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The effect of waiting time and distance on hospital choice for English cataract patients

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  • Peter Sivey

Abstract

This paper applies latent-class and multinomial logit models to the choice of hospital for cataract operations in the UK NHS. We concentrate on the effects of travel time and waiting time and especially on the waiting time elasticity of demand. Models including hospital fixed effects rely on changes over time in waiting time to indentify coefficients. We show how using latent-class multinomial logit models characterises the unobserved heterogeneity in GP practices' choice behaviour and affects the estimated waiting time elasticities of demand. The models estimate waiting time elasticities of demand of approximately -0.1, comparable with previous waiting time-demand models. For the average waiting time elasticity, the simple multinomial logit models are good approximations of the latent-class logit results.

Suggested Citation

  • Peter Sivey, 2010. "The effect of waiting time and distance on hospital choice for English cataract patients," Health, Econometrics and Data Group (HEDG) Working Papers 10/09, HEDG, c/o Department of Economics, University of York.
    • Handle: RePEc:yor:hectdg:10/09
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    References listed on IDEAS

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    1. 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.
    2. Propper, Carol & Burgess, Simon & Green, Katherine, 2004. "Does competition between hospitals improve the quality of care?: Hospital death rates and the NHS internal market," Journal of Public Economics, Elsevier, vol. 88(7-8), pages 1247-1272, July.
    3. Hodgkin, Dominic, 1996. "Specialized service offerings and patients' choice of hospital: The case of cardiac catheterization," Journal of Health Economics, Elsevier, vol. 15(3), pages 305-332, June.
    4. Sophia Rabe-Hesketh & Anders Skrondal & Andrew Pickles, 2002. "Reliable estimation of generalized linear mixed models using adaptive quadrature," Stata Journal, StataCorp LP, vol. 2(1), pages 1-21, February.
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    Citations

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    Cited by:

    1. Luigi Siciliani & Tor Iversen, 2012. "Waiting Times and Waiting Lists," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 24, Edward Elgar Publishing.
    2. Rita Santos & Hugh Gravelle & Carol Propper, 2013. "Does quality affect patients’ choice of doctor? Evidence from the UK," The Centre for Market and Public Organisation 13/306, The Centre for Market and Public Organisation, University of Bristol, UK.
    3. Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2013. "Hospital Mergers: A Spatial Competition Approach," Discussion Paper Series in Economics 8/2013, Norwegian School of Economics, Department of Economics.
    4. Gravelle, Hugh & Schroyen, Fred, 2016. "Optimal hospital payment rules under rationing by random waiting," Discussion Paper Series in Economics 8/2016, Norwegian School of Economics, Department of Economics.
    5. Siciliani, Luigi & Rune Straume, Odd & Cellini, Roberto, 2013. "Quality competition with motivated providers and sluggish demand," Journal of Economic Dynamics and Control, Elsevier, vol. 37(10), pages 2041-2061.
    6. M. Lippi Bruni & C. Ugolini & R. Verzulli, 2018. "Disentangling the effect of waiting times on hospital choice: Evidence from a panel data analysis," Working Papers wp1118, Dipartimento Scienze Economiche, Universita' di Bologna.
    7. Rita Santos & Hugh Gravelle & Carol Propper, 2013. "Does quality affect patients’ choice of doctor? Evidence from the UK," Working Papers 088cherp, Centre for Health Economics, University of York.
    8. Yoshimi Adachi & Hiroyasu Iso & Junyi Shen & Kanami Ban & On Fukui & Hiroyuki Hashimoto & Takako Nakashima & Kenichiro Morishige & Tatuyoshi Saijo, 2013. "Impact of specialization in gynecology and obstetrics departments on pregnant women’s choice of maternity institutions," Health Economics Review, Springer, vol. 3(1), pages 1-11, December.
    9. repec:nip:nipewp:10/2014 is not listed on IDEAS
    10. Moscelli, Giuseppe & Siciliani, Luigi & Gutacker, Nils & Cookson, Richard, 2018. "Socioeconomic inequality of access to healthcare: Does choice explain the gradient?," Journal of Health Economics, Elsevier, vol. 57(C), pages 290-314.
    11. Kurt R. Brekke & Luigi Siciliani & Odd Rune Straume, 2017. "Hospital Mergers with Regulated Prices," Scandinavian Journal of Economics, Wiley Blackwell, vol. 119(3), pages 597-627, July.

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    More about this item

    Keywords

    Hospital Choice; Waiting Time; Latent Class Model;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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