[在普通外科服务中排序等候名单的线性积分系统]。

IF 1.5
Fernando-Ignacio Sánchez-Martínez, José-María Abellán-Perpiñán, Jorge-Eduardo Martínez-Pérez
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引用次数: 0

摘要

目的:设计一种线性积分系统对普通外科候诊患者进行排序。方法:采用混合技术(名义分组和预测试),根据外科医生和患者在普通外科服务中表达的偏好选择优先级系统的标准和水平。通过排序练习,由普通人群(n=474)和外科专业人员(n=20)两个样本评估可能的标准和水平组合的子集。使用有序逻辑回归估计模型系数(系统分数)。第二个样本来自一般人群(n=120),用于验证积分系统。结果:开发了一个线性积分系统,有五个标准或属性,每个标准或属性有两个或三个级别。从样本中计算出的平均分数对临床方面(例如,等待期间恶化的风险)赋予了显著的重要性,但也考虑了患者的生活质量(疼痛/不适和日常活动的限制)以及社会标准(与工作相关的限制)。结论:优先排序系统有助于提高获得医疗服务的公平性,并有助于减少等待时间。考虑到社会标准,以及严格的临床标准,符合世界卫生组织对健康的定义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Linear points system for prioritizing the waiting list in a general surgery service].

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.

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