Queuing for Surgery: Is the U.S. or Canada Worse Off?
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
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 82 (2000)
Issue (Month): 2 (May)
|Contact details of provider:|| Web page: http://mitpress.mit.edu/journals/|
|Order Information:||Web: http://mitpress.mit.edu/journal-home.tcl?issn=00346535|
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.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Anna Pollock-Nelson)
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.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with 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 profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.