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Waiting time prioritisation: evidence from England

Author

Listed:
  • Nils Gutacker

    (Centre for Health Economics, University of York, UK)

  • Richard Cookson

    (Centre for Health Economics, University of York, UK)

  • Luigi Siciliani

    (Centre for Health Economics and Department of Economics and Related Studies, University of York, UK)

Abstract

A number of OECD countries have introduced waiting time prioritisation policies which give explicit priority to severely ill patients with high marginal disutility of waiting. There is however little empirical evidence on how patients are actually prioritised. We exploit a unique opportunity to investigate this issue using a large national dataset with accurate measures of severity on over 200,000 patients. We link data from a national patient-reported outcome measures survey to administrative data on all patients waiting for a publicly funded hip and knee replacement in England during the years 2009-12. We find that patients suffering the most severe pain and immobility have shorter waits than those suffering the least, by about 29% for hip replacement and 9% for knee replacement, and that the association is approximately linear. These differentials are more closely associated with pain than immobility, and are larger in hospitals with longer average waiting times

Suggested Citation

  • Nils Gutacker & Richard Cookson & Luigi Siciliani, 2015. "Waiting time prioritisation: evidence from England," Working Papers 114cherp, Centre for Health Economics, University of York.
  • Handle: RePEc:chy:respap:114cherp
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    References listed on IDEAS

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    1. Nils Gutacker & Luigi Siciliani & Giuseppe Moscelli & Hugh Gravelle, 2015. "Do patients choose hospitals that improve their health?," Working Papers 111cherp, Centre for Health Economics, University of York.
    2. 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.
    3. Johar, Meliyanni & Jones, Glenn & Keane, Micheal P. & Savage, Elizabeth & Stavrunova, Olena, 2013. "Discrimination in a universal health system: Explaining socioeconomic waiting time gaps," Journal of Health Economics, Elsevier, vol. 32(1), pages 181-194.
    4. Carol Propper & Simon Burgess & Denise Gossage, 2008. "Competition and Quality: Evidence from the NHS Internal Market 1991–9," Economic Journal, Royal Economic Society, vol. 118(525), pages 138-170, January.
    5. Manning, Willard G., 1998. "The logged dependent variable, heteroscedasticity, and the retransformation problem," Journal of Health Economics, Elsevier, vol. 17(3), pages 283-295, June.
    6. Stephen Martin & Peter C. Smith, 2003. "Using panel methods to model waiting times for National Health Service surgery," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 166(3), pages 369-387, October.
    7. Hugh Gravelle & Luigi Siciliani, 2009. "Third degree waiting time discrimination: optimal allocation of a public sector healthcare treatment under rationing by waiting," Health Economics, John Wiley & Sons, Ltd., vol. 18(8), pages 977-986, August.
    8. Siciliani, Luigi & Moran, Valerie & Borowitz, Michael, 2014. "Measuring and comparing health care waiting times in OECD countries," Health Policy, Elsevier, vol. 118(3), pages 292-303.
    9. 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.
    10. Oddvar Kaarboe & Fredrik Carlsen, 2014. "Waiting Times And Socioeconomic Status. Evidence From Norway," Health Economics, John Wiley & Sons, Ltd., vol. 23(1), pages 93-107, January.
    11. Sharma, Anurag & Siciliani, Luigi & Harris, Anthony, 2013. "Waiting times and socioeconomic status: Does sample selection matter?," Economic Modelling, Elsevier, vol. 33(C), pages 659-667.
    12. Silviya Nikolova & Mark Harrison & Matt Sutton, 2016. "The Impact of Waiting Time on Health Gains from Surgery: Evidence from a National Patient‐reported Outcome Dataset," Health Economics, John Wiley & Sons, Ltd., vol. 25(8), pages 955-968, August.
    13. 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.
    14. 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.
    15. 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.
    16. Hugh Gravelle & Luigi Siciliani, 2008. "Is waiting‐time prioritisation welfare improving?," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 167-184, February.
    17. Luigi Siciliani & Steve Martin, 2007. "An empirical analysis of the impact of choice on waiting times," Health Economics, John Wiley & Sons, Ltd., vol. 16(8), pages 763-779, August.
    18. Nancy J. Devlin & Koonal K. Shah & Yan Feng & Brendan Mulhern & Ben van Hout, 2018. "Valuing health‐related quality of life: An EQ‐5D‐5L value set for England," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 7-22, January.
    19. Martin, Stephen & Smith, Peter C., 1999. "Rationing by waiting lists: an empirical investigation," Journal of Public Economics, Elsevier, vol. 71(1), pages 141-164, January.
    20. Meliyanni Johar, 2014. "Are Waiting List Prioritization Guidelines Being Followed in Australia?," Medical Decision Making, , vol. 34(8), pages 976-986, November.
    21. 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.
    22. Karin Monstad & Lars Birger Engesæter & Birgitte Espehaug, 2014. "Waiting Time And Socioeconomic Status—An Individual‐Level Analysis," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 446-461, April.
    23. Martin, Stephen & Rice, Nigel & Jacobs, Rowena & Smith, Peter, 2007. "The market for elective surgery: Joint estimation of supply and demand," Journal of Health Economics, Elsevier, vol. 26(2), pages 263-285, March.
    24. Lindsay, Cotton M & Feigenbaum, Bernard, 1984. "Rationing by Waiting Lists," American Economic Review, American Economic Association, vol. 74(3), pages 404-417, June.
    25. 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.
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    Cited by:

    1. Richards-Shubik, Seth & Roberts, Mark S. & Donohue, Julie M., 2022. "Measuring quality effects in equilibrium," Journal of Health Economics, Elsevier, vol. 83(C).
    2. Fabián Silva-Aravena & Eduardo Álvarez-Miranda & César A. Astudillo & Luis González-Martínez & José G. Ledezma, 2021. "Patients’ Prioritization on Surgical Waiting Lists: A Decision Support System," Mathematics, MDPI, vol. 9(10), pages 1-27, May.
    3. Nicolai Fink Simonsen & Anne Sophie Oxholm & Søren Rud Kristensen & Luigi Siciliani, 2020. "What explains differences in waiting times for health care across socioeconomic status?," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1764-1785, December.
    4. Nils Gutacker & Andrew Street, 2018. "Multidimensional performance assessment of public sector organisations using dominance criteria," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 13-27, February.
    5. Fabián Silva-Aravena & Jenny Morales, 2022. "Dynamic Surgical Waiting List Methodology: A Networking Approach," Mathematics, MDPI, vol. 10(13), pages 1-23, July.
    6. Swami, Megha & Scott, Anthony, 2021. "Impact of rural workforce incentives on access to GP services in underserved areas: Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 281(C).
    7. Moscelli, Giuseppe & Siciliani, Luigi & Gutacker, Nils & Cookson, Richard, 2018. "Socioeconomic inequality of access to healthcare: Does choice explain the gradient?," Journal of Health Economics, Elsevier, vol. 57(C), pages 290-314.
    8. Fabián Silva-Aravena & Jimmy H. Gutiérrez-Bahamondes & Hugo Núñez Delafuente & Roberto M. Toledo-Molina, 2022. "An Intelligent System for Patients’ Well-Being: A Multi-Criteria Decision-Making Approach," Mathematics, MDPI, vol. 10(21), pages 1-22, October.
    9. Joana Cima & Paulo Guimarães & Álvaro Almeida, 2018. "Explaining the gender gap in waiting times for scheduled surgery in the Portuguese National Health Service," FEP Working Papers 607, Universidade do Porto, Faculdade de Economia do Porto.
    10. Fabián Silva-Aravena & Hugo Núñez Delafuente & César A. Astudillo, 2022. "A Novel Strategy to Classify Chronic Patients at Risk: A Hybrid Machine Learning Approach," Mathematics, MDPI, vol. 10(17), pages 1-17, August.
    11. Christine A. Yee & Aaron Legler & Michael Davies & Julia Prentice & Steven Pizer, 2020. "Priority access to health care: Evidence from an exogenous policy shock," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 306-323, March.
    12. Siciliani, L., 2016. "Waiting Time Policies in the Health Sector," Seminar Briefings 001724, Office of Health Economics.

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