Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Med J Aust. 2010 Feb 15;192(4):217-20. doi: 10.5694/j.1326-5377.2010.tb03482.x.
In the Australian public health system, access to elective surgery is rationed through the use of waiting lists in which patients are assigned to broad urgency categories. Surgeons are principally responsible for referring patients to waiting lists, deciding on the appropriate urgency category, and selecting patients from the waiting list to receive surgery. There are few agreed-upon criteria to help surgeons make these decisions, leading to striking differences between institutions in proportions of patients allocated to urgency categories. In other countries with publicly funded health systems, programs have been developed that aim to make prioritisation more consistent and access to surgery more equitable. As demand for health care increases, similar programs should be established in Australia using relevant clinical and psychosocial factors. Prioritisation methodology adapted for elective surgery may have a role in prioritising high-demand procedures in other areas of health care.
在澳大利亚的公共卫生系统中，通过使用等待名单来配给选择性手术，患者被分配到广泛的紧急类别中。外科医生主要负责将患者转介到等待名单上，决定适当的紧急类别，并从等待名单中选择接受手术的患者。几乎没有达成共识的标准来帮助外科医生做出这些决定，导致不同机构之间在分配给紧急类别患者的比例上存在显著差异。在其他拥有公共资助卫生系统的国家，已经制定了旨在使优先级排序更加一致、手术机会更加公平的计划。随着对医疗保健需求的增加，澳大利亚应该使用相关的临床和社会心理因素来建立类似的计划。为选择性手术量身定制的优先级排序方法可能在优先考虑其他卫生保健领域的高需求程序方面发挥作用。
