Waiting lists and elective surgery: ordering the queue

Abstract

In the Australian public health system, access to elective surgery is rationed through the use of waiting lists in which patients are assigned to broad urgency categories. Surgeons are principally responsible for referring patients to waiting lists, deciding on the appropriate urgency category, and selecting patients from the waiting list to receive surgery. There are few agreed‐upon criteria to help surgeons make these decisions, leading to striking differences between institutions in proportions of patients allocated to urgency categories. In other countries with publicly funded health systems, programs have been developed that aim to make prioritisation more consistent and access to surgery more equitable. As demand for health care increases, similar programs should be established in Australia using relevant clinical and psychosocial factors. Prioritisation methodology adapted for elective surgery may have a role in prioritising high‐demand procedures in other areas of health care.

The goldilocks effect: the rhythms and pace of hospital life

“…Faced with ever-increasing cost constraints as well as demands for services, hospitals have experienced accelerating pressures to step up the pace [6, 13]. For example, time-based targets, such as the rule in Emergency Departments in the United Kingdom and Australia that people need to be seen within four hours [14, 15] and throughput pressures exemplified by elective surgery wait lists [16, 17] are pushing staff to fit more and more tasks into a set amount of time. Work is expanding in other ways too, such as with the introduction of burdensome documentation, rules and regulations [18].…”

Geographic Differences in Hospital Waiting Times

“…Noseworthy et al. (2002), Gravelle and Siciliani (2008) and Curtis et al. (2010) have suggested that a more systematic and consistent system of urgency assignment may bring an outcome that promotes greater equity.…”

Impact of dental National Partnership Agreements on public dental service waiting lists in Queensland

“…Waiting lists further provide a buffer between the demand for services and the capacity of the system to provide these services. They are consistently newsworthy as they are portrayed as one of the major issues experienced in government/tax‐funded health systems 12 . Waiting times for dental care are considered to be one of the major reasons for patient dissatisfaction 13–16 .…”

“…They are consistently newsworthy as they are portrayed as one of the major issues experienced in government/tax-funded health systems. 12 Waiting times for dental care are considered to be one of the major reasons for patient dissatisfaction. [13][14][15][16] It has been reported that those who waited less than 3 months experienced less inconvenience than those that waited for more than 3 months.…”