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J Eval Clin Pract. 2008 Feb;14(1):59-64. doi: 10.1111/j.1365-2753.2007.00794.x.

Prioritizing surgical waiting lists.

Author information

  • 1Department of Economics and Quantitative Methods, University of Genova, Genova, Italy. testi@economia.unige.it

Abstract

RATIONALE, AIMS AND OBJECTIVES:

This paper deals with the problem of surgical waiting lists and is aimed, in particular, at comparing two different prioritization approaches: (1) the clinical assessment of treatment urgency aimed at categorizing patients into urgency-related groups (URGs) with a given recommended maximum waiting time for treatment; and (2) the implementation of an original prioritization scoring algorithm aimed at determining the relative priority of each patient in the waiting list and the corresponding order of admission.

METHODS:

A modelling exercise based on a cohort of 236 patients enrolled on the waiting list of a surgical department in an Italian public university hospital, from 1 January to 30 June 2004, is presented. The comparison is based on a measure called need-adjusted-waiting-days, which allows to take into proper account both urgency and priority.

RESULTS:

The results show that both methods should be implemented simultaneously for increasing the department's performance in terms of both efficiency--outcome gained from a given amount of resources--and equity--how patients are admitted according to their need.

CONCLUSIONS:

Waiting list prioritization should not be limited to classifying patients into URGs, but to using a scoring system as well, in order to schedule patient admissions in an explicit and transparent way.

PMID:
18211645
[PubMed - indexed for MEDLINE]
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