Queue Jumping Research Articles

Sociodemographic Disparities in Queue Jumping for Emergency Department Care

Emergency department (ED) triage models are intended to queue patients for treatment. In the absence of higher acuity, patients of the same acuity should room in order of arrival. To characterize disparities in ED care access as unexplained queue jumps (UQJ), or instances in which acuity and first come, first served principles are violated. Retrospective, cross-sectional study between July 2017 and February 2020. Participants were all ED patient arrivals at 2 EDs within a large Northeast health system. Data were analyzed from July to September 2022. UQJ was defined as a patient being placed in a treatment space ahead of a patient of higher acuity or of a same acuity patient who arrived earlier. Primary outcomes were odds of a UQJ and association with ED outcomes of hallway placement, leaving before treatment complete, escalation to higher level of care while awaiting inpatient bed placement, and 72-hour ED revisitation. Secondary analysis examined UQJs among high acuity ED arrivals. Regression models (zero-inflated Poisson and logistic regression) adjusted for patient demographics and ED operational variables at time of triage. Of 314 763 included study visits, 170 391 (54.1%) were female, the mean (SD) age was 50.46 (20.5) years, 132 813 (42.2%) patients were non-Hispanic White, 106 401 (33.8%) were non-Hispanic Black, and 66 465 (21.1%) were Hispanic or Latino. Overall, 90 698 (28.8%) patients experienced a queue jump, and 78 127 (24.8%) and 44 551 (14.2%) patients were passed over by a patient of the same acuity or lower acuity, respectively. A total of 52 959 (16.8%) and 23 897 (7.6%) patients received care ahead of a patient of the same acuity or higher acuity, respectively. Patient demographics including Medicaid insurance (incident rate ratio [IRR], 1.11; 95% CI, 1.07-1.14), Black non-Hispanic race (IRR, 1.05; 95% CI, 1.03-1.07), Hispanic or Latino ethnicity (IRR, 1.05; 95% CI, 1.02-1.08), and Spanish as primary language (IRR, 1.06; 95% CI, 1.02-1.10) were independent social factors associated with being passed over. The odds of a patient receiving care ahead of others were lower for ED visits by Medicare insured (odds ratio [OR], 0.92; 95% CI, 0.88-0.96), Medicaid insured (OR, 0.81; 95% CI, 0.77-0.85), Black non-Hispanic (OR, 0.94; 95% CI, 0.91-0.97), and Hispanic or Latino ethnicity (OR, 0.87; 95% CI, 0.83-0.91). Patients who were passed over by someone of the same triage severity level had higher odds of hallway bed placement (OR, 1.01; 95% CI, 1.00-1.02) and leaving before disposition (OR, 1.02; 95% CI, 1.01-1.04). In this cross-sectional study of ED patients in triage, there were consistent disparities among marginalized populations being more likely to experience a UQJ, hallway placement, and leaving without receiving treatment despite being assigned the same triage acuity as others. EDs should seek to standardize triage processes to mitigate conscious and unconscious biases that may be associated with timely access to emergency care.

Vaccine Justice and Bioethical Reflections of COVID-19 Immunization in Malaysia

Malaysia has the highest infection rate in Southeast Asia, with over 1 million positive COVID-19 cases and over 8500 deaths. The National Immunization Programme, which began in late February 2021, had a particularly slow vaccination rate, with only 4% of the targeted group receiving vaccination in three months. The delay has sparked a lot of public debate and concern, especially in light of allegations of vaccine injustice, unclear prioritization, queue jumping by people in positions of power, and other aspects of the vaccination process. Using an interpretative social science approach, this paper examines the ethical issues that arise in Malaysia’s COVID-19 vaccination discourse, focusing on vaccine justice and the bioethical principle of ‘respect for autonomy’. The paper finds that despite several shortfalls in the immunization process, most Malaysians remain optimistic and support the government’s immunization initiatives. The paper contributes to the understanding that building public trust is critical to the success of the immunization programme. Health agencies should make more efforts to inform the public about the benefits and risks of vaccines, as well as the transparency of immunization processes, which will increase public trust in health systems.

139 Inequities of Emergency Department Queue Jumping

139 Inequities of Emergency Department Queue Jumping

Multi-vehicle mixed formation driving method based on fuzzy decision

This paper presents a multi-vehicle driving method based on fuzzy decision. Fuzzy decision-making is used to realize the process of multi vehicle merging to observe how he turns and joins other teams successfully. Establish the multi-vehicle driving fleet model, and initialize its relevant data, mainly including the speed of multi vehicle driving, the distance between vehicles in the multi vehicle driving fleet and the location from the intersection. Establish the model and data of the vehicle to be inserted into the multi vehicle driving team, mainly including its speed, the position of the vehicle to the intersection, and the intersection of the queue jumping is a fixed T-junction, and the whole process of fleet merging is implemented The method proposed in the paper can be applied in practice.

Queue Jumping in Non-emergent Spaces

Queue Jumping in Non-emergent Spaces

Private Schools and Queue-jumping: A reply to White

Abstract John White defends the UK private school system from the accusation that it allows an unfair form of ‘queue jumping’ in university admissions. He offers two responses to this accusation, one based on considerations of harm, and one based on meritocratic distribution of university places. We will argue that neither response succeeds: the queue-jumping argument remains a powerful case against the private school system in the UK. We begin by briefly outlining the queue-jumping argument, before evaluating White's no-harm and meritocracy arguments.

Is the rise of crowdfunding for medical expenses in the United Kingdom symptomatic of systemic gaps in health and social care?

Crowdfunding for medical care is a new phenomenon but increasingly used by individuals to seek financial help to cover the costs of health care. Ethical concerns have been raised about medical crowdfunding, including implications for equity, resource allocation, medical decision-making, the promotion of non-evidence based therapies, platforms' lack of transparency and corporate interests. Medical crowdfunding efforts may point to shortcomings in health service provision, but they tend to have wider motivations and implications. However, there is no firm evidence base for establishing answers to even the most basic questions, such as who is seeking funds, for what, where and why. In this Essay, we provide an introduction to medical crowdfunding in the United Kingdom (UK). We synthesize what is currently known and the insights that might be gained from an exploratory review of 400 medical crowdfunding campaigns on the GoFundMe UK website: for instance, whether medical crowdfunding occurs in response to gaps in service provision, supports 'queue jumping' and how it relates to 'medical tourism'. We conclude with a call for research on medical crowdfunding in the UK (and elsewhere) as a means to better understand patients' perceived or actual unmet need for health and social care and inform policy development.

Dissolution of Canada's Single-Tiered Health System Would Threaten the Health of Women with Disabilities.

Dissolution of Canada's single-tiered health system is now before the Supreme Court of British Columbia and will soon be before the Supreme Court of Canada. If our Supreme Court justices are persuaded to dissolve the Canada Health Act, financially advantaged Canadians will be permitted to purchase privileged access to physicians, diagnostic tests, and surgical facilities. This queue jumping will diminish access for the socioeconomically disadvantaged, among whom women are overrepresented, including women living with disabilities, women of Indigenous heritage, and women who have recently immigrated to Canada. For example, women with disabilities receive fewer Pap tests and mammograms, as do women of First Nations communities, who are also reported to have a higher incidence of cervical cancer deaths. The option for physicians to "opt out" of public care is particularly problematic in Canada because we have one of the lowest physician-to-patient ratios of "developed" countries. Social justice in health promotion in Canada is threatened by those who would dissolve the Canada Health Act in neoliberal-thinking ink because social justice can flourish only when the prevailing imperatives in our health system are equality and not wallet size, access and not gatekeeping, fairness and not finance. Social justice in health promotion insists on improving the social determinants of health of all Canadians, not just financially better-off Canadians who already have access to better health outcomes through better nutrition, better environments, and better access to health professionals.

Jumping the queue: An experiment on procedural preferences

We present a three-player queuing game to study procedural preferences in a laboratory experiment. Together with markets, queues and waiting lists are universal procedures for allocating goods and services. We designed our queuing game to disentangle motivations of outcome-oriented egoistic preferences, outcome-oriented distributional (inequality aversion) preferences and outcome-independent procedural preferences. In a series of treatments, we introduce a market element and allow two of the three players to bargain over a queue jump, thus violating the queuing procedure. A third player is able to engage in peer punishment to sanction queue jumping. We provide evidence that a simple model of procedural preferences is able to explain the behavior of a share of the subjects in our experiment.

Polycentricity and queue jumping in public law remedies: A two-track response

This article examines complex public law remedies in light of Lon Fuller’s famous critique that courts are ill-equipped to deal with polycentric or multifaceted issues and the related critique that remedies for health care and other socio-economic rights result in queue jumping. Most contemporary commentators interpret Fuller as hostile to courts’ ordering complex remedies. A more nuanced interpretation of Fuller advanced in part ii of this article suggests that polycentricity is a matter of degree and that courts can cautiously engage with polycentric issues by relying on negotiation among parties and drawing dialogically on the expertise of the legislature and the executive. At the same time, many commentators subsequent to Fuller have unwisely dismissed his concern about maintaining the integrity of adjudication by ensuring that successful litigants receive a tangible remedy. Part iii will examine the American experience with complex remedies, suggesting that a recent California prison case illustrates some dangers of courts losing adjudicative focus when they take on too many polycentric problems. Part iv will suggest that, while Doucet-Boudreau and section 24(1) of the Charter should allow Canadian courts carefully to manage polycentric tasks by retaining jurisdiction, there have been some regrettable retreats from the majority’s decision. Nevertheless, a new remedy of a ‘declaration plus’ will be defended as appropriate in prison and other complex cases. Part v will examine remedies in the polycentric context of health care. It will suggest that suspended declarations of invalidity such as was used in Chaoulli can also help manage polycentricity. The two-track approach to remedies defended in the part vi would involve courts where possible, providing individual remedies to litigants while using more cautious dialogic remedies to address complex polycentric issues such as unconstitutional health care and prison conditions.

Sub-Penny and Queue-Jumping

We develop a model where a public limit order book (PLB) competes with a Sub-Penny Venue, which allows Sub-Penny Trading (SPT). SPT occurs when a trader undercuts orders in the PLB by less than one penny, a practice we call queue-jumping (QJ). QJ is higher for NASDAQ than for NYSE stocks. We confirm the model's predictions that QJ increases in liquidity and in the tick-to-price ratio. We also find that QJ is associated with improved PLB market quality, especially for large capitalization stocks. Finally, we show that High Frequency Trading is negatively related to QJ.

Ethics in Radiology: Wait Lists Queue Jumping

Education in ethics is a requirement for all Royal College residency training programs as laid out in the General Standards of Accreditation for residency programs in Canada. The ethical challenges that face radiologists in clinical practice are often different from those that face other physicians, because the nature of the physician-patient interaction is unlike that of many other specialties. Ethics education for radiologists and radiology residents will benefit from the development of teaching materials and resources that focus on the issues that are specific to the specialty. This article is intended to serve as an educational resource for radiology training programs to facilitate teaching ethics to residents and also as a continuing medical education resource for practicing radiologists. In an environment of limited health care resources, radiologists are frequently asked to expedite imaging studies for patients and, in some respects, act as gatekeepers for specialty care. The issues of wait lists, queue jumping, and balancing the needs of individuals and society are explored from the perspective of a radiologist.

Introduction to the Special Section on Assisted Outpatient Treatment in New York State

Introduction to the Special Section on Assisted Outpatient Treatment in New York State

Constitutional and Human Rights Disturbances: Australia’s Privative Clauses Created Both in an Immigration Context

With the arrival of another wave of “boat people” to Australian waters in late 2009, issues of human rights of asylum seekers and refugees once again became a major feature of the political landscape. Claims of “queue jumping” were made, particularly by some sections of the media, and they may seem populist, but they are also ironic, given the protracted efforts on the part of the federal government to stymie any orderly appeals process, largely through resort to “privative clauses”. Such clauses demonstrate the many ways in which human rights of those seeking asylum in far-off lands and are potential future immigrants, who often lack much-touted needed papers, yet who are for the most part genuine refugees, are subject to the slings and arrows of political fortune (and misfortune). Approaching the courts if treated unfairly or seeking a further decision as to your fate would seem one of the fundamental premises of human rights. Yet privative clauses—or attempts to ouster the jurisdiction of the courts and to insulate decisions from appeal—have become an increasingly frequent feature of the Australian migration legislation. With a seemingly watertight federal constitutional power set in stone since 1901, to deal with migration and aliens, and without the tempered contemporary update of a federal Bill of Rights, the Australian federal government has been able to narrow the grounds of judicial review in those contexts. We argue that the concerted efforts to deny such fundamental rights of appeal to those most in need of the full armoury of the protection of the law in a modern, affluent democracy, constitutes both a breach of their human rights and a breach of core constitutional principles such as separation of powers. Those principles may not be formally articulated in the text of the Australian Constitution, but in our view they are implicit in the constitutional arrangements, and hence we can conclude with the arguments of former Justice of the High Court of Australia, Michael Kirby, who asked—to whom does sovereignty truly belong?

Is the Canadian System Right for the United States?

While political realities make it quite unlikely the United States will move to a single-payer system, there may nevertheless be lessons to be drawn from Canada’s experience as well as from the experience of other nations. Canadian Medicare is presented as both a savior and a foe to American patients. On the one hand, it is a symbol to progressive American scholars of accessible health care without the command-and-control features of, for example, the UK system. On the other, its effective bans on supplementary PHI for queue jumping and top-ups leave too little room for embedded private insurance companies. The most likely model would see a significant role for private health insurance in providing the core plan to which there is universal access.This paper argues that whatever the path forward for the United States, there will be a need to attend to the interplay between private health insurance (supplementary and complementary) and the established “basic” or core plan — whether single payer, social health insurance, regulated universal private health insurance, or some variant thereof — with a view to balancing access, equity, and cost. If the basic or core plan is bare bones, the role for complementary/ supplementary private insurance will be proportionately large, particularly if co-payments are high. If rationing is too severe within the core or basic plan, this will generate demand for private alternatives to avoid queues. If private insurers are harnessed to provide the core or basic plan and are also allowed to tie this product to offerings of supplemental or complementary private health insurance, then regulation will likely be required to ensure that the tied products are not used to effectively circumvent requirements that private insurers not select on risk in the basic or core plan. The dynamics within a particular system are very context specific, which, it must be conceded, limits our ability to reliably transplant lessons from one country to another Hence, the enormous challenge facing U.S. lawmakers as they attempt to design and implement foundational changes.

The holy trinity of Canadian health policy

Exploring Social Insurance: Can a Dose of Europe Cure Canadian Health Care Finance? Colleen M. Flood, Mark Stabile and Carolyn Hughes Tuohy, Eds.; McGill-Queen's University Press; 2008. 290 pp $34.95 Better health care. No queue jumping. And lower taxes. Most Canadians favour all 3 parts of this

Do as I say, not as I do: a survey of public impressions of queue-jumping and preferential access

The Canada Health Act legislates that Canadian citizens have access to healthcare that is publicly administered, universal, comprehensive, portable, and accessible (i.e. unimpeded by financial, clinical, or social factors). We surveyed public impressions and practices regarding preferential access to healthcare and queue jumping. Households were randomly selected from the Toronto telephone directory. English speakers aged 18 years or older were solicited for a standardized telephone survey. Statistical analysis was performed using SPSS and SAS. Fifteen percent (n=101) of 668 solicited were surveyed. Ninety-five percent advocated equal access based on need. Support for queue jumping in the emergency department (ED) was strong for cases of emergency, severe pain, and pediatrics, equivocal for police, and minimal for the homeless, doctors, hospital administrators, and government officials. To improve a position on a waiting list, approximately half surveyed would call a friend who is a doctor, works for a doctor, or is a hospital administrator. Sixteen percent reported having done this. The likelihoods of offering material inducement for preferential access were 30 and 51% for low and high-impact medical scenarios, respectively. The likelihoods of offering nonmaterial inducement were 56 and 71%, respectively. Responses were not associated with sex, occupation, or education. Respondents expressed support for equal access based on need. Policy and scenario-type questions elicited different responses. Expressed beliefs may vary from personal practice. Clearly defined and enforced policies at the hospital and provincial level might enhance principles of fairness in the ED queue.

Restricted permutations and queue jumping

A connection between permutations that avoid 4231 and a certain queuing discipline is established. It is proved that a more restrictive queuing discipline corresponds to avoiding both 4231 and 42513, and enumeration results for such permutations are given.

Queue jumping in health care

Queue jumping in health care

Effective jump-pointer prefetching for linked data structures

Current techniques for prefetching linked data structures (LDS) exploit the work available in one loop iteration or recursive call to overlap pointer chasing latency. Jump pointers, which provide direct access to non-adjacent nodes, can be used for prefetching when loop and recursive procedure bodies are small and do not have sufficient work to overlap a long latency. This paper describes a framework for jump-pointer prefetching (JPP) that supports four prefetching idioms: queue, full, chain, and root jumping and three implementations: software-only, hardware-only, and a cooperative software/hardware technique. On a suite of pointer intensive programs, jump pointer prefetching reduces memory stall time by 72% for software, 83% for cooperative and 55% for hardware, producing speedups of 15%, 20% and 22% respectively.