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Waiting lists and elective surgery: ordering the queue.

Andrea J Curtis1, Colin O H Russell, Johannes U Stoelwinder

  • 1Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia. andrea.curtis@med.monash.edu.au

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Australian public hospitals ration elective surgery access using waiting lists and broad urgency categories. Implementing standardized prioritization criteria, incorporating clinical and psychosocial factors, can improve surgical access equity.

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Area of Science:

  • Public Health
  • Health Services Research
  • Surgical Prioritization

Background:

  • Access to elective surgery in Australia's public health system is managed via waiting lists, with patients assigned to broad urgency categories.
  • Surgeons primarily determine patient referral, urgency allocation, and selection for surgery, often without standardized criteria.
  • This leads to significant inter-institutional variability in patient prioritization and equitable access.

Purpose of the Study:

  • To highlight the need for improved, consistent prioritization methods for elective surgery in Australia.
  • To advocate for the development of programs that enhance the equity of surgical access.
  • To explore the potential application of prioritization methodologies in other high-demand healthcare areas.

Main Methods:

  • The study reviews current practices in Australian public health systems regarding elective surgery waiting lists.
  • It examines the lack of agreed-upon criteria for urgency categorization and patient selection.
  • It references international models for more consistent and equitable prioritization in publicly funded healthcare.

Main Results:

  • Current elective surgery prioritization in Australia lacks standardized criteria, resulting in significant disparities.
  • International examples demonstrate successful programs for more consistent and equitable surgical access.
  • Increasing healthcare demand necessitates the adoption of structured prioritization approaches.

Conclusions:

  • Australia should establish programs for elective surgery prioritization using clinical and psychosocial factors.
  • Standardized prioritization can lead to more equitable access to timely surgical care.
  • Prioritization methodologies developed for surgery may be adaptable to other healthcare domains facing high demand.