Rationing by waiting lists: an empirical investigation

Martin, Stephen; Smith, Peter

doi:10.1016/s0047-2727(98)00067-x

Cited by 165 publications

(201 citation statements)

References 19 publications

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“…We know from UK studies that increased resources at hospitals may reduce waiting times (Martin and Smith, 1999;Dawson et al, 2007). Evidence from 12 OECD countries suggests that increased hospital capacity can play an important role in reducing waiting times (Siciliani and Hurst, 2005).…”

Section: Discussionmentioning

confidence: 99%

Prioritization and the elusive effect on welfare – A Norwegian health care reform revisited

Aakvik¹,

Holmås²,

Kjerstad³

2015

Social Science & Medicine

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A health and labour policy reform aiming to reduce hospital waiting times and sickness absences, the Faster Return to Work (FRW) scheme, is evaluated by creating treatment and comparison groups to facilitate causal interpretations of the empirical results. We use a dataset on individuals where we merge hospital data with social security data and socio-economic characteristics. The main idea behind the FRW scheme is that long waiting times for hospital treatment lead to unnecessarily long periods of sick leave and postponed return to work after illness or injury. Using a program evaluation model allowing for endogeneity we find that the average waiting period for treatment or consultation for FRW patients (treatment group) is 12-15 days shorter than for people on sick leave on the regular waiting list (comparison group). This reduction is only partially transformed into a reduction in the total length of sick leave. On average, the reduction is approximately eight days. There is a significant difference between surgical and non-surgical patients, where surgical patients benefit the most from the reform in terms of significantly faster return to work. We find no effect for non-surgical patients.JEL Numbers: C26, I12, H51

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Section: Discussionmentioning

confidence: 99%

Prioritization and the elusive effect on welfare – A Norwegian health care reform revisited

Aakvik¹,

Holmås²,

Kjerstad³

2015

Social Science & Medicine

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“…It has been argued that, in the absence of other rationing mechanisms, waiting times help to bring into equilibrium the demand for and the supply of health care by deterring patients with small benefit from asking for treatment (Lindsay and Feigenbaum, 1984, Martin and Smith, 1999, Cullis et al, 2000. Other rationing mechanisms also exist.…”

Section: Introductionmentioning

confidence: 99%

Waiting times and socioeconomic status: Evidence from England

Laudicella

Siciliani

Cookson

2012

Social Science & Medicine

113

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This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link ABSTRACTWaiting times for elective surgery are often referred to as an equitable rationing mechanism in publicly-funded healthcare systems providing access to care not on the basis on willingness to pay or socioeconomic status. This study uses patient level administrative data from the Hospital Episode Statistics database in England to investigate whether patients with higher socioeconomic status (as measured by small area level income and education deprivation) wait less than other patients. The analysis focuses on the time waited for an elective hip replacement in 2001. Overall, it provides evidence of inequity in waiting times favouring more educated individuals and, to a lesser extent, richer individuals. The results from log-linear regression models and duration analysis bring evidence that inequalities occur within hospital providers and over large part of the waiting time distribution. Controlling for hospital heterogeneity reduces bias in the measurement of inequality experienced by the lowest income groups.

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“…Despite the theoretical and empirical interest in this issue [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15], only a few authors in Portugal have tested the impact of time costs on the medical care utilization, mainly on hospital care [14]. This paper provides evidence on this matter describing the results of an empirical analysis of the responses of GP visits to time costs in health centres.…”

Section: Introductionmentioning

confidence: 99%

“…Most of the literature on the effects of an appointment delay refers to the hospital setting, mainly for elective surgery [7][8][9][10][11][12], thus, of little relevance to public primary health care utilization. In addition, the health reasons that drive the demand for primary health care are totally different from those related to hospital care, therefore precluding the direct extrapolation of the results obtained in these studies to the Portuguese GP demand.…”

Section: Introductionmentioning

confidence: 99%

Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

Lourenço¹,

Ferreira²

2005

Health Economics

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SummaryThe impact of time costs on the utilization of medical care has been a subject of theoretical and empirical research since the early 1970s.The main goal of this paper is to show the effect of time costs on the number of visits to general practitioners (GP) in Portuguese public health centres. We measured the elasticity of primary health care utilization relative to the total time spent in the health centre and relative to travel time. We also provided evidence regarding the impact of an appointment delay on the utilization of public GP services.Our data resulted from the application of an endogenous sampling scheme, resulting in a truncated-at-zero data set. To model our dependent variable, number of visits, and accounting for the truncated nature of the data we used a finite mixture model specification.The data were obtained from the most recent implementation in Portugal of the 2003/2004 Europep Survey. The two-component negative binomial II finite mixture model led to the identification of two different latent classes of health centre users: a low-users class that comprises 88% of patients with an estimated utilization mean of 4.3 GP visits per year and a frequent-users class with an estimated utilization mean of 11.1 visits for the remaining 12% of the population.We failed to find any statistically significant elasticity of time cost utilization, when this variable is measured as the total time spent in the health centre. Regarding the effect of an appointment delay on health centre utilization we concluded that individuals respond to this variable by lowering the number of GP visits. This last finding may have policy implications, which will be discussed at the end of the paper.

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Rationing by waiting lists: an empirical investigation

Cited by 165 publications

References 19 publications

Prioritization and the elusive effect on welfare – A Norwegian health care reform revisited

Prioritization and the elusive effect on welfare – A Norwegian health care reform revisited

Waiting times and socioeconomic status: Evidence from England

Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

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