Developing A Prioritisation Framework for Patients in Need of Coronary Artery Angiography

Background: Effective waiting list management and comprehensive prioritisation can provide timely delivery of appropriate services to ensure that the patient needs are met and increase equity in the provision of health services. We developed a prioritisation framework for patients in need of coronary artery angiography (CAA). Methods: : We used a mixed-methods approach to elicit effective factors that affect CAA patient prioritisation. Informed by a scoping literature review and open semi-structured interviews with 15 experts, the final set of factors was selected using Delphi method. The framework was finalised during expert panel meetings. Results: : 212 effective factors were identified based on the literature review, interviews, and expert panel discussion. Of them, 37 factors were selected for Delphi study. Following two rounds of Delphi discussions, seven final factors were selected and weighed by ten experts using pair-wise comparisons. The following weights were given: the severity of pain and symptoms (0.22), stress testing (0.18), background diseases (0.15), number of myocardial infarctions (0.15), waiting time (0.10), reduction of economic and social performance (0.12), and special conditions (0.08). Conclusion: Clinical effective factors were important for CAA prioritisation framework. Using this framework can potentially lead to improved accountability and justice in the health system.