Who gets priority Waiting list management using a scoring system for joint replacement surgery

Background Osteoarthritis is one of the major causes of disability and quality of life. Population aging, increased obesity and life expectancy have increased stiffness and joint replacement, especially on the knee and hip. In studies, joint replacement cost-effective and even cost savings are known. There is a serious challenge to fill the gap between supply and demand. Rationing is the solution to managing important but non-emergency medical conditions in the health system. Although the cost-effective switching operation is cost effective, there is a need for prioritizing patients due to the limited resources of health. The purpose of this report is to examine solutions for rationing the joint replacement. In this report, various prioritization and scoring systems have been evaluated for joint replacement surgery using a public fund.Method According to the main research question, keywords were selected and searched in Persian sources including SID and MAGIRAN and English including PubMed and ISI. Based on the search strategy, 40 articles were find, which 15 were included in the study. In order to have an appropriate viewpoint on the health of Iran, several health professionals and practitioners interviewed about the current way of selecting patients for surgery with the government, and their opinion was questioned from the perspective of the beneficiaries.Results Various scoring systems are running around the world. In our study, the factor that has the most frequent repetition in different systems has been the limitations of doing daily tasks (with 100% repetition). Thereafter, the most frequent was the pain, ability to work and live independently, the amount of movement and the benefit of surgery.Discussion and Conclusion Prioritizing identifies the patient s access to general care for surgery. Despite the differences between different scoring systems, their overall structure is similar and follows the same goal. The most important factor for prioritizing the emergency or non-humanitarian need is the patient s need. The design of the rationing system is recommended according to the circumstances of the country and with the opinion of the concerned stakeholders. The prerequisite is the implementation of a successful scoring system for referral systems. Patients will be referred to specialists if needed by general practitioners, and if they have a surgical indication, they will be placed on the waiting list according to the score obtained from the system.

Keywords:

Prioritizing , joint replacement