IDEAS home Printed from https://ideas.repec.org/a/gam/jmathe/v9y2021i10p1097-d553580.html
   My bibliography  Save this article

Patients’ Prioritization on Surgical Waiting Lists: A Decision Support System

Author

Listed:
  • Fabián Silva-Aravena

    (Doctorado en Sistemas de Ingeniería, Faculty of Engineering, Universidad de Talca, Curicó 3340000, Chile
    Departamento de Planificación y Control de Gestión, Hospital Regional de Talca, Talca 3460000, Chile)

  • Eduardo Álvarez-Miranda

    (School of Economics and Business, Universidad de Talca, Talca 3460000, Chile
    Instituto Sistemas Complejos de Ingeniería (ISCI), Santiago 8320000, Chile)

  • César A. Astudillo

    (Department of Computer Science, Faculty of Engineering, Universidad de Talca, Curicó 3340000, Chile)

  • Luis González-Martínez

    (Doctorado en Sistemas de Ingeniería, Faculty of Engineering, Universidad de Talca, Curicó 3340000, Chile)

  • José G. Ledezma

    (Departamento de Planificación y Control de Gestión, Hospital Regional de Talca, Talca 3460000, Chile)

Abstract

Currently, in Chile, more than a quarter-million of patients are waiting for an elective surgical intervention. This is a worldwide reality, and it occurs as the demand for healthcare is vastly superior to the clinical resources in public systems. Moreover, this phenomenon has worsened due to the COVID-19 sanitary crisis. In order to reduce the impact of this situation, patients in the waiting lists are ranked according to a priority. However, the existing prioritization strategies are not necessarily systematized, and they usually respond only to clinical criteria, excluding other dimensions such as the personal and social context of patients. In this paper, we present a decision-support system designed for the prioritization of surgical waiting lists based on biopsychosocial criteria. The proposed system features three methodological contributions; first, an ad-hoc medical record form that captures the biopsychosocial condition of the patients; second, a dynamic scoring scheme that recognizes that patients’ conditions evolve differently while waiting for the required elective surgery; and third, a methodology for prioritizing and selecting patients based on the corresponding dynamic scores and additional clinical criteria. The designed decision-support system was implemented in the otorhinolaryngology unit in the Hospital of Talca, Chile, in 2018. When compared to the previous prioritization methodology, the results obtained from the use of the system during 2018 and 2019 show that this new methodology outperforms the previous prioritization method quantitatively and qualitatively. As a matter of fact, the designed system allowed a decrease, from 2017 to 2019, in the average number of days in the waiting list from 462 to 282 days.

Suggested Citation

  • Fabián Silva-Aravena & Eduardo Álvarez-Miranda & César A. Astudillo & Luis González-Martínez & José G. Ledezma, 2021. "Patients’ Prioritization on Surgical Waiting Lists: A Decision Support System," Mathematics, MDPI, vol. 9(10), pages 1-27, May.
  • Handle: RePEc:gam:jmathe:v:9:y:2021:i:10:p:1097-:d:553580
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/2227-7390/9/10/1097/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/2227-7390/9/10/1097/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Siciliani, Luigi & Moran, Valerie & Borowitz, Michael, 2014. "Measuring and comparing health care waiting times in OECD countries," Health Policy, Elsevier, vol. 118(3), pages 292-303.
    2. Siciliani, Luigi & Hurst, Jeremy, 2005. "Tackling excessive waiting times for elective surgery: a comparative analysis of policies in 12 OECD countries," Health Policy, Elsevier, vol. 72(2), pages 201-215, May.
    3. J Bowers, 2010. "Waiting list behaviour and the consequences for NHS targets," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(2), pages 246-254, February.
    4. Gutacker, Nils & Siciliani, Luigi & Cookson, Richard, 2016. "Waiting time prioritisation: Evidence from England," Social Science & Medicine, Elsevier, vol. 159(C), pages 140-151.
    5. Las Hayas, Carlota & González, Nerea & Aguirre, Urko & Blasco, Juan Antonio & Elizalde, Belen & Perea, Emilio & Escobar, Antonio & Navarro, Gemma & Castells, Xabier & Quintana, Jose María, 2010. "Can an appropriateness evaluation tool be used to prioritize patients on a waiting list for cataract extraction?," Health Policy, Elsevier, vol. 95(2-3), pages 194-203, May.
    6. Julia Witt & Anthony Scott & Richard H. Osborne, 2009. "Designing choice experiments with many attributes. An application to setting priorities for orthopaedic waiting lists," Health Economics, John Wiley & Sons, Ltd., vol. 18(6), pages 681-696, June.
    7. L. Sampietro-Colom & M. Espallargues & E. Rodríguez & M. Comas & J. Alonso & X. Castells & J.L. Pinto, 2008. "Wide Social Participation in Prioritizing Patients on Waiting Lists for Joint Replacement: A Conjoint Analysis," Medical Decision Making, , vol. 28(4), pages 554-566, July.
    8. Sutherland, Jason Murray & Crump, R. Trafford & Chan, Angie & Liu, Guiping & Yue, Elizabeth & Bair, Matthew, 2016. "Health of patients on the waiting list: Opportunity to improve health in Canada?," Health Policy, Elsevier, vol. 120(7), pages 749-757.
    9. Hadorn, D.C., 2000. "Setting Priorities for Waiting Lists: Defining Our Terms," Centre for Health Services and Policy Research 2000:11r, University of British Columbia - Centre for Health Services and Policy Research..
    10. Mullen, Penelope M., 2003. "Prioritising waiting lists: how and why?," European Journal of Operational Research, Elsevier, vol. 150(1), pages 32-45, October.
    11. Hadorn, D.C., 2000. "Setting Priorities for Waiting Lists: Defining Our Terms," Centre for Health Services and Policy Research 2000:11, University of British Columbia - Centre for Health Services and Policy Research..
    12. Oudhoff, Jurriaan P. & Timmermans, D.R.M. & Knol, D.L. & Bijnen, A.B. & Van der Wal, G., 2007. "Prioritising patients on surgical waiting lists: A conjoint analysis study on the priority judgements of patients, surgeons, occupational physicians, and general practitioners," Social Science & Medicine, Elsevier, vol. 64(9), pages 1863-1875, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Fabián Silva-Aravena & Jenny Morales, 2022. "Dynamic Surgical Waiting List Methodology: A Networking Approach," Mathematics, MDPI, vol. 10(13), pages 1-23, July.
    2. Fabián Silva-Aravena & Jimmy H. Gutiérrez-Bahamondes & Hugo Núñez Delafuente & Roberto M. Toledo-Molina, 2022. "An Intelligent System for Patients’ Well-Being: A Multi-Criteria Decision-Making Approach," Mathematics, MDPI, vol. 10(21), pages 1-22, October.
    3. Fabián Silva-Aravena & Hugo Núñez Delafuente & César A. Astudillo, 2022. "A Novel Strategy to Classify Chronic Patients at Risk: A Hybrid Machine Learning Approach," Mathematics, MDPI, vol. 10(17), pages 1-17, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Fabián Silva-Aravena & Jenny Morales, 2022. "Dynamic Surgical Waiting List Methodology: A Networking Approach," Mathematics, MDPI, vol. 10(13), pages 1-23, July.
    2. 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.
    3. Fabián Silva-Aravena & Jimmy H. Gutiérrez-Bahamondes & Hugo Núñez Delafuente & Roberto M. Toledo-Molina, 2022. "An Intelligent System for Patients’ Well-Being: A Multi-Criteria Decision-Making Approach," Mathematics, MDPI, vol. 10(21), pages 1-22, October.
    4. Fabián Silva-Aravena & Hugo Núñez Delafuente & César A. Astudillo, 2022. "A Novel Strategy to Classify Chronic Patients at Risk: A Hybrid Machine Learning Approach," Mathematics, MDPI, vol. 10(17), pages 1-17, August.
    5. Siciliani, L., 2016. "Waiting Time Policies in the Health Sector," Seminar Briefing 001724, Office of Health Economics.
    6. Guillermo Durán & Pablo A. Rey & Patricio Wolff, 2017. "Solving the operating room scheduling problem with prioritized lists of patients," Annals of Operations Research, Springer, vol. 258(2), pages 395-414, November.
    7. Heinrich Nils & Wübker Ansgar & Wuckel Christiane, 2018. "Waiting Times for Outpatient Treatment in Germany: New Experimental Evidence from Primary Data," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 238(5), pages 375-394, September.
    8. Gutacker, Nils & Siciliani, Luigi & Cookson, Richard, 2016. "Waiting time prioritisation: Evidence from England," Social Science & Medicine, Elsevier, vol. 159(C), pages 140-151.
    9. Meiland, F. J. M. & Danse, J. A. C. & Wendte, J. F. & Gunning-Schepers, L. J. & Klazinga, N. S., 2002. "Urgency coding as a dynamic tool in management of waiting lists for psychogeriatric nursing home care in The Netherlands," Health Policy, Elsevier, vol. 60(2), pages 171-184, May.
    10. Mariotti, Giuliano & Siciliani, Luigi & Rebba, Vincenzo & Coretti, Silvia & Gentilini, Maria, 2022. "Consensus among clinicians on referrals’ priority and use of digital decision-making support systems," Health Policy, Elsevier, vol. 126(9), pages 906-914.
    11. Dew, Kevin & Cumming, Jacqueline & McLeod, Deborah & Morgan, Sonya & McKinlay, Eileen & Dowell, Anthony & Love, Tom, 2005. "Explicit rationing of elective services: implementing the New Zealand reforms," Health Policy, Elsevier, vol. 74(1), pages 1-12, September.
    12. Christine A. Yee & Aaron Legler & Michael Davies & Julia Prentice & Steven Pizer, 2020. "Priority access to health care: Evidence from an exogenous policy shock," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 306-323, March.
    13. Carnazza, Giovanni & Liberati, Paolo & Resce, Giuliano, 2023. "Income-related unmet needs in the European countries," Socio-Economic Planning Sciences, Elsevier, vol. 87(PA).
    14. Kelly, Mark & Kuhn, Michael, 2022. "Congestion in a public health service: A macro approach," Journal of Macroeconomics, Elsevier, vol. 74(C).
    15. Acuna, Jorge A. & Cantarino, Daniela & Martinez, Rodrigo & Zayas-Castro, José L., 2024. "A two-stage stochastic game model for elective surgical capacity planning and investment," Socio-Economic Planning Sciences, Elsevier, vol. 91(C).
    16. Gevaert, Koen & Keinemans, Sabrina & Roose, Rudi, 2018. "Deciding on priorities in youth care: A systematic literature review," Children and Youth Services Review, Elsevier, vol. 95(C), pages 191-199.
    17. Christine A. Yee & Kyle Barr & Taeko Minegishi & Austin Frakt & Steven D. Pizer, 2022. "Provider supply and access to primary care," Health Economics, John Wiley & Sons, Ltd., vol. 31(7), pages 1296-1316, July.
    18. Igor Sheiman, 2019. "Maximum Waiting Times Guarantee In Russia: Does It Improve Access To Health Care?," HSE Working papers WP BRP 23/PSP/2019, National Research University Higher School of Economics.
    19. Wang, Qinan, 2004. "Modeling and analysis of high risk patient queues," European Journal of Operational Research, Elsevier, vol. 155(2), pages 502-515, June.
    20. Testi, Angela, 2012. "Rationalizing Waiting Times in Health Care Delivery: An International Comparison - Governare i tempi di attesa in sanità: un confronto internazionale Comparison -," Economia Internazionale / International Economics, Camera di Commercio Industria Artigianato Agricoltura di Genova, vol. 65(1), pages 189-201.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jmathe:v:9:y:2021:i:10:p:1097-:d:553580. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.