Total hip and knee replacement surgery : what's the hold-up?
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(Published version)
Date
2010
Authors
Walters, Julie Lynette
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thesis
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Abstract
In public health systems the patient pathway to total hip or knee replacement surgery (THR or TKR) includes a waiting period of variable duration due to a supply-demand mismatch. To date, health reforms generating short-term reductions in waiting time for elective THR or TKR have not translated into long-term declines. One possible explanation is a misunderstanding of waiting list behaviour resulting from the types of research approaches used to examine them (i.e. reductionist, modelling). The aim of this research was to explore the delivery of THR and TKR in the Central Northern Adelaide Health Service using a systems theory framework and multi-site case study approach. An ‘Organisations-as-systems’ perspective enabled holistic examination of the structure and function of the elective surgery system. The systems’ boundary, components and tasks, as well as barriers to system function, were examined over three stages using multiple data collection strategies.
This programme of research used a contemporary, multiple perspective approach to examine and describe a complex and under-bounded elective surgery system. The results indicate that the longest delay in the system (outpatient department waiting list) did not contribute to patients’ official waiting time, highlighting a discrepancy between government, hospital and patient perspectives of the elective surgery system. Interview participants concurred with the literature suggesting that single-strategy reforms are unlikely to reduce waiting times. Multiple-strategy reforms, possibly in the form of a custom-designed elective surgery system, may have greater long-term success.
School/Discipline
School of Health Sciences
Dissertation Note
Thesis (PhD)--University of South Australia, 2010.
Provenance
Copyright 2010 Julie Lynette Walters. This work is made available under the Creative Commons Attribution-NonCommercial-NoDerivs Australia 3.0 licence (http://creativecommons.org/licenses/by-nc-nd/3.0/au/)
Description
xxi, 395 leaves
ill. (some col.)
Includes bibliographical references (leaves 295-310)
ill. (some col.)
Includes bibliographical references (leaves 295-310)
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506 0#$fstar $2Unrestricted online access