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Geographic Differences in Hospital Waiting Times

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  • Meliyanni Johar
  • Elizabeth Savage
  • Olena Stavrunova
  • Glenn Jones
  • Michael Keane

Abstract

Access to elective surgery in Australian public hospitals is rationed using waiting lists. In this paper we undertake a DiNardo-Fortin-Lemieux reweighting approach to attribute variation in waiting time to clinical need or to discrimination. Using data from NSW public patients in 2004-2005, we find the discrimination effect dominates clinical need especially in the upper tail of the waiting time distribution. We find evidence of favourable treatment of patients who reside in remote areas and discrimination in favour of patients residing in particular Area Health Services. These findings have policy implications for the design of equitable quality targets for public hospitals.
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Suggested Citation

  • Meliyanni Johar & Elizabeth Savage & Olena Stavrunova & Glenn Jones & Michael Keane, 2012. "Geographic Differences in Hospital Waiting Times," The Economic Record, The Economic Society of Australia, vol. 88(281), pages 165-181, June.
    • Handle: RePEc:bla:ecorec:v:88:y:2012:i:281:p:165-181
    DOI: j.1475-4932.2011.00785.x
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    File URL: http://hdl.handle.net/10.1111/j.1475-4932.2011.00785.x
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    References listed on IDEAS

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    1. Keane, Michael P, 1994. "A Computationally Practical Simulation Estimator for Panel Data," Econometrica, Econometric Society, vol. 62(1), pages 95-116, January.
    2. Olena Stavrunova & Oleg Yerokhin, 2011. "An Equilibrium Model of Waiting Times for Elective Surgery in NSW Public Hospitals," The Economic Record, The Economic Society of Australia, vol. 87(278), pages 384-398, September.
    3. Pylypchuk, Yuriy & Selden, Thomas M., 2008. "A discrete choice decomposition analysis of racial and ethnic differences in children's health insurance coverage," Journal of Health Economics, Elsevier, vol. 27(4), pages 1109-1128, July.
    4. Fortin, Nicole & Lemieux, Thomas & Firpo, Sergio, 2011. "Decomposition Methods in Economics," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 4, chapter 1, pages 1-102, Elsevier.
    5. Meliyanni Johar & Glenn Jones & Michael Keane & Elizabeth Savage & Olena Stavrunova, 2010. "Differences in waiting times for elective admissions in NSW public hospitals: A decomposition analysis by non-clinical factors. CHERE Working Paper 2010/7," Working Papers 2010/7, CHERE, University of Technology, Sydney.
    6. Nicole M. Fortin, 2008. "The Gender Wage Gap among Young Adults in the United States: The Importance of Money versus People," Journal of Human Resources, University of Wisconsin Press, vol. 43(4).
    7. Hugh Gravelle & Luigi Siciliani, 2008. "Is waiting‐time prioritisation welfare improving?," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 167-184, February.
    8. 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.
    9. Propper, Carol & Sutton, Matt & Whitnall, Carolyn & Windmeijer, Frank, 2010. "Incentives and targets in hospital care: Evidence from a natural experiment," Journal of Public Economics, Elsevier, vol. 94(3-4), pages 318-335, April.
    10. Meliyanni Johar & Elizabeth Savage, 2010. "Do Private Patients have Shorter Waiting Times for Elective Surgery? Evidence from New South Wales Public Hospitals," Economic Papers, The Economic Society of Australia, vol. 29(2), pages 128-142, June.
    11. Oaxaca, Ronald L. & Ransom, Michael R., 1994. "On discrimination and the decomposition of wage differentials," Journal of Econometrics, Elsevier, vol. 61(1), pages 5-21, March.
    12. Luigi Siciliani & Rossella Verzulli, 2009. "Waiting times and socioeconomic status among elderly Europeans: evidence from SHARE," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1295-1306, November.
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    Cited by:

    1. Mohammad Hajizadeh, 2018. "Does socioeconomic status affect lengthy wait time in Canada? Evidence from Canadian Community Health Surveys," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(3), pages 369-383, April.
    2. Meliyanni Johar, 2014. "Are Waiting List Prioritization Guidelines Being Followed in Australia?," Medical Decision Making, , vol. 34(8), pages 976-986, November.
    3. Suziedelyte, Agne & Johar, Meliyanni, 2013. "Can you trust survey responses? Evidence using objective health measures," Economics Letters, Elsevier, vol. 121(2), pages 163-166.
    4. McQuestin, Dana & Noguchi, Masayoshi, 2020. "Worth the wait: The impact of government funding on hospital emergency waiting times," Health Policy, Elsevier, vol. 124(12), pages 1340-1344.

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    1. Johar, Meliyanni & Jones, Glenn & Keane, Micheal P. & Savage, Elizabeth & Stavrunova, Olena, 2013. "Discrimination in a universal health system: Explaining socioeconomic waiting time gaps," Journal of Health Economics, Elsevier, vol. 32(1), pages 181-194.
    2. Johar, Meliyanni & Jones, Glenn & Keane, Micheal P. & Savage, Elizabeth & Stavrunova, Olena, 2013. "Discrimination in a universal health system: Explaining socioeconomic waiting time gaps," Journal of Health Economics, Elsevier, vol. 32(1), pages 181-194.

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J7 - Labor and Demographic Economics - - Labor Discrimination
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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