Developing a universal tool for the prioritization of patients waiting for elective surgery

Solans‐Domènech, Maite; Adam, Paula; Tebé, Cristian; Espallargues, Mireia

doi:10.1016/j.healthpol.2013.07.006

Cited by 38 publications

(31 citation statements)

References 28 publications

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“…It is striking that among the dozens of articles published on the effects of the recession on the health system and on public health in Spain, only a few have quantified or rigorously analysed its impact on waiting lists, which are consistently among the main complaints made by citizens, according to the health barometer 8 This situation varies among the Autonomous Communities, as a result of the diverse approaches taken to financial and policy restrictions, as discussed above. An ambitious step to minimise the harm done by extended waiting lists is the prioritisation of patients according to specific criteria, which has been launched in Catalonia for some processes [17].…”

Section: Impact On Healthcare Service Access and Uptakementioning

confidence: 99%

Economic Crisis, Austerity Policies, Health and Fairness: Lessons Learned in Spain

López-Valcarcel

Pérez

2016

Appl Health Econ Health Policy

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This paper reviews economic and medical research publications to determine the extent to which the measures applied in Spain to control public health spending following the economic and financial crisis that began in 2008 have affected healthcare utilization, health and fairness within the public healthcare system. The majority of the studies examined focus on the most controversial cutbacks that came into force in mid-2012. The conclusions drawn, in general, are inconclusive. The consequences of this new policy of healthcare austerity are apparent in terms of access to the system but no systematic effects on the health of the general population are reported. Studies based on indicators of premature mortality, avoidable mortality or self-perceived health have not found clear negative effects of the crisis on public health. The increased demands for co-payment provoked a short-term cutback in the consumption of medicines, but this effect faded after 12-18 months. No deterioration in the health of immigrants after the onset of the crisis was unambigously detected. The impact of the recession in the general population in diseases associated with mental health is well documented, although the high levels of unemployment are identified as direct causes, and therefore it is social policies rather than measures affecting the healthcare system that would be primarily responsible. In addition, some health problems have a clear social dimension, which seems to have become more acute during the crisis, affecting in particular the most vulnerable population groups and the most disadvantaged social classes, thus widening the inequality gap. 3 Key points for decision makers Some health problems have a clear social dimension, which seems to have become more acute during the crisis  The public health system has borne a disproportionate share of the burden of spending cuts provoked by the crisis, but it has managed to avoid irreversible deterioration. The most tangible consequences of healthcare spending cuts and austerity measures concern problems of access to health care, both for specific population groups (undocumented immigrants) and for patients in general (longer waiting lists). The studies have common limitations: use of cross-sectional data and no consideration of lags between the cause (economic recession) and its effects (mortality, morbidity). In order to better estimate the effects of the crisis on health population, up-to-date data of cohorts from clinical records and registries would be needed. No attempt has been made in Spain so far to reform the health system with a view to achieving its long-term sustainability, in response to the 2008 recession and for preventing future recessions

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Section: Impact On Healthcare Service Access and Uptakementioning

confidence: 99%

Economic Crisis, Austerity Policies, Health and Fairness: Lessons Learned in Spain

López-Valcarcel

Pérez

2016

Appl Health Econ Health Policy

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“…Seven documents dealt with payment mechanisms, and one referred to dual medical practice in the public and the private sectors . On the demand side, we found 12 papers on prioritization mechanisms . The charting table that contains the detailed data extraction for the documents included for the qualitative‐conceptual synthesis that falls outside the scope of this article can be found in Appendix S4.…”

Section: Resultsmentioning

confidence: 99%

Policy strategies to reduce waiting times for elective surgery: A scoping review and evidence synthesis

Bachelet

Goyenechea²,

Carrasco

2019

Health Planning & Management

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Summary Objectives The purpose of this evidence‐based review is to identify and describe the interventions that have been implemented to reduce waiting times for major elective surgery. Methods Scoping review and presentation of the results according to the SUPPORT tools. We searched MEDLINE/PubMed, Embase, Cochrane Library, SciELO, DARE‐HTA, and Google Scholar. The inclusion criteria for research design were comprehensive. Results We identified 5200 records. After eliminating duplicates and screening by title and abstract, 171 records remained for full‐text assessment, of which 12 were ultimately included for this review because they reported specific interventions and 96 records were included for further reference. The included studies show significant variability regarding elective procedures, population, and type of provider, as well as in the characteristics of the interventions and the settings. All the studies had methodological limitations. We graded the certainty of the evidence as very low. Conclusions According to the evidence found for this review, interventions most likely should be multidimensional, with prioritization strategies on the waiting lists to incorporate equity criteria, together with quality management improvements of the surgical pathways and the use of operating rooms, as well as improvements in the planning of the surgical schedule.

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“…A review of the relevant literature showed that many scholars in other countries have considered this issue. Solans‐Domènech et al () developed a priority scoring system for patients waiting for elective surgery, based on the condition of the patient and other situational factors. Rahimi et al () proposed a risk‐based framework for patient prioritization that involved using soft FSs to help hospitals to select high‐risk patients.…”

Section: A Case Study: Healthcare Management At Wchmentioning

confidence: 99%

“…In addition, many scholars have investigated this issue regarding the patient admission evaluation, but there are drawbacks to all the approaches proposed so far. First, the approaches proposed for handing inpatient admission management in other countries (see Ashour & Kremer, ; Mariotti, Siciliani, Rebba, et al, ; Rahimi, Jamshidi, Ait‐Kadi, & Bartolome, ; Rahimi, Jamshidi, Ruiz, & Ait‐kadi, ; Solans‐Domènech, Adam, Tebé, & Espallargues, ; Valente et al, ) are not appropriate to the China context. Second, although some Chinese scholars (Zhang et al, ) have considered the problem, they have only considered evaluation criteria such as “urgency,” “need for hospitalization,” “value of clinical pathology,” and not other factors such as the limitations on the person's activity or time spent on the waiting list.…”

Section: Introductionmentioning

confidence: 99%

Distance‐based intuitionistic multiplicative multiple criteria decision‐making methods for healthcare management in West China Hospital

et al. 2019

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Intuitionistic multiplicative sets use an asymmetric, unbalanced scale to express information from positive, negative, and indeterminate information. They have been found capable of comprehensively and objectively representing a person's intuitive understanding and hence have attracted much attention. Distance techniques are widely used to measure the degree to which arguments deviate from one another. Several fuzzy set extensions have been developed, but little research has been conducted on measures of distance between intuitionistic multiplicative sets. In this paper, we start by presenting a variety of measures of the distance between intuitionistic multiplicative sets, including Hausdorff distance measures, weighted distance measures, ordered weighted distance measures, and continuous weighted distance measures. We then develop a distance‐based intuitionistic multiplicative‐technique for order preference by similarity to ideal solution method and a distance‐based intuitionistic multiplicative‐Vlsekriterijumska Optimizacija I Kompromisno Resenje method for handling multiple criteria decision‐making problems with intuitionistic multiplicative evaluation information. To demonstrate the practical application of these distance measures and the proposed methods, we provide a case study of hospital management of inpatient admission. The paper ends with comparative analyses of the two methods and some concluding remarks.

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Developing a universal tool for the prioritization of patients waiting for elective surgery

Cited by 38 publications

References 28 publications

Economic Crisis, Austerity Policies, Health and Fairness: Lessons Learned in Spain

Economic Crisis, Austerity Policies, Health and Fairness: Lessons Learned in Spain

Policy strategies to reduce waiting times for elective surgery: A scoping review and evidence synthesis

Distance‐based intuitionistic multiplicative multiple criteria decision‐making methods for healthcare management in West China Hospital

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