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Do maximum waiting time guarantees change clinical priorities for elective treatment? Evidence from Scotland

Author

Listed:
  • Silviya Nikolova

    (Leeds Institute of Health Sciences, University of Leeds)

  • Arthur Sinko

    (Economics, School of Social Sciences,University of Manchester, Manchester, U.K.)

  • Matt Sutton

    (Manchester Centre for Health Economics, Institute of Population Health, University of Manchester, Manchester, U.K.)

Abstract

The level and distribution of patient waiting times for elective treatment is a major concern in publicly funded health care systems. Strict targets, which have specified maximum waiting times, have been introduced in the NHS over the last decade and have been criticised for distorting existing clinical priorities in scheduling hospital treatment. We demonstrate the usefulness of Conditional Density Estimation (CDE) in the evaluation of the reform using data for Scotland for 2002 and 2007. We develop a modified goodness of fit test to discriminate between models with different numbers of bins. We document a change in prioritisation between different patient groups with longer waiting patients benefiting at the expense of those who previously waited less. Our results contribute to understanding the response of publicly funded health systems to enforced targets for maximum waiting times.

Suggested Citation

  • Silviya Nikolova & Arthur Sinko & Matt Sutton, 2015. "Do maximum waiting time guarantees change clinical priorities for elective treatment? Evidence from Scotland," Working Papers 1501, Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds.
    • Handle: RePEc:lee:wpaper:1501
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    File URL: http://medhealth.leeds.ac.uk/download/1421/auhe_wp15_01
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    References listed on IDEAS

    as
    1. Sharma, Anurag & Siciliani, Luigi & Harris, Anthony, 2013. "Waiting times and socioeconomic status: Does sample selection matter?," Economic Modelling, Elsevier, vol. 33(C), pages 659-667.
    2. Siciliani, Luigi & Hurst, Jeremy, 2005. "Tackling excessive waiting times for elective surgery: a comparative analysis of policies in 12 OECD countries," Health Policy, Elsevier, vol. 72(2), pages 201-215, May.
    3. Cullis, John G. & Jones, Philip R. & Propper, Carol, 2000. "Waiting lists and medical treatment: Analysis and policies," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 23, pages 1201-1249, Elsevier.
    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    health care; waiting times; conditional density estimation;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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