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September 8, 2026The International Journal of Health Planning and Management

The Impact of Prolonged Emergency Department Waiting Time on Elective Surgical Activities: A Cross‐Sectional Observational Study in National Health Service (NHS) Scotland

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Authors

JKJia Jin KwongKSKawan Shalli

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Overview

Cross-sectional study finds prolonged emergency department waits correlate with delays in elective surgery, highlighting capacity competition.

Key Points

  • To investigate whether high emergency department attendance and prolonged emergency waiting times correlate with delays in planned elective surgical services.
  • Retrospective cross-sectional observational study analyzing data from all patients presenting to emergency departments across the five largest health boards in NHS Scotland during 2021.
  • Applied univariate and multivariate regression analyses to assess relationships between emergency attendance metrics (including 4-hour target non-compliance) and elective surgical services (inpatient and outpatient waiting lists and clinic reviews).
  • Emergency department non-compliance with the 4-hour national waiting time target ranged between 6% and 20% across the five health boards, peaking in the second and third quarters.
  • Both univariate and multivariate regression analyses demonstrated a significant positive correlation between prolonged emergency department stays (>8 and >12 hours) and extended waiting times for elective surgical procedures and outpatient clinic reviews.

Cite This Study

Kwong et al. (2026) studied this question.

synapsesocial.com/papers/6a9fd7c658e84d0ff5b46bd9https://doi.org/10.1002/hpm.70124
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