Online solution for waiting lists in hospitals

• Abstract
• Purpose of health policy or idea
• Characteristics of this policy
• Political and economic background
• Purpose and process analysis
• Expected outcome
• References

Abstract

Given that there were very different data concerning effective waiting list periods in different hospitals, a decision was taken that a national waiting list for a number of the most common conditions should be formed. In order to support such an approach, a web-based solution was developed, which should clearly present the up-to-date situation in Slovenia. The National Institute of Public Health was appointed to carry out this task, because of its role in the reporting system in health care.

Purpose of health policy or idea

The main purposes of this health policy tool were to form a national waiting list system, which would:

• offer information on waiting list times to patients and their relatives as well as to their GPs,
• prevent repetition of input of the same patient,
• set some benchmarking goals for hospitals among them in order to aim for reductions in waiting list times.

There would therefore be three types of benefits - for national health policy, for patients and for hospitals as providers of health care. The instrument is intended as a pure orientation tool and does not incur any financial liability or consequences. It is currently a voluntary system with no specific sanctions in place, but it is supposed to become compulsory with possibly some sanctions for extreme 'outliers'. This question, however, is still under discussion.

Main points

Main objectives

A web-based solution for a monthly insight into the situation with waiting times for the most common diagnostic and therapeutic procedures.

Type of incentives

The main incentive for the providers is currently non-financial and it is the possibility of their patients to have an insight into the situation, thus offering transparency and a certain level of competitiveness.

Groups affected

Hospitals (as providers), patients, Ministry of Health/national health policy makers

Innovationsgrad	traditionell		innovativ
Kontroversität	unumstritten		kontrovers
Strukturelle Wirkung	marginal		fundamental
Medienpräsenz	sehr gering		sehr hoch
Übertragbarkeit	sehr systemabhängig		systemneutral

Political and economic background

Waiting lists in health care have become a very serious political issue and there were a lot of complaints about the lack of transparency in the system. On the one hand, patients had no insight into which hospital would have the shortest waiting times for the treatment they require. On the other hand, patients, striving to overcome the burden of waiting, would sometimes decide to apply for a certain procedure simultaneously in different hospitals.

Change based on an overall national health policy statement

National health policy aimed at reducing waiting times and to provide more transparency both for patients as well as for health care providers.

Purpose and process analysis

Current Process Stages

	Idee	Pilotprojekt	Strategiepapier	Gesetzgebung	Umsetzung	Evaluation	Veränderung/Richtungswechsel
Implemented in this survey?

Origins of health policy idea

The solution proposed is not an authentic Slovenian solution but it builds on the domestic and foreign experience related to the development of centralised support for the waiting list system.

Initiators of idea/main actors

• Regierung

• Leistungserbringer

• Patienten, Verbraucher

Approach of idea

The approach of the idea is described as:
new:

Stakeholder positions

The idea was welcomed both by providers as well as by patient groups. The system will allow for patients to review the situation with waiting lists and to select their potential speediest provider of the services they require.

Actors and positions

Regierung
Health policy	sehr unterstützend		stark dagegen
Leistungserbringer
Hospitals as health care providers	sehr unterstützend		stark dagegen
Patienten, Verbraucher
Patients	sehr unterstützend		stark dagegen

Influences in policy making and legislation

Whether the outcomes of this process would lead to a formal piece of legislation or standing orders by the Minister of Health, it needs to be noted that the pilot implementation and testing of the solution were the most important steps towards its full implementation.

Legislative outcome

n/a

Actors and influence

Regierung
Health policy	sehr groß		kein
Leistungserbringer
Hospitals as health care providers	sehr groß		kein
Patienten, Verbraucher
Patients	sehr groß		kein

Positions and Influences at a glance

Adoption and implementation

Adoption and implementation will be done by the MoH in agreement with the key providers, that is all the hospitals involved. The only tool that is currently missing is the obligation against the contract with the Health Insurance Institute of Slovenia (HIIS) in order to ensure adequate and timely delivery of reports. Patients will be represented by the Consumer Association of Slovenia and will be able to participate in the structuring of the final solution.

Monitoring and evaluation

In itself the solution is open to continued evaluation and monitoring given that it is a 'live' application. Its correspondence to the real situation on ground is the most important factor in evaluating its success and the quality of the data presented.

Review mechanisms

Halbzeitevaluation, Abschlussevaluation (intern)

Dimensions of evaluation

Prozess, Ergebnis

Expected outcome

It is expected that there will be better co-ordination of access to certain procedures, which had the longest waiting lists in the past. Also, the waiting times now serve as benchmarks in attracting patients. As these procedures commonly yield decent incomes and are of important volumes even to smaller providers, a certain level of competition is going to be observed. The most important limiting factor to this process is the shortage of health professionals which may have adverse effects on the availability of certain services and procedures.

Impact of this policy

Qualität	kaum Einfluss		starker Einfluss
Gerechtigkeit	System weniger gerecht		System gerechter
Kosteneffizienz	sehr gering		sehr hoch

References

Sources of Information

Ministry of Health: www.mz.gov.si

Institute of Public Health of Slovenia - online application: http://ivztest.marg.si/Pages/Anonimni_CakalneDobe.aspx

Author/s and/or contributors to this survey

Albreht, Tit

Empfohlene Zitierweise für diesen Online-Artikel:

Albreht, Tit. "Online solution for waiting lists in hospitals". Health Policy Monitor, October 2007. Available at http://www.hpm.org/survey/si/a10/1