The application of Fuzzy Delphi Method for evaluating biopsychosocial factors for prioritization of patients

Unprioritized waiting lists are a common issue in publicly funded healthcare systems. Prioritization of patients is an effort to provide care to patients in need and those who can benefit more from it, while ensuring transparency, equity, and certainty. Prioritization is affected by biopsychosocial factors that involve procedure, wait time, disease, clinical and socio-economic conditions of the patient. The objective of the paper is to systematically identify biopsychosocial factors for prioritization of patients on waiting lists with a methodology of assigning weights to the identified factors. The choosen objectives and its application are based on hospital conditions, and in consultation with the surgeons in hospital in Pakistan. The proposed methodology presents identification, selection and assignments of weights to biopsychosocial factors for prioritization of waiting lists patients through Root Cause Analysis and Fuzzy Delphi Method. Case study of patients on surgical waiting list has been presented to demonstrate the proposed methodology. During initial research, eleven papers having 192 biopsychosocial factors were identified. The application of the proposed methodology resulted in finalization of 17 biopsychosocial factors related to surgical procedures, wait time, disease, and socio-economic conditions of patient. These factors were assigned weights and measurable objectives and observed clinical probabilities by the panel of surgeons. Prioritizing patients on elective surgery waiting lists is a very pressing concern which has been further exacerbated during COVID-19 pandemic. Previously, as the weighted biopsychosocial factors affecting prioritization were not considered objectively, the present study proposes a methodology that systematically and objectively identify and assign weights to biopsychosocial factors.