[Waiting list guarantee between medicine and bureaucracy]

Area of Science:

• Health Services Research
• Medical Sociology
• Public Health Policy

Context:

• The increasing implementation of bureaucratic regulations in healthcare services globally aims to control costs and ensure equitable access.
• Norway's guaranteed maximum waiting time policy, introduced in 1990 and revised in 1997, exemplifies such external control over healthcare delivery.
• This regulation impacts physicians' traditional methods of patient prioritization based on disease severity and first-come, first-served principles.

Purpose:

• To investigate the compatibility of Norway's waiting time guarantee with established professional norms for patient prioritization in healthcare.
• To explore the perceptions of healthcare professionals regarding the equity and impact of externally imposed regulations versus professional judgment.

Summary:

• A postal survey of 152 physicians and nurses responsible for patient waiting list allocation in Norway was conducted.
• Results indicate that the majority of respondents do not perceive the waiting time guarantee as promoting more equitable priorities.
• Health professionals appear to adhere more closely to their professional norms than to externally mandated rules, with difficulties in rule interpretation and observed infringements contributing to negative attitudes.

Impact:

• The study suggests that externally imposed healthcare regulations may conflict with professional norms and are not universally perceived as equitable by practitioners.
• Physicians expressed more negative attitudes towards the waiting time guarantee compared to nurses.
• Findings highlight potential challenges in implementing and enforcing bureaucratic healthcare reforms that override professional discretion and established prioritization practices.