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Development of the General surgery prioritisation tool implemented in New Zealand in 2018

Author

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  • Srikumar, Gajan
  • Eglinton, Tim
  • MacCormick, Andrew D.

Abstract

Patients waitlisted for elective general surgery in New Zealand used to be prioritised by multiple tools that were inconsistent, did not reflect clinical judgement and were not validated. We describe the development and implementation of a national prioritisation tool for elective general surgery in New Zealand, which could be applicable to other OECD countries. The tool aims to achieve equity of access, transparency, reliability and should be aligned with clinical judgement. The General Surgery Prioritisation Tool Working Group commenced development of a prioritisation tool in 2014 which showed strong correlation with clinical judgement (r = 0.89), excellent test-retest reliability (r = 0.98) and significantly lower variability (p < 0.001). Preliminary findings showed no significant difference in scores attributable to age, gender or ethnicity. General Surgeons were in favour of the tool criteria and agreed on the importance of prioritisation; however a minority opposed its introduction. Health organisations and general practitioner groups were in favour, however, along with many surgeons, expressed apprehensions regarding subjectivity, manipulation, equity of access and degree of benefit. Despite reservations, the majority of stakeholders were supportive and through collaboration between clinicians and the government, the tool was implemented in 2018 in New Zealand. Overall, the prioritisation tool is a reliable method of assessing priority, demonstrating transparency and reflecting clinical judgement, with equity of access to be further assessed by evaluation in clinical practice.

Suggested Citation

  • Srikumar, Gajan & Eglinton, Tim & MacCormick, Andrew D., 2020. "Development of the General surgery prioritisation tool implemented in New Zealand in 2018," Health Policy, Elsevier, vol. 124(10), pages 1043-1049.
    • Handle: RePEc:eee:hepoli:v:124:y:2020:i:10:p:1043-1049
    DOI: 10.1016/j.healthpol.2020.07.018
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    References listed on IDEAS

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    1. Solans-Domènech, Maite & Adam, Paula & Tebé, Cristian & Espallargues, Mireia, 2013. "Developing a universal tool for the prioritization of patients waiting for elective surgery," Health Policy, Elsevier, vol. 113(1), pages 118-126.
    2. Vivienne C. Bachelet & Matías Goyenechea & Víctor A. Carrasco, 2019. "Policy strategies to reduce waiting times for elective surgery: A scoping review and evidence synthesis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(2), pages 995-1015, April.
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    Cited by:

    1. Guo, Michael Y. & Crump, R. Trafford & Karimuddin, Ahmer A & Liu, Guiping & Bair, Matthew J. & Sutherland, Jason M., 2022. "Prioritization and surgical wait lists: A cross-sectional survey of patient's health-related quality of life," Health Policy, Elsevier, vol. 126(2), pages 99-105.
    2. Jack Powers & James M. McGree & David Grieve & Ratna Aseervatham & Suzanne Ryan & Paul Corry, 2023. "Managing surgical waiting lists through dynamic priority scoring," Health Care Management Science, Springer, vol. 26(3), pages 533-557, September.
    3. Babashahi, Saeideh & Hansen, Paul & Sullivan, Trudy, 2021. "Creating a priority list of non-communicable diseases to support health research funding decision-making," Health Policy, Elsevier, vol. 125(2), pages 221-228.

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