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The Impact of the NHS Reforms on Queues and Surgical Outcomes in England: Evidence from Hip Fracture Patients

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  • Hamilton, Barton H
  • Bramley-Harker, Robert Edward

Abstract

National Health Service (NHS) reform introduced incentives for efficiency and cost effectiveness, yet little is known about their effectiveness in reducing waiting times for surgery or improving postsurgical outcomes. This paper finds that waiting times for hip fracture surgery declined after the NHS reforms and patients were more likely to be discharged to another provider. However, hospitals have not simply shifted the burden of care to other providers, since lengths of stay ending in a discharge to home fell. The effect of wait time on surgical outcomes is small in magnitude and cannot explain the postreform improvements in outcomes.

Suggested Citation

  • Hamilton, Barton H & Bramley-Harker, Robert Edward, 1999. "The Impact of the NHS Reforms on Queues and Surgical Outcomes in England: Evidence from Hip Fracture Patients," Economic Journal, Royal Economic Society, vol. 109(457), pages 437-462, July.
    • Handle: RePEc:ecj:econjl:v:109:y:1999:i:457:p:437-62
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    Citations

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    Cited by:

    1. Anika Reichert & Rowena Jacobs, 2018. "The impact of waiting time on patient outcomes: Evidence from early intervention in psychosis services in England," Health Economics, John Wiley & Sons, Ltd., vol. 27(11), pages 1772-1787, November.
    2. Laudicella, Mauro & Siciliani, Luigi & Cookson, Richard, 2012. "Waiting times and socioeconomic status: Evidence from England," Social Science & Medicine, Elsevier, vol. 74(9), pages 1331-1341.
    3. Zack Cooper & Stephen Gibbons & Simon Jones & Alistair McGuire, 2011. "Does Hospital Competition Save Lives? Evidence From The English NHS Patient Choice Reforms," Economic Journal, Royal Economic Society, vol. 121(554), pages 228-260, August.
    4. Cooper, Zack & Gibbons, Stephen & Jones, Simon & McGuire, Alistair, 2010. "Does hospital competition improve efficiency? An analysis of the recent market-based reforms to the English NHS," LSE Research Online Documents on Economics 28578, London School of Economics and Political Science, LSE Library.
    5. Propper, Carol & Croxson, Bronwyn & Shearer, Arran, 2002. "Waiting times for hospital admissions: the impact of GP fundholding," Journal of Health Economics, Elsevier, vol. 21(2), pages 227-252, March.
    6. Farnworth, Michael G., 2003. "A game theoretic model of the relationship between prices and waiting times," Journal of Health Economics, Elsevier, vol. 22(1), pages 47-60, January.
    7. Cookson R & Laudicella M, 2009. "Do the poor still cost more? The relationship between small area income deprivation and length of stay for elective hip replacement in the English NHS from 2001/2 to 2006/7," Health, Econometrics and Data Group (HEDG) Working Papers 09/07, HEDG, c/o Department of Economics, University of York.
    8. Moscelli, Giuseppe & Siciliani, Luigi & Tonei, Valentina, 2016. "Do waiting times affect health outcomes? Evidence from coronary bypass," Social Science & Medicine, Elsevier, vol. 161(C), pages 151-159.
    9. Laudicella, Mauro & Li Donni, Paolo & Smith, Peter C., 2013. "Hospital readmission rates: Signal of failure or success?," Journal of Health Economics, Elsevier, vol. 32(5), pages 909-921.
    10. Cookson, Richard & Laudicella, Mauro, 2011. "Do the poor cost much more? The relationship between small area income deprivation and length of stay for elective hip replacement in the English NHS from 2001 to 2008," Social Science & Medicine, Elsevier, vol. 72(2), pages 173-184, January.
    11. Williams, Jenny & Bretteville-Jensen, Anne Line, 2022. "What's Another Day? The Effects of Wait Time for Substance Abuse Treatment on Health-Care Utilization, Employment and Crime," IZA Discussion Papers 15083, Institute of Labor Economics (IZA).
    12. Godoey, Anna & Haaland, Venke Furre & Huitfeldt, Ingrid & Votruba, Mark, 2019. "Impacts of Hospital Wait Time on Health and Labor Supply," Institute for Research on Labor and Employment, Working Paper Series qt32d4g5xh, Institute of Industrial Relations, UC Berkeley.
    13. Fabbri, Daniele & Monfardini, Chiara, 2009. "Rationing the public provision of healthcare in the presence of private supplements: Evidence from the Italian NHS," Journal of Health Economics, Elsevier, vol. 28(2), pages 290-304, March.
    14. Raymond Y.T. Yeung & Gabriel M. Leung & Sarah M. McGhee & Janice M. Johnston, 2004. "Waiting time and doctor shopping in a mixed medical economy," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1137-1144, November.
    15. Anna Godøy & Venke Furre Haaland & Ingrid Huitfeldt & Mark Votruba, 2019. "Impacts of hospital wait time on patient health and labor supply," Discussion Papers 919, Statistics Norway, Research Department.
    16. Verzulli, R.; & Lippi Bruni, M.;, 2022. "The quicker the better: Fostering timely responses in public hospitals," Health, Econometrics and Data Group (HEDG) Working Papers 22/08, HEDG, c/o Department of Economics, University of York.
    17. Goddard, John & Tavakoli, Manouche, 2008. "Efficiency and welfare implications of managed public sector hospital waiting lists," European Journal of Operational Research, Elsevier, vol. 184(2), pages 778-792, January.

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