Unmet Needs and Waiting List Prioritization for Knee Arthroplasty

Comas, Mercè; Román, Rubén; Quintana, José M.; Castells, Xavier

doi:10.1007/s11999-009-1163-5

Cited by 13 publications

(17 citation statements)

References 22 publications

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“…Assessing actual bene ts remains, in our opinion, one of the most important drawbacks of the reported PPTs. In fact, we found that only 10 studies (13,28,29,39,44,46,50,58,62,64) investigated the effects or outcomes of the proposed PPTs, while six other studies (23,36,(48)(49)(50)67) merely reported opinions expressed by stakeholders about essential bene ts and limitations of PPTs.…”

Section: Effects On the Waiting List Processmentioning

confidence: 99%

“…Waiting time is the most studied outcome assessment (13,28,29,39,58,62,64). Four studies (28,29,39,62) used a computer simulation model to evaluate the impact of the PPT on waiting times. In their simulations, the authors compared the use of a PPT to the FIFO model, and reported mixed ndings.…”

Section: Effects On the Waiting List Processmentioning

confidence: 99%

“…In their simulations, the authors compared the use of a PPT to the FIFO model, and reported mixed ndings. Comas et al (28,29) showed that prioritization systems produced better results than a FIFO strategy in the contexts of cataract and knee surgeries. They concluded that the waiting times weighted by patient priority produced by prioritization systems were 1.54 and 4.5 months shorter than the ones produced by FIFO in the case of cataract and knee surgeries, respectively.…”

Section: Effects On the Waiting List Processmentioning

confidence: 99%

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A systematic review of patient prioritization tools in non-emergency healthcare services

Déry

Ruíz

Routhier

et al. 2020

Preprint

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Background. Patient prioritization is a strategy used to manage access to healthcare services. Patient prioritization tools (PPT) contribute to supporting the prioritization decision process, and to its transparency and fairness. Patient prioritization tools can take various forms and are highly dependent on the particular context of application. Consequently, the sets of criteria change from one context to another, especially when used in non-emergency settings. This paper systematically synthesizes and analyzes the published evidence concerning the development and challenges related to the validation and implementation of PPTs in non-emergency settings.Methods. We conducted a systematic mixed studies review. We searched evidence in five databases to select articles based on eligibility criteria, and information of included articles was extracted using an extraction grid. The methodological quality of the studies was assessed by using the Mixed Methods Appraisal Tool. The article selection process, data extraction, and quality appraisal were performed by at least two reviewers independently.Results. We included 48 studies listing 34 different patient prioritization tools. Most of them are designed for managing access to elective surgeries in hospital settings. Two thirds of the tools were investigated based on reliability or validity. Inconclusive results were found regarding the impact of PPTs on patient waiting times. Advantages associated with PPT use were found mostly in relationship to acceptability of the tools by clinicians and increased transparency and equity for patients.Conclusions. This review describes the development and validation processes of PPTs used in non-urgent healthcare settings. Despite the large number of PPTs studied, implementation into clinical practice seems to be an open challenge. Based on the findings of this review, recommendations are proposed to develop, validate, and implement such tools in clinical settings.Systematic review registration: PROSPERO CRD42018107205

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Section: Effects On the Waiting List Processmentioning

confidence: 99%

Section: Effects On the Waiting List Processmentioning

confidence: 99%

Section: Effects On the Waiting List Processmentioning

confidence: 99%

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A systematic review of patient prioritization tools in non-emergency healthcare services

Déry

Ruíz

Routhier

et al. 2020

Preprint

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“…The length of the waiting period for consultation and/or surgery can potentially have an impact on the patient's quality of life or an athletes' performance, as well as financial impacts in terms of cost related to time loss from work, physiotherapy treatments, and pain management . While this has been extensively investigated for hip and knee arthroplasty, there is no published data that analyse the wait time and the referral processes for patients needing hip arthroscopy.…”

Section: Introductionmentioning

confidence: 99%

Analysis of the referral pattern and wait time for hip arthroscopy in a single payer publicly funded health care system

Petrera

Yanez‐Siller

Whelan

et al. 2019

Evaluation Clinical Practice

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Rationale and objectives:To analyse the referral pattern for hip pain and to investigate the wait time for an orthopaedic assessment by a hip arthroscopy surgeon in a single payer health care system. We hypothesized that a significant delay from time of onset of symptoms to time of assessment by a hip arthroscopy surgeon exists. Method:Retrospective review of prospectively collected data in an academic hospital in a single payer health care system. An electronic database analysis was conducted searching for all referrals for hip pain between February 2017 and June 2017. Data were then analysed with the aim to identify the most common reason for hip referral, calculate the duration of symptoms between onset and orthopaedic assessment, and categorize previous investigations and treatments.Results: A total of 96 patients were included (47 male and 49 female). Main source of referrals was Family Medicine Physicians in 37% of cases and Primary Care Sports Medicine Physicians in 35%. The most common reason for referral was labral tear in 44.7% of cases followed by combined femoroacetabular impingement and labral tear in 21.8%.The duration of symptoms was longer than 2 years in 42% of cases and between 1 and 2 years in 40% of cases. Twenty percent of patients had previous intraarticular injection while 53% of patients had physiotherapy treatment (64% of patient underwent physiotherapy for longer than 6 months). Conclusion:In the Canadian single payer health care system, a significant delay from the time of onset of symptoms to the time of assessment by a hip arthroscopy surgeon exists with the vast majority of patients in our cohort waiting more than 1 year. It is unknown if this delay affects the patient outcomes. This will require further investigation. Certainly, based on our findings, we should advocate for a better screening process, centralized referrals to hip arthroscopy specialists, and appropriate patient work-up. KEYWORDShealth care, patient-centred care, public health Investigation was performed at Women's

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“…One of the strategies proposed to tackle the problem of waiting lists for surgery is the prioritization of patients according to clinical necessity, functional capacity or other social determining factors. Different studies at a national [1] and international [2–4] level have shown the benefits of prioritizing patients on waiting lists for surgical interventions with respect to a system based exclusively on the waiting time. Prioritization improves fairness, reduces waiting times of patients with a more urgent need and can also have repercussions on the variations between regions because it allows available resources to be assigned within each region more efficiently [5].…”

Section: Introductionmentioning

confidence: 99%