Wide social participation in prioritizing patients on waiting lists for joint replacement: A conjoint analysis

L. Sampietro-Colom, M. Espallargues, E. Rodríguez, M. Comas, J. Alonso, X. Castells, J. L. Pinto

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27 Citations (Scopus)


Objective. The aim was to develop a priority scoring system for patients on waiting lists for joint replacement based on a wide social participation, and to analyze the differences among participants. Methods. Conjoint analysis. Focus groups in combination with a nominal technique were employed to identify the priority criteria (N=36). A rank-ordered logit model was then applied for scoring estimations. Participants (N=860) represented: consultants, allied-health professionals, patients and their relatives, and the general population of Catalonia. Results. Clinical and social criteria were selected, and their relative importance (over 100 points) was: pain (33), difficulty in doing activities of daily living (21), disease severity (18), limitations on ability to work (10), having someone to look after the patient (9), being a caregiver (6), and recovery probability (4). Estimated criteria coefficients had the expected positive sign and all were statistically significant (P < 0.001). There were differences between groups; pain was rated higher by patients/relatives, and difficulty in doing activities was rated lower by patients/relatives and the general public. Most interaction terms for these criteria and groups were significant (P < 0.001). Consultants and allied-health professionals had the most similar prioritization pattern (r=0.97). Conclusion. Both clinical and social criteria are considered for prioritization of joint replacement surgery from a wide social perspective. The preference among professional and social groups varies and this might impact the result of patient prioritization. A wide social participation for obtaining adequate prioritizing systems for patients on waiting lists is desirable.
Original languageEnglish
Pages (from-to)554-566
JournalMedical Decision Making
Issue number4
Publication statusPublished - 1 Jul 2008


  • Conjoint analysis
  • Elective surgery
  • Hip/knee replacement
  • Preferences
  • Priority setting
  • Social participation


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