Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 6;9(1):227.
doi: 10.1186/s13643-020-01482-8.

A systematic review of patient prioritization tools in non-emergency healthcare services

Julien Déry  1   2 , Angel Ruiz  2   3   4 , François Routhier  1   2 , Valérie Bélanger  4   5 , André Côté  3   6   7 , Daoud Ait-Kadi  2   4   8 , Marie-Pierre Gagnon  6   9 , Simon Deslauriers  1   2 , Ana Tereza Lopes Pecora  2 , Eduardo Redondo  3   4 , Anne-Sophie Allaire  2 , Marie-Eve Lamontagne  10   11
Affiliations

A systematic review of patient prioritization tools in non-emergency healthcare services

Julien Déry et al. Syst Rev. .

Abstract

Background: Patient prioritization is a strategy used to manage access to healthcare services. Patient prioritization tools (PPT) contribute to supporting the prioritization decision process, and to its transparency and fairness. Patient prioritization tools can take various forms and are highly dependent on the particular context of application. Consequently, the sets of criteria change from one context to another, especially when used in non-emergency settings. This paper systematically synthesizes and analyzes the published evidence concerning the development and challenges related to the validation and implementation of PPTs in non-emergency settings.

Methods: We conducted a systematic mixed studies review. We searched evidence in five databases to select articles based on eligibility criteria, and information of included articles was extracted using an extraction grid. The methodological quality of the studies was assessed by using the Mixed Methods Appraisal Tool. The article selection process, data extraction, and quality appraisal were performed by at least two reviewers independently.

Results: We included 48 studies listing 34 different patient prioritization tools. Most of them are designed for managing access to elective surgeries in hospital settings. Two-thirds of the tools were investigated based on reliability or validity. Inconclusive results were found regarding the impact of PPTs on patient waiting times. Advantages associated with PPT use were found mostly in relationship to acceptability of the tools by clinicians and increased transparency and equity for patients.

Conclusions: This review describes the development and validation processes of PPTs used in non-urgent healthcare settings. Despite the large number of PPTs studied, implementation into clinical practice seems to be an open challenge. Based on the findings of this review, recommendations are proposed to develop, validate, and implement such tools in clinical settings.

Systematic review registration: PROSPERO CRD42018107205.

Keywords: Healthcare services; Outcomes; Patient prioritization; Systematic review; Waiting lists.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram from Moher et al. [17]
Fig. 2
Fig. 2
Stakeholders participating in the PPTs development
Fig. 3
Fig. 3
Portion of the 34 PPTs assessed for each aspect of quality
See this image and copyright information in PMC

References

    1. Hurst J, Siciliani L. Tackling excessive waiting times for elective surgery: a comparative analysis of policies in 12 OECD countries. Health Policy. 2003;72(2):201–215. - PubMed
    1. Harding K, Taylor N. Triage in nonemergency services. In: Hall R, editor. Patient flow. Boston: Springer; 2013. pp. 229–250.
    1. Hadorn DC, Steering Committee of the Western Canada Waiting List Project Setting priorities for waiting lists: defining our terms. CMAJ. 2000;163(7):857–860. - PMC - PubMed
    1. Noseworthy T, McGurran J, Hadorn D. Waiting for scheduled services in Canada: development of priority-setting scoring systems. J Eval Clin Pract. 2003;9(1):23–31. doi: 10.1046/j.1365-2753.2003.00377.x. - DOI - PubMed
    1. MacCormick AD, Collecutt WG, Parry BR. Prioritizing patients for elective surgery: a systematic review. ANZ J Surg. 2003;73(8):633–642. doi: 10.1046/j.1445-2197.2003.02605.x. - DOI - PubMed

Publication types