Original article (in Slovenian) was published on 13/02/2023
The National Institute of Public Health is required to publish statistics about hospital waiting times at least once a month, but for 2022 only reports for October and November are available.
On 10 January, Health Minister Danijel Besic Loredan told Vecer in an interview that the Health Ministry had started “clearing” waiting lists and that waiting times were now on a downward trajectory.
Verifying this statement and obtaining information took more time than usual owing to inconsistent data on the number of patients waiting for procedures. In fact, the editorial team started writing this debunking the day the interview was published.
Asked which source Besic Loredan was referring to when he said that they had started to “clear the waiting lists”, the Health Ministry replied that in the current term they had set up a Directorate for Digitalisation in Health and that it had reduced waiting lists by 23,000 patients.
The acting director general of the Directorate for Digitalisation in Health Alenka Kolar told the STA in September last year that there were people on the waiting lists who did not exist, some entries were duplicated, and some people were deceased. She estimated that there were three times as many errorsas had been detected until then.
In January, the ministry explained in the Slovenia Healthcare Review that various aspects need to be taken into account in interpreting the number of patients and the waiting times data in the eReferral electronic patient referral system. Since 2018, the credibility of the data has been affected by upgrades to the system, while the reliability and accuracy of the data has also been affected by the outbreak of coronavirus. Over the past two years, they say, a number of activities have been carried out to improve the data in eReferral. They did not explain which activities those were.
Asked what data the minister was referring to in claiming that waiting times were getting shorter, the ministry replied that these data were taken from the monthly report of the National Institute of Public Health (NIJZ) on waiting times as of 1 November last year.
According to this data, the number of people waiting longer than the permissible waiting time for a first examination had fallen by 13.4% compared to 1 October last year. According to the applicable regulations, the waiting time is the window within which a health service must be provided in order to ensure that the patient’s health or quality of life does not deteriorate.
The total number of people waiting longer than the permissible waiting time for a selected range of therapeutic and diagnostic services decreased by 14.9% over the period, the ministry added.
The data provided by the ministry are correct, but the NIJZ also reports the total number of all patients on waiting lists regardless of the length of waiting period, which they omitted to mention. According to these data, the number of people waiting for a first examination increased by 4 % last November compared to October. There was a 1.9% increase in those waiting for therapeutic and diagnostic services.
Data on waiting times inconsistent
The Health Ministry’s Slovenia Healthcare Review shows that the total number of people waiting and the number of people waiting beyond the permissible waiting period have been increasing since 2018, with the exception of 2021, when the total number of people waiting decreased by 19% compared to the previous year, and the number of people waiting beyond the permissible waiting period decreased by 25%.
As stipulated in the Regulation on the referral of patients, the management of waiting lists, and the maximum permissible waiting times, the NIJZ is required to publish statistics on the number of people waiting at least once a month. The Regulation has been in force since January 2018.
However, for the last two years, only two waiting time monitoring reports are available on the NIJZ website, for October and November 2022 and for January and February 2021. Eight reports are available for 2020, all reports for 2019, and nine for 2018.
The NIJZ explained to Razkrinkavanje.si that they did not publish the reports regularly because the data on waiting times from 2021 are unreliable. Due to covid many health services had to be cancelled or postponed, and providers did not know when they would start scheduling patients again. “As a result, many patients did not receive new appointments for their health services but were still on waiting lists.”
The NIJZ did not reply to repeated queries as to whether the missing reports would be published once the data is accurate.
The NIJZ provided us with monthly data on waiting times from March 2021 to January this year, but the data on the number of people waiting for a first examination and the number of people waiting for therapeutic or diagnostic services in October and November last year do not match the data they have made public.
The NIJZ believes that this discrepancy is the consequence of technical problems at healthcare providers who report the data to the NIJZ and are responsible for accuracy. However, they stressed that the data in the reports are only a snapshot of the situation on the day the report is produced, which is subject to change depending on provider.
While the part of Minister Besic Loredan’s claim that the ministry is clearing waiting lists is true, the part about the downward trend in waiting times is unfounded as it is not supported by sufficiently reliable and accurate data.
