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Do waiting times affect health outcomes? Evidence from coronary bypass

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  • Moscelli, Giuseppe
  • Siciliani, Luigi
  • Tonei, Valentina

Abstract

Long waiting times for non-emergency services are a feature of several publicly-funded health systems. A key policy concern is that long waiting times may worsen health outcomes: when patients receive treatment, their health condition may have deteriorated and health gains reduced. This study investigates whether patients in need of coronary bypass with longer waiting times are associated with poorer health outcomes in the English National Health Service over 2000–2010. Exploiting information from the Hospital Episode Statistics (HES), we measure health outcomes with in-hospital mortality and 28-day emergency readmission following discharge. Our results, obtained combining hospital fixed effects and instrumental variable methods, find no evidence of waiting times being associated with higher in-hospital mortality and weak association between waiting times and emergency readmission following a surgery. The results inform the debate on the relative merits of different types of rationing in healthcare systems. They are to some extent supportive of waiting times as an acceptable rationing mechanism, although further research is required to explore whether long waiting times affect other aspects of individuals’ life.

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  • 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.
    • Handle: RePEc:eee:socmed:v:161:y:2016:i:c:p:151-159
    DOI: 10.1016/j.socscimed.2016.05.043
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    1. Martin Gaynor & Carol Propper & Stephan Seiler, 2012. "Free to Choose? Reform and Demand Response in the English National Health Service," CEP Discussion Papers dp1179, Centre for Economic Performance, LSE.
    2. 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.
    3. 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.
    4. repec:imp:wpaper:9224 is not listed on IDEAS
    5. 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.
    6. Koopmanschap, M.A. & Brouwer, W.B.F. & Hakkaart-van Roijen, L. & van Exel, N.J.A., 2005. "Influence of waiting time on cost-effectiveness," Social Science & Medicine, Elsevier, vol. 60(11), pages 2501-2504, June.
    7. Barton H. Hamilton & Vivian Ho & Dana P. Goldman, 2000. "Queuing for Surgery: Is the U.S. or Canada Worse Off?," The Review of Economics and Statistics, MIT Press, vol. 82(2), pages 297-308, May.
    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. 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. 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.
    11. 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.
    12. Hugh Gravelle & Luigi Siciliani, 2008. "Is waiting‐time prioritisation welfare improving?," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 167-184, February.
    13. Siciliani, Luigi & Stanciole, Anderson & Jacobs, Rowena, 2009. "Do waiting times reduce hospital costs?," Journal of Health Economics, Elsevier, vol. 28(4), pages 771-780, July.
    14. Hamilton, Barton H. & Hamilton, Vivian H. & Mayo, Nancy E., 1996. "What are the costs of queuing for hip fracture surgery in Canada?," Journal of Health Economics, Elsevier, vol. 15(2), pages 161-185, April.
    15. 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.
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    5. Laia Bosque-Mercader & Luigi Siciliani, 2023. "The association between bed occupancy rates and hospital quality in the English National Health Service," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(2), pages 209-236, March.
    6. Mujaheed Shaikh & Marisa Miraldo & Anna-Theresa Renner, 2018. "Waiting time at health facilities and social class: Evidence from the Indian caste system," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-16, October.
    7. Luca Armanaschi & Elisabetta Barzan & Magda Cavallucci & Carlo Federici & Marco Sartirana & Florian Zerzer, 2022. "I dati amministrativi per la governance dei tempi di attesa delle prestazioni ambulatoriali: l?esperienza dell?Azienda Sanitaria dell?Alto Adige," MECOSAN, FrancoAngeli Editore, vol. 2022(123), pages 53-75.
    8. Cristina Borra & Jerònia Pons-Pons & Margarita Vilar-Rodríguez, 2020. "Austerity, healthcare provision, and health outcomes in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 409-423, April.
    9. Kelly, Mark & Kuhn, Michael, 2022. "Congestion in a public health service: A macro approach," Journal of Macroeconomics, Elsevier, vol. 74(C).
    10. 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).

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