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The effects of expanding patient choice of provider on waiting times: evidence from a policy experiment

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  • Diane Dawson
  • Hugh Gravelle
  • Rowena Jacobs
  • Stephen Martin
  • Peter C. Smith

Abstract

Long waiting times for inpatient treatment in the UK National Health Service have been a source of popular and political concern, and therefore a target for policy initiatives. In the London Patient Choice Project, patients at risk of breaching inpatient waiting time targets were offered the choice of an alternative hospital with a guaranteed shorter wait. This paper develops a simple theoretical model of the effect of greater patient choice on waiting times. It then uses a difference in difference econometric methodology to estimate the impact of the London choice project on ophthalmology waiting times. In line with the model predictions, the project led to shorter average waiting times in the London region and a convergence in waiting times amongst London hospitals. Copyright © 2006 John Wiley & Sons, Ltd.

Suggested Citation

  • Diane Dawson & Hugh Gravelle & Rowena Jacobs & Stephen Martin & Peter C. Smith, 2007. "The effects of expanding patient choice of provider on waiting times: evidence from a policy experiment," Health Economics, John Wiley & Sons, Ltd., vol. 16(2), pages 113-128, February.
    • Handle: RePEc:wly:hlthec:v:16:y:2007:i:2:p:113-128
    DOI: 10.1002/hec.1146
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    References listed on IDEAS

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    1. Peter Smith, 2005. "Performance Measurement in Health Care: History, Challenges and Prospects," Public Money & Management, Taylor & Francis Journals, vol. 25(4), pages 213-220.
    2. Hugh Gravelle & Peter Smith & Ana Xavier, 2003. "Performance signals in the public sector: the case of health care," Oxford Economic Papers, Oxford University Press, vol. 55(1), pages 81-103, January.
    3. repec:rus:hseeco:122140 is not listed on IDEAS
    4. Sascha O. Becker & Andrea Ichino, 2002. "Estimation of average treatment effects based on propensity scores," Stata Journal, StataCorp LP, vol. 2(4), pages 358-377, November.
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    1. Giorgia Marini & Marisa Miraldo & Rowena Jacobs & Maria Goddard, 2008. "Giving greater financial independence to hospitals—does it make a difference? The case of English NHS Trusts," Health Economics, John Wiley & Sons, Ltd., vol. 17(6), pages 751-775, June.
    2. Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2008. "Competition and waiting times in hospital markets," Journal of Public Economics, Elsevier, vol. 92(7), pages 1607-1628, July.
    3. Dixon, Huw & Siciliani, Luigi, 2009. "Waiting-time targets in the healthcare sector: How long are we waiting?," Journal of Health Economics, Elsevier, vol. 28(6), pages 1081-1098, December.
    4. Aakvik, Arild & Holmås, Tor Helge & Kjerstad, Egil, 2012. "Hospital Capacity, Waiting Times and Sick Leave Duration - an Empirical Analysis of a Norwegian Health Policy Reform," Working Papers in Economics 10/12, University of Bergen, Department of Economics.
    5. Andritsos, Dimitrios A. & Tang, Christopher S., 2014. "Introducing competition in healthcare services: The role of private care and increased patient mobility," European Journal of Operational Research, Elsevier, vol. 234(3), pages 898-909.
    6. Kristian Niemietz, 2015. "Internal Markets, Management by Targets, and Quasi-Markets: An Analysis of Health Care Reforms in the English NHS," Economic Affairs, Wiley Blackwell, vol. 35(1), pages 93-108, February.
    7. Fernández-Pérez, Ángel & Jiménez-Rubio, Dolores & Robone, Silvana, 2022. "Freedom of choice and health services’ performance: Evidence from a national health system," Health Policy, Elsevier, vol. 126(12), pages 1283-1290.
    8. Mark Braverman & Jing Chen & Sampath Kannan, 2016. "Optimal Provision-After-Wait in Healthcare," Mathematics of Operations Research, INFORMS, vol. 41(1), pages 352-376, February.
    9. Aakvik, Arild & Holmås, Tor Helge & Kjerstad, Egil, 2015. "Prioritization and the elusive effect on welfare – A Norwegian health care reform revisited," Social Science & Medicine, Elsevier, vol. 128(C), pages 290-300.
    10. Karin Monstad & Lars Birger Engesæter & Birgitte Espehaug, 2014. "Waiting Time And Socioeconomic Status—An Individual‐Level Analysis," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 446-461, April.
    11. Moscelli, Giuseppe & Gravelle, Hugh & Siciliani, Luigi, 2023. "The effect of hospital choice and competition on inequalities in waiting times," Journal of Economic Behavior & Organization, Elsevier, vol. 205(C), pages 169-201.
    12. Siciliani, Luigi & Stanciole, Anderson & Jacobs, Rowena, 2009. "Do waiting times reduce hospital costs?," Journal of Health Economics, Elsevier, vol. 28(4), pages 771-780, July.
    13. Hiroshi Aiura, 2013. "Inter-regional competition and quality in hospital care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(3), pages 515-526, June.
    14. Andritsos, Dimitrios A. & Tang, Christopher S., 2013. "The impact of cross-border patient movement on the delivery of healthcare services," International Journal of Production Economics, Elsevier, vol. 145(2), pages 702-712.
    15. Jonathan Sussex & Shelley Farrar, 2009. "Activity-based funding for National Health Service hospitals in England: managers’ experience and expectations," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(2), pages 197-206, May.

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