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Prioritization and surgical wait lists: A cross-sectional survey of patient's health-related quality of life.

Guo MY, Crump RT, Karimuddin AA, Liu G, Bair MJ, Sutherland JM. Prioritization and surgical wait lists: A cross-sectional survey of patient's health-related quality of life. Health policy (Amsterdam, Netherlands). 2022 Feb 1; 126(2):99-105.

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INTRODUCTION: In many countries, there are waits for elective (planned) surgery. In these settings, processes for triaging patients are applied to determine how long patients wait for their surgery. There are very few instances that evaluate the effectiveness of surgical triage processes. METHODS: A sample of patients from four acute care hospitals in Vancouver, Canada, completed a number of patient-reported outcomes shortly after being registered on the surgical wait list. Patients' diagnosis was used to triage and determine their expected wait for surgery. The associations between patient-reported outcomes with surgical triage were measured. RESULTS: The mean wait times for participants were similar across wait times categories. Participants whose expected waits for surgery were the longest reported successively lower levels of self-rated health (p  <  0.01) and successively higher levels of pain (p  <  0.01.) There was no difference in symptoms of anxiety among participants expected to wait the longest. DISCUSSION: The diagnosis-based system for prioritizing patients found higher levels of pain and lower health status among those expected to wait the longest for their surgery. Screening waiting patients for treatable mental health conditions should be implemented and the process of surgical triage could be redesigned to allow for a broader set of attributes of health to determine how long a patient waits for their elective surgery.

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