Impacte del sistema de priorització de pacients en llista d’espera per artroplàsties de genoll i maluc i cirurgia de cataracta
Introduction: the Catalan Agency for Health Technology Assessment and Research (before the Agency for Health Technology Assessment and Research) has developed two scoring systems for prioritizing the waiting list for cataract surgery and hip and knee arthroplasties. The aim of the study is to evaluate the impact of applying the prioritization system for cataract surgery and hip and knee arthroplasties in the healthcare system. Methodology: a retrospective evaluation was carried out with data from the Registry data tracking and management of patients on the waiting list for cataract surgery and hip and knee in hospitals of the Catalan Health Service in the period 2003-2009. Analyses were performed for each procedure. A description of the characteristics of patients on the waiting list and the evolution of waiting time was performed. We have analyzed the association between priority score and the waiting time and order of intervention. Finally, we conducted a simulation using a deterministic model based on the date of registration in the list and the number of surgeries performed daily. Results: the number of patients included on the waiting list in the period studied for knee arthroplasty was 67.403 and 67% had priority score. For hip arthroplasty the number of patients included was 27.200 and 49% had priority score. For cataract surgery the number of patients included was 367.929 and 3% had priority score. The distribution of the priority score for arthroplasty was negative skew with an average score of 70 points and symmetrical with an average score over 40 points for cataract surgery. During the study period the median waiting time was reduced up to 5 months for arthroplasty and up to 3 months for cataract surgery. No association was found between the priority score and waiting time, and with the order of intervention, although the results were not uniform by center except for cataract surgery. Conclusions: the study concludes that the system of prioritization has not been implemented. Compliance: is remarkable for hip and knee arthroplasty. In spite of its impact on the order of intervention appears to not differ from a first in first out (FIFO) system. Nevertheless in some centers a moderate correlation between the priority score and both the waiting time and the intervention order was identified.
Waiting list prioritization; Cataract surgery; Hip arthroplasty; Knee arthoplasty
Tebé-Cordomí C, Adam P, Alomar S, Espallargues-Carreras M. Impacte del sistema de priorització de pacients en llista d’espera per artroplàsties de genoll i maluc i cirurgia de cataracta. Barcelona: Agència d’Informació, Avaluació i Qualitat en Salut; 2011.
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