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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Estimar y comparar las preferencias de los ciudadanos sobre la priorizaci&#243;n de pacientes en lista de espera para cirug&#237;a de cataratas&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todo</span><p class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis de conjunto&#46; Identificaci&#243;n y selecci&#243;n de criterios de priorizaci&#243;n&#58; 4 grupos focales&#47;nominales de poblaci&#243;n general&#44; pacientes&#47;familiares&#44; profesionales relacionados&#44; y especialistas de Catalunya &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>36&#41;&#46; Estimaci&#243;n de las preferencias &#40;puntuaciones de los criterios&#41;&#58; entrevista a una muestra representativa de los 4 grupos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>771&#41; y aplicaci&#243;n del modelo del <span class="elsevierStyleItalic">rank-ordered logit</span>&#46; Las diferencias se estudiaron mediante an&#225;lisis separado por grupo y su comparaci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Los criterios seleccionados y su importancia relative fueron&#58; incapacidad visual &#40;45&#37;&#41;&#44; limitaci&#243;n de las actividades &#40;15&#37;&#41;&#44; limitaci&#243;n para trabajar &#40;14&#37;&#41;&#44; tener alguna persona que le cuide &#40;11&#37;&#41;&#44; ser cuidador &#40;8&#37;&#41; y probabilidad de recuperaci&#243;n &#40;7&#37;&#41;&#46; Existieron diferencias entre grupos en la puntuaci&#243;n de los criterios&#46; La poblaci&#243;n general y los pacientes&#47;familiares valoraron m&#225;s la incapacidad visual que los otros grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; A su vez&#44; estos dos grupos valoraron menos la limitaci&#243;n de las actividades &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; La probabilidad de recuperaci&#243;n fue uno de los menos valorados por todos los grupos&#46; Aunque las correlaciones de las ordenaciones de pacientes hipot&#233;ticos entre grupos fueron altas &#40;r<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;9&#41;&#44; la ordenaci&#243;n final de &#233;stos en la lista de espera podia variar hasta 27 posiciones al aplicar las preferencias obtenidas de un grupo o de otro&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Se consider&#243; relevantes los criterios cl&#237;nicos y los sociales&#46; La existencia de diferencias sobre c&#243;mo deber&#237;an priorizarse los pacientes en espera recomienda tener en cuenta las preferencias de todas las partes afectadas&#46;</p>"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To estimate and compare citizen preferences regarding patient prioritization for cataract surgery&#46;</p> <span class="elsevierStyleSectionTitle">Method</span><p class="elsevierStyleSimplePara elsevierViewall">A conjoint analysis was performed&#46; Priority criteria were identified and selected using 4 focus&#47;nominal groups consisting of the general public&#44; patients&#47;relatives&#44; allied healthprofessionals and specialists from Catalonia &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>36&#41;&#46; Preferences elicitation &#40;score of criteria&#41;&#58; representative sample survey of the above mentioned groups &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>771&#41; and rank-ordered logit model application&#46; Differences were assessed by group analysis and their comparison&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The criteria selected and their relative importance were&#58; visual impairment &#40;45&#37;&#41;&#44; difficulty in performing activities of daily living &#40;ADL&#41; &#40;15&#37;&#41;&#44; limitation of ability to work &#40;14&#37;&#41;&#44; being looked after by someone &#40;11&#37;&#41;&#44; being a caregiver &#40;8&#37;&#41;&#44; and recovery probability &#40;7&#37;&#41;&#46; Differences in scores were observed among groups&#46; Visual impairment was scored more highly by the general public and patients&#47;relatives than by other groups &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; These two groups also assigned less importance to difficulty in performing ADL &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; The probability of recovery was the least scored criterion by most groups&#46; Correlations among the order of hypothetical patient scenarios were high &#40;r<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;9&#41;&#46; However&#44; the final order of patients on the waiting list could differ by up to 27 positions when different group scores were applied&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Social and clinical criteria were considered important&#46; The observed differences among citizens regarding how to prioritize patients on the waiting lists indicates the need to take into account the preferences of all groups of citizens&#46;</p>"
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Vol. 20. Núm. 5.
Páginas 342-351 (septiembre - octubre 2006)
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Vol. 20. Núm. 5.
Páginas 342-351 (septiembre - octubre 2006)
Originales
Open Access
Priorización de pacientes en lista de espera para cirugía de cataratas: diferencias en las preferencias entre ciudadanos
Prioritizing patients on waiting list for cataract surgery:preference differences among citizens
Visitas
968
Laura Sampietro-Coloma,b,
Autor para correspondencia
lsampietro@catsalut.net

Correspondencia: Laura Sampietro-Colom. Travessera de les Corts, 131-159. Edifici Olimpia. 08028 Barcelona. España.
, Mireia Espallarguesa, Mercè Comasc, Eva Rodríguezd, Xavier Castellsc, José Luis Pintoe
a Agencia de Evaluación de Tecnología e Investigación Médicas, España
b Dirección de Planificación y Evaluación, Departamento de Salud,Generalidad de Cataluña, Barcelona, España
c Servicio de Evaluación y Epidemiología Clínica, Instituto Municipal de Asistencia Sanitaria, España
d Departamento de Economía Aplicada, Universidad de Vigo, Vigo, Pontevedra, España
e Centro de Investigación en Economía y Salud, Universidad Pompeu Fabra, Barcelona, España
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Bibliografía
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Estadísticas
Resumen
Objetivos

Estimar y comparar las preferencias de los ciudadanos sobre la priorización de pacientes en lista de espera para cirugía de cataratas.

Método

Análisis de conjunto. Identificación y selección de criterios de priorización: 4 grupos focales/nominales de población general, pacientes/familiares, profesionales relacionados, y especialistas de Catalunya (n=36). Estimación de las preferencias (puntuaciones de los criterios): entrevista a una muestra representativa de los 4 grupos (n=771) y aplicación del modelo del rank-ordered logit. Las diferencias se estudiaron mediante análisis separado por grupo y su comparación.

Resultados

Los criterios seleccionados y su importancia relative fueron: incapacidad visual (45%), limitación de las actividades (15%), limitación para trabajar (14%), tener alguna persona que le cuide (11%), ser cuidador (8%) y probabilidad de recuperación (7%). Existieron diferencias entre grupos en la puntuación de los criterios. La población general y los pacientes/familiares valoraron más la incapacidad visual que los otros grupos (p<0,001). A su vez, estos dos grupos valoraron menos la limitación de las actividades (p<0,001). La probabilidad de recuperación fue uno de los menos valorados por todos los grupos. Aunque las correlaciones de las ordenaciones de pacientes hipotéticos entre grupos fueron altas (r>0,9), la ordenación final de éstos en la lista de espera podia variar hasta 27 posiciones al aplicar las preferencias obtenidas de un grupo o de otro.

Conclusiones

Se consideró relevantes los criterios clínicos y los sociales. La existencia de diferencias sobre cómo deberían priorizarse los pacientes en espera recomienda tener en cuenta las preferencias de todas las partes afectadas.

Palabras clave:
Establecimiento de prioridades
Cirugía electiva
Cataratas
Análisis de conjunto
Preferencias
Participación social
Abstract
Objectives

To estimate and compare citizen preferences regarding patient prioritization for cataract surgery.

Method

A conjoint analysis was performed. Priority criteria were identified and selected using 4 focus/nominal groups consisting of the general public, patients/relatives, allied healthprofessionals and specialists from Catalonia (n=36). Preferences elicitation (score of criteria): representative sample survey of the above mentioned groups (n=771) and rank-ordered logit model application. Differences were assessed by group analysis and their comparison.

Results

The criteria selected and their relative importance were: visual impairment (45%), difficulty in performing activities of daily living (ADL) (15%), limitation of ability to work (14%), being looked after by someone (11%), being a caregiver (8%), and recovery probability (7%). Differences in scores were observed among groups. Visual impairment was scored more highly by the general public and patients/relatives than by other groups (p<0.001). These two groups also assigned less importance to difficulty in performing ADL (p<0.001). The probability of recovery was the least scored criterion by most groups. Correlations among the order of hypothetical patient scenarios were high (r>0.9). However, the final order of patients on the waiting list could differ by up to 27 positions when different group scores were applied.

Conclusions

Social and clinical criteria were considered important. The observed differences among citizens regarding how to prioritize patients on the waiting lists indicates the need to take into account the preferences of all groups of citizens.

Key words:
Priority setting
Elective surgery
Cataract
Conjoint analysis
Preferences
Social participation
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