REMOVING PATIENTS FROM AN ORTHOPAEDIC SURGERY WAITING LIST BECAUSE THEY DO NOT REACH THE “FINANCIALLY SUSTAINABLE THRESHOLD” FOR ACCESS TO PUBLICLY FUNDED SERVICES

Abstract

In 2002, one hundred and thirty nine patients had their names removed from the orthopaedic surgical waiting list at Taranaki Base Hospital for financial reasons. They fell below the “financially sustainable threshold” for access to publicly funded services. We wished to determine the status of these patients and the effects of this management decision.

All patients were invited to attend clinic for assessment. They completed the SF-36 Health Survey and were interviewed regarding effects of not having surgery. In addition, hips were assessed using Harris Hip Scores and knees were assessed using Knee Society Scores.

These standardised methods of assessment allowed comparisons to be made with overseas data. Our group of patients are experiencing significant impairment as a result of not being able to have surgery. A number of resulting medical and social problems were identified in the course of assessment. Patients also expressed a high level of discontent with the process.

Removing patients who have been assessed and placed on an orthopaedic surgical waiting list is an inefficient means of utilising health resources. It has also been met with a high level of patient dissatisfaction.