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Waiting-time targets in the healthcare sector: How long are we waiting?

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  • Dixon, Huw
  • Siciliani, Luigi

Abstract

Waiting-time targets are used by policy makers to monitor providers' performance. Such targets are based on the distribution of the patients on the list. We compare and link such distribution with the distribution of waiting time of patients treated, as opposed to on the list, which is a better measure of total disutility from waiting (although can only be calculated retrospectively). We show that the latter can be calculated from the former, and vice versa. We also show that, depending on how the hazard rate varies with time waited, the proportion of patients on the list waiting more than x periods can be higher or lower than the proportion of patients treated waiting more than x periods. However, empirically we find that the proportion of patients waiting on the list more than x months is smaller than our estimate of the proportion of patients treated waiting more than x months.

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  • 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.
  • Handle: RePEc:eee:jhecon:v:28:y:2009:i:6:p:1081-1098
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    1. Gravelle, Hugh & Dusheiko, Mark & Sutton, Matthew, 2002. "The demand for elective surgery in a public system: time and money prices in the UK National Health Service," Journal of Health Economics, Elsevier, vol. 21(3), pages 423-449, May.
    2. Diane Dawson & Hugh Gravelle & Rowena Jacobs & Stephen Martin & Peter C. Smith, 2007. "The effects of expanding patient choice of provider on waiting times: evidence from a policy experiment," Health Economics, John Wiley & Sons, Ltd., vol. 16(2), pages 113-128, February.
    3. Hugh Gravelle & Peter Smith & Ana Xavier, 2003. "Performance signals in the public sector: the case of health care," Oxford Economic Papers, Oxford University Press, vol. 55(1), pages 81-103, January.
    4. Carol Propper & Simon Burgess & Denise Gossage, 2008. "Competition and Quality: Evidence from the NHS Internal Market 1991–9," Economic Journal, Royal Economic Society, vol. 118(525), pages 138-170, January.
    5. Hoel, Michael & Saether, Erik Magnus, 2003. "Public health care with waiting time: the role of supplementary private health care," Journal of Health Economics, Elsevier, vol. 22(4), pages 599-616, July.
    6. 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.
    7. Luigi Siciliani & Jeremy Hurst, 2003. "Explaining Waiting Times Variations for Elective Surgery Across OECD Countries," OECD Health Working Papers 7, OECD Publishing.
    8. Gravelle, Hugh & Siciliani, Luigi, 2008. "Optimal quality, waits and charges in health insurance," Journal of Health Economics, Elsevier, vol. 27(3), pages 663-674, May.
    9. 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, October.
    10. Pedro Pita Barros & Pau Olivella, 2005. "Waiting Lists and Patient Selection," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 14(3), pages 623-646, September.
    11. Dixon, Huw, 2006. "The distribution of contract durations across firms: a unified framework for understanding and comparing dynamic wage and price setting models," Working Paper Series 676, European Central Bank.
    12. 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.
    13. Iversen, Tor, 1997. "The effect of a private sector on the waiting time in a national health service," Journal of Health Economics, Elsevier, vol. 16(4), pages 381-396, August.
    14. Luigi Siciliani, 2005. "Does more choice reduce waiting times?," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 17-23, January.
    15. Johannesson, Magnus & Johansson, Per-Olov & Soderqvist, Tore, 1998. "Time spent on waiting lists for medical care: an insurance approach," Journal of Health Economics, Elsevier, vol. 17(5), pages 627-644, October.
    16. Hugh Gravelle & Luigi Siciliani, 2009. "Third degree waiting time discrimination: optimal allocation of a public sector healthcare treatment under rationing by waiting," Health Economics, John Wiley & Sons, Ltd., vol. 18(8), pages 977-986, August.
    17. Propper Carol & Sutton Matt & Whitnall Carolyn & Windmeijer Frank, 2008. "Did 'Targets and Terror' Reduce Waiting Times in England for Hospital Care?," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 8(2), pages 1-27, January.
    18. Luigi Siciliani, 2008. "A note on the dynamic interaction between waiting times and waiting lists," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 639-647, May.
    19. Engin Kara & Huw Dixon, 2005. "Persistence and Nominal Inertia in a Generalized Taylor Economy: How Longer Contracts Dominate Shorter Contracts," Computing in Economics and Finance 2005 87, Society for Computational Economics.
    20. Bishai, David M. & Lang, Hui Chu, 2000. "The willingness to pay for wait reduction: the disutility of queues for cataract surgery in Canada, Denmark, and Spain," Journal of Health Economics, Elsevier, vol. 19(2), pages 219-230, March.
    21. MARCHAND, Maurice & SCHROYEN, Fred, 2005. "Can a mixed health care system be desirable on equity grounds?," LIDAM Reprints CORE 1765, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    22. Stephen W. Salant, 1977. "Search Theory and Duration Data: A Theory of Sorts," The Quarterly Journal of Economics, Oxford University Press, vol. 91(1), pages 39-57.
    23. Olivella, Pau, 2003. "Shifting public-health-sector waiting lists to the private sector," European Journal of Political Economy, Elsevier, vol. 19(1), pages 103-132, March.
    24. Lancaster,Tony, 1992. "The Econometric Analysis of Transition Data," Cambridge Books, Cambridge University Press, number 9780521437899.
    25. Smith, Peter C. & van Ackere, Ann, 2002. "A note on the integration of system dynamics and economic models," Journal of Economic Dynamics and Control, Elsevier, vol. 26(1), pages 1-10, January.
    26. Sofia Dimakou & David Parkin & Nancy Devlin & John Appleby, 2009. "Identifying the impact of government targets on waiting times in the NHS," Health Care Management Science, Springer, vol. 12(1), pages 1-10, March.
    27. Hugh Gravelle & Luigi Siciliani, 2008. "Is waiting‐time prioritisation welfare improving?," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 167-184, February.
    28. 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, August.
    29. Iversen, Tor, 1993. "A theory of hospital waiting lists," Journal of Health Economics, Elsevier, vol. 12(1), pages 55-71, April.
    30. Paula González, 2005. "On a policy of transferring public patients to private practice," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 513-527, May.
    31. Martin, Stephen & Smith, Peter C., 1999. "Rationing by waiting lists: an empirical investigation," Journal of Public Economics, Elsevier, vol. 71(1), pages 141-164, January.
    32. Carlson, John A & Horrigan, Michael W, 1983. "Measures of Unemployment Duration as Guides to Research and Policy: Comment [An Experience-Weighted Measure of Employment and Unemployment Duration]," American Economic Review, American Economic Association, vol. 73(5), pages 1143-1150, December.
    33. Propper, Carol, 1990. "Contingent Valuation of Time Spent on NHS Waiting Lists," Economic Journal, Royal Economic Society, vol. 100(400), pages 193-199, Supplemen.
    34. Siciliani Luigi, 2007. "Optimal Contracts for Health Services in the Presence of Waiting Times and Asymmetric Information," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 7(1), pages 1-27, August.
    35. Maurice March & Fred Schroyen, 2005. "Can a Mixed Health Care System be Desirable on Equity Grounds?," Scandinavian Journal of Economics, Wiley Blackwell, vol. 107(1), pages 1-23, March.
    36. Mark Dusheiko & Hugh Gravelle & Rowena Jacobs, 2004. "The effect of practice budgets on patient waiting times: allowing for selection bias," Health Economics, John Wiley & Sons, Ltd., vol. 13(10), pages 941-958, October.
    37. 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.
    38. 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.
    39. Lindsay, Cotton M & Feigenbaum, Bernard, 1984. "Rationing by Waiting Lists," American Economic Review, American Economic Association, vol. 74(3), pages 404-417, June.
    40. Sicilani Luigi & Jeremy Hurst, 2005. "Explaining Waiting-time Variations for Elective Surgery Across OECD Countries," OECD Economic Studies, OECD Publishing, vol. 2004(1), pages 95-123.
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    Cited by:

    1. Siciliani, Luigi & Moran, Valerie & Borowitz, Michael, 2014. "Measuring and comparing health care waiting times in OECD countries," Health Policy, Elsevier, vol. 118(3), pages 292-303.
    2. Cinzia Di Novi & Anna Marenzi & Dino Rizzi, 2018. "Do healthcare tax credits help poor-health individuals on low incomes?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 293-307, March.
    3. 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.
    4. Sofia Dimakou & Ourania Dimakou & Henrique Basso, 2015. "Waiting time distribution in public health care: empirics and theory," Health Economics Review, Springer, vol. 5(1), pages 1-27, December.
    5. Dixon Huw, 2012. "A Unified Framework for Using Micro-Data to Compare Dynamic Time-Dependent Price-Setting Models," The B.E. Journal of Macroeconomics, De Gruyter, vol. 12(1), pages 1-45, July.
    6. Viberg, Nina & Forsberg, Birger C. & Borowitz, Michael & Molin, Roger, 2013. "International comparisons of waiting times in health care – Limitations and prospects," Health Policy, Elsevier, vol. 112(1), pages 53-61.
    7. John Bowers, 2011. "Simulating waiting list management," Health Care Management Science, Springer, vol. 14(3), pages 292-298, September.
    8. Sofia Dimakou & Ourania Dimakou & Henrique S. Basso, 2015. "The Asymmetric Effects of Waiting Time Targets in Health Care," BCAM Working Papers 1502, Birkbeck Centre for Applied Macroeconomics.
    9. Thu-Ba T. Nguyen & Appa Iyer Sivakumar & Stephen C. Graves, 2017. "Scheduling rules to achieve lead-time targets in outpatient appointment systems," Health Care Management Science, Springer, vol. 20(4), pages 578-589, December.
    10. Dixon, Huw David & Tian, Maoshan, 2022. "The Confidence Interval of Cross-Sectional Distribution of Durations," Cardiff Economics Working Papers E2022/15, Cardiff University, Cardiff Business School, Economics Section.
    11. Maoshan Tian & Huw Dixon, 2022. "The variances of non-parametric estimates of the cross-sectional distribution of durations," Econometric Reviews, Taylor & Francis Journals, vol. 41(10), pages 1243-1264, November.

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