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Patients' views on priority setting in neurosurgery: A qualitative study.

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Neurosurgical patients support fair operating theater (OT) prioritization systems but suggest improvements. Key changes include prioritizing canceled surgeries and reducing emphasis on volume-funded cases for better healthcare system trust.

Keywords:
brain tumorsneurosurgeryoperative experiencetheater time utilization

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Area of Science:

  • Health Services Research
  • Medical Ethics
  • Neurosurgery

Background:

  • The Accountability for Reasonableness framework guides fair priority setting in healthcare.
  • Limited research exists on patient perspectives regarding operating theater (OT) time allocation, especially in resource-constrained neurosurgery settings.

Purpose of the Study:

  • To investigate neurosurgical patients' views on the daily prioritization system for allocating OT time.
  • To understand patient acceptance and suggestions for improving fairness in resource allocation within a tertiary and quaternary referral center.

Main Methods:

  • Qualitative study involving semi-structured interviews with 37 neurosurgery patients.
  • Inclusion of accompanying family and friends in discussions.
  • Thematic analysis of transcribed interviews using open and axial coding.

Main Results:

  • Patients generally approve of fairness-based prioritization systems for OT time.
  • Suggested improvements include prioritizing canceled surgeries and de-emphasizing volume-funded cases.
  • Effective communication, timely notification, and prompt rescheduling of canceled surgeries enhance patient confidence in the healthcare system.

Conclusions:

  • This is the first qualitative study to explore patient perspectives on OT time prioritization in neurosurgery within a socialized healthcare system.
  • Findings highlight the importance of patient input in refining resource allocation policies to improve fairness and trust.