Department of Surgery, University of British Columbia, Vancouver, Canada.
Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Health Policy. 2022 Feb;126(2):99-105. doi: 10.1016/j.healthpol.2021.12.006. Epub 2021 Dec 28.
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.
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.
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.
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.
在许多国家，都存在着选择性（计划性）手术的等待时间。在这些情况下，应用分诊流程来确定患者需要等待多久才能接受手术。很少有研究评估手术分诊流程的有效性。
在加拿大温哥华的四家急性护理医院中抽取了部分患者，他们在登记手术等候名单后不久就完成了多项患者报告的结果。根据患者的诊断对其进行分诊，并确定他们预期的手术等待时间。测量了患者报告的结果与手术分诊之间的关联。
在不同的等待时间类别中，参与者的平均等待时间相似。预计手术等待时间最长的患者，自我报告的健康状况依次较低（p<0.01），疼痛程度依次较高（p<0.01）。预计等待时间最长的患者中，焦虑症状没有差异。
基于诊断的患者优先级排序系统发现，预计等待时间最长的患者疼痛程度更高，健康状况更差。应该对等待手术的患者进行可治疗的心理健康状况筛查，并且可以重新设计手术分诊流程，以纳入更广泛的健康属性，从而确定患者需要等待多久才能接受选择性手术。
