Rationing of surgery for varicose veins based on the presence or absence of cosmetic symptoms

Tiwari, Alok; Douek, Michael; Ackroyd, Jenny S.

doi:10.1046/j.1365-2753.2002.00362.x

Cited by 4 publications

(6 citation statements)

References 8 publications

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“…4 Indeed, the UK Audit Commission classifies varicose veins as ‘potentially cosmetic’, against the evidence. 5 This reinforces the common misperception that varicose veins are not a significant condition. 6…”

Section: Introductionmentioning

confidence: 53%

Short-term gain for long-term pain? Which patients should be treated and should we ration?

et al. 2013

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Section: Introductionmentioning

confidence: 53%

Short-term gain for long-term pain? Which patients should be treated and should we ration?

et al. 2013

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“…Five studies were identified that examined surgical criteria to determine level of need for potential varicose vein surgery 10,19–22 . These studies were predominantly correlational in nature, where studies aimed to determine whether a relationship exists between the presence and nature of symptoms and the requirement for surgery.…”

Section: Resultsmentioning

confidence: 99%

“…Tiwari et al. conducted a study to assess symptoms of varicose veins and the importance placed on those symptoms by patients in the UK 20 . Fifty consecutive day surgery unit patients undergoing primary varicose vein surgery completed a questionnaire addressing the presence or absence of varicose vein symptoms just before surgery.…”

Section: Resultsmentioning

confidence: 99%

“…Patients' expectations and reasons for seeking treatment for varicose veins have been explored at length in the literature. While it was recognised in much of the literature that patients do not undergo surgery for cosmetic reasons alone, it was suggested that often patients present with symptoms that are not related to their varicose veins, concluding that the presence or absence of symptoms is not a sufficient indicator alone to determine surgical need 20,21 . Specifically, it was suggested that many patients did not in fact require a surgical consult and that a general practitioner who had sufficient education and training to do so could appropriately manage the patients' condition.…”

Section: Discussionmentioning

confidence: 99%

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Policy related to varicose veins in publicly funded elective surgery programs: a comprehensive systematic review

Pearson

Wiechula

Jordan

et al. 2009

International Journal of Evidence-Based Healthcare

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Objectives This systematic review set out to establish best practice in relation to policy for the inclusion/exclusion of varicose vein procedures within public health systems. Inclusion criteria The review considered any studies relating to varicose veins that addressed issues of inclusion/exclusion from publicly funded health systems including criteria for clinical need, contraindications, fit/ready for surgery, policy compliance and issues in relation to surgical training. Search strategy The search strategy sought to find published and unpublished studies that were limited to English. An initial search of Medline and CINAHL was undertaken, followed by an analysis of key words contained in the title, abstract and index terms. A second comprehensive search was then undertaken using Medline, CINAHL, EMBASE, AUSTROM, Health Business FullTEXT Elite and PsycINFO. The search was restricted to the period 1995-2005. Methodological quality Each paper was assessed by two independent reviewers for methodological quality before inclusion in the review using an appropriate critical appraisal instrument from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information software (JBI-SUMARI). Results A total of nine papers were included in the review. Because of the diverse nature of these papers, meta-analysis and synthesis of the results was not possible. For this reason, results are presented in narrative form. The majority of papers included in the review related to the identification of indicators for surgical intervention for the treatment of varicose veins. Other major themes were related to measures of quality of life of patients with varicose veins and the potential for surgical training. Recommendations for practice and research 1 Reasons for presentation should be thoroughly examined before any decision is made regarding surgery for varicose veins and indications documented thoroughly. 2 Every effort should be made to ensure opportunities are available to trainees within the constraints of the system. 3 In considering varicose veins surgery specifically, there would be value in examining further the use of psychometric scales/instruments to assess individual need for surgery. 4 The financial impact of varicose veins surgery should be investigated by way of a cost utility study. 5 Further investigation of the impact of excluding varicose vein surgery on training would be warranted.

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“…6 Despite this impressive evidence base, the funding of operative procedures for non-life-threatening chronic conditions such as chronic venous disease is given low priority worldwide, for example, in the United Kingdom, where SVS has frequently been subject to rationing in the publicly funded National Health Service. 7,8 The prime motivation behind the imposition of limits to health resource allocation is a desire to limit spending. 9,10 Some might argue that given ever-increasing patient expectations, technological advances, and costs, rationing is inevitable within any health care system.…”

mentioning

confidence: 99%

A comparison of the changes in generic quality of life after superficial venous surgery with those after laparoscopic cholecystectomy

Sam

Darvall

Adam

et al. 2006

Journal of Vascular Surgery

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Rationing of surgery for varicose veins based on the presence or absence of cosmetic symptoms

Cited by 4 publications

References 8 publications

Short-term gain for long-term pain? Which patients should be treated and should we ration?

Short-term gain for long-term pain? Which patients should be treated and should we ration?

Policy related to varicose veins in publicly funded elective surgery programs: a comprehensive systematic review

A comparison of the changes in generic quality of life after superficial venous surgery with those after laparoscopic cholecystectomy

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