Prioritization and patients' rights: Analysing the effect of a reform in the Norwegian hospital sector
AbstractThe 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 InfoArticle provided by Elsevier in its journal Social Science & Medicine.
Volume (Year): 70 (2010)
Issue (Month): 2 (January)
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Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description
Other versions of this item:
- Askildsen, Jan Erik & Holmås, Tor Helge & Kaarbøe, Oddvar, 2009. "Prioritization and patients' rights: Analysing the effect of a reform in the Norwegian Hospital Sector," Working Papers in Economics 07/09, University of Bergen, Department of Economics.
- I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
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- 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.
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Economics Series Working Papers
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- Meliyanni Johar & Glenn Jones & Michael P. Keane & Elizabeth Savage & Olena Stavrunova, 2012. "Discrimination in a universal health system: Explaining socioeconomic waiting time gaps," Economics Papers 2012-W11, Economics Group, Nuffield College, University of Oxford.
- Meliyanni Johar & Glenn Jones & Michael Keane & Elizabeth Savage & Olena Stavrunova, 2011. "Discrimination in a Universal Health System: Explaining Socioeconomic Waiting Time Gaps," Working Paper Series 165, Finance Discipline Group, UTS Business School, University of Technology, Sydney.
- 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.
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