Proposal for criteria of public coverage and prioritisation in assisted human reproduction
Oliva G
Record ID 32006000051
Catalan, English, Spanish
Authors' objectives:
The objective of this report is to propose criteria for the optimisation of resources allocated to assisted human reproduction (AHR) by means of in vitro techniques in a public coverage system and to discuss the possible establishment of a patient prioritisation system.
Authors' results and conclusions:
In the literature, two documents, the National Health Committee of New Zealand and the preliminary version of the AHR interest group of the National Health System present a points allocation system to prioritise patients on the waiting list for AHR. The New Zealand document was established using the Delphi technique and consists of a formula that evaluates different variables and assigns a specific weight to each one of them. The Spanish system, made by a consensus group comprised of 34 AHR service and unit managers of different Spanish public hospitals, is a preliminary document.
Authors' recommendations:
From the standpoint of the optimisation of health resources, the following public coverage and prioritisation criteria in assisted fecundation in Catalonia are proposed:
1) Offer IVF treatment to women up to the age of 39 (or less than 40).
2) Establish a maximum of 3 treatment cycles and according to the availability of resources, address the possibility of offering only 2 cycles. If there is a record of a previous treatment attempt cancelled due to insufficient ovarian response, only a second cycle of ovarian stimulation should be carried out.
3) Alternate treatment cycles, i.e., after a first attempt at getting pregnant, the patients will have to go back on the waiting list for the other two cycles of treatment. The existence of two waiting lists is proposed: one list only for first attempts and if it fails, pass the patient onto the second waiting list for the second and third attempts. The centre will have to alternate patients from the two waiting lists.
4) Carry out the first treatment cycle as soon as possible.
In view of the complexity of establishing a waiting list patient prioritisation system for assisted fecundation, the possibility of making a consensus group comprised of experts recruited according to criteria accrediting knowledge and experience in AHR is proposed, with the objective of defining and selecting prioritisation criteria and establishing a score of the categories in the criteria identified. Adding up the scores gives a global priority assessment for each patient so they can be classified on the waiting list.
Authors' methods:
Review
Details
Project Status:
Completed
Year Published:
2005
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Spain
MeSH Terms
- Health Priorities
- Patient Selection
- Reproductive Techniques, Assisted
Contact
Organisation Name:
Agencia de Qualitat i Avaluacio Sanitries de Catalunya
Contact Address:
Antoni Parada, CAHTA, Roc Boronat, 81-95 (2nd floor), 08005 Barcelona, Spain, Tel. +34 935 513 928, Fax: +34 935 517 510
Contact Name:
direccio@aatrm.catsalut.net / aparada@aatrm.catsalut.net
Contact Email:
direccio@aatrm.catsalut.net / aparada@aatrm.catsalut.net
Copyright:
Catalan Agency for Health Technology Assessment and Research (CAHTA)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.