Equitable service provision: a feasibility study of the common waiting lists model

Area of Science:

• Health Services Research
• Surgical Outcomes
• Healthcare Management

Background:

• Long waiting lists for surgical procedures remain a persistent challenge for healthcare systems.
• Current referral practices lead to significant variations in waiting times based on consultant choice.
• Healthcare reforms have inadvertently created a two-tiered service, exacerbating inequities.

Purpose of the Study:

• To evaluate the feasibility and impact of common waiting lists for high-volume routine surgical procedures.
• To assess case severity differences among surgeons performing specific procedures.
• To explore strategies for improving equity and efficiency in surgical patient pathways.

Main Methods:

• A pilot study was conducted for arthroscopic knee examination and inguinal hernia repair.
• Case severity was compared between patients referred to different general and orthopaedic surgeons.
• The proportion of procedures performed by middle-grade doctors was analyzed.

Main Results:

• No statistically significant differences in case severity were found between patients of different surgeons.
• A substantial number of operations were performed by middle-grade doctors.
• Current waiting times vary considerably, leading to inequitable patient experiences.

Conclusions:

• Common waiting lists at the departmental level are a viable solution for routine surgical procedures.
• This model promotes equitable access to care and has the potential to increase operational efficiency.
• Serious consideration should be given to implementing common waiting lists to address systemic inequities.