Priority assessment of patients for elective general surgery: game on?

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dc.contributor.author MacCormick, Andrew en
dc.contributor.author Tan, Chuan en
dc.contributor.author Parry, Bryan en
dc.date.accessioned 2017-07-25T00:15:10Z en
dc.date.accessioned 2017-10-10T01:33:16Z en
dc.date.issued 2004-03 en
dc.identifier.citation ANZ Journal of Surgery, 74(3):143-145 March 2004 en
dc.identifier.issn 1445-1433 en
dc.identifier.uri http://hdl.handle.net/2292/35935 en
dc.description.abstract Background: Clinical priority assessment criteria (CPAC) are used to generate a score by which patients are prioritized and rationed for elective surgery. It is widely believed that surgeons elevate scores to ensure their patients’ acceptance for elective surgery, colloquially called gaming. The purpose of the present paper was therefore to investigate whether there was a temporal trend to an increase in the assigned priority score from the inception of CPAC to the present. Methods: Priority and weighted inlier equivalent separations (WIES) scores between 23 April 1999 and 23 July 2002 were collected for elective general surgical cases at Auckland Hospital. A total of 5440 cases was retrospectively analysed using multiple regression techniques. Priority score was included as the dependent variable and time as an independent variable. Any change in case complexity over that period was accounted for by including the WIES score as a covariate. Multiple regression was undertaken for the combined surgeons and for individuals. Results: The combined model was statistically significant but accounted for only 17% of the priority score variance. An increase of one WIES unit leads to an increase of 2.7 in priority score (P = 0.0001). The relationship of priority score with time was dependent on the surgeon performing the prioritization. However, only half the surgeons had individual models that indicated gaming. Conclusions: The results show that gaming is occurring but that not all surgeons participate in this. The difference between surgeons’ participation in gaming is a potential source of practice variation in the prioritization process. en
dc.language English en
dc.publisher Wiley en
dc.relation.ispartofseries ANZ Journal of Surgery en
dc.relation.replaces http://hdl.handle.net/2292/34480 en
dc.relation.replaces 2292/34480 en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://sherpa.ac.uk/romeo/issn/1445-1433/ https://authorservices.wiley.com/author-resources/Journal-Authors/licensing-open-access/open-access/self-archiving.html en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Priority assessment of patients for elective general surgery: game on? en
dc.type Journal Article en
dc.identifier.doi 10.1046/j.1445-1433.2003.02911.x en
pubs.issue 3 en
pubs.begin-page 143 en
pubs.volume 74 en
dc.rights.holder Copyright: Wiley en
dc.identifier.pmid 14996162 en
pubs.author-url http://onlinelibrary.wiley.com/doi/10.1046/j.1445-1433.2003.02911.x/abstract en
pubs.end-page 145 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 6918 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Surgery Department en
dc.identifier.eissn 1445-2197 en
pubs.record-created-at-source-date 2010-09-01 en
pubs.online-publication-date 2004-03-01 en
pubs.dimensions-id 14996162 en


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