Clinical categorization for elective surgery in Victoria.
OBJECTIVE
The aim of the present paper was to assess trends in clinician's utilization of urgency categories for elective surgery.


METHODS
The present paper reviews the additions to the Victorian elective surgery waiting list for hip replacement and prostatectomy as recorded by the Elective Surgery Information System database. Review of general trends in utilization over two separate 12 month periods were undertaken.


RESULTS
There is inconsistency in categorization of patients referred to the waiting list for hip joint replacement and prostatectomy. An increasing trend to categorize patients as semi-urgent (category 2) in preference to non-urgent (category 3) emerged over this period (category creep). Semi-urgent cases might be competing for access within the category 2 band with less urgent cases.


CONCLUSIONS
There seems to be an increasing imbalance between demand for and availability of elective surgery for lower urgency elective surgical procedures. This imbalance, characterized by lengthening waiting times, means that not all patients will receive treatment within the clinically recommended waiting times. The variable approach to categorization of urgency suggests that the process lacks objectivity and consensus. Simple clinical tools to assist prioritization are currently being evaluated in Victoria (Australia) and other countries.
Russell
Colin
C
Peninsula Health and Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia. crussell@phen.vic.gov.au
Roberts
Maree
M
Williamson
Timothy G
TG
McKercher
Jane
J
Jolly
Simon E
SE
McNeil
John
J
D019644:Arthroplasty, Replacement, Hip; D017558:Elective Surgical Procedures / Q000145:classification*; D006801:Humans; D008297:Male; D011468:Prostatectomy; D014739:Victoria; D014850:Waiting Lists