Skip to main content

Improving equity of surgical waitlists

Hospital ward with empty beds

Auckland-based surgeons are using a new, improved method to decide where patients sit on surgical waiting lists. 

The COVID-19 pandemic is widely understood to have had a negative effect on equity globally, and an equity adjuster tool has been designed to help address this. 

Navigation teams set up 3 years ago by Te Toka Tumai for Māori and Pacific Peoples patients looked at surgical waitlists and identified some equity issues around access to care. A steering group was created to build an equity adjuster considering 5 key factors. Different weightings are then applied to adjust where someone sits on a surgical waiting list. It’s the clinical service or surgeon who makes the ultimate decision about the waitlist.

The 5 factors are: 

  • clinical priority 
  • time spent on the waitlist 
  • geographic location (isolated areas) 
  • ethnicity 
  • deprivation level. 

 Pilot studies using the equity adjustment tool at Auckland Hospital’s urology surgical service showed a positive impact on equity.  

The equity adjuster tool is now being used across all surgical services at Te Whatu Ora Te Toka Tumai Auckland, including Starship Children’s Hospital. It will soon be rolled-out at Waitematā and Counties Manukau. 

References

  1. Auckland algorithm improves equity of waitlists HINZ, 2023 
  2. New ranking system prioritising patients on ethnicity to improve equity, experts say Stuff, 2023