Systematic Reviews
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2024; 16(4): 1155-1164
Published online Apr 27, 2024. doi: 10.4240/wjgs.v16.i4.1155
Quality-adjusted life years and surgical waiting list: Systematic review of the literature
Roberto de la Plaza Llamas, Lorena Ortega Azor, Marina Hernández Yuste, Ludovica Gorini, Raquel Aránzazu Latorre-Fragua, Daniel Alejandro Díaz Candelas, Farah Al Shwely Abduljabar, Ignacio Antonio Gemio del Rey
Roberto de la Plaza Llamas, Ludovica Gorini, Raquel Aránzazu Latorre-Fragua, Daniel Alejandro Díaz Candelas, Farah Al Shwely Abduljabar, Ignacio Antonio Gemio del Rey, Department of General and Digestive Surgery, Hospital Universitario de Guadalajara, Guadalajara 19002, Spain
Roberto de la Plaza Llamas, Lorena Ortega Azor, Marina Hernández Yuste, Raquel Aránzazu Latorre-Fragua, Farah Al Shwely Abduljabar, Ignacio Antonio Gemio del Rey, Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares 28871, Madrid, Spain
Author contributions: de la Plaza Llamas R, Ortega Azor L, Hernández Yuste M, Gorini L, Latorre-Fragua RA, Díaz Candelas DA, Al Shwely Abduljabar F, and Gemio del Rey IA contributed to conception and design of the study, acquisition of data, and analysis and interpretation of data; de la Plaza Llamas R, Ortega Azor L, Hernández Yuste M, Gorini L, Latorre-Fragua RA, Díaz Candelas DA, Al Shwely Abduljabar F, and Gemio del Rey IA drafted the article or made critical revisions to important intellectual content in the manuscript; All authors gave final approval of the version of the article to be published.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Roberto de la Plaza Llamas, FACS, MD, MSc, PhD, Associate Professor, Chief Physician, Department of General and Digestive Surgery, Hospital Universitario de Guadalajara, Calle del donante de sangre s/n, Guadalajara 19002, Spain. dlplr@yahoo.es
Received: December 28, 2023
Peer-review started: December 28, 2023
First decision: January 16, 2024
Revised: January 26, 2024
Accepted: February 25, 2024
Article in press: February 25, 2024
Published online: April 27, 2024
ARTICLE HIGHLIGHTS
Research background

The quality-adjusted life year (QALY) is a measure that is being increasingly used in the field of health economics to assess the value of different medical treatments and procedures. Surgical waiting lists (SWL) represent a significant health problem and cause a negative effect on patients’ quality of life and an incalculable social and economic cost.

Research motivation

It would be useful to quantify the QALYs lost in SWLs. This information would help guide healthcare managers’ decisions regarding the allocation of economic resources in the attempt to reduce surgical waiting time in the most cost-effective manner.

Research objectives

The primary aim was to quantify the QALYs lost on SWLs. The secondary aims were to identify: (1) The specialties and surgical procedures in which the QALY metric has been used; (2) The models applied; (3) The quality surveys used to specify QALYs; (4) The countries in which they have been studied; and (5) The willingness-to-pay per QALY.

Research methods

Systematic review of the literature published on QALYs and SWLs. The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. An unlimited search was carried out in PubMed, updated on January 19, 2024, with the following search terms: [(Quality-Adjusted Life Year) OR (QALY)] AND (Surgery) AND [(Waiting list) OR (Waitlist)]. Two independent authors screened the titles and abstracts to select the articles for inclusion. After this first selection, the entire article was read to establish whether it met the inclusion criteria.

Research results

Forty-eight articles were selected for the study. No data were found regarding QALYs lost on SWLs. The specialties in which QALYs were studied the most in relation to the waiting lists were urology and general surgery, with 15 articles each. The country in which the most studies of QALYs were carried out was the United States (n = 21). The most studied procedure was organ transplantation (n = 39). Thirty-nine of the models used were theoretical, and nine were real-life. The survey used to measure quality of life in 11 articles was the European quality of life-5 dimensions, but in 32 articles the survey was not specified. The willingness-to-pay per QALY gained ranged from $100000 in the United States to €20000 in Spain.

Research conclusions

QALYs lost on SWLs have not been accurately determined. The relationship between QALYs and SWLs has only rarely been studied in the literature. Organ transplantation is the most frequently evaluated procedure, and the models used have tended to be theoretical.

Research perspectives

Studies investigating the QALYs that are lost in SWLs are now a priority. The data they provide can improve the distribution of public resources in the attempts to shorten SWLs, reduce costs, and guarantee the provision of quality healthcare.