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基于及时性与公平性的候诊名单管理模式

[Waiting lists management model based on timeliness and justice].

作者信息

Julio Cristian, Wolff Patricio, Vegoña Yarza María

机构信息

Departamento de Ingeniería Industrial, Facultad de Ciencias Físicas y Matemáticas, Universidad de Chile, Santiago, Chile.

Fundación Red Sonreir, Santiago, Chile,

出版信息

Rev Med Chil. 2016 Jun;144(6):781-7. doi: 10.4067/S0034-98872016000600014.

Abstract

Waiting lists for elective surgery are considered a major health policy concern in most countries of the world. The most common reason to explain this phenomenon is that demand exceeds supply. Traditionally, the management of waiting lists has been focused on timeliness of medical attention. The objective of this paper is to present a waiting lists management model that includes the concepts of timeliness and justice simultaneously. We designed a prioritization method based solely on medical criteria. We developed a computer software to register patients, to prioritize and monitor the waiting lists. The system was implemented in 2013 and is currently used in all surgical specialties at a public hospital. The results show that timeliness does not suffice to manage the waiting lists for elective surgery, and therefore it should be complemented with an indicator of justice. Under this management model, hospitals should attempt to balance justice with timeliness of care and prioritize initiatives that improve both indicators at the same time. In addition, we propose using this model to manage the waiting lists of other hospital processes.

摘要

在世界上大多数国家,择期手术等候名单都被视为一项重大的卫生政策关注点。解释这一现象最常见的原因是需求超过供给。传统上,等候名单管理一直侧重于医疗救治的及时性。本文的目的是提出一种同时包含及时性和公平性概念的等候名单管理模式。我们设计了一种仅基于医学标准的优先排序方法。我们开发了一款计算机软件来登记患者、对等候名单进行优先排序并进行监测。该系统于2013年实施,目前在一家公立医院的所有外科专科中使用。结果表明,仅靠及时性不足以管理择期手术的等候名单,因此应辅以公平性指标。在这种管理模式下,医院应尝试在公平性与护理及时性之间取得平衡,并优先开展能同时改善这两个指标的举措。此外,我们建议使用该模式来管理医院其他流程的等候名单。

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