Ending waiting-list mismanagement: principles and practice.

Abstract

2we found that the state of waiting-list information and management systems in Canada is woefully inadequate, particularly for elective procedures. Here, we identify key lessons and outline a number of initiatives that should contribute to more durable solutions both in Canada and in other countries experiencing similar problems. Fairness: a core public expectation Why should we worry about how waiting lists — especially those for elective procedures — are organized and managed? The main reason is fairness or equity. A core underpinning of publicly financed health care systems is “to each according to his or her need.” Assuming that a health care intervention offers a reasonable probability of tangible benefit, those with the greatest need for the intervention should be served first, if all else is equal. The probability that tens of thousands of individual, uncoordinated decisions taken in a large, complex and diverse system will combine to yield fairness for all is vanishingly low. Thresholds for diagnostic or therapeutic intervention in medicine are highly variable. 3