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An examination of difficulties accessing surgical care in Canada from 2005-2014: Results from the Canadian Community Health Survey.

ABSTRACT: BACKGROUND:Difficulties accessing surgical care (e.g., related to wait times, cancellations, cost, receiving a diagnosis) are understudied in Canada. Using population-based data, we studied difficulty accessing non-emergency surgical care, including (1) the incidence and annual changes in incidence, (2) types of difficulties, and (3) associated factors (e.g., sociodemographics, surgery characteristics). METHODS:Cross-sectional data from the Canadian Community Health Survey annual components were analyzed from 2005-2014. Weighted frequencies established the annual incidence of difficulty accessing surgical care, and total incidence of types of difficulties. Chi-square analyses, independent samples t-tests, and a multivariable logistic regression examined sociodemographic and surgery-related characteristics associated with difficulty accessing surgical care. RESULTS:Among individuals who required past-year non-emergency surgery between 2005-2014 (weighted n = 3,052,072), 15.6% experienced difficulty accessing surgical care. The most common difficulty was "waited too long for surgery" (58.5%). There were significant differences in the incidence of difficulty according to year (?2 = 83.50, p < .001) from 2005-2014. The incidence of difficulty accessing surgery varied according to sex (?2 = 4.02, p < .05), surgery type (?2 = 96.09, p < .001), party responsible for cancellation/postponement (?2 range: 4.36-19.01, p < .05), and waiting time (t = 10.59, p < .001). In particular, males, orthopedic surgery, and surgery cancelled by the surgeon or hospital had the highest rates of difficulty. CONCLUSION:Results provide insight into the difficulties experienced by patients accessing elective surgery, and the associated factors. These results may inform targeted healthcare interventions and resource reallocation to reduce these occurrences.

SUBMITTER: Sommer JL

PROVIDER: S-EPMC7577481 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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An examination of difficulties accessing surgical care in Canada from 2005-2014: Results from the Canadian Community Health Survey.

Sommer Jordana Liyat JL Noh Edward E Jacobsohn Eric E Christodoulou Chris C El-Gabalawy Renée R

PloS one 20201021 10

<h4>Background</h4>Difficulties accessing surgical care (e.g., related to wait times, cancellations, cost, receiving a diagnosis) are understudied in Canada. Using population-based data, we studied difficulty accessing non-emergency surgical care, including (1) the incidence and annual changes in incidence, (2) types of difficulties, and (3) associated factors (e.g., sociodemographics, surgery characteristics).<h4>Methods</h4>Cross-sectional data from the Canadian Community Health Survey annual ...[more]

PMID: 33085681

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Project description:Biogas plants (BGPs) produce methane and carbon dioxide through the anaerobic digestion of agricultural waste. Identification of strategies for more stable biogas plant operation and increased biogas yields require better knowledge about the individual degradation steps and the interactions within the microbial communities. The metaprotein profiles of ten agricultural BGPs and one laboratory reactor were investigated using a metaproteomics pipeline. Fractionation of samples using SDS-PAGE was combined with a high resolution Orbitrap mass spectrometer, metagenome sequences specific for BGPs, and the MetaProteomeAnalyzer software. This enabled us to achieve a high coverage of the metaproteome of the BGP microbial communities. The investigation revealed approx. 17,000 protein groups (metaproteins), covering the majority of the expected metabolic networks of the biogas process such as hydrolysis, transport, fermentation processes, amino acid metabolism, methanogenesis and bacterial C1-metabolism. Biological functions could be linked with the taxonomic composition. Two different types of BGPs were classified by the abundance of the acetoclastic methanogenesis and by abundance of enzymes implicating syntrophic acetate oxidation. Linking of the identified metaproteins with the process steps of the Anaerobic Digestion Model 1 proved the main model assumptions but indicated also some improvements such as considering syntrophic acetate oxidation. Beside the syntrophic interactions, the microbial communities in BGPs are also shaped by competition for substrates and host-phage interactions causing cell lysis. In particular, larger amounts of Bacteriophages for the bacterial families Bacillaceae, Enterobacteriaceae and Clostridiaceae, exceeding the cell number of the Bacteria by approximately four-fold. In contrast, less Bacteriophages were found for Archaea, but more CRISPR proteins were detected. On the one hand, the virus induced turnover of biomass might cause slow degradation of complex biomass in BGP. On the other hand, the lysis of bacterial cells allows cycling of essential nutrients.

Dataset Information

An examination of difficulties accessing surgical care in Canada from 2005-2014: Results from the Canadian Community Health Survey.

Publications

An examination of difficulties accessing surgical care in Canada from 2005-2014: Results from the Canadian Community Health Survey.

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