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Prioritization and patients' rights: Analysing the effect of a reform in the Norwegian hospital sector

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  • Askildsen, Jan Erik
  • Holmås, Tor Helge
  • Kaarboe, Oddvar

Abstract

The right to equal treatment, irrespective of age, gender, ethnicity, socio-economic status and place of residence, is an important principle for several health care systems. A reform of the Norwegian hospital sector of 2002 may be used as a relevant experiment for investigating whether centralization of ownership and management structures will lead to more equal prioritization practices over geographical regions. One concern was variation in waiting times across the country. The reform was followed up in subsequent years by some other policy initiatives that also aimed at reducing waiting lists. We measure prioritization practice by a method that takes departure in recommended maximum waiting times from medical guidelines. We merge the information from the guidelines with individual patient data on actual waiting times for the period 1999-2005. This way we can monitor whether each patient in the available register of actual hospital visits has waited shorter or longer than what is considered medically acceptable by the guideline. The results indicate no equalization between the five new health regions, but we find evidence of more equal prioritization within four of the health regions. Our method of measuring prioritizations allows us to analyse how prioritization practice evolved over time after the reform, thus covering some further initiatives with the same objective. The results indicate that an observed reduction in waiting times after the reform have favoured patients of lower prioritization status, something we interpret as a general worsening of prioritization practices over time.

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Bibliographic Info

Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 70 (2010)
Issue (Month): 2 (January)
Pages: 199-208

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Handle: RePEc:eee:socmed:v:70:y:2010:i:2:p:199-208

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Keywords: Prioritization Waiting time Hospital reform Patient rights Norway;

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Cited by:
  1. Januleviciute, Jurgita & Askildsen, Jan Erik & Holmås, Tor Helge & Kaarbøe, Oddvar & Sutton, Matt, 2010. "The Impact of Different Prioritisation Policies on Waiting Times: A Comparative Analysis of Norway and Scotland," Working Papers in Economics 07/10, University of Bergen, Department of Economics.
  2. Carlsen, Fredrik & Kaarbøe, Oddvar Martin, 2010. "Waiting times and socioeconomic status. Evidence from Norway," Working Papers in Economics 08/10, University of Bergen, Department of Economics.
  3. Januleviciute, Jurgita & Askildsen, Jan Erik & Kaarboe, Oddvar & Holmås, Tor Helge & Sutton, Matt, 2013. "The impact of different prioritisation policies on waiting times: Case studies of Norway and Scotland," Social Science & Medicine, Elsevier, vol. 97(C), pages 1-6.
  4. Michael Keane & Meliyanni Johar & Glenn Jones & Elizabeth Savage & Olena Stavrunova, 2012. "Discrimination in a universal health system: Explaining socioeconomic waiting time gaps," Economics Series Working Papers 2012-W11, University of Oxford, Department of Economics.

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