Advanced Search
MyIDEAS: Login

The Impact of Different Prioritisation Policies on Waiting Times: A Comparative Analysis of Norway and Scotland

Contents:

Author Info

  • Januleviciute, Jurgita

    () (University of Bergen)

  • Askildsen, Jan Erik

    () (Uni Research - Department of Economics, University of Bergen)

  • Holmås, Tor Helge

    () (Institute for Research in Economics and Business Administration)

  • Kaarbøe, Oddvar

    () (University of Bergen)

  • Sutton, Matt

    () (University of Manchester)

Abstract

We compare the distributional consequences of two different waiting times initiatives. The primary focus of Scotland’s recent waiting time reforms has been on reducing maximum waiting times through the imposition of high profile national targets. In Norway, the focus has been on appropriate prioritisation of referrals to hospital based on disease severity, the expected benefit of the treatment and cost-effectiveness. We use large, national administrative datasets from before and after each of these reforms and assign priority groups based on the maximum waiting times stipulated in Norwegian medical guidelines. To equalise case-mix over time, we use Exact Matching to weight the pre-reform patients to the patient composition in the post-reform period. We regress patient-level waiting times on patient characteristics and on a post-reform indicator interacted with the patient’s priority group. The analysis shows that the least-prioritised patients benefited most from both reforms. This was at the cost of longer waiting times for patients that should have been given higher priority in Norway, while Scotland’s high priority patients remained unaffected. This comparative analysis indicates that blanket waiting times initiatives may be more effective in reducing waiting times while preserving prioritisation between patients with different health needs.

Download Info

If you experience problems downloading a file, check if you have the proper application to view it first. 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.
File URL: http://www.uib.no/filearchive/wp-0710_1.pdf
Download Restriction: no

Bibliographic Info

Paper provided by University of Bergen, Department of Economics in its series Working Papers in Economics with number 07/10.

as in new window
Length: 30 pages
Date of creation: 01 Jun 2010
Date of revision:
Handle: RePEc:hhs:bergec:2010_007

Contact details of provider:
Postal: Institutt for økonomi, Universitetet i Bergen, Postboks 7802, 5020 Bergen, Norway
Phone: (+47)55589200
Fax: (+47)55589210
Email:
Web page: http://www.uib.no/econ/en
More information through EDIRC

Related research

Keywords: Waiting times; prioritisation; Norway; Scotland;

Find related papers by JEL classification:

This paper has been announced in the following NEP Reports:

References

References listed on IDEAS
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.:
as in new window
  1. Hugh Gravelle & Luigi Siciliani, 2007. "Ramsey Waits: Allocating Public Health Service Resources when there is Rationing by Waiting," Discussion Papers 07/15, Department of Economics, University of York.
  2. Jeremy Hurst & Luigi Siciliani, 2003. "Tackling Excessive Waiting Times for Elective Surgery: A Comparison of Policies in Twelve OECD Countries," OECD Health Working Papers 6, OECD Publishing.
  3. Carol Propper & Matt Sutton & Carolyn Whitnall & Frank Windmeijer, 2008. "Incentives and Targets in Hospital Care: Evidence from a Natural Experiment," The Centre for Market and Public Organisation 08/205, Department of Economics, University of Bristol, UK.
  4. Hagen, Terje P. & Kaarboe, Oddvar M., 2006. "The Norwegian hospital reform of 2002: Central government takes over ownership of public hospitals," Health Policy, Elsevier, vol. 76(3), pages 320-333, May.
  5. Sofia Dimakou & David Parkin & Nancy Devlin & John Appleby, 2009. "Identifying the impact of government targets on waiting times in the NHS," Health Care Management Science, Springer, vol. 12(1), pages 1-10, March.
  6. Magnussen, Jon & Hagen, Terje P. & Kaarboe, Oddvar M., 2007. "Centralized or decentralized? A case study of Norwegian hospital reform," Social Science & Medicine, Elsevier, vol. 64(10), pages 2129-2137, May.
  7. 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.
  8. Hugh Gravelle & Luigi Siciliani, 2006. "Is Waiting-time Prioritisation Welfare Improving?," Discussion Papers 06/13, Department of Economics, University of York.
  9. Stefano Iacus & Gary King & Giuseppe Porro, . "cem: Software for Coarsened Exact Matching," Journal of Statistical Software, American Statistical Association, vol. 30(i09).
Full references (including those not matched with items on IDEAS)

Citations

Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
as in new window

Cited by:
  1. Silviya Nikolova; & Arthur Sinko; & Matt Sutton;, 2012. "Do maximum waiting times guarantees change clinical priorities? A Conditional Density Estimation approach," Health, Econometrics and Data Group (HEDG) Working Papers 12/07, HEDG, c/o Department of Economics, University of York.

Lists

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

Statistics

Access and download statistics

Corrections

When requesting a correction, please mention this item's handle: RePEc:hhs:bergec:2010_007

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Kjell Erik Lommerud).

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.