Clinicians' reported use of clinical priority assessment criteria and their attitudes to prioritization for elective surgery: a cross-sectional survey.
OBJECTIVE
To explore the attitudes of clinicians working in New Zealand publicly funded hospitals towards prioritizing patients for elective surgery, and their reported use of clinical priority assessment criteria (CPAC).


METHODS
A cross-sectional study using a postal questionnaire. The questionnaire drew on themes identified from an earlier qualitative study. Questions were closed and information was sought about perceptions of the need to prioritize patients, effective ways of doing so and the use of CPAC.


METHODS
New Zealand.


METHODS
A national sample of cardiologists, cardiac, general and orthopaedic surgeons, and registrars.


RESULTS
Three hundred and thirty-two clinicians responded to the survey (74.1%). Respondents generally agreed that a nationally consistent method of prioritizing patients for surgery was required but felt their clinical judgement was the most effective way of prioritizing patients. Current CPAC were considered to be administrative tools and there was marked variation in their reported use. Consistent use of CPAC using the constructs provided was more likely to be reported by cardiac specialists than general or orthopaedic surgeons. Other features of the hospital system in which surgeons worked also had a major impact on access to elective surgery.


CONCLUSIONS
Clinicians recognized the need for a nationally consistent method of prioritizing patients. Although most did not consider current CPAC were effective in achieving this, many felt there was some potential in further development of tools. However, further development is problematic in the absence of objective measures of need and ability to benefit.
McLeod
Deborah
D
Department of General Practice, Wellington School of Medicine and Health Sciences, Wellington, New Zealand. dmcleod@wnmeds.ac.nz
Morgan
Sonya
S
McKinlay
Eileen
E
Dew
Kevin
K
Cumming
Jackie
J
Dowell
Anthony
A
Love
Tom
T
D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003625:Data Collection; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D015276:Health Care Rationing; D006292:Health Priorities; D006801:Humans; D009520:New Zealand; D018579:Patient Selection; D010820:Physicians / Q000523:psychology*; D017064:Process Assessment, Health Care; D013222:State Medicine; D011795:Surveys and Questionnaires