Priority Setting with Regard to Placement on Waiting List to a Pain Clinic

Short waiting periods for all patients referred to a pain clinic is desirable but ordinarily not possible. In a questionnaire, 25% of the Swedish anaesthetic pain clinics reported a waiting list exceeding 6 months. The long waiting-time shows that some kind of priority setting is necessary. The aim of the present investigation was to study the feasibility of a rational priority setting based on a ranking procedure. Secretary and nurse priority ranked patients according to a system utilizing the physicians's referral and a questionnaire completed by the patient. These priority ratings were compared to the final ranking by the doctor which was done after an interview without access to the questionnaire. The results of the present investigation show that the secretary as well as two nurses generally ‘overestimated’ the patients' pain problems compared with the priority made by the doctor. However, 12 out of 142 patients' problems were ‘underestimated’ but this was deemed to increase risk in only one case. The possible risks with a delegated ranking procedure have, however, to be judged against the disadvantages of no priority setting at all and the advantages of a rational use of staff members. This experiment has indicated the feasibility of a delegated ranking procedure.

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