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Waiting time prioritisation: Evidence from England

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  • Gutacker, Nils
  • Siciliani, Luigi
  • Cookson, Richard

Abstract

A number of OECD countries have introduced waiting time prioritisation policies which give explicit priority to severely ill patients with high marginal disutility of waiting. There is however little empirical evidence on how patients are actually prioritised. We exploit a unique opportunity to investigate this issue using a large national dataset with accurate measures of severity on nearly 400,000 patients. We link data from a national patient-reported outcome measures survey to administrative data on all patients waiting for a publicly funded hip and knee replacement in England during the years 2009–14. We find that patients suffering the most severe pain and immobility have shorter waits than those suffering the least, by about 24% for hip replacement and 11% for knee replacement, and that the association is approximately linear. These differentials are more closely associated with pain than immobility, and are larger in hospitals with longer average waiting times. These result suggests that doctors prioritise patients according to severity even when no formal prioritisation policy is in place and average waiting times are short.

Suggested Citation

  • Gutacker, Nils & Siciliani, Luigi & Cookson, Richard, 2016. "Waiting time prioritisation: Evidence from England," Social Science & Medicine, Elsevier, vol. 159(C), pages 140-151.
  • Handle: RePEc:eee:socmed:v:159:y:2016:i:c:p:140-151
    DOI: 10.1016/j.socscimed.2016.05.007
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    2. Richards-Shubik, Seth & Roberts, Mark S. & Donohue, Julie M., 2022. "Measuring quality effects in equilibrium," Journal of Health Economics, Elsevier, vol. 83(C).
    3. Fabián Silva-Aravena & Eduardo Álvarez-Miranda & César A. Astudillo & Luis González-Martínez & José G. Ledezma, 2021. "Patients’ Prioritization on Surgical Waiting Lists: A Decision Support System," Mathematics, MDPI, vol. 9(10), pages 1-27, May.
    4. Nicolai Fink Simonsen & Anne Sophie Oxholm & Søren Rud Kristensen & Luigi Siciliani, 2020. "What explains differences in waiting times for health care across socioeconomic status?," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1764-1785, December.
    5. Nils Gutacker & Andrew Street, 2018. "Multidimensional performance assessment of public sector organisations using dominance criteria," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 13-27, February.
    6. Fabián Silva-Aravena & Jenny Morales, 2022. "Dynamic Surgical Waiting List Methodology: A Networking Approach," Mathematics, MDPI, vol. 10(13), pages 1-23, July.
    7. Swami, Megha & Scott, Anthony, 2021. "Impact of rural workforce incentives on access to GP services in underserved areas: Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 281(C).
    8. 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.
    9. Fabián Silva-Aravena & Jimmy H. Gutiérrez-Bahamondes & Hugo Núñez Delafuente & Roberto M. Toledo-Molina, 2022. "An Intelligent System for Patients’ Well-Being: A Multi-Criteria Decision-Making Approach," Mathematics, MDPI, vol. 10(21), pages 1-22, October.
    10. Joana Cima & Paulo Guimarães & Álvaro Almeida, 2018. "Explaining the gender gap in waiting times for scheduled surgery in the Portuguese National Health Service," FEP Working Papers 607, Universidade do Porto, Faculdade de Economia do Porto.
    11. Fabián Silva-Aravena & Hugo Núñez Delafuente & César A. Astudillo, 2022. "A Novel Strategy to Classify Chronic Patients at Risk: A Hybrid Machine Learning Approach," Mathematics, MDPI, vol. 10(17), pages 1-17, August.
    12. Christine A. Yee & Aaron Legler & Michael Davies & Julia Prentice & Steven Pizer, 2020. "Priority access to health care: Evidence from an exogenous policy shock," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 306-323, March.
    13. Siciliani, L., 2016. "Waiting Time Policies in the Health Sector," Seminar Briefing 001724, Office of Health Economics.
    14. Acuna, Jorge A. & Cantarino, Daniela & Martinez, Rodrigo & Zayas-Castro, José L., 2024. "A two-stage stochastic game model for elective surgical capacity planning and investment," Socio-Economic Planning Sciences, Elsevier, vol. 91(C).

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