The goal of this study was the analysis of time accessibility of selected procedures in Slovakia in selected categories of health care and their comparison with the situation in the past. The time accessibility of planned procedures was observed by two methods:
On the waiting list are placed patients with indicated health care which is not possible to provide because of financial, capacity or other reasons. Those are generally patients who do not require acute health care and where the deferral will not worsen the state of health. Waiting (being on the waiting list), or waiting period indicates the time between including the patient on the waiting list and his displacing. In elective health care it in general means the time between approval and realization of the procedure.
Health insurance companies (HIC) are according to law and respective edict obliged to keep the waiting lists for chosen diseases which demand operational or invasive procedure. In April 2013 were on the waiting lists of all health insurance companies 10,611 insured persons out of whom were in health insurance company Dôvera 2,709 (25.5%), in General Health Insurance Company (VšZP) 7,778 (73.3%) and in HIC Union 124 (1.2%).
The most of the insured persons on the waiting lists even after taking into account the insured base has General Health Insurance Company (232,7 on every 100,000 of insured persons), in which for the monitored procedures is waitng 8.3 times more insured persons than in Union HIC (28.2 on every 100,000 insured). At the second place in the number of insured waiting for planned procedures is health insurance company Dôvera (188.9 on every 100,000 insured) which has on the lists 6.7 times more insured persons than Union.
Even though the comparison with the past is impeded by wrongly reported data by VšZP from 2012, in general it is possible to say that the number of patients on the waiting lists from 2010 was first rising but in the last year it is possible to observe in all three health insurance companies a gradual decline. In contrast with Union the numbers of insured neither in Dôvera nor in VšZP did not drop to the values from 2010.
In Slovakia for a long time the most of the patients have been waiting for total knee (3,036) and hip (2,721) replacement, cataract surgery (2,580) and several diseases related to cardiovascular system. The number of patients included on the waiting list in the first three groups in all health insurance companies was rising until March 2012 and subsequnetly decreased.
Regardless of the health care provider or health insurance company the waiting time for total knee or hip replacement in Slovakia is on average 9 months and for cataract surgery almost 3 months. The length of the waiting period on total hip replacement in between 2012 and 2013 fell down by 5.3 months, while the length of the waiting period for cataract surgery between 2012 and 2013 did not change.
For total knee replacement for the longest time are waiting the policyholders of VšZP (10.9 months) and for the shortest time are waiting the policyholders of Union health insurance company. Similarly, even for the total hip replacement for the longest time waiting are policyholders of VšZP (11.2 months) and the shortest waiting are policyholders of Union health insurance company (8.9 months). For the total hip replacement the differences among health insurance companies are not that big (2.3 months) as for the knee replacement (4.2 months). As for the cataract surgery the difference among health insurance companies is the smallest, approximately 1 week, where for the longest waiting are the policyholders of VšZP (90 days) and for the shortest waiting are policyholders of Union health insurance company (82 days).
Totally the shortest waiting times for the most frequent disesases included on the waiting lists has healt insurance company Union. Although the total number of insured on the waiting lists did not lower within the last year, the waiting period was shortened for the observed procedures.
For the improvement of situation with waiting times for elective procedures we suggest the four following measurements:
The study in Slovak language can be downloaded for free here.