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The impact of cancellations in waiting times analysis: evidence from scheduled surgeries in the Portuguese NHS

Author

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  • Joana Cima

    (Universidade Do Porto)

  • Álvaro Almeida

    (Universidade Do Porto)

Abstract

Background Equity in access to scheduled surgery has been a topic of attention of researchers and decision-makers on healthcare. Most studies analyse the number of days that patients wait before undergoing surgery, and ignore patients that have been on the waiting list but have not benefited from surgery. This study contributes to the existing literature on waiting lists by analysing cancellations along with surgery episodes. Methods We use a database comprising all patients that entered the waiting list for scheduled surgeries in the Portuguese National Health Service from 2011 to 2015 (around 3 million observations) and estimate survival models to explain waiting times, where cancellations are introduced as censored data. Results The cancellation rate is significant (around 14%), and has a considerable impact on results: ignoring cancellations biases estimates, in particular for gender differences (that are overestimated without cancelations), and for the age effect (that is underestimated). Conclusion Thus, our approach provides a more accurate understanding of the impact that several factors have on overall access to scheduled surgery.

Suggested Citation

  • Joana Cima & Álvaro Almeida, 2022. "The impact of cancellations in waiting times analysis: evidence from scheduled surgeries in the Portuguese NHS," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(1), pages 95-104, February.
    • Handle: RePEc:spr:eujhec:v:23:y:2022:i:1:d:10.1007_s10198-021-01354-5
    DOI: 10.1007/s10198-021-01354-5
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    References listed on IDEAS

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    1. 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.
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    5. Graham Cookson & Simon Jones & Ioannis Laliotis, 2017. "Cancelled Procedures in the English NHS: Evidence from the 2010 Tariff Reform," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 126-139, December.
    6. 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.
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    More about this item

    Keywords

    Scheduled surgery; Access; Cancellations; Survival models; Portugal;
    All these keywords.

    JEL classification:

    • C01 - Mathematical and Quantitative Methods - - General - - - Econometrics

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