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Use of, and attitudes to, clinical priority assessment criteria in elective surgery in New Zealand

NZ Literature Abstract

posted by Research Admin on 20 April 2010

Authors

Deborah McLeod
Sonya Morgan
Eileen McKinlay
Kevin Dew
Jacqueline Cumming
Anthony C. Dowell
Tom Love

Year of Publication

2004

Source

Journal of Health Services Research and Policy, 9(2), 91-99

Publication Type

Journal article (peer reviewed)

Publication Status

Completed

Abstract

This qualitative study in selected New Zealand localities aimed to describe the ways patients access elective surgery in New Zealand, and to understand the use of, and attitudes to, clinical priority assessment criteria (CPAC) in determining access to publicly funded elective surgery. A purposive sample of general practitioners, surgeons and administrators in publicly funded hospitals were interviewed. Data were analysed by a process of thematic analysis. Sixty-five interviews were completed. General practitioners had a key role in determining which patients were seen in the public sector and, by utilising strategies to actively advocate for patients. CPAC had been developed with the intention that they would provide transparency and equity in determining access. However, there was variation in the way CPAC were being used both in score construction and in the influence of the score on access to surgery. The management of the hospital system also limited the extent to which CPAC could be used to prioritise patients for surgery. The authors conclude that variability in the use of CPAC tools meant that at the time of the study they did not provide a transparent and equitable method of determining access to surgery. They suggest that further development is difficult in the absence of evidence to identify patients who will benefit the most from surgery.

Type of Study

Qualitative