‘Procedures with longest waiting lists most cost-effective’
The procedures with the longest hospital waiting lists are also among the most cost-effective, according to a study — raising questions as to whether our health system is allocating public funds in the best way possible.
The study’s authors argue that the health system and patients may be better served if more funding is focussed on these cost-effective procedures — such as fiberoptic colonoscopy, cataract surgery and gastrointestinal endoscopy — in a bid to reduce long waiting lists.
The study, published this week by a team from Trinity College, argues that many of these treatments come well under the current spending thresholds for cost-effectiveness and that lowering these thresholds further could make health spending more effective by prioritising these procedures.
The research team was led by Dr James O’Mahony, health economist at the Centre for Health Policy and Management at Trinity College in collaboration with members of the School of Medicine.
It surveyed the cost-effectiveness of the interventions with the top 20 waiting lists for inpatient care within Irish public hospitals.
The results show that 19 of the 20 interventions are highly cost-effective relative to current spending guidelines.
“This analysis demonstrates that most interventions with the largest inpatient and day case waiting lists for public health services in Ireland are more cost-effective than the current threshold,” the paper concludes.
“This suggests that a fairer and more efficient allocation of resources could be achieved by reducing the threshold to divert funding from new interventions to currently constrained services.
“Policymakers should take note of the manifest inconsistency and ethical difficulty of large numbers of patients waiting for highly cost-effective care while maintaining an apparently high threshold that lacks an evidence base and is not rigorously enforced.”
“Health service researchers have a responsibility to address the technical challenge of finding an appropriate evidence base for health care resource allocation decision rules.
“Nevertheless, we argue that using waiting lists data represents a pragmatic and tractable way forward in developing evidence required for achieving a threshold that is consistent with its theoretical basis and that serves the objective of improving the health of the Irish population in an equitable and efficient way,” the paper states.
