The effect of practice budgets on patient waiting times: allowing for selection bias
Under the UK fundholding scheme, general practices could elect to hold a budget to meet the costs of some types of elective surgery (chargeable admissions) for their patients. It was alleged that patients of fundholding practices had shorter waits for elective surgery than the patients of non-fundholders. Comparison of waiting times between fundholding and non-fundholding practices are potentially confounded by selection bias as fundholding was voluntary. We estimate the effect of a practice's fundholding status on the waiting times of its patients using both cross-sectional methods (OLS, propensity score, instrumental variables, Heckman selection correction and Heckman heterogenous effects estimators) and difference in differences methodologies to correct for selection bias. The estimated effect of fundholding status was to significantly reduce the waiting times for chargeable admissions of the patients of fundholders by 4.1-6.6% (or 4-7 days) with the instrumental variables and Heckman selection correction estimators yielding the highest estimates. We also find that patients of fundholding practices had shorter waits (by 3.7% or 2 days) for non-chargeable elective admissions, suggesting that fundholders were able to obtain shorter waits for all types of elective admissions. Copyright © 2004 John Wiley & Sons, Ltd.
Volume (Year): 13 (2004)
Issue (Month): 10 ()
|Contact details of provider:|| Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749|
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Christopher F Baum & Mark E. Schaffer & Steven Stillman, 2003.
"Instrumental variables and GMM: Estimation and testing,"
StataCorp LP, vol. 3(1), pages 1-31, March.
- Christopher F Baum & Mark E. Schaffer & Steven Stillman, 2002. "Instrumental variables and GMM: Estimation and testing," United Kingdom Stata Users' Group Meetings 2003 02, Stata Users Group.
- Christopher F Baum & Mark E. Schaffer & Steven Stillman, 2002. "Instrumental variables and GMM: Estimation and testing," Boston College Working Papers in Economics 545, Boston College Department of Economics, revised 14 Feb 2003.
- Christopher F Baum & Mark E. Schaffer & Steven Stillman, 2002. "Instrumental variables and GMM: Estimation and testing," North American Stata Users' Group Meetings 2003 05, Stata Users Group.
- Propper, Carol & Croxson, Bronwyn & Shearer, Arran, 2002. "Waiting times for hospital admissions: the impact of GP fundholding," Journal of Health Economics, Elsevier, vol. 21(2), pages 227-252, March.
- Croxson, Bronwyn & Propper, Carol & Shearer, Arran, 2000. "Waiting Times for Hospital Admissions: the Impact of GP Fundholding," CEPR Discussion Papers 2489, C.E.P.R. Discussion Papers.
- Mark Dusheiko & Hugh Gravelle & Rowena Jacobs & Peter C Smith, "undated". "The Effect of Budgets on Doctor Behaviour: Evidence From A Natural Experiment," Discussion Papers 03/04, Department of Economics, University of York.
- Mark Dusheiko & Hugh Gravelle & Rowena Jacobs & Peter Smith, 2003. "The Effects of Budgets on Doctors Behaviour: Evidence from a Natural Experiment," The Centre for Market and Public Organisation 03/064, Department of Economics, University of Bristol, UK.
- Whynes, David K. & Ennew, Christine T. & Feighan, Teresa, 1999. "Entrepreneurial attitudes of primary health care physicians in the United Kingdom," Journal of Economic Behavior & Organization, Elsevier, vol. 38(3), pages 331-347, March.
- James Heckman & Justin L. Tobias & Edward Vytlacil, 2003. "Simple Estimators for Treatment Parameters in a Latent-Variable Framework," The Review of Economics and Statistics, MIT Press, vol. 85(3), pages 748-755, August.
- Heckman, J J & Tobias, Justin & Vytlacil, Ed, 2003. "Simple Estimators for Treatment Parameters in a Latent Variable Framework," Staff General Research Papers Archive 12012, Iowa State University, Department of Economics.
- Heckman, James J. & Lalonde, Robert J. & Smith, Jeffrey A., 1999. "The economics and econometrics of active labor market programs," Handbook of Labor Economics,in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 31, pages 1865-2097 Elsevier.
- Davis, George C. & Kim, Sung-Yong, 2002. "Measuring instrument relevance in the single endogenous regressor-multiple instrument case: a simplifying procedure," Economics Letters, Elsevier, vol. 74(3), pages 321-325, February.
- Hugh Gravelle & Peter C. Smith & Ana Xavier, "undated". "Waiting Times and Waiting Lists: A Model of the Market for Elective Surgery," Discussion Papers 00/27, Department of Economics, University of York.
- Richard Blundell & Monica Costa Dias, 2000. "Evaluation methods for non-experimental data," Fiscal Studies, Institute for Fiscal Studies, vol. 21(4), pages 427-468, January.
- Arild Aakvik & James J. Heckman & Edward J. Vytlacil, 2000. "Treatment Effects for Discrete Outcomes when Responses to Treatment Vary Among Observationally Identical Persons: An Application to Norwegian ..," NBER Technical Working Papers 0262, National Bureau of Economic Research, Inc.
- James J. Heckman & Justin L. Tobias & Edward Vytlacil, 2000. "Simple Estimators for Treatment Parameters in a Latent Variable Framework with an Application to Estimating the Returns to Schooling," NBER Working Papers 7950, National Bureau of Economic Research, Inc.
- Sascha O. Becker & Andrea Ichino, 2002. "Estimation of average treatment effects based on propensity scores," Stata Journal, StataCorp LP, vol. 2(4), pages 358-377, November. Full references (including those not matched with items on IDEAS)