Intended for healthcare professionals

Education And Debate

The New Zealand priority criteria project. Part 1: Overview

BMJ 1997; 314 doi: (Published 11 January 1997) Cite this as: BMJ 1997;314:131
  1. David C Hadorn, manager, special projectsa,
  2. Andrew C Holmes, senior medical advisera
  1. a National Advisory Committee on Health and Disability Ministry of Health Wellington New Zealand
  • Accepted 16 October 1996


New Zealand restructured its health system in 1992 with the aim of achieving greater levels of assessment and accountability in the publicly funded health sector. A committee was established specifically to advise the minister of health on the kinds, and relative priorities, of health services that should be publicly funded. One of its projects has been to develop standardised sets of criteria to assess the extent of benefit expected from elective surgical procedures. These have been developed with the help of professional advisory groups using a modified Delphi technique to reach consensus. So far the committee has developed criteria for cataract surgery, coronary artery bypass grafting, hip and knee replacement, cholecystectomy, and tympanostomy tubes for otitis media with effusion. These criteria incorporate both clinical and social factors. Use of priority criteria to ensure consistency and transparency regarding patients' priority for surgery is required for access to a dedicated NZ$130m (£57m; US$90m) pool of money, created to help eliminate surgical waiting lists and move to booking systems. The criteria will also be used in surgical outcome studies, currently in the planning phase.


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