Instrumentos económicos para la priorización de pacientes en lista de espera: La aplicación de modelos de elección discreta

Abstract

Objectives: To identify which clinical and social characteristics should be used to prioritize patients on the waiting list for elective surgical procedures. Methods: A discrete choice experiment (DCE) was conducted using a representative sample of the general population in Navarre (Spain). The sample was selected through simple random sampling by age and sex quotas, stratified by the areas and municipalities of residence of the population aged more than 18 years old. Data were analyzed using Bayesian methods. Results: The relative weights of attributes show that the most important attributes when prioritizing patients were the disease, the cost of the intervention, and waiting time. As expected, severity of illness was the most important attribute and, contrary to prior expectations, improvements in health were considered less important. These findings show that prioritization according to waiting time alone may not take into account other issues considered important by the general public. Conclusions: Patients should not be prioritized according to waiting time only. An interesting finding that should be analyzed in future is that cost was considered an important prioritization criterion. This study provides a further example of the potential of DCE in health economics. If its limitations are borne in mind, this tool may be useful to develop prioritization scoring systems for patients on waiting lists.