Queuing for Surgery: Is the U.S. or Canada Worse Off?

This file is part of IDEAS, which uses RePEc data

Queuing for Surgery: Is the U.S. or Canada Worse Off?

Author Info

Barton H. Hamilton
Vivian Ho
Dana P. Goldman

Additional information is available for the following registered author(s):

Barton Hamilton

Abstract

Restricted government spending along with universal health insurance has led to longer queues for surgical procedures in Canada versus the United States. Yet it is unclear whether these treatment delays affect health outcomes. This paper tests this hypothesis by comparing the determinants of wait time for hip-fracture surgery and its impact on postsurgery length of stay and inpatient mortality in Canada and the United States. Hazards for surgery/no surgery and discharge alive versus dead are modeled using a competing-risks model. Day of the week of admission is used to help identify the surgery wait-time distribution. We control for unobserved (to the econometrician) health status which may affect wait times and outcomes by assuming a semiparametric distribution for unobserved heterogeneity. We find that predicted hazards for inpatient mortality are virtually identical in Canada and the United States. Yet wait times for surgery are longer in Canada, and surgery delay has a significant impact on postsurgery length of stay in both countries. However, the magnitude of this effect is small relative to other patient and hospital-specific factors. Focusing attention on treatment delays as a weakness in the Canadian health care system may be misleading policymakers from hospital-specific inefficiencies that may have more-important implications for health care costs and patient welfare. © 2000 by the President and Fellows of Harvard College and the Massachusetts Institute of Technology

Download Info
To download:

If you experience problems downloading a file, check if you have the proper application to view it first. Information about this may be contained in the File-Format links below. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

Publisher Info
Article provided by MIT Press in its journal The Review of Economics and Statistics.

Volume (Year): 82 (2000)
Issue (Month): 2 (May)
Pages: 297-308
Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
Handle: RePEc:tpr:restat:v:82:y:2000:i:2:p:297-308

Contact details of provider:
Web page: http://mitpress.mit.edu/journals/

Order Information:
Web: http://mitpress.mit.edu/journal-home.tcl?issn=00346535

For technical questions regarding this item, or to correct its listing, contact: (Christopher F. Baum).

Related research
Keywords:

Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

Steven Globerman & Luther H. Hodges & Aidan Vining, 2004. "Canadian And Us Health Care Systems Performance And Governance: Elements Of Convergence," Public Economics 0404003, EconWPA. [Downloadable!]
Marcelin Joanis & David Boisclair & Claude Montmarquette, 2004. "La santé au Québec : des options pour financer la croissance," CIRANO Project Reports 2004rp-04, CIRANO. [Downloadable!]
Daniel Serra & Francisco Silva, 2002. "Locating Emergency Services With Priority Rules: The Priority Queuing Covering Location Problem," Economics Working Papers 642, Department of Economics and Business, Universitat Pompeu Fabra, revised May 2008. [Downloadable!]

Statistics

Access and download statistics

Did you know? RePEc also has a blog.

This page was last updated on 2009-11-16.

This information is provided to you by IDEAS at the Department of Economics, College of Liberal Arts and Sciences, University of Connecticut using RePEc data on a server sponsored by the Society for Economic Dynamics.