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Patients’ Prioritization on Surgical Waiting Lists: A Decision Support System

Author

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  • Fabián Silva-Aravena

    (Doctorado en Sistemas de Ingeniería, Faculty of Engineering, Universidad de Talca, Curicó 3340000, Chile
    Departamento de Planificación y Control de Gestión, Hospital Regional de Talca, Talca 3460000, Chile)

  • Eduardo Álvarez-Miranda

    (School of Economics and Business, Universidad de Talca, Talca 3460000, Chile
    Instituto Sistemas Complejos de Ingeniería (ISCI), Santiago 8320000, Chile)

  • César A. Astudillo

    (Department of Computer Science, Faculty of Engineering, Universidad de Talca, Curicó 3340000, Chile)

  • Luis González-Martínez

    (Doctorado en Sistemas de Ingeniería, Faculty of Engineering, Universidad de Talca, Curicó 3340000, Chile)

  • José G. Ledezma

    (Departamento de Planificación y Control de Gestión, Hospital Regional de Talca, Talca 3460000, Chile)

Abstract

Currently, in Chile, more than a quarter-million of patients are waiting for an elective surgical intervention. This is a worldwide reality, and it occurs as the demand for healthcare is vastly superior to the clinical resources in public systems. Moreover, this phenomenon has worsened due to the COVID-19 sanitary crisis. In order to reduce the impact of this situation, patients in the waiting lists are ranked according to a priority. However, the existing prioritization strategies are not necessarily systematized, and they usually respond only to clinical criteria, excluding other dimensions such as the personal and social context of patients. In this paper, we present a decision-support system designed for the prioritization of surgical waiting lists based on biopsychosocial criteria. The proposed system features three methodological contributions; first, an ad-hoc medical record form that captures the biopsychosocial condition of the patients; second, a dynamic scoring scheme that recognizes that patients’ conditions evolve differently while waiting for the required elective surgery; and third, a methodology for prioritizing and selecting patients based on the corresponding dynamic scores and additional clinical criteria. The designed decision-support system was implemented in the otorhinolaryngology unit in the Hospital of Talca, Chile, in 2018. When compared to the previous prioritization methodology, the results obtained from the use of the system during 2018 and 2019 show that this new methodology outperforms the previous prioritization method quantitatively and qualitatively. As a matter of fact, the designed system allowed a decrease, from 2017 to 2019, in the average number of days in the waiting list from 462 to 282 days.

Suggested Citation

  • Fabián Silva-Aravena & Eduardo Álvarez-Miranda & César A. Astudillo & Luis González-Martínez & José G. Ledezma, 2021. "Patients’ Prioritization on Surgical Waiting Lists: A Decision Support System," Mathematics, MDPI, vol. 9(10), pages 1-27, May.
    • Handle: RePEc:gam:jmathe:v:9:y:2021:i:10:p:1097-:d:553580
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    References listed on IDEAS

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    Cited by:

    1. Fabián Silva-Aravena & Jenny Morales, 2022. "Dynamic Surgical Waiting List Methodology: A Networking Approach," Mathematics, MDPI, vol. 10(13), pages 1-23, July.
    2. Fabián Silva-Aravena & Jimmy H. Gutiérrez-Bahamondes & Hugo Núñez Delafuente & Roberto M. Toledo-Molina, 2022. "An Intelligent System for Patients’ Well-Being: A Multi-Criteria Decision-Making Approach," Mathematics, MDPI, vol. 10(21), pages 1-22, October.
    3. Fabián Silva-Aravena & Hugo Núñez Delafuente & César A. Astudillo, 2022. "A Novel Strategy to Classify Chronic Patients at Risk: A Hybrid Machine Learning Approach," Mathematics, MDPI, vol. 10(17), pages 1-17, August.

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