Clinical categorization for elective surgery in Victoria

Abstract

There seems to be an increasing imbalance between demand for and availability of elective surgery for lower urgency elective surgical procedures. This imbalance, characterized by lengthening waiting times, means that not all patients will receive treatment within the clinically recommended waiting times. The variable approach to categorization of urgency suggests that the process lacks objectivity and consensus. Simple clinical tools to assist prioritization are currently being evaluated in Victoria (Australia) and other countries.

Waiting lists and elective surgery: ordering the queue

“…Further, priority for surgery is determined implicitly by unspecified, intuitive criteria that may vary between doctors. This probably explains the substantial variability observed in the use of urgency categories across surgeons and hospitals in a Victorian study of waiting list data 15 . Variation in Australian waiting times for surgery according to socioeconomic status and remoteness also reflect this inconsistency in access to elective services 16…”

A new dynamic integrated framework for surgical patients' prioritization considering risks and uncertainties

“…Despite all these efforts, some important points are still overlooked and some major shortcomings in current prioritization systems need to be improved [16] , [17], [18], [19], [10]. Among them, special…”

Management of waiting lists needs sound data

“…The clinical urgency categories that have been used as part of the waiting‐list management process also have important limitations. Patients are classified into three broad urgency categories (Box) by a largely subjective process with poor reproducibility between clinicians and across health services 6 . While the intensity of clinical symptoms such as pain has been fundamental to assigning urgency categories, clinicians vary in how they assess these symptoms.…”