Gestión de la lista de espera y criterios de priorización en los tratamientos de reproducción asistida en los centros del Sistema Nacional de Salud de España

Introduction

In the current context, The National Health System Assisted Reproduction working teams need to coordinate themselves to ensure that the waiting list management is equitable and efficient avoiding great inequalities between centers. To this end, prioritization criteria must be protocolized and agreed according to quality standards, and these protocols must be followed with total transparency by all professionals. The aim of this study is to analyze with the Hanlon methodology different conditions that can be prioritized in assisted reproduction programs.

The National Health System Assisted Reproduction working teams need to coordinate themselves to ensure that the waiting list management is equitable and efficient avoiding great inequalities between centers.

Material and methods

A working group composed of 9 experts from public centers located in 7 autonomous communities have identified 14 conditions susceptible to prioritization by means of modal analysis through brainstorming. These conditions have been evaluated with the Hanlon methodology, scoring the magnitude, severity, feasibility and effectiveness of each condition, adapting the model to the specific circumstances. Based on the score obtained for each of the conditions, 4 levels of priority have been established and the maximum deadlines for their attention.

Results

Recently diagnosed oncological diseases in both, men and women should be given absolute priority, and procedures must be performed in less than one month. Urgent care (1–6 months) should be provided to people with oncological diseases who have overcome the disease and women over 39 years with low ovarian reserve. Less urgent care (6–9 months) is required for non-oncological diseases, endometriosis, and women aged over 39 years.

Conclusions

The health authorities should use this information when establishing maximum waiting times if the purpose is to maintain the equity of the public system.

Each assisted reproduction center should analyze the demanding care population and features in order to establish its self-prioritization systems.