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Using panel methods to model waiting times for National Health Service surgery


  • Stephen Martin
  • Peter C. Smith


Long waiting times for non-emergency (elective) procedures are a central feature of the UK's National Health Service, with about 1 million people waiting for surgery at any one time. This paper develops empirical models of the demand for and supply of elective surgery which simultaneously determine waiting times. The models are tested by using a panel of annual data for 5499 small areas from 1991 to 1998. Supply and demand functions are estimated for all specialties combined and for seven individual specialties, using panel data methods that incorporate simultaneously determined variables. The elasticity of demand with respect to waiting time varies between specialties but is always quite small. The results are discussed in the light of UK Government policy initiatives designed to reduce waiting times substantially. The analysis suggests that these initiatives will not stimulate demand markedly and therefore stand a good chance of succeeding provided that adequate additional resources are made available. Copyright 2003 Royal Statistical Society.

Suggested Citation

  • Stephen Martin & Peter C. Smith, 2003. "Using panel methods to model waiting times for National Health Service surgery," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 166(3), pages 369-387.
  • Handle: RePEc:bla:jorssa:v:166:y:2003:i:3:p:369-387

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    1. Harvey, Andrew, 2001. "Testing in Unobserved Components Models," Journal of Forecasting, John Wiley & Sons, Ltd., vol. 20(1), pages 1-19, January.
    2. De Jong, Piet & Boyle, Phelim P., 1983. "Monitoring mortality : A state-space approach," Journal of Econometrics, Elsevier, vol. 23(1), pages 131-146, September.
    3. Alexander Morton & Bärbel F. Finkenstädt, 2005. "Discrete time modelling of disease incidence time series by using Markov chain Monte Carlo methods," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 54(3), pages 575-594.
    4. Linda Allen & Anthony Saunders, 2003. "A survey of cyclical effects in credit risk measurement model," BIS Working Papers 126, Bank for International Settlements.
    5. B. F. Finkenstädt & B. T. Grenfell, 2000. "Time series modelling of childhood diseases: a dynamical systems approach," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 49(2), pages 187-205.
    6. Gaudry, M., 1984. "Drag, un Modele de la Demande Routiere, des Accidents et de Leur Gravite, Applique au Quebec de 1956 a 1982," Cahiers de recherche 8432, Universite de Montreal, Departement de sciences economiques.
    7. Lel Li & Karl Kim, 2000. "Estimating driver crash risks based on the extended Bradley-Terry model: an induced exposure method," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 163(2), pages 227-240.
    8. Francesca Dominici & Aidan M.C. Dermott & Trevor J. Hastie, 2004. "Improved Semiparametric Time Series Models of Air Pollution and Mortality," Journal of the American Statistical Association, American Statistical Association, vol. 99, pages 938-948, December.
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    Cited by:

    1. Gaynor, Martin & Laudicella, Mauro & Propper, Carol, 2012. "Can governments do it better? Merger mania and hospital outcomes in the English NHS," Journal of Health Economics, Elsevier, vol. 31(3), pages 528-543.
    2. Gutacker, Nils & Siciliani, Luigi & Cookson, Richard, 2016. "Waiting time prioritisation: Evidence from England," Social Science & Medicine, Elsevier, vol. 159(C), pages 140-151.
    3. Siciliani, Luigi, 2006. "A dynamic model of supply of elective surgery in the presence of waiting times and waiting lists," Journal of Health Economics, Elsevier, vol. 25(5), pages 891-907, September.
    4. Luigi Siciliani & Tor Iversen, 2012. "Waiting Times and Waiting Lists," Chapters,in: The Elgar Companion to Health Economics, Second Edition, chapter 24 Edward Elgar Publishing.
    5. Fabrizio Iacone & Steve Martin & Luigi Siciliani & Peter C. Smith, 2012. "Modelling the dynamics of a public health care system: evidence from time-series data," Applied Economics, Taylor & Francis Journals, vol. 44(23), pages 2955-2968, August.
    6. 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.
    7. Marc Saez & Carme Saurina & Germà Coenders & Sònia González-Raya, 2006. "Use of primary health care services according to the different degrees of obesity in the Girona Health Region, Spain," Health Economics, John Wiley & Sons, Ltd., vol. 15(2), pages 173-193.
    8. 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.
    9. Luigi Siciliani & Steve Martin, 2007. "An empirical analysis of the impact of choice on waiting times," Health Economics, John Wiley & Sons, Ltd., vol. 16(8), pages 763-779.
    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. Gutacker, Nils & Siciliani, Luigi & Moscelli, Giuseppe & Gravelle, Hugh, 2016. "Choice of hospital: Which type of quality matters?," Journal of Health Economics, Elsevier, vol. 50(C), pages 230-246.
    12. Huw Dixon & Luigi Siciliani, 2009. "Waiting Time Targets in Healthcare Markets: How Long Are We Waiting?," Discussion Papers 09/05, Department of Economics, University of York.
    13. Guillem López-Casasnovas & Marc Saez, 2007. "A multilevel analysis on the determinants of regional health care expenditure: a note," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(1), pages 59-65, March.
    14. Martin, Stephen & Rice, Nigel & Jacobs, Rowena & Smith, Peter, 2007. "The market for elective surgery: Joint estimation of supply and demand," Journal of Health Economics, Elsevier, vol. 26(2), pages 263-285, March.
    15. Frank Windmeijer & Hugh Gravelle & Pierre Hoonhout, 2005. "Waiting lists, waiting times and admissions: an empirical analysis at hospital and general practice level," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 971-985.
    16. Brown, Sarah & Dietrich, Michael & Ortiz-Nuñez, Aurora & Taylor, Karl, 2011. "Self-employment and attitudes towards risk: Timing and unobserved heterogeneity," Journal of Economic Psychology, Elsevier, vol. 32(3), pages 425-433, June.

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