Health Care Management Science

, Volume 10, Issue 2, pp 195–215 | Cite as

Predicting joint replacement waiting times

  • Lauren E. Cipriano
  • Bert M. Chesworth
  • Chris K. Anderson
  • Gregory S. Zaric


Currently, the median waiting time for total hip and knee replacement in Ontario is greater than 6 months. Waiting longer than 6 months is not recommended and may result in lower post-operative benefits. We developed a simulation model to estimate the proportion of patients who would receive surgery within the recommended waiting time for surgery over a 10-year period considering a wide range of demand projections and varying the number of available surgeries. Using an estimate that demand will grow by approximately 8.7% each year for 10 years, we determined that increasing available supply by 10% each year was unable to maintain the status quo for 10 years. Reducing waiting times within 10 years required that the annual supply of surgeries increased by 12% or greater. Allocating surgeries across regions in proportion to each region’s waiting time resulted in a more efficient distribution of surgeries and a greater reduction in waiting times in the long-term compared to allocation strategies based only on the region’s population size.


Waiting times Joint replacement Queuing simulation Projecting demand for health care services Surgical allocation planning Resource allocation 


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Lauren E. Cipriano
    • 1
  • Bert M. Chesworth
    • 2
  • Chris K. Anderson
    • 3
  • Gregory S. Zaric
    • 4
  1. 1.Institute for Technology AssessmentMassachusetts General HospitalBostonUSA
  2. 2.School of Physical Therapy and Bachelor of Health Sciences Program, Faculty of Health Sciences, and Department of Epidemiology and Biostatistics, Schulich School of Medicine & DentistryUniversity of Western OntarioLondonCanada
  3. 3.School of Hotel AdministrationCornell UniversityIthacaUSA
  4. 4.Richard Ivey School of BusinessUniversity of Western OntarioLondonCanada

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