The demand for elective surgery in a public system: time and money prices in the UK National Health Service

Gravelle, Hugh; Dusheiko, Mark; Sutton, Matt

doi:10.1016/s0167-6296(01)00137-0

Cited by 56 publications

(58 citation statements)

References 20 publications

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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%

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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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Section: Introductionmentioning

confidence: 99%

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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“…1 Economics can involve studies of 1) individuals' demand for goods and services, 2 2) individuals' health behaviors that are affected by the availability of scarce resources and the quantity of scarce resources required to adopt the behaviors, 3 3) the production of goods and services, 4 and 4) the comparison of the costs and value of outcomes of health or other programs. 5 Economic measures can also be used in the description of the distribution of health conditions that are the result of the choices that have been made.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

Global Burden of Trachoma and Economics of the Disease

Frick

Hanson

Jacobson

2003

The American Journal of Tropical Medicine and Hygiene

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Abstract. Interest in the economics of trachoma is high because of the refinement of a strategy to control trachomatous blindness, an ongoing global effort to eliminate incident blindness from trachoma by 2020, and an azithromycin donation program that is a component of trachoma control programs in several countries. This report comments on the economic distribution of blindness from trachoma and adds insight to published data on the burden of trachoma and the comparative costs and effects of trachoma control. Results suggest that 1) trichiasis without visual impairment may result in an economic burden comparable to trachomatous low vision and blindness so that 2) the monetary burden of trachoma may be 50% higher than conservative, published figures; 3) within some regions more productive economies are associated with less national blindness from trachoma; and 4) the ability to achieve a positive net benefit of trachoma control depends importantly on the cost per dose of antibiotic.

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“…3 But there is considerable evidence that waiting times do a¤ect demand for elective care. Higher waiting times lead patients to switch within the public sector to hospitals with lower waiting times (Sivey, 2012), to opt for private hospitals (Besley et al 1999, Aarbu, 2010 or to forgo care entirely (Martin and Smith, 1999;Gravelle et al, 2002;Windmeijer et al, 2005).…”

Section: Introductionmentioning

confidence: 99%