IDEAS home Printed from https://ideas.repec.org/a/tpr/restat/v82y2000i2p297-308.html
   My bibliography  Save this article

Queuing for Surgery: Is the U.S. or Canada Worse Off?

Author

Listed:
  • Barton H. Hamilton
  • Vivian Ho
  • Dana P. Goldman

Abstract

Restricted government spending along with universal health insurance has led to longer queues for surgical procedures in Canada versus the United States. Yet it is unclear whether these treatment delays affect health outcomes. This paper tests this hypothesis by comparing the determinants of wait time for hip-fracture surgery and its impact on postsurgery length of stay and inpatient mortality in Canada and the United States. Hazards for surgery/no surgery and discharge alive versus dead are modeled using a competing-risks model. Day of the week of admission is used to help identify the surgery wait-time distribution. We control for unobserved (to the econometrician) health status which may affect wait times and outcomes by assuming a semiparametric distribution for unobserved heterogeneity. We find that predicted hazards for inpatient mortality are virtually identical in Canada and the United States. Yet wait times for surgery are longer in Canada, and surgery delay has a significant impact on postsurgery length of stay in both countries. However, the magnitude of this effect is small relative to other patient and hospital-specific factors. Focusing attention on treatment delays as a weakness in the Canadian health care system may be misleading policymakers from hospital-specific inefficiencies that may have more-important implications for health care costs and patient welfare. © 2000 by the President and Fellows of Harvard College and the Massachusetts Institute of Technology

Suggested Citation

  • 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.
    • Handle: RePEc:tpr:restat:v:82:y:2000:i:2:p:297-308
    as

    Download full text from publisher

    File URL: http://www.mitpressjournals.org/doi/pdf/10.1162/003465300558687
    Download Restriction: Access to full text is restricted to subscribers.
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. 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.
    2. Bhattacharya, Jay & Shaikh, Azeem M. & Vytlacil, Edward, 2012. "Treatment effect bounds: An application to Swan–Ganz catheterization," Journal of Econometrics, Elsevier, vol. 168(2), pages 223-243.
    3. Steven Globerman & Luther H. Hodges & Aidan Vining, 2004. "Canadian And Us Health Care Systems Performance And Governance: Elements Of Convergence," Public Economics 0404003, University Library of Munich, Germany.
    4. Andrew J. Epstein & Jonathan D. Ketcham & Sean Nicholson, 2010. "Specialization and matching in professional services firms," RAND Journal of Economics, RAND Corporation, vol. 41(4), pages 811-834, December.
    5. Marcelin Joanis & David Boisclair & Claude Montmarquette, 2004. "La santé au Québec : des options pour financer la croissance," CIRANO Project Reports 2004rp-04, CIRANO.
    6. Ann P. Bartel & Carri W. Chan & Song-Hee Kim, 2020. "Should Hospitals Keep Their Patients Longer? The Role of Inpatient Care in Reducing Postdischarge Mortality," Management Science, INFORMS, vol. 66(6), pages 2326-2346, June.
    7. Verzulli, R.; & Lippi Bruni, M.;, 2022. "The quicker the better: Fostering timely responses in public hospitals," Health, Econometrics and Data Group (HEDG) Working Papers 22/08, HEDG, c/o Department of Economics, University of York.
    8. Daniel Serra & Francisco Silva, 2002. "Locating emergency services with priority rules: The priority queuing covering location problem," Economics Working Papers 642, Department of Economics and Business, Universitat Pompeu Fabra, revised May 2008.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:tpr:restat:v:82:y:2000:i:2:p:297-308. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Kelly McDougall (email available below). General contact details of provider: https://direct.mit.edu/journals .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.