Specific Guidelines Needed To Prioritise Elective Surgery Waiting Lists, Australia

Main Category: Public Health
Article Date: 15 Feb 2010 - 4:00 PDT


A lack of specific guidelines to help surgeons decide how to prioritise public hospital patients' elective surgery may be compromising patient care, according to an article published in the Medical Journal of Australia.

Dr Andrea Curtis, a Research Fellow at the Department of Epidemiology and Preventive Medicine at Monash University and Prof John McNeil, Head of the Department of Epidemiology and Preventive Medicine at Monash University, and their co-authors write that new evidence-based criteria should be developed to ensure that patients on public hospital elective surgery lists are assigned to the most appropriate urgency category.

"It is essential that those who have the greatest need for surgery and will benefit most from it receive it in a timely manner and before those with lesser need," Prof McNeil said. "However, priority for surgery is determined … by unspecified, intuitive criteria that may vary between doctors."

"The lack of specific guidelines to help surgeons make decisions about patients' need for surgery is a shortcoming of the current Australian system that may compromise patients' equity of access and clinical outcomes.

"Although assignment of urgency categories applies a basic form of prioritisation, it is an informal and relatively insensitive process that does not ensure transparency and equity of access to available services, and does not take into account the numerous factors that can contribute to a patient's urgency for surgery."

Prof McNeil said ensuring equal access to surgery for those with equal need and the quickest access for these with greatest need should be the key goals for a new elective surgery prioritisation system.

"Equity, transparency and certainty should be key elements of the prioritisation system," Prof McNeil said.

"Overseas experiences have highlighted the importance of ensuring the scientific validity of all prioritisation tools.

"This requires debate about the key clinical, social and other patient- or health service-related criteria that should be considered, development of methods for scoring these criteria and a contextual framework."

The Medical Journal of Australia is a publication of the Australian Medical Association.

Source
Medical Journal of Australia

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