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The Impact of the NHS Reforms on Queues and Surgical Outcomes in England: Evidence from Hip Fracture Patients

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  • Hamilton, Barton H
  • Bramley-Harker, Robert Edward

Abstract

National Health Service (NHS) reform introduced incentives for efficiency and cost effectiveness, yet little is known about their effectiveness in reducing waiting times for surgery or improving postsurgical outcomes. This paper finds that waiting times for hip fracture surgery declined after the NHS reforms and patients were more likely to be discharged to another provider. However, hospitals have not simply shifted the burden of care to other providers, since lengths of stay ending in a discharge to home fell. The effect of wait time on surgical outcomes is small in magnitude and cannot explain the postreform improvements in outcomes.

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Bibliographic Info

Article provided by Royal Economic Society in its journal The Economic Journal.

Volume (Year): 109 (1999)
Issue (Month): 457 (July)
Pages: 437-62

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Handle: RePEc:ecj:econjl:v:109:y:1999:i:457:p:437-62

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Cited by:
  1. Daniele Fabbri & Chiara Monfardini, 2006. "Rationing The Public Provision Of Healthcare In The Presence Of Private Supplements: Evidence From The Italian Nhs," CHILD Working Papers wp21_06, CHILD - Centre for Household, Income, Labour and Demographic economics - ITALY.
  2. Cookson R & Laudicella M, 2009. "Do the poor still cost more? The relationship between small area income deprivation and length of stay for elective hip replacement in the English NHS from 2001/2 to 2006/7," Health, Econometrics and Data Group (HEDG) Working Papers 09/07, HEDG, c/o Department of Economics, University of York.
  3. Croxson, Bronwyn & Propper, Carol & Shearer, Arran, 2000. "Waiting Times for Hospital Admissions: the Impact of GP Fundholding," CEPR Discussion Papers 2489, C.E.P.R. Discussion Papers.
  4. Laudicella, Mauro & Li Donni, Paolo & Smith, Peter C., 2013. "Hospital readmission rates: Signal of failure or success?," Journal of Health Economics, Elsevier, vol. 32(5), pages 909-921.
  5. Zack Cooper & Stephen Gibbons & Simon Jones & Alistair McGuire, 2010. "Does hospital competition save lives?: evidence from the English NHS patient choice reforms," LSE Research Online Documents on Economics 28584, London School of Economics and Political Science, LSE Library.
  6. Farnworth, Michael G., 2003. "A game theoretic model of the relationship between prices and waiting times," Journal of Health Economics, Elsevier, vol. 22(1), pages 47-60, January.
  7. Laudicella, Mauro & Siciliani, Luigi & Cookson, Richard, 2012. "Waiting times and socioeconomic status: Evidence from England," Social Science & Medicine, Elsevier, vol. 74(9), pages 1331-1341.
  8. Raymond Y.T. Yeung & Gabriel M. Leung & Sarah M. McGhee & Janice M. Johnston, 2004. "Waiting time and doctor shopping in a mixed medical economy," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1137-1144.

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