Chapter 4. Timeliness

Timeliness is the health care system's capacity to provide health care quickly after a need is recognized. Timeliness¹ is one of the six dimensions of quality established by the Institute of Medicine as a priority for improvement in the health care system.² Measures of timeliness include waiting time spent in doctors' offices and emergency departments (EDs) and the interval between identifying a need for specific tests and treatments and actually receiving those services.

Importance and Measures

Morbidity and Mortality

• Lack of timeliness can result in emotional distress, physical harm, and financial consequences for patients.³
• Stroke patients' mortality and long-term disability are largely influenced by the timeliness of therapy.^4,5
• Timely delivery of appropriate care can also help reduce mortality and morbidity for chronic conditions such as chronic kidney disease.⁶

Cost

• Early care for comorbid conditions has been shown to reduce hospitalization rates and costs for Medicare beneficiaries.⁷
• Some research suggests that, over the course of 30 years, the costs of treating diabetic complications can approach $50,000 per patient.⁸ Early care for complications in patients with diabetes can reduce overall costs of the disease.⁹
• Timely outpatient care can reduce admissions for pediatric asthma, which account for $835 million in total hospitalization charges annually.^10,11

Measures

This report focuses on three core report measures related to timeliness of primary, emergency, and hospital care:

• Getting care for illness or injury as soon as wanted
• Emergency department visits in which the patient left without being seen
• Time to initiation of thrombolytic therapy for heart attack patients

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