[Determinants of clinical priority and of actual waiting times for surgical interventions].
OBJECTIVE
To explore determinants of clinical priority and of actual waiting times for elective surgical interventions. DESIGN, SETTING PARTECIPANTS: 405 patients cared for at two general surgery wards, receiving an explicit judgement of clinical priority and whose actual waiting times to surgery were assessed. Clinicalpriority was assessed through 0 (no priority) to 10 (maximum priority).


METHODS
Identification through multivariate regression techniques of the clinical characteristics associated with high clinical priority (score 28) and with shorter actual waiting times.


RESULTS
Patients with cancer, severe pain, relevant impairment in functional status and relevant expert improvement on quality and duration of survival were more frequently attributed a high clinical priority. As for waiting times, presence of cancer was the only factor associated with shorter waitings. Only for cancer patients high priority judgement was associated with shorter waiting times (median 21 vs. 69 days; p < 0.008).


CONCLUSIONS
These findings suggest that actual waiting times are not influenced by the same clinical characteristics that clinicians value when assigning clinical priority. That may have some relevant implications on how waiting lists are managed, if consideration of relevant aspects of patients' needs are missed.
Melotti
Rita Maria
RM
Dipartimento di scienze chirurgiche e anestesiologiche, Università degli studi di Bologna.
Negro
Antonella
A
Amenta
Enrico
E
Taffurelli
Mario
M
Credico
Carmen
C
Grilli
Roberto
R
D000368:Aged; D005260:Female; D006292:Health Priorities; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000601:surgery; D011336:Probability; D013514:Surgical Procedures, Operative; D013997:Time Factors; D014850:Waiting Lists