Developing waiting list framework for elective coronary angiography in Shahid Madani Heart Hospital, Tabriz – 2017

Abstract

Abstract: Introduction: Waiting list management and a comprehensive prioritization can ensure timely and appropriate patient care and increase equity in health care delivery. Therefore, this study aimed to develop a waiting list framework for non-emergency patients undergoing angiography. Methods: This study was a qualitative review. The statistical population was selected by purposeful sampling. Systematic review and semi-structured interviews were used to extract the effective factors. The extracted factors were selected by Delphi method and were weighted by paired comparison method. Eventually the framework was finalized with the formation of an expert panel. Results: A total of 81 clinical and 79 nonclinical studies and 42 effective factors were extracted from 45 studies that reviewed the literature. The sum of the factors extracted from the previous steps was evaluated by a panel of experts based on the indigenous conditions of the country and 37 effective factors were selected for discussion after the Delphi study. Based on the results of the Delphi study that took place in two rounds, 7 factors were finally selected. Then, the factors were weighted by 10 experts by paired comparisons, which were weighted by pain severity and symptoms (0.22), stress test (0.18), underlying diseases (0.15), and number of myocardial infarction (0.15), waiting time (0.1), decrease in socio-economic performance (0.12) and special conditions (0.08) were estimated. Conclusion: Providing a comprehensive framework for prioritizing patients in need of coronary angiography that considers all factors and risk factors involved in the decision to receive timely service with regard to all clinical and nonclinical factors can lead to Promote accountability and equity in the health system, especially in the provision of health services.