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Wide Social Participation in Prioritizing Patients on Waiting Lists for Joint Replacement: A Conjoint Analysis

^* To whom correspondence should be addressed. E-mail: lsampiet{at}clinic.ub.es.

	Abstract

Objective. The aim was to develop a priority scoring system for patients on waiting lists for joint replacement based on a wide social participation, and to analyze the differences among participants. Methods. Conjoint analysis. Focus groups in combination with a nominal technique were employed to identify the priority criteria (N = 36). A rank-ordered logit model was then applied for scoring estimations. Participants (N = 860) represented: consultants, allied-health professionals, patients and their relatives, and the general population of Catalonia. Results. Clinical and social criteria were selected, and their relative importance (over 100 points) was: pain (33), difficulty in doing activities of daily living (21), disease severity (18), limitations on ability to work (10), having someone to look after the patient (9), being a caregiver (6), and recovery probability (4). Estimated criteria coefficients had the expected positive sign and all were statistically significant (P<0.001). There were differences between groups; pain was rated higher by patients/relatives, and difficulty in doing activities was rated lower by patients/relatives and the general public. Most interaction terms for these criteria and groups were significant (P<0.001). Consultants and allied-health professionals had the most similar prioritization pattern (r = 0.97). Conclusion. Both clinical and social criteria are considered for prioritization of joint replacement surgery from a wide social perspective. The preference among professional and social groups varies and this might impact the result of patient prioritization. A wide social participation for obtaining adequate prioritizing systems for patients on waiting lists is desirable. Key words: priority setting; elective surgery; hip/knee replacement; conjoint analysis; preferences; social participation. (Med Decis Making XXXX;XX:xx–xx)

First published on March 25, 2008, doi:10.1177/0272989X08315235

Medical Decision Making 2008;28:554.

A more recent version of this article appeared on July 1, 2008


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