[Linear points system for prioritizing the waiting list in a general surgery service].

Abstract

Objective: To design a linear points system to prioritize patients on the waiting list for a general surgery service.

Method: Using a mixed technique (nominal groups and pretesting), criteria and levels for the prioritization system were selected based on the preferences expressed by surgeons and patients in a general surgery service. A subset of the possible combinations of criteria and levels was evaluated by two samples of general population (n=474) and surgical professionals (n=20), through a ranking exercise. The model coefficients (system scores) were estimated using ordered logistic regression. A second sample from the general population (n=120) was used to validate the points system.

Results: A linear points system was developed with five criteria or attributes, each with two or three levels. The scores, calculated as averages from the samples, assigned significant importance to clinical aspects (e.g., risk of deterioration while waiting), but also considered patients' quality of life (pain/discomfort and limitations in daily activities), as well as social criteria (work-related limitations).

Conclusions: Prioritization systems help improve equity in access to healthcare and can contribute to reducing waiting times. Considering social criteria, alongside strictly clinical ones, aligns with the World Health Organization's definition of health.