Insights into how universal, tax-funded, single payer health systems manage their waiting lists: A review of the literature.

IF 1.6 Q3 HEALTH POLICY & SERVICES
Health Services Management Research Pub Date : 2024-08-01 Epub Date: 2023-07-02 DOI:10.1177/09514848231186773
Francesco Amigoni, Federico Lega, Elena Maggioni
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引用次数: 0

Abstract

Background: A conspicuous consequence of gatekeeping arrangements in universal, tax-funded, single-payer health care systems is the long waiting times. Besides limiting equal access to care, long waiting times can have a negative impact on health outcomes. Long waiting times can create obstacles in a patient's care pathway. Organization for Economic Co-operation and Development (OECD) countries have implemented various strategies to tackle this issue, but there is little evidence for which approach is the most effective. This literature review examined waiting times for ambulatory care. Objective: The aim was to identify the main policies or combinations of policies universal, tax-funded, and single-payer healthcare systems have implemented to improve the governance of outpatient waiting times. Methods: Starting from 1040 potentially eligible articles, a total of 41 studies were identified via a 2-step selection process. Findings: Despite the relevance of the issue, the literature is limited. A set of 15 policies for the governance of ambulatory waiting time was identified and categorized by the type of intervention: generation of supply capacity, control of demand, and mixed interventions. Even if a primary intervention was always identifiable, rarely a policy was implemented solo. The most frequent primary strategies were: guidelines implementation and/or clinical pathways, including triage, guidelines for referral and maxim waiting times (14 studies), task shifting (9 studies), and telemedicine (6 studies). Most studies were observational, with no data on costs of intervention and impact on clinical outcomes.

洞察由税收资助的全民单一支付医疗系统如何管理候诊名单:文献综述。
背景:在由税收资助的全民单一付费医疗系统中,把关安排的一个显著后果就是漫长的候诊时间。除了限制平等获得医疗服务的机会外,漫长的等候时间还会对健康结果产生负面影响。漫长的候诊时间会给病人的治疗路径造成障碍。经济合作与发展组织(OECD)国家已实施了各种策略来解决这一问题,但几乎没有证据表明哪种方法最有效。本文献综述研究了非住院治疗的候诊时间。目的:旨在确定全民医疗保健系统、税收资助医疗保健系统和单一支付者医疗保健系统为改善门诊病人候诊时间管理而实施的主要政策或政策组合。方法:从 1040 项可能符合条件的政策中筛选出 1040 项:从 1040 篇可能符合条件的文章中,经过两步筛选,共确定了 41 项研究。研究结果尽管该问题具有相关性,但文献却很有限。研究确定了 15 项门诊候诊时间管理政策,并按干预类型进行了分类:创造供应能力、控制需求和混合干预。即使总能找到主要干预措施,但很少有政策是单独实施的。最常见的主要策略是:实施指南和/或临床路径,包括分流、转诊指南和最长等候时间(14 项研究)、任务转移(9 项研究)和远程医疗(6 项研究)。大多数研究都是观察性的,没有关于干预成本和对临床结果影响的数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health Services Management Research
Health Services Management Research HEALTH POLICY & SERVICES-
CiteScore
4.00
自引率
4.80%
发文量
33
期刊介绍: Health Services Management Research (HSMR) is an authoritative international peer-reviewed journal which publishes theoretically and empirically rigorous research on questions of enduring interest to health-care organizations and systems throughout the world. Examining the real issues confronting health services management, it provides an independent view and cutting edge evidence-based research to guide policy-making and management decision-making. HSMR aims to be a forum serving an international community of academics and researchers on the one hand and healthcare managers, executives, policymakers and clinicians and all health professionals on the other. HSMR wants to make a substantial contribution to both research and managerial practice, with particular emphasis placed on publishing studies which offer actionable findings and on promoting knowledge mobilisation toward theoretical advances.
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