Waiting time prioritisation for specialist services in Italy: the homogeneous waiting time groups approach.

The demand for referrals and diagnostic procedures in Italy has been rising constantly in recent years, making access to diagnostic services increasingly difficult with significant waiting times. A number of Health Authorities (known as Local Health Units) have responded by implementing formalised waiting-time prioritisation tools, giving rise to what are known as Homogeneous Waiting Groups (HWGs). The study describes the implementation of the HWG approach in Italy. This represents a promising tool for improving the prioritisation of patients waiting to see a specialist or to receive a diagnostic test. The study of the Italian HWG experience provides useful insights to improve the outpatient referral process for those countries where the demand prioritisation policies have focused more on inpatient care than outpatient specialist care and diagnostic services.

[1]  V. Heimly,et al.  Standardization, innovation and deployment of electronic referral software in Norway , 2008, Journal of telemedicine and telecare.

[2]  Sowmya R. Rao,et al.  Electronic health records in ambulatory care--a national survey of physicians. , 2008, The New England journal of medicine.

[3]  G. de Pretis,et al.  Improving the appropriateness of referrals and waiting times for endoscopic procedures , 2008, Journal of health services research & policy.

[4]  Cynthia Fraser,et al.  Interventions to improve outpatient referrals from primary care to secondary care. , 2008, The Cochrane database of systematic reviews.

[5]  Larry Constantine,et al.  Change agents , 1995 .

[6]  O. Norheim Clinical priority setting , 2008, BMJ : British Medical Journal.

[7]  William G Paterson,et al.  Canadian consensus on medically acceptable wait times for digestive health care. , 2006, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[8]  Penelope M. Mullen,et al.  Prioritising waiting lists: how and why? , 2003, Eur. J. Oper. Res..

[9]  John Goddard,et al.  Efficiency and welfare implications of managed public sector hospital waiting lists , 2008, Eur. J. Oper. Res..

[10]  Giovanni Fattore,et al.  Chapter 7. Italy , 2013 .

[11]  David W Bates,et al.  "I wish I had seen this test result earlier!": Dissatisfaction with test result management systems in primary care. , 2004, Archives of internal medicine.

[12]  Jeremy Hurst,et al.  Explaining Waiting Times Variations for Elective Surgery Across OECD Countries , 2003 .

[13]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[14]  L. R. Hoffman,et al.  Management of Organizational Behavior. , 1970 .

[15]  G. Fattore,et al.  Review of waiting times policies. Country case studies: Italy , 2013 .

[16]  D C Hadorn,et al.  Waiting for scheduled services in Canada: development of priority-setting scoring systems. , 2003, Journal of evaluation in clinical practice.

[17]  K. Gunning,et al.  Guidelines, compliance, and effectiveness: a 12 months’ audit in an acute district general healthcare trust on the two week rule for suspected colorectal cancer , 2002, Postgraduate medical journal.

[18]  B. Leese,et al.  Urgent GP referrals for suspected lung, colorectal, prostate and ovarian cancer. , 2006, The British journal of general practice : the journal of the Royal College of General Practitioners.

[19]  M. Frommer,et al.  Waiting lists in NSW public hospitals , 1995 .

[20]  C. Anthony Di Benedetto,et al.  Diffusion of Innovation , 2015 .