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Prioritising waiting lists.

C Gudex1, A Williams, M Jourdan

  • 1Centre for Health Economics, University of York.

Health Trends
|December 10, 1989
PubMed
Summary

General surgeons evaluated patient conditions on surgical waiting lists. Anal fissures offered the most benefit relative to resources, unlike varicose veins and epigastric hernias, indicating a more rational approach to prioritizing treatments.

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Area of Science:

  • Health Services Research
  • Surgical Outcomes
  • Resource Allocation

Background:

  • Surgical waiting lists present challenges in resource allocation and patient prioritization.
  • Assessing the true benefit of treatments versus resource utilization is crucial for efficient healthcare delivery.

Purpose of the Study:

  • To evaluate and compare the net health benefits of treating common general surgical conditions.
  • To determine which treatments offer the greatest benefit per unit of constrained resources (operating time, length of stay).

Main Methods:

  • Five general surgeons independently rated 22 conditions on a surgical waiting list.
  • Estimates included peri-operative mortality, treatment benefit, life expectancy, and quality of life.
  • Quality-adjusted life-years (QALYs) were calculated to quantify net benefits, related to resource use.

Main Results:

  • Anal fissures were identified as the least resource-intensive condition relative to benefits generated.
  • Varicose veins and epigastric hernias were found to be more resource-intensive.
  • The study provides a method for a rational interpretation of waiting list data.

Conclusions:

  • The developed approach offers a more rational basis for interpreting surgical waiting list data.
  • Prioritizing treatments based on benefit-to-resource ratios can optimize healthcare efficiency.
  • Further studies across different specialties and locations are recommended to validate this methodology.

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