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The impact of different prioritisation policies on waiting times: Case studies of Norway and Scotland

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  • Januleviciute, Jurgita
  • Askildsen, Jan Erik
  • Kaarboe, Oddvar
  • Holmås, Tor Helge
  • Sutton, Matt

Abstract

We investigate the distributional consequences of two different waiting times initiatives, one in Norway, and one in Scotland. The primary focus of Scotland's recent waiting time reforms, introduced in 2003, and modified in 2005 and 2007, has been on reducing maximum waiting times through the imposition of high profile national targets accompanied by increases in resources. In Norway, the focus of the reform introduced in September 2004, has been on assigning patients referred to hospital a maximum waiting time based on disease severity, the expected benefit and the cost-effectiveness of the treatment. We use large, national administrative datasets from before and after each of these reforms and assign priority groups based on the maximum waiting times stipulated in medical guidelines. The analysis shows that the lowest priority patients benefited most from both reforms. This was at the cost of longer waiting times for patients that should have been given higher priority in Norway, while Scotland's high priority patients remained unaffected.

Suggested Citation

  • Januleviciute, Jurgita & Askildsen, Jan Erik & Kaarboe, Oddvar & Holmås, Tor Helge & Sutton, Matt, 2013. "The impact of different prioritisation policies on waiting times: Case studies of Norway and Scotland," Social Science & Medicine, Elsevier, vol. 97(C), pages 1-6.
  • Handle: RePEc:eee:socmed:v:97:y:2013:i:c:p:1-6
    DOI: 10.1016/j.socscimed.2013.07.010
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    References listed on IDEAS

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    1. 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.
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    3. Siciliani, Luigi & Hurst, Jeremy, 2005. "Tackling excessive waiting times for elective surgery: a comparative analysis of policies in 12 OECD countries," Health Policy, Elsevier, vol. 72(2), pages 201-215, May.
    4. Askildsen, Jan Erik & Holmås, Tor Helge & Kaarboe, Oddvar, 2010. "Prioritization and patients' rights: Analysing the effect of a reform in the Norwegian hospital sector," Social Science & Medicine, Elsevier, vol. 70(2), pages 199-208, January.
    5. Propper, Carol & Sutton, Matt & Whitnall, Carolyn & Windmeijer, Frank, 2010. "Incentives and targets in hospital care: Evidence from a natural experiment," Journal of Public Economics, Elsevier, vol. 94(3-4), pages 318-335, April.
    6. 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.
    7. Jan Erik Askildsen & Tor Helge Holmås & Oddvar Kaarboe, 2011. "Monitoring prioritisation in the public health‐care sector by use of medical guidelines. The case of Norway," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 958-970, August.
    8. Ho, Daniel E. & Imai, Kosuke & King, Gary & Stuart, Elizabeth A., 2007. "Matching as Nonparametric Preprocessing for Reducing Model Dependence in Parametric Causal Inference," Political Analysis, Cambridge University Press, vol. 15(3), pages 199-236, July.
    9. Arnesen, Kjell E. & Erikssen, Jan & Stavem, Knut, 2002. "Gender and socioeconomic status as determinants of waiting time for inpatient surgery in a system with implicit queue management," Health Policy, Elsevier, vol. 62(3), pages 329-341, December.
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    Cited by:

    1. Breton, Mylaine & Smithman, Mélanie Ann & Kreindler, Sara A. & Jbilou, Jalila & Wong, Sabrina T. & Gard Marshall, Emily & Sasseville, Martin & Sutherland, Jason M. & Crooks, Valorie A. & Shaw, Jay & C, 2021. "Designing centralized waiting lists for attachment to a primary care provider: Considerations from a logic analysis," Evaluation and Program Planning, Elsevier, vol. 89(C).
    2. Breton, Mylaine & Smithman, Mélanie Ann & Sasseville, Martin & Kreindler, Sara A. & Sutherland, Jason M. & Beauséjour, Marie & Green, Michael & Marshall, Emily Gard & Jbilou, Jalila & Shaw, Jay & Brou, 2020. "How the design and implementation of centralized waiting lists influence their use and effect on access to healthcare - A realist review," Health Policy, Elsevier, vol. 124(8), pages 787-795.
    3. Carlsen, Fredrik & Kaarboe, Oddvar Martin, 2015. "The relationship between educational attainment and waiting time among the elderly in Norway," Health Policy, Elsevier, vol. 119(11), pages 1450-1458.
    4. Gutacker, Nils & Siciliani, Luigi & Cookson, Richard, 2016. "Waiting time prioritisation: Evidence from England," Social Science & Medicine, Elsevier, vol. 159(C), pages 140-151.
    5. Shimaa Elkomy & Graham Cookson, 2020. "Performance Management Strategy: Waiting Time in the English National Health Services," Public Organization Review, Springer, vol. 20(1), pages 95-112, March.
    6. Nikolova, Silviya & Sinko, Arthur & Sutton, Matt, 2015. "Do maximum waiting times guarantees change clinical priorities for elective treatment? Evidence from Scotland," Journal of Health Economics, Elsevier, vol. 41(C), pages 72-88.

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