0.57 (0.27 to 1.24, P=0.16) | 0.92 (0.48 to 1.76, P=0.79) |
| Standardised mortality ratio: | ||||
| Simple model | 0.93 (0.58 to 1.47, P=0.74) | 0.72 (0.42 to 1.23, P=0.23) | 0.95 (0.54 to 1.70, P=0.87) | 0.69 (0.43 to 1.11, P=0.13) |
| Adjusted model | 0.79 (0.36 to 1.76, P=0.57) | 0.93 (0.38 to 2.24, P=0.87) | 0.68 (0.25 to 1.86, P=0.45) | 1.06 (0.46 to 2.46, P=0.89) |
| Rate of limiting long term illness (%): | ||||
| Simple model | 1.05 (0.64 to 1.71, P=0.86) | 0.57 (0.32 to 1.01, P=0.055) | 0.87 (0.46 to 1.65, P=0.67) | 0.56 (0.34 to 0.93, P=0.024) |
| Adjusted model | 1.30 (0.56 to 3.01, P=0.54) | 0.68 (0.27 to 1.73, P=0.41) | 1.66 (0.56 to 4.91, P=0.36) | 0.61 (0.26 to 1.43, P=0.25) |
| Other trust characteristics | ||||
| Acute teaching trust status*: | ||||
| Simple model | 3.84 (1.51 to 9.76, P=0.005) | 1.63 (0.59 to 4.47, P=0.35) | 1.42 (0.45 to 4.47, P=0.55) | 2.35 (0.77 to 7.13, P=0.13) |
| Adjusted model | 2.52 (0.67 to 9.51, P=0.17) | 0.72 (0.16 to 3.19, P=0.67) | 0.47 (0.09 to 2.59, P=0.39) | 1.43 (0.33 to 6.19, P=0.63) |
| Three star status†: | ||||
| Simple model | 0.75 (0.29 to 1.98, P=0.56) | 0.45 (0.14 to 1.46, P=0.19) | 0.64 (0.19 to 2.16, P=0.48) | 0.49 (0.18 to 1.38, P=0.18) |
| Adjusted model | 0.78 (0.28 to 2.20, P=0.64) | 0.56 (0.16 to 1.93, P=0.36) | 0.75 (0.20 to 2.79, P=0.67) | 0.51 (0.16 to 1.57, P=0.24) |
Effect size is odds ratio (upper quarter of trusts v lower three quarters) per unit increase in third of each explanatory variable.
Simple model controls for population denominator and total number of finished consultant episodes only. Adjusted model also controls for number of available beds, number of anaesthetists, number of specialty specific surgeons, number of private beds, proportion of people aged >65 years, Jarman score, standardised mortality ratio, rate of limiting long term illness.
Odds ratios >1 indicate a positive association between being an acute teaching hospital and prolonged waiting, and an odds ratio <1 indicates an inverse association.
Odds ratios >1 indicate a positive association between being rated three stars and prolonged waiting, and an odds ratio <1 indicates an inverse association.