Long waiting lists in public health services remain a major challenge across regions, from the European Union (EU) to the United States (US) and Latin America (LATAM). Despite the differing structures of these healthcare systems, the persistence of this issue highlights a common concern: timely access to care. In this post, I aim to explore the root causes behind long waiting lists across these regions and propose how Artificial Intelligence (AI) could help decision-makers address the problem efficiently.
EU Healthcare Systems: Overburdened but Universal
European healthcare systems are built on the promise of providing universal access, yet this inclusivity often leads to challenges in delivering timely care. Countries like the UK, Spain, and Sweden, despite having well-established public health systems, face significant delays in certain types of treatments, particularly in specialized surgeries such as spinal operations.
In the United Kingdom, the National Health Service (NHS) has been facing unprecedented pressure. As of 2023, it was reported that more than 7 million people are on waiting lists for treatment across the country. When it comes to spinal operations, the waiting time can be especially long. On average, a patient requiring spinal surgery may wait anywhere from 6 to 12 months for treatment depending on the region and severity of their condition. According to the British Spine Registry, some patients in England have waited over a year for elective spinal surgeries due to backlogs exacerbated by the pandemic.
In Spain, the situation is similar. The average waiting time for any kind of surgery in the public healthcare system was around 123 days in 2022. However, for specialized surgeries such as spinal operations, the wait can extend to over 200 days. Spanish hospitals, particularly in regions with older populations like Galicia and Andalusia, face a significant burden in managing the demand for both elective and emergency surgeries.
Sweden, often seen as having one of the most advanced healthcare systems, is not immune to this issue either. According to the Swedish National Board of Health and Welfare, the average waiting time for a spinal surgery can reach up to 9 months in some regions, well above the EU target of providing surgery within 90 days of diagnosis.
Some common factors in the EU’s waiting list crisis can be find in:
Aging Population: Europe has one of the oldest populations in the world, with 20% of the EU’s population aged 65 and above. This demographic place increasing pressure on healthcare systems, as older patients tend to need more surgeries and treatments, especially for musculoskeletal issues such as spinal problems.
Specialist Shortages: Across the EU, there is a growing shortage of healthcare specialists. A report from the European Commission stated that by 2030, there could be a shortfall of 4.1 million healthcare workers, including surgeons and nurses. This shortage directly impacts the availability of surgeries like spinal operations, where specialized expertise is required.
Budget Constraints and Infrastructure: Many public health systems in the EU struggle with budget constraints. Governments allocate limited funds to healthcare, making it difficult to invest in expanding hospital infrastructure or hiring more staff. In 2022, the UK government spent 9.9% of its GDP on healthcare, while the EU average hovered around 9.5%, often inadequate to meet rising healthcare demands.
The US Healthcare System.
The US healthcare system, with its mix of private and public providers, faces a unique set of challenges that contribute to long waiting lists for certain types of treatments. Despite having some of the most advanced medical facilities, disparities in access and coverage create significant delays, particularly for patients dependent on public insurance programs like Medicare and Medicaid.
As one example, In the US, waiting times for specialized surgeries such as spinal operations can vary widely depending on the patient’s insurance type and geographic location. According to a 2023 report from the American Association of Neurological Surgeons (AANS), the average wait time for elective spinal surgery ranges from 3 to 6 months. For patients with Medicaid or those in lower-income brackets, these wait times can extend further due to lower reimbursement rates and fewer available surgical slots.
For Medicaid patients, wait times can be notably longer. The Kaiser Family Foundation reported in 2023 that Medicaid patients often face extended wait times for elective procedures due to lower reimbursement rates for hospitals, leading to fewer available slots for surgery. Medicare Patients also experience delays, though generally shorter than Medicaid patients. A 2022 study published in the Journal of the American Medical Association (JAMA) found that Medicare patients faced average wait times of about 4 to 5 months for non-urgent spinal surgeries.
Urban vs. rural areas can also vary significantly between urban and rural areas. In urban centers with high patient volumes, such as New York City or Los Angeles, patients might face waits of up to 6 months for spinal operations. In contrast, patients in rural areas, where access to specialized care is more limited, might experience even longer delays. The Rural Health Research Center highlights that rural patients can wait up to 12 months due to a shortage of specialists and longer travel times.
The Root Causes of long Wait Times in the US can be addressed by resource allocation and access inequities. High costs and disparities in insurance coverage contribute to prolonged wait times. A 2022 survey by the American Hospital Association (AHA) found that hospitals serving high Medicaid populations experienced significant financial strain, affecting their capacity to schedule surgeries promptly.
As mentioned, when we discussed the EU case, the shortage in specialists is affecting the medical attention nationwide. The Association of American Medical Colleges (AAMC) projected a shortage of up to 43,000 surgeons by 2034, exacerbating wait times for elective surgeries.
Addressing long waiting lists in the US healthcare system requires targeted interventions, including the strategic use of AI technologies to enhance scheduling, optimize resource allocation, and improve care coordination. By investing in AI-driven solutions, such as predictive analytics for demand forecasting and automated scheduling systems, healthcare providers can better manage patient flow and reduce waiting times.
Some cases In LATAM
In Latin America, public healthcare systems often face significant challenges in managing patient wait times. Each country has its unique set of issues that contribute to extended waiting lists for medical procedures, including specialized treatments. Here, we’ll explore the specific situations in Mexico and Costa Rica (two countries I know well), highlighting the underlying causes and metrics that define their healthcare landscapes.
In Mexico, the public healthcare system is primarily managed by the Instituto Mexicano del Seguro Social (IMSS) and the Secretaría de Salud. While these institutions provide coverage to millions of Mexicans, Despite the populist phrase of Mexican´s President Andrés Manuel López Obrador (AMLO) that their healthcare system is better than the one in Denmark, the reality is that the complete public healthcare system, struggle with resource constraints and inefficiencies that contribute to long waiting lists. Waiting times for elective surgeries, including spinal operations, can range from 6 to 12 months. According to a 2023 report from the Mexican Ministry of Health, patients requiring non-emergency surgeries face delays due to high demand and limited operating room availability.
Emergency cases, although prioritized, can still experience delays due to overburdened hospitals. Data from the National Institute of Statistics and Geography (INEGI) reveals that emergency patients might wait up to 48 hours in some areas, particularly in regions with fewer healthcare facilities.
The root case of long waiting lists in Mexico´s public hospitals often face shortages of medical supplies and equipment. The World Health Organization (WHO) reported in 2022 that 50% of Mexican hospitals lack essential medical devices, contributing to longer waiting times for procedures.
There is a significant disparity between urban and rural healthcare access. Patients in rural areas may face longer wait times due to fewer medical facilities and specialists. INEGI data shows that rural areas have 30% fewer healthcare providers compared to urban centers.
For the Costa Rican case, despite the international position of one robust healthcare system, largely managed by the Caja Costarricense de Seguro Social (CCSS), the reality is that waiting times for certain procedures can be problematic.
According to one article called “Waiting lists in the CCSS: a bioethical perspective” by Wilmer Casasola-Rivera, published in 2004 by the Social Studies Magazine in the TEC webpage, the waiting list in days for a general physicians’ appointment is 390 days and for a surgery is 432 days.
The author concludes that “Waiting lists represent a social problem if not managed properly, but they also offer the opportunity to implement significant improvements in the administration of health services.”
It is clear that the CCSS haven’t had the interest in decades to address this problem. I remember when I graduated from med school back in 1995, the opportunities to study one medical residence were limited by the myopia of the bad administrators who led the institution back then, that not only artificially limited the creation of resident places to allow a shortage of doctors to have a limited supply, which allowed maintaining a status quo that benefited few.
The high demand for specialized care, coupled with limited resources, strains the system. The Costa Rican Ministry of Health reported a 20% increase in demand for specialized services over the past five years.
In Mexico and Costa Rica, long waiting lists are driven by a combination of resource limitations, systemic inefficiencies, and high patient demand.
Addressing these issues requires targeted investments in healthcare infrastructure, improved resource management, and the adoption of innovative technologies like AI. By leveraging AI for predictive analytics, resource optimization, and streamlined administrative processes, these countries can potentially reduce waiting times and improve overall healthcare delivery.
Software solutions like Epic Systems, Cerner, and LeanTaaS offer tools that can streamline administrative processes and improve efficiency. For example, LeanTaaS’s iQueue uses AI to optimize operating room utilization, potentially reducing waiting times for surgeries.
Investing in these technologies not only improves patient access but also enhances overall healthcare system efficiency, ultimately leading to better outcomes and more equitable care across the board.
AI: The Game-Changer in Reducing Waiting Times
AI offers powerful tools to help health systems better manage their resources, reduce inefficiencies, and ultimately shorten waiting lists. Here’s how:
- Predictive Analytics: AI-driven systems can forecast patient demand based on historical data, allowing hospitals to anticipate spikes in service needs and allocate resources accordingly. This has been successfully implemented in parts of Europe, where AI is used to predict and prepare for flu seasons, helping hospitals adjust in advance.
- Patient Prioritization Algorithms: AI can prioritize patients based on the urgency of their condition, leading to more efficient triaging and better resource allocation. In the US, some hospitals are already leveraging AI to prioritize surgeries and diagnostic tests, ensuring that critical patients are treated faster.
- Automated Administrative Tasks: By using AI to handle administrative tasks like appointment scheduling, resource allocation, and patient follow-ups, hospitals can free up medical personnel to focus on patient care. This is particularly useful in LATAM, where administrative inefficiencies often lead to significant delays.
- Telemedicine & Remote Monitoring: AI-powered telemedicine platforms and wearables can monitor patient conditions remotely, reducing the need for physical hospital visits and decreasing the burden on healthcare facilities. In the EU, AI-driven telemedicine has proven effective in managing chronic disease patients remotely, reducing the number of in-person consultations.
- Optimizing Surgical Scheduling: AI tools can also optimize operating room schedules, minimizing downtime and increasing the number of procedures that can be performed daily.
The global healthcare challenge of long waiting lists can be addressed with the strategic integration of AI technologies. By improving resource allocation, reducing administrative burden, and prioritizing urgent care, AI can help transform how public health systems operate across the world.
Software solutions like IBM Watson Health, Google Health’s AI, and LeanTaaS are already making strides in optimizing healthcare processes. Hospitals investing in these technologies not only improve patient outcomes but also significantly reduce operational costs over time.
The time to act is now. By investing in AI-driven solutions, we can ensure faster, more equitable access to healthcare and build a system that is both resilient and efficient.
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