Systematic literature review on biopsychosocial factors in the surgical waiting list

Prioritizing patients on elective surgical waiting lists is one of the strategies to reduce waiting times for care, improve Health-Related Quality of Life (HRQoL), and optimize clinical resources. According to the World Health Organization (WHO) recommendations, including biopsychosocial factors in the Clinical Priority Assessment Criteria (CPAC) is critical for an equitable and efficient allocation of surgical treatments. Long waiting lists, decreased Health-Related Quality of life (HRQoL), lack of capacity of health care facilities, and lack of policies to improve these problems negatively affect the population worldwide. This article presents a systematic literature review to identify biopsychosocial factors that can be used for prioritizing patients on surgical waiting lists. 71 articles were studied, finding that the most frequently mentioned biopsychosocial factors are pain and/or discomfort, followed by patient age, disease severity, comorbidities, expected complications after the procedure, ability to work and/or study, efficacy of the procedure and/or expected improvement, time on the waiting list, ability to participate in family/social activities, impact on the disease if surgery is delayed, need for a caregiver, effect on the procedure if surgery is delayed, composition and size of the surgical team, being a caregiver, length of hospital stay, urgency of the procedure, among others. These findings reinforce the importance of a comprehensive assessment of the patient and the environment to improve clinical outcomes and equity in access to surgical interventions by integrating the patient and physician perspectives in pursuit of better outcomes.